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?

Stotie because pretty much all my experience indicates it so.

A complete lack of empathy is on the psychopathic spectrum

so come on mrsh, tell me, are nurses psychopaths?

Mrs. H maybe you just have totally unrealistic expectations of a Nurse?

The number one priority for a ward nurse is actioning the orders that doctors give for the treatment of medical and surgical conditions. That is number one. Everything else comes secondary. If the Nurses did not prioritize like this then a lot more patients would be dying. Most ward nurses are just getting slammed with these kinds of things constantly and they have to make some really tough decisions about who will get care. A nurse with 30 patients cannot handle that kind of load and also be a personal carer. Management will only staff the ward with enough qualified staff to keep the patients alive. The unskilled workers really are just there to convince the public that the ward is staffed with nurses. There is not a lot they can do to help, even if they want to.

If you go into a hospital expecting to have a carer with you at all times ( or even just immediately if you want something) and who can provide all the emotional and physical support that you want and need.......................... then you are going to be incredibly disappointed in nursing in both private and nhs hospitals. Your expectations regarding the kind of care you can get when you are sharing your nurse with 20 other patients are unrealistic.

And 10 porters, phlebs, and care assistants on the ward or sitting around at the nurse's station isn't going to make any kind of impact with actual nursing care.

Am 'signing off' now as am on call tonight. Thanks all for the spirited debate. Sleep well all of you. Not so sure I will.

You haven't answered mrsh

of course you don't have to but would be interested in your reply

Night nursenic

I've been nursing for nearly 19 years, qualified for nearly 16 of them.

I wouldn't work on a hospital ward now if you paid me a million pounds a year.

I was fortunate enough to be trained and work in the military; we were well staffed, well resourced and well managed. We provided superb care to service men and women and the civilian population of the town our Naval Hospital was located in. There was local uproar when they closed our hospital down due to budget and staff cuts.

Secondary care has now changed beyond all recognition - inpatients are sicker, older, undergoing hugely complex surgery/investigations/care. They are admitted and discharged at speed and discharged home with drains, catheters, lines, wounds and on medications that they would have been kept in hospital for for much longer in the olden days.

Staffing levels are abysmal and IMO unsafe. We used to be very busy on a 26 bedded surgical ward with a ward sister, 4 registered nurses and 2 medical assistants (naval medics qualified almost to paramedic level). How registered nurses cope now with 30-40 patients for 2-3 nurses I don't know.

Inadequate staffing doesn't excuse laziness, rudeness, that attitude of "not my job/team/patient" that does exist. But I truly think it's the minority and most nurses are doing the very best they can for their patients.

Giving nurses more targets to meet, more paperwork to fill in, more spurious quality indicators to reach will be totally counterproductive. They're already running on empty.

Mrs H, it does sound as if you have unrealistic expectations of NHS staff.

You really should have hired a private maternity nurse to give you additional assistance with your personal care and particularly with the care of your twins. Plenty of new parents, especially of twins, do this.

It sounds as if you were not really prepared for the reality of your post birth condition, understandable perhaps if you had a difficult pregnancy and feared for the health of your babies. Your focus was on getting to and through the birth, not on what was going to happen after.

As I said, I hope you did complain to management about the level of care you received and how disappointed you were. This is the only way to possibly effect change.

But your experience is not unusual in a busy NHS hospital and if you and your babies were relatively well you would have been a low priority to the staff. Unpalatable maybe but true.

Lesley,

You also have to remember that health care assistants do not have a nursing registration to protect. If they make a mistake (i.e. leaving a siderail down causing a patient to fall out of bed) it is my job and my license not theirs.

Basic care is when a Nurse asseses you for changes in condition and problems. health care assistants may be able to do a good bed bath but noticing subtle changes in condition that require a phone call to a doc is beyond them.

Health care assistants don't care if the Nurse is swamped in Doctors orders and that her registration is on the line. They simply don't care. They demand that the Nurse do the basic care as well. I will be the only nurse on the ward carrying all the orders and meds for 