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?

Thanks Midnight, Boglach and Wubbly- I have gained so much from my profession and hope i have given back more. My first day of training will always be with me when the head of the school told us of the 'privilege of nursing and the honour of being alongside the sick and the dying' and I hear her words always.

As I have suffered the consequences both professionally and personally of reporting bad, prejudiced nursing, i still get terribly emotional at being lumped in with nurses who do not care about other nurses delivering bad care. I do care and still experience nightmares each week related to the two years of bullying I experienced from the groups of staff who were associated with the nurse manager I reported.

I have witnessed my pregnant colleague kicked to the ground by visitors angry that she couldn't talk to them about their relative immediately-she was doing the drug round and as the only dispenser, could not leave the trolley. i have seen colleagues have their front teeth knocked out by aggressive patient, I have been threatened and told i would be drenched in acid by an aggressive boyfriend of an inpatient because i asked him to leave after catching him hitting her.

Yet if i was MrsH i would therefore accuse every relative of being a violent thug.

And no, I did not say all distant relatives do not care. I said that often, the guilt they feel at not being able to visit is displaced onto staff. And this is not anecdotal, there are qualitative studies currently being carried out with the goal of trying to avoid this and it is evidenced.

And the issue of parents providing care for inpatient children is not a random, 'taken for granted' thing', rather it is built into the parent/child assessment process. Staff do observe and evaluate a parents ability and motivation to carry out child care on the ward to ensure that post-discharge needs are met if there are any. The goal is to empower parents with the skill, confidence and knowledge to meet any ongoing health needs such as diabetic care.

'yet if i was MRSH i would therefore accuse every relative of being a violent thug'

indeed

A patient attempted to strangle a colleague of mine with his catheter tube. I have been spat at, shouted at and verbally abused by relatives and patients alike. I have been groped and called a slag

But no I know not all patients and relatives are violent thugs. i also understand circumstances such as confusion, distress and make allowances

i think you're being unreasonable to expect cameron would ever make sense.
i've been in hospital quite a few times, so has my son, have to say mostly the staff are excellent. thankyou.

Getting back to the op's question.We clearly disagree on the reasons.I have said I've experienced the occasional gem who did show some empathy,sadly I can only go on my experience.

If 80% of your contact with relatives was such as you've described I'm pretty sure you'd say there was a problem and procedures needed to be put in place.

It is hardly my fault I've experienced very little decent nursing care and going by this thread/media it's fairly obvious to see nurses aren't already doing these things being suggested by DC(for whatever reason) whatever the op says so clearly he is quite right in addressing this problem.

Surely all of us must agree that every single patient should get minimum standards in care.

I too agree that with Scameron, it is all glossy rhetoric designed to appeal to the 'knee jerk' brigade.

How can he possibly understand? Kudos to the consultant who tried to chuck Scameron off a ward he was PRing (visiting).

There are all sorts of problems with the NHS but I always remember a thread on an american site in which a mother sought advice after her baby fell from a high chair. She could not afford even basic health care and a collection was initiated to help her pay for emergency room costs. Not saying that means we should accept bad care and/or bad attitudes. But....I'll never forget that thread as an example of how fortunate we are. We may pay via taxes and national insurance but you will still get the same care even if you have never paid a penny in tax your whole life.

I do think a proper review of how nursing students are selected is well overdue. More jobbing nurses are needed on university selection panels.

I give everyone of my patients, their families and carers far more than the minimum standards. Many of my colleagues do too. It is a matter of ingrained morality for me. From this thread, it is clear that my colleagues who have posted all care deeply about their profession and their patients. I would guess that all of us nurses here work over and above our allocated hours and take our work (in the form of emotional responses) home with us. My patients (especially because I am in psychiatry) become part of my wider life. My colleague even got permission to invite many of her patients to her wedding.

Many nurses are not meeting these basic elements of care. They are exceeding them by miles every shift. And they do it in the face of awful generalised derogatory comments led by this non elected govt.

If that is the case why is there a crisis on our elderly wards? Sorry you now are generalising ie saying because you care and do a good job everybody does.Quite clearly that isn't the case.

Also if every nurse are already doing these things as standard not sure what you're worried about.

