AIBU to think that Cameron is telling nurses to do things that they already do?

[MyNameIsNotNurse]

Or aim to do given the oppertunity.
Link

David Cameron's 'ideas'
Hourly checks on patients to make sure they have had enought to eat/drink and are comefortable.
Isn't this just basic care?
Also to have members of the public doing spot checks on their local hospitals, isn't this just going a bit too far?

I would really like him to do a 12 hour shift on a busy ward, with sick people needing more than just the hourly walk around to make sure that things are ok.
What about the patients who are in need of 15 minute observations. Patients with poor mobility who take more than 30 seconds to get to the toilet and needs assistance every step of the way. What about the drug rounds? Then multiply that by 30 pateints for 2 staff nurses (some with little experiance) If 1 patient is really ill thats 1 nurse down so 30 patients beeing looked after by 1 nurse, and maybe 1 or 2 HCA.

Why does he not discuss the staffing issues, which most wards have the mountains of paper work which each and every nurse has to get through every shift which takes away from the care of patients.
Most nurses I know stay behind to finish paperwork, turn into work when they or their family is not well, go without breaks, work 12hours a shift, do extra shifts and Given up our measily 3% payrise over 3 years.

He's just making a lot of noise saying we should do things we already do in order that the public think we're not doing them and we lose support?

I'm not saying nurses are perfect or saintly, but the majority of them are trying their best too look after you/your relative/ your neighbour ect all the while they are expected to go without food/breaks/drinks to ensure their patients get theirs.

Last year (and the previous 9 before) I have given up my christmas and new year with my family, turned into work when I was ill/injured (from patients) stayed behind for 4+ hours (unpaid) after a 12 hour shift gone without food/drink, sat with confused patients, because their family couldn't be bothered to look after them over xmas. Delivered personal property to nursing homes because the ambulance can only take 1 bag.
Been shouted at, kicked, punched and stalked. All for crap pay and poor working conditions, you tell me any other job where people are expected to work in those conditions?

Really frustrating to read responses from posters criticising nurses when A] they themselves are not nurses and B] they or someone they know used to nurse back in the good old days so have little experience of how difficult it is to nurse now under current constraints and budget cuts.

Oh and the poster who posted about their nurse practitioner mother, that is a completely different role to ward based nursing. A nurse practitioner sees patients much in the way a consultant does. They have a client load and specialise in a particular area, ie mental health or anaesthetics. They do not have 15 patients to bathe, feed, mobilise, dispense medications to, apply pressure area care and wound dressings, etc, etc.

So it's great that your mother is so appreciated by her patients but I very much doubt she is working with the same pressures as her ward based colleagues.

The environment I work in frustrates me, once a year we have execs come in, tell us the new year business focus and then leave us to try and work out how it can be accommodated, this is all whilst not addressing the issues that prevented last years plans being as successful as they could... And I work in insurance.

I can't imagine having to work under the same careless consideration for less money, poor working conditions and my personal safety at risk, and to top it off being responsible for someone living or dying.

I always wonder why we hear so loudly from David Cameron, or whatever mouthpiece of corporate interest is in power and not the actual people on the work levels.

Ward are being closed, staff are being cut left and right. Patient numbers continue to increase. Surely DC should sort that out instead if encouraging trusts to do this to save money.

I truly despair, I am not lazy nor evil. I am overstreched.

If DC has some ideas on how two RN and two HCA responsible for 30 patients can manage to meet all basic care needs, provide medication, ivs, dressings, discharges and admittance, ward rounds, social need sorting, talking to relatives, answering phones, caring for critical patients, dealing with terminal patients and their families, liasing with irate management and matrons, inputting bed numbers, observations, washing, turning,toileting, feeding, talking to and documenting everything done. Plus maybe fitting a toilet and tea stop for staff I would love to hear them!

I think one of the issues is that nursing is over idealised as a "vocation" - you don't have to be a saint to work here but it helps!

