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?

Nitpicking!

i see no one has responded to my post about the conditions some nurses work in

I think it is most insulting to say that HCAs are not trained because they are, not to anywhere near the same level, obviously, but to dismiss them all as not having knowledge and skills is outrageous!
There will be some crap ones and some excellent ones, a bit like the registered nurses then?

boglach - it really isn't nitpicking. Nursing is a highly skilled job that requires a lot of knowledge and training. Delegating that job to untrained people is dangerous.

A trained nurse will notice signs of dehydration or heart failure, for example, in time to take action. An unqualified person will not, and by the time someone does notice, and tells the nurse or the doctor, the patient is really ill, and the situation may be irretrievable.

boglach - I have said many times on this thread that most wards are understaffed and of course this leads to poor working conditions.

3littlefrogs - cadets in the past were not qualified, but were given on the job nursing training. I don't whether this was good enough for the basic nursing care they needed to do - but although training is needed, a qualification by itself is imo not essential. And as I understand many HCAs do have a qualification - NVQ's.

Sorry - they do have training, I know. But they were never supposed to be working in place of qualified nurses, unsupervised.

Yes, technically they are supervised, but as I have already said, most of the time the one qualified nurse is rushed off his or her feet and can't stand over the HCAs.

I work with some excellent HCAs, but the first thing I did when I took over my current role was to have a big fight with management to change their job description and take out the bits that should be done by qualified nurses.

It has made a lot of extra work for me, but the patients are a lot safer.

I don't have any HCAs without a qualification on my ward and they're shit hot at telling us if something is wrong.
They may not be able to always diagnose the root of the problem but will know immediately if Mr Bloggs isn't right.

I trained 30 years ago. The difference then was that cadets worked with someone more experienced/qualified, not alone.

militantmedicalnurse.blogspot.com/2008/03/protected-meal-times-what-fucking-joke.html

This is interesting.

Have to go now.

This is a painful subject for me having lost someone close to me due to sheer neglect and incompetence in an NHS hospital. Lack of qualified nurses was a contributing factor.

The good old days of nursing - what a joke!

Unqualified student nurses being left in charge of CCU's, ITU's in their third year of training at night with two untrained 'auxillary nurses' as they were called. No qualified nursing mentor to hand....nothing...

My mother in law was frequently left in charge of an entire ward from the early part of her second year of training, being asked to take on wildly inappropriate care needs in relation to her experience.

Students of nursing spend nearly as much time now on the wards but are protected from inappropriate levels of responsibility by not being rostered or counted in the numbers.

As for lesley33's comment about nurses not owning bad practice- well as a psych nurse who was harassed and bullied out of her job for whistle blowing, I take exception to that. There are plenty of bad nurses out there. I have never shirked from acknowledging/owning that fact. I train all mu students to have the highest standards when it comes to how they speak to patients and conduct themselves around them. To not patronise, to not speak over a patient, to not assume as to how they might like to be addressed. I say it and role model it over and over again.

What we need is the reinforcement of higher standards across the board and some nationwide research into the way universities select 'suitable' candidates for nurse training...

Because believe me, these university selection panels send us some serious dross dressed up as student nurses. If a university only has nurse lecturers on its selection panel (who only have to do a few hours per year on the wards work as a nurse to maintain their nursing registration) and no actual 'working' nurses, then you will have problems and a gap between the reality of being a nurse and what is taught.

3littlefrogs-

Sorry to contradict a fondly held misconception about the good old days but 30 years ago, student nurses frequently had to work alone and take charge of a ward alone as experienced by my DH, mother and mother in law and my sister-all pre project 2000.

Now, student nurses are appointed a nurse mentor who holds ENB certificate of nurse teaching 998 or is working towards it. There may be shifts where a student does not work with her mentor but will be given an alternative mentor to supervise and advise. The mentor (or other qualified nurse) must counter sign every entry into the nursing and careplan notes made by the student.

I trained pre Project 2000 (just!) and vividly remember students being left in charge of wards with no registered nurses.

Thank god for you sauvignonblanche- Am relieved that you have validated my anecdotal accounts of family nursing experience!

It is not a case of the good old days versus now.

You're certainly not suffering from false memories. It wasn't just third years that were left in charge either, second years could be left in charge at night!
It all changed pretty quickly post Project 2000 but I'm not saying all for the better. I do think students need to spend more time (supervised though) at the bedside during their training.
I get some on my ward who are having their first ward placement - in their third year!

Thats weird that their first placement is in their 3rd year. I did P2000 and my training was divided into 3 months lectures/seminars then 3 months in placement. This happened from the start of year one and was the same for all branches plus midwifery. My friend is now training and it is much the same except their first placement is after the first 8 weeks of yr 1.

Think there needs to be much better selection of students with a thorough assessment of their beliefs and values. i am continually horrified by the casual racism, ageism and homophobia found in students. Nothing seems to be dome at interview to explore these issues.

