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?

featherbag if everyone stayed and did it just for a couple of weeks then you would have a great arguement for getting things eased off staff wise in the long term.

By NOT doing it you are on paper saying "no we're fine actually! everything is done!"

I did a shift recently where the night staff stayed and moaned to the morning staff for about 10 mins about how 2 falls were really because they were so short staffed. When the day nurse said "don't tell me, document it, everyone keeps moaning but noone properly reports it!" they said "oh no we told the ward manager and she was very nice about it"

Oh ok!

as you were.

If something isn't done it becomes an incident, and an incident form needs to be filled out, this takes approx 30 mins as everyone who is involved needs to have their details written down and in what way it affected their care.
30 minutes for everything which hasn't been done would take most of the shift up !
The saying goes that if it isn't documented then it isn't done.

12 patients per nurse. so 5 minutes every hour with each patient. great.

Mrs J I can take you to the loo - you have 5 minutse.

Mr P I know you need washing but I only have 5 minutes so I'm afraid I can only do some of you.

Mr K I will do your dressing but Mr l and M i'm afraid I won't be able to see you this hour, or next.

Mrs O I can hold your hand for 5 minutes but that is it

Mrs A, B C and D. Hello. that's it, I have to move on.

Mrs E I will take you to theatre but that means Mrs F and G I can't see you for the next 3 hours. Hope your BPs are OK.

my 4 other patents Hi there. don't speak to me my hour is up.

back to the beginning

End of a 12 hour shift -oh look. I haven't written anything down and as we all know, if it isn't documented it hasn't been done. the bells haven't been answered, nobody has been fed, nobody except Mrs J has been to the loo and nobody has been washed. So I'll spend the next unpaid hour catching up with what I haven't done yet but should have.

The phones haven't been answered. No case conferences attended. No discharges organised. No doctors, physios or OTs spoken to, No social workers have been asked to visit.

No paperwprk has been done

I haven't had a drink for 12 hours nor been to the loo.

But it's OK. I have seen all my patients every hour.

What's new>?

given some well documented audits of poor nutrition,poor hydration, and numerous reports into sub-optimal care in many hospitals...PM has a valid point

I am not in any way disputing nursing workload is difficult,stressful with considerable paperwork. that is true,but nonetheless basic baseline care provision has in some hospitals been lacking

sorry but I dont think all staff attend to the minuimum to meet baseline needs and maintain dignity

Sorry, OP but the public do not "think" you are not doing them. They "know" you are not doing them by their own experiences and that of their loved ones. We dont need to have it pointed out to us by any politician.

I am sorry but I also think David Cameron has a good point and I can't stand him or his party. I am afraid most of my experiences with hospitals (and I have loads in many different hospitals) support all the negative press. The good nurses really stand out because it is rare to see for all the many, many reasons. I do believe the major problem is lack of staff and too much admin but maybe this will lead to a proper discourse and measures as to why patient care is woefully lacking.

PM has a valid point if nurse topatient ratios are very drastically reduced wuith massive amounts of more staff. impossible otherwise.

I know how long it doesnt take to fill in an incident form because I DO THEM, despite being told not to bother half the time, because it is incredibly short sighted not to and if you don't you are consenting to the current state of affairs continuing.

ILoveJudgeJudy

I agree. My late DH was in hospital towards the end and I spent all day with him. He was in an Acute Care ward and I was surprised at how long the other elderly people had to wait for attention after ringing their bell. Older people are not incontinent; they are just not helped when they need it. My DH was prescribed with water tablets which have such an effect that the desire to pee is immediate and, if there is no bottle there, it goes everywhere. He was lucky in that I ensured he had a supply of bottles. I felt for the others.

He was cold at night so I asked for an extra blanket and took one of our own in, too.

There were a couple of occasions when I had to call out (that made a nurse come) for someone to help me when he tried to get out of bed and once I had to go to the nurses' desk to prise one out of a seat. I expect I was unpopular but eventually they knew that ignoring my husband would cause trouble.

There was the usual personal medical record at the bottom of the bed which I read. I noticed that, after a few days, oxygen was not to be given so when I found he was being given oxygen (nasal fork), I checked the notes and made enquiries He was still not to be given oxygen (something to do with red blood count or similar - can't remember now).

One nurse, Tanya, was so cold blooded that I wouldn't let her near my DH. She would approach a patient to give an injection, say nothing to him, inject, swab and walk away without saying anything at all.

It isn't all about low staffing levels (although there are far fewer staff on duty at night). I think it probably is owing to two reasons: (1) there is too much record keeping and (2) If nurses' stations were in the centres of wards as they used to be, patients would be able to see them and know that they were there. Nurses would therefore know who needed attention when a bell was rung. Perhaps the bells are not loud enough to be heard above the machinery bleeping etc.

I used to be that sort of nurse but the 3 years ago my job became so stressful because of staff shortages that I would come home and cry because people's basic needs weren't being met and I felt so guilty that I eventually left altogether after 10 years in the nhs. I didn't want to be the snappy horrible person I had become. Nurse training now is so poor and hospitals are so understaffed I can't see how it will get better. Caring is no longer a culture for some nurses . I have worked In a few other countries and never experienced this anywhere else.