The public feel let down that their saints and angels are actually just ordinary human beings working in their chosen career.

Some nurses will be highly capable and competent, some not so.
Some will be naturally empathetic and enjoy working with people, some not so.

It is a profession like law, accounting, engineering whereby you get some who are very good at their job, a lot are average and some are downright lousy.

But in other careers the very good are often rightly rewarded for their knowledge and expertise.
Not in nursing however. Instead nurses are encouraged to enjoy their "special status" as angels but are also constantly reminded that those put on pedestals can be toppled by not hitting the ideal required. This status as an angel is meant to compensate for the low pay and miserable working conditions...

Personally, when I was a nurse, I did not want to be seen as a saint in a vocation but rather as a professional who studied for 3 years to obtain a nursing degree and then completed subsequent training to specialise in recovery and intensive care nursing. I would have liked to feel I was valued by the hospital I worked for and for my pay and working conditions to have reflected this.

Instead my concerns about working conditions were ignored by management, I often worked over my rostered hours to make sure good care was provided, often went without proper breaks, had to battle to get study leave to keep myself updated and was paid a princely sum of about £20,000 [about 10 years ago] as a nurse with at the time 7 years post graduate experience.

Management would be silent on so many important issues but could always be relied upon to comment on nurses with a floral clip in their hair or who could be seen drinking their tea at the nurses station [this is on the rare occasion they actually deigned to walk the wards instead of remaining behind a closed door in their office].

So one day I thought enough is enough and I left the nursing profession. I had had enough of being treated as invisible and "saintly" or as an irritation and unworthy when I complained about an issue affecting either the staff or patients.

Problem is that helping patients with elimination, feeding, other personal care is seen as 'basic nursing' when in fact we need to see them as fundamental nursing tasks.

We are taught Maslow's Hierarchy of Needs' and I have always followed this model-get the fundamental 'bottom' layer of human need correctly met as it is essential to life.

Leaving feeding to HCA's is not good enough. It is so much more then merely transferring the contents of a plate into a human being. It is an assessing and evaluative process-are there any mouth problems? How does the patient chew and swallow? Any pain? Valuable insight into Mental state can be gained from evaluating how the patient approaches meals-do they enjoy them? Is it a sociable time for them? Do they have taste impairment? Could they benefit from an OT consult to help them manage the mechanical side of eating-utensils, plate sides being raised etc? How do conditions like arthritis, ageing skeletal systems affect their eating? What has caused that loss of appetite?

These examples are the tip of a really interesting iceberg. Nurses are trained not just to do, but to know why they are doing something and to identify the aims/objectives/outcomes of every nursing action. That is why we need an attitudinal change towards these so called basic nursing actions.

As rapapum was saying, nurses were called 'angels' and it was seen as a vocation. The feminist position I take on this is that society/govt encourages often female dominated careers/jobs to be seen as vocational because a useful 'by-product' of this attitude is that we can be paid less.

We do it because it is a 'calling', you see and it doesn't matter what we are paid. It is a horrid, cynical exploitation.

And it is an exploitation which the RCN willingly collude in imo.

Oh don't they just...... The RCN, like many unions, had its teeth pulled long ago. So agree with you Rapapapum.

it didn't go over my head baddayattheorrifice, I'm still hearing
"why should we change the less important things which we have control over and can change when there are more important issues in nursing which we have less control over and can't change so easily from the bottom up to complain about?"

How do you BEGIN to address the big issue of apathy and resentment which has crept in? IMO its by reclaiming the tangable symptoms like how you turn up to work and letting it trickle down to more of a consciousness about how everything you do makes patients feel.

BadDayattheOrifice
wrong emphasis code!

RRR you're right, apathy and resentment has crept into the nursing profession and it is not an easy problem to solve.

It just seems incredibly facile to keep harping on about nurses and their appearance. It is treating adult professionals like naughty schoolchildren.

In my experience it is rare that nurses are turning up for work unkempt, unwashed and hungover. If there are individuals that are, well of course they should be pulled up for it by management and given verbal or written warning dependent upon severity and frequency of offence.