MrsH, I must say you have been spectacularly unlucky to have not encountered one single good nurse.

I wouldn't/couldn't be a nurse for all the money you could chuck at me, they have to deal with so much shit (literally and figuratively) and very littl recompense, monetary or otherwise.

I too have unfortunately had extensive experience of hospitals, clinics, the whole gamut of the NHS. And whilst I would have to be honest and say that, yes, I have encountered some bad nurses, I can also say, hand on heart, that I have encountered far more dedicated, hard-working, caring, competent nurses, and I will never be able to thank them enough.

Changes do need to be made, I don't think anyone disputes that. But all the changes in the world will not make a bad nurse good, so just like in every other walk of life, you're always going to have someone who lets the side down.

Read my posts correctly, MrsH. I said many nurses! Over my longish career i have known and worked with many nurses. I have worked in many different care arenas as has my DH. I have far more objective and subjective experience than you mrsH. I have seen good, adequate and bad. I am not generalising, nor have I generalised. Like I said, read my posts correctly.

My name is Nikki and I was one of the authors on the Nurse Anne blog (Militant Medical Nurse). I stopped writing last spring when I walked out of my NHS staff Nurse job in North Yorkshire. I walked out, set my British nursing registration on fire and flew home to the United States where I was born and raised and educated as a Registered Nurse.

I wrote another post before this one but it seems to have disappeared. I'll try again.

1.The RN to patient ratios in NHS wards are horrific. The Nursing profession has no control over staffing levels. Most of the staff you see hanging around the station are not Nurses.

1. The poster who said the HCAs were brought in because Nurses don't want to do Nursing is insane. The nursing profession fought hard against the HCAs being brought on board. An NHS staff nurse who has an HCA working with her instead of another qualified nurse has her workload tripled. Most tasks that need to be completed on a ward can only be done by an RN. Basic care is only the tip of the iceberg. HCAs were brought in to save on staffing costs. Hospital managers and the public want decent nursing care but DO NOT want to pay for adequate staffing.

1. An RN who is working short staffed cannot stop and chat, take her time and be patient, listen, or focus on the basics. If she does, she will get someone killed. RNs are getting slammed with orders from doctors for acutely ill patients. If she delays hanging a blood transfusion in order to listen to a relative who approaches her at that time to complain about the food, her patient will die. If she is late titrating a cardiac drip or monitoring an insulin drip because she is hand holding and making tea and primping her her hair so that she looks professional, her patient will die.

An RN has more orders for these kinds of things thrown at her than she can handle. It is constant and it is happening simultaneously while other patients need basic care. Handling it involves paperwork (i.e. transfusion forms, pharmacy order forms, equipment ordering for transfusions), computer work and work at the Nurse's station.

1. Anyone who expects immediate attention from an RN who is responsible for multiple patients is immediately labeled crazy. You could cause the RN to make a fatal error by distracting her and causing her to miss orders. We do care about your grandma getting to the toilet on time, we care about her hygeine and whether or not her bed is clean. But can you imagine if I let a patient bleed to death or arrest because I was off changing sheets or "listening"? You would flip out. Actually no you wouldn't. All you care about is your immediate wants being met. You don't think about consequences. If you want your granny to have a commode you don't give a shit about the bleeder in bed 5 or the insulin drip that is behind in bed 10. You just want what you want and to hell with the other patients that your nurse is responsible for right?

1. Nurses are constantly prioritizing and triaging. They are working their way down from the most immediate life threatening problem to the least. And missing an order or titration on an insulin drip because a family member was asking you to fetch gran a commode is a damn good way to kill someone and get fired.

1. Most of the people sitting around the Nurse's station are not Nurses. And if the lone RN on duty is there she is focusing on orders, information, and charting etc in order to avoid making a fatal mistake. Do not cause her to fuck up by distracting her. She will not enjoy going to jail for manslaughter simply because you want what you want and you want it now (without wanting to pay for one to one nursing care).

1. If you don't like any of this I highly suggest that you start paying for one to one care. Then your Nurses won't give you poor care because they are overloaded and busy with sicker patients.

1. Nurses have no control over food, the trays, what kitchen sends up for you, how much linen they store on the ward and whether or not it is enough to change all the beds, how long your doctor takes to see you, how long pharmacy takes to prepare and send your meds to the floor and what your doctor prescribes for you. No control whatsoever.