I agree, good bedside training and better knowledge of and use of nursing models is needed and nurse mentors need better support in training and assessing their student nurses. I regularly meet nurses with 2 or more students attached which is just ridiculous.

THey had done plenty of placements but had all been either in the community, nursing homes and a charity shop!

3littlefrogs - So sorry to hear that! I am so sorry for your loss.

Can understand that'd be odd for general nurses and wholly inappropriate. It happens more with mental health and learning dis students who have less of an inpatient focus. Midwives have to do a medical or surgical placement and a mental health one in my trust.

The midwifery students spend their time wandering about with long faces moaning that they aren't nurses so do not see the placement's relevance. It requires continual pointing out that a confined to bed pregnant woman will need midwives with knowledge of pressure care, M+H, circulatory disorders, that midwives need to understand about mental health problems and the surgical placement will teach them post surgical care (for those C sections), amongst other post surgical needs! The moans about having to learn bedmaking are tediously funny too- they do not realise that a wrinkled badly made bed will cause pressure sores in a confined to bed pregnant woman or a post surgical newly delivered woman!

I am sure there are some wonderful nurses but sadly I did not experience one when I had surgery in the uk. They were rough, resentful of having to help me out of the bed to the toilet.something has gone wrong with the way many nurses care in the Nhs.
I am relieved I do not have to use the uk system for now.

It's very appropriate for student MW's to have those placements.
We general nurses did an 8 week Psychiatric placement and the MH students did an 8 week placement with us. They were always great fun, invariably naughty and rebellious.

I always enjoy having general nursing students because once they've overcome their nervousness of being in a mental health placement, they invariably develop a real fascination.

Am always trying to promote psych liaison between general wards and the mental health units/teams. Can really help ward nurses manage dementia and confusion manifested in patients with physical illnesses.

I trained in the 1980's and no way were they the good old days.
The main difference is that now nurses take on so many more medicalised tasks thatt there is often no time for the nursing care they want to give and should give.
I don't remember missing as many breaks or staying late as often as we do now.And there is no paid overtime,only time owing which is never given as there is no slack in the system.
It is unsafe to expect a nurse who has worked 12plus hours without a break to be in a fit state to calculate nd administer complicated drugs,often into central or iv lines which demands a great degree of concentration.
Long distance lorry drivers have to have a break by law.

"Now, student nurses are appointed a nurse mentor who holds ENB certificate of nurse teaching 998 or is working towards it. There may be shifts where a student does not work with her mentor but will be given an alternative mentor to supervise and advise. The mentor (or other qualified nurse) must counter sign every entry into the nursing and careplan notes made by the student."

I trained pre Project 2000 too and this was exactly how it was for us then. Even as a third year student nurse we were never left totally in charge of the ward. We may have been "in charge" for a shift to gain management experience but their was ALWAYS a qualified member of staff on the ward holding "the keys"

As a qualified staff nurse we weren't able to mentor a student nurse unless we held the 998.

I hate the way nurses are referred as angels. They get paid to provide medical treatment - care isn't necessary and sometimes not given. Point is that they are paid, very well in some areas for what they do. If they were angels they would be missionaries.

Most nurses are good at their jobs, but some arent and that leaves a big impression on families that are affected by poor nursing.

I have to say that the different between elderly nursing care and paediatric nursing is huge. Elderly nursing seems to require very different skills and temperament than paediatric, and having witnessed both sets of care, I would say that it's much harder nursing the elderly. I really support the current proposals as I do feel they would benefit the elderly in hospital, hopefully they will be allocated funds to make this possible.

I know some amazing paediatric nurses who are so supportive and genuinely care, and some who do not. However on a recent admission, we were told that nurses wouldn't be able to do DS's gastrostomy care, not because they were too busy, but because as we do all the care at home, we would need to do all the medical care in hospital. I found that quite astonishing as it is still a medical need, that should be covered by them. So I would rather they get paediatric nurses to define what is and isn't there job, before they start adding to their workload.

I started my training in 1981 so not too long ago. I was left in charge of a female medical ward in my 2nd year of training on nights (just in my second year). In my first year |I was left in charge of a childrens ward when the enrolled nurse went on break.

The good old days - I don't think so.

You know what I really think? People are becoming grouchier/more stressed then ever before. Nurses are just like the general public, so a proportion of them will be grouchy etc. Not saying its right, just what is happening in the world.

And nursing when I trained was a far different kettle of fish to now. I was the only SRN who did IV drugs on our surgical wards, the House Officer usuallydid them. Nurses did not do bloods, ECG's etc. That has all been dumped on us now because of working times directive on doctors hours.

Australia and USA have legal RN to patient ratios, why don't we? Will be asking DC this question when I e-mail him.

Message sent to DC - will let you know the reply.