But to think that this is the main issue affecting nursing is a smokescreen really.

Nurses as a profession are demoralised and devalued. Until we tackle this endemic issue we will continue to see some of the profession who act this out in a culture of apathy, hopelessness and disinterest. This attitude trickles down from the management levels to the front line unfortunately.

RRR are you senior staff? If you are, do you listen to your staff and take their concerns seriously or are you just primarily morivated by good appearances?

RRR-

As they say about depression, a sign of recovery is when a person improves personal care by putting on make up or washing/styling hair. Applies as a metaphor for nursing, does it not?

And the way to make nurses feel better is by addressing the structural fundamental issues causing such demoralisation. And by putting out a message based not just on fatuous statements that nurses are valued.

Scameron and his 'frat' buddies are the least informed regarding the NHS. When you do not have to rely upon it, it reduces the validity of your point of view. Makes such a crucial difference, having other options.

Sorry, RRR- I hope my post 'addressed' to you above did not come across as an attack or challenge to your point of view as I didn't intend that. I meant to add to the post but presses 'post' too fast!

I thought nursing was traditionally seen as a vocation as traditionally it was nuns, or other religious orders and those helping them who were nurses. Nuns would understandably talk about a vocation to help the sick. I don't think it is simple as saying it was seen as a vocation because it is traditionally women's work. After all secretaries or air stewardesses were never expected to have a vocation.

And I think most peopel accept that wards are understaffed and this needs to be addressed. However people like myself who unfortunately have a lot of experience of hospitals also know that in some cases the attitude of some nurses simply adds to the problems. I posted earlier about the poor practice and poor way of talking to patients that my DP witnessed during just 1 hospital stay. None of this was about lack of time to do nursing care, but it was totally about attitude.

People I speak to who frequently go into hospital say the same thing. Things like 2 staff lifting or giving a patient a bed bath while talking over the top of them about gossip, talking loudly on the wards at night, calling elderly patients by first names without checking this is okay, reacting to complaints in a defensive or aggressive manner - these all seem really routine practices.

And on threads like this I find it is rare for a nurse to say yes these things shouldn't happen. Instead there is usually just a load of excuses when all of these things are in the individuals control.

RRR I believe you tackle it in part by increasing staff to patient ratios, allowing for a feeling of achieving something for your patients and doing the job you trained to do, instead of fire fighting
Staff then feel fulfilled and allows for a break, also reduces conflict and stress levels.

I also spent quite a bit of a time in an elderly mental health ward last year with a relative. My relative wasn't actually too ill and got good care. But it was quite striking that staff clearly preferred to spend time with my relative, than the frightened dementia patient wandering the ward or responding to the women bed bound who frequently cried out "help me."

This wasn't about staffing levels but about staff choosing to work with "easier" patients. There have been a few letters in the local paper from relatives complaining about the care for elderly demented patients on that ward, and after spending a lot of time there I understood why.

The frustration from the public is that nothing seems to change.

Actually lesley33 is correct - there are some appalling attitudes out there. No way should nurses be having a conversation over a patient while lifting or bathing - that is totally unacceptable. This was drummed into me as a student nurse - perhaps the staff in universities train differently. Academia is all well and good but it doesn't replace the need to treat people as human beings.

Thank you dillydaydreaming! You wouldn't believe on threads like this how rare it is for a nurse to say things like that shouldn't happen.

lesley33 I'm not excusing it or saying it doesn't happen as I have seen first hand appauling nursing practice.
However I do find your examples a bit petty, for a start staff under no circumstances should be lifting!
maybe the 2 nurses were having a conversation just to break the silence? I find it very awkward to wash someone in silence, talking about last nights soaps etc gives the oppertunity for the patient to join in on a familiar topic.

communicating whether it be day or night needs to be done as do the use of machines to administer drugs, take obs etc, unfortunatly machines can not distinguish between day and night. Unfortunatly hospital is not always a restful place admissions/discharges need to take place especially on a busy admissions ward.
I'm sorry to sound patronising but how do you know that the elderly patint hasn't been asked what they would be preferred to be called, in our hospital it is in the admission pack and a box has to be filled in with 'preferred name' on admission they may have stated that they wished to be called by their first name. you are not there when everyone is being admitted. In 10 years of working I have never ince come across some who has said call me Mr/Mrs X this doesn't mean I don't ask!