I have called pharmacy crying and begging them to hurry up and send a patients pain med up because the family is screaming at me. Not all meds can be stored on the ward and every order has to be checked by pharmacy.I have called kitchen to pass on complaints about the trays. I have called doctors because patients are yelling at me because something wasn't prescibed. None of them gave a DAMN about the fact that patients were not getting what they needed because it's not them who gets yelled at it's the Nurse. And no pharmacy didn't care that I was being threatened with bodily harm, they still took their good old time getting the meds to the ward. And no, kitchen won't do shit to improve the food or efficiency with food service. They don't give a fuck because there are no consequences for them. They aren't the ones who get complained at and yelled at and threatened by patients and visitors.

99% of the complaints made are regarding things that the Nurse has no control over. And most of them are petty and stupid in comparison to what else was going on in the ward at the same time.

Patients and families are angry over their illness, crazy, and looking for someone to lash out much more so than they are frightened and meek. Many of them are regulars who know how to milk and manipulate the system.

Anyway I just want to say to the Nurses still left in the UK: Get the hell out of there. These assholes are forcing you to take on more patients than you can handle because they don't want to pay for staffing and then they are chiding you for poor care. They are blaming you for things that you cannot control (like food and pharmacy taking forever to get meds and infusions to you). They don't want to wait but they get angry and complain when you rush and take short cuts.

And I just wanted to add that it is often very difficult to speak and relate to patients properly and patiently when there are so many things going on that you literally need to be in 10 places at once to avoid killing someone through omission, and neglect. How can a person be expected to do that with a smile and handle all of that while simultaneously taking the time to talk to everyone and listen to their concerns, complaints, fears, and anxieties. The RNs spend their entire shift afraid that they are going to get someone killed by missing an order or not staying on top of things general. It is NOT a nice sunny place to be emotionally.

And 10 members of the multidisciplinary team sitting around the Nurse's station gossiping are not going to be able to give me a hand with any of these tasks.

And I certainly don't know how NHS Nurses are supposed to go around every hour and ask everyone if they are okay while they have so many tasks and orders to deal with and constant, constant, never ending interruptions. I don't think I could have done hourly rounds as an NHS nurse if you had a gun to my head. It would just have been physically impossible.

Now that I am nursing in the USA I only have 6 patients and I am in and out of their rooms constantly. Most of them are medicare and therefore paid for by the government so don't start with the private health blah blah blah shite.

If I can condense tasks into a 15 minute time frame I can see 4 of them an hour and then move onto the other two as long as I am not getting interrupted by visitors, critical labs, allied health professionals, doctors, and as long as no one is acutely ill etc.

But in the NHS I had 12-20 patients at once. No way. Totally impossible. If you want your NHS Nurse's to be able to do this stuff you need to start paying for RN staffing.

I am glad that nearly a year on you must be in a better place. All the best for your future.

I wondered where Nurse Ann was, pleased you're still about Nikki!

Welcome NewJob - good to hear from you.

Very sad.

The fact that nurses won't go on strike means, again, they are waving the vocation card.

I think they should strike for minimum numbers of trained staff per patient. Or go on a working to actual hours only regime.
I can't see what else will do it. I know many retired nurses in other jobs or private work because of the horrors of working for the NHS.

I was a radiographer - we went on strike in 1971 I think it was but the nurses wouldn't strike. After that it at least meant the public new who we were which they hadn't before that.

As it is, the managers/politicians/medical staff are able stand by tutt tutting about the poor quality of/ non-caring nursing staff. You are taking all the flak and would do us all a favour by taking a stand.

Striking will of course be used as an example of how selfish and uncaring the nursing staff truly are and there will be tales of lives being lost (assuming strike is short medical staff could stand in) but in the long run, assuming changes are made, it will save alot of lives.

Hi *Nikki/Newjobthankgod&

My god, what other job fills people with such anger, betrayal and pain? Funnily enough we are considering Canada after all our children'[s wings have grown strong. Similar reasons plus a wonderful country.
Psychiatry has a whole load of similar and very different challenges-longer and more intense contact over time, more sole responsibility for a case load and that makes it even harder to face patients who you know are being shafted by the system. Compensating for this invariably takes place in my own unpaid time.