All of you saying nursing care isn't what it should be seem to miss the point that introducing a target which requires more box ticking isn't going to magic up more efficient care.

I'm reigning myself in tightly here, DC makes me want to swear more than anything else ever has. As a nurse, I care about patients. I want them all to be well fed, well hydrated, comfortable, clean and to feel cared for. I also want them to have had all of their essential medication (which I have to locate, as it's never in the cupboard, then mix and have checked). To give them this, I first have to know several things about their vital signs. I want to be able to make sure their dressings are clean, their wounds uninfected, their chest pains are investigated, their cannulae are insitu, their bloods have been taken and sent in a timely manner, they are sent for the various investigations and procedures the doctor has ordered, their IV fluids are running, their blood is ordered, checked and running (while not killing them: important!). I have to make sure I document in several places every time I do any of the above. I then have to share various bits of that documentation with several other departments and agencies, usually by fax on a rickety old fax machine that works 50% of the time, then document that I've done that.

If I have sole responsibility for 15 patients with the assistance of 1 untrained HCA, would one of the 'no, all nurses are crap uncaring witches' brigade please tell me how I do all of the above in the time I have? I don't expect a break, or a drink (hey, then I'd need toilet breaks), or even to leave on time after my 13 hour shift, I've given up on that. But how, exactly, do I do everything I'm told I absolutely, positively, without fail must do in those 13 hours and have time to actually talk to the patients? I'd love to! But how is it, in the circumstance described above (which is perfectly normal and not even slightly exaggerated btw), that it's my fault when I can't find the time? Why is it not the fault of the trust that won't employ any more nurses because DC has cut their funding and they don't have the money?

Rantrantrantrantrant...

But that is not your op.

Your op said nurses are already doing these things.
They often aren't.

Stop running a fruitless argument by saying 'we do hourly checks' and make the argument about why they aren't being done.

The premis of your op puts you on the wring side of the argument. Nothing to do with the press. My view that care can be poor was very reluctantly formed by being on the end of poor care.

working, what another box to tick WILL do is flag up how often it is NOT done (apart from the wards that will tick them anyway ) so that the issue can be properly audited and addressed

I don't think seeing all your patients once an hour is necessary.

I was in hospital for a week once, the doctors were a pile of crap but the nurses were great, when I was very ill I saw them far more than once an hour and when I was recovering I saw them less. That makes total sense to me. Why should they have wasted their time checking up on me when I was able to ask for help as and when I needed it? Not doing that meant they could check on patients who weren't able to ask for help themselves.

the question is does he really think that there are enough nurses on the wards to do everything that needs to be done?
and if not then why is he squeezing the nhs budget even more?

I understand people have bad experiences in hospital, your not there because you fancy a visit, you are there because you need care and at your most vunerable.

TeWihara, maybe you were able to lift a cup to your mouth or re-fil a glass, but many arent and they are NOT offered a sip between meals A LOT of the time

From what I have read on Twitter today, there are 48000 nursing jobs being cut.

Anyone know about that?

I cannot see how they can improve care while cutting staff.

Yes, but that's not how audit works in the NHS is it? What happens is that managers who manage managers have a screaming match in a board room and some nurse gets a slap on the wrist for not meeting the target and/or everyone gets told that you have to "do more for less" in sober tones at some endless team meeting with new flashy "initiatives" with meaningless names like "liberating leadership".

Well then post that as an op. Post an op about how it can't be done
Don't post that these things are being done.

Erm, yes. That's what I said.

Because I wasn't being pointlessly checked on every hour once I got to the stage where I didn't need that, the nurses were able to check on other patients more often.

When I worked in oz i had a max number of 4 patients because realistically that's about all you can manage sometimes I had 20 here ( a&e) I could sometimes not get back to somebody who I had assessed at the start of the shift because their was so much emphasis on moving people to a back room through because of the four hour target. It was the end of everything. Constantly telling old ladies that they had to hang on to go to the loo because you had a gazillion jobs to do which were deemed higher priority twas horrible.

Many a time I have had to spend time with my two in A&E due to accidents and falls over the last couple of years and the nurses have been fantastic on the children's ward but.... leading up to Christmas 2009 my 9 year old daughter who suffers from athsma spent four nights in hospital due to awful flu symtoms that affected her lungs (Our doctor's surgery had run out of vaccinations in October). Due to the 'swine flu' scare she was put into isolation and my husband and I took it in turn to stay the night. During her stay she was forgotten about and missed meals and my husband and I would have to empty the comode. This was while a group of nurses were standing around the reception area laughing and giggling and talking about partying, I was too exhausted for confrontation but looking back, our daughter was neglected. Only about 2 nurses we saw in that period did we feel that they did their duty of care. Bring back old style matrons I say!!

Does he not realise if this is implemented he will be creatingmore paperwork for every patient, for each hour? The management will want 'proof' nurses are doing this. There will be a box to tick on another new form where all th pt's info will have to be entered onto.

Then you realise that patient has ran out of stickers with their name/address/ tel no on, so then you have a choice- write them all out by hand or go to a computer, print the stickers, but then you have to go to the next clinical area to fetch said stickers as the printer on our ward has not worked for the last 3 months

The management costs must be hideous. They never seem to get cut do they.