Have you gone to the ward manager about complaints as they are the ones who are trained to deal with such matters.

Lesley, I imagine the frightened dementia patient wandering the ward and the one who frequently called "help me" needed one-to-one care.

Otherwise whatever care was given would never be enough.

Was one-to-one care possible in this ward? Was there the staff or budget for it?

It's not just nurses choosing to work with "easier" patients. I think it is more likely that nurses had to prioritise care based on what resources were available. And acute conditions often get priority over chronic cases as they can be more quickly discharged enabling an empty bed for next admission.

The cases you describe sound as if they required outpatient residential care?

In a hospital discharge to the community asap is often the priority [hence your relative's good care] rather than long term care which the ward may be under resourced to provide. It may not be right but it's not likely to change until there is more investment into geriatric care and mental health

I once had a very demented patient who would continually say 'help me' over and over day and night, whenever you went to her and ask if eveything was ok, she would always reply 'oh yes thank you my love' with a great big grin then go back to saying 'help me' again, when you discovered she was soiled or needed some intervention, the minute you drew the curtain she would be shrieking profanities! I know how this must have looked to all the visitors but what are we supposed to do leave her in soiled bed?

When I say lifting i mean helpinga patient to transfer or moving a patient while a bed is being made.

The fact that you see nurses talking over a patient about gossip or the tv as petty shows you don't really get the issues I and another poster have been raising. Having nurses talk over you about tv for example while they wash you makes you feel less than human. It makes you feel like a slab of meat.

Most people with lots of experience on wards as a patient know wards are usually understaffed. But how nurses actually treat the patients they deal with is bound to influence patients views of nurses.

Yes of course machines make noise at night and of course nurses need to talk at night. But my point was that nurses almost universally seem to talk at the same volume as trhey do during the day. I honestly don't understand why they can't tal;k a bit more quietly.

And my gran who only over referred to her best friend as Mrs x, was referred to in hospital throughout by her 1st name. I have no idea if she was asked what she preferred to be called - but unless she was led by being asked you don't mind if we call you by your 1st name do you - there is no way she would have chosen this.

It is very very common for elderly peopel above 80 to be prefer to be called by their surname by people who are not close friends or relatives. So the fact that you have never come across this leads me to believe elderly patients are being led in your hospital to agree to being called by their 1st name.

Yes the demented patients probably did need 1-1 care. But the fact that this wasn't possible is not an excuse to ignore them a lotof the time.

My relative as an acute admission needed more care at the beginning. But in the last 2 weeks she really did not need the level of "care" - usually just a chat about tv, etc, that she actually got. There was always 1 nurse as well who was very keen for her to go for frequent smoking breaks as it mean't he could accompany her and smoke too.

My relative had a visitor with her for at least 2-3 hours every day, usually a lot lot more. She had a lot of support and care provided by relatives and friends as well.

Meanwhile trhe frightened elderly demented patient wandering the ward would be wandering around for 3 hours during which time I would not see 1 single nurse or member of staff talk to her. So I do think they were choosing to concentrate on the easier patients.

And go to the ward manager about complaints! When I have even tentatively mentioned a complaint whatever it is all I get in return is excuses along the variety of we are so busy and understaffed. Even when the issue is not related to how busy someone is. I honestly don't think from my experience that complaining makes any difference whatsoever. For it to do so nurses would have to be prepared to listen and consider whether complaints are justified and they as individuals could do anything about it. Most nurses reactions on this thread show that they are not.