*JozieZ8-

How right you are. I'm a very big supporter of all the PAM's and my good friend is a diagnostic radiographer. I used to slip down to see her when she was on call to be educated on fractures etc!

Hi Nicki,
Nice to hear your views. I have actually copied your post and a link to the old blog on my facebook, because you make so much sense.
An over tired, slightly burnt out would love to get another job but can't find one because there are no decent jobs around any more nurse.

Remember the Modern Matron fabulous idea to change the NHS?
Most of ours have been made redundant.
No frontline staff redundancies?
Thats a lie. They just update the job description and say you now have to reapply for your job. Then they offer you a downgraded post. (Sorry about that, but your job no longer exits. But we value you and want to keep you. and use your same skills but pay you less
If you leave because of this, your post is not filled. But we will not be making nurses redundant.

Cost savings and efficiencies? Well the biggest cost is nursing salaries.
So we restructure and adjust the skill mix. HCA, brilliant idea. (Someone mentioned band 4s a few pages back. We dont have any band 4 HCAs, just 1, 2 and 3.)
If we have more HCAs, we dont need as many nurses. The nurses fought this, but lost. So now, we have a band 6 nurse in charge, 2 band 5s and 2 HCAs . For 30 patients. Oh says management, the numbers are good. Actually, why cant the nurse in charge take patients? OK, great, now we have 2 nurses and 2 HCAs for the same 30 patients.

Rubbing hands together with glee, thinks about the cost savings.....

When I qualified, back in the dark ages, we did earlies and lates. We had 8 on an early, and 4/5 on a late. And 2+2 on nights. Never more than 2 HCAs or nursing auxillaries as they were then. They were there to help the nursing staff, not replace them.
Then management changed to long day shifts, to save money. There was a changeover period of 2 hours . This was used for lunches, handover and teaching. But it was inefficient. So we were forced onto 13 hr shifts not as a poster upthread said so we could do extra shifts, but because we had no choice.
Every year we have new targets and more efficiency savings, less nurses, more managers, but you want us to smile????
Here you go.

I will now go an bash my head against that brick wall.

Three of the early shift rang in sick today leaving two staff for the ward, 46 patients. So 23 patients each......I wish them luck going round trying to find the time to say hello to them all every hour. Dc needs to live in the real world.

Vivalabeaver

And lets not forget that if we have to go round the ward doing these 'specific' checks on top of the usual ones, they'll need documenting because of the fact that if it is not documented, then it legally has not been done. And Scameron seems totally ignorant of the legal requirement for every nursing action to be documented. So that'll be ten mins per patient just charting this extra check which adds up to how many minutes out of an hour for a nurse with 1-2-3 bays of patients?
I'm sure a ward nurse will come along and add up what chunk of time that'll cost her.

tbh when people complain about "nurses" they know they are not just talking about qualified nurses. I know on wards there are very few qualified nurses and they are largely doing what doctors used to do. The term nurses has been used for decades and decades to describe all the staff who nurse on wards e.g. cadets.

So how do we make sure all those other staff are doing traditional nursing well? Some already do, but some certainly don't.

Newjob

"petty" "all you care is about your immediate needs being met" "do not cause her to fuck up"- what leaving an elderly old patient all day in the same position,out of reach of water,leaving a patient who had a c/s that day to lift and crawl out of bed to get her newborns.

Your attitude is appalling and pretty much sums up what I experienced continuously and what I find so very,very worrying re nursing today.

It doesn't take long to move a jug of water or ask other staff to check water on each bed. The amount of staff hanging around I've seen(whoever they are) sorry there was no excuse for lack of basic care.Several of my experiences in hospital have been in wards with very few patients and plenty of staff.

You have a voice so delegate or is it the simple fact you don't deem many patients needs as actually being of any importance?This 'don't bother me I have more important things to do' attitude is shit.

Come on MrsH- answer the task ranking question. Your argument that it is not your 'job' to have to answer that means your arguments lack any credibility. Because that question gets right to the heart of what nurses have to face very day. Great lists of tasks, all of equal importance, all for patients with relatives wondering why their relative had to wait.

Come on, answer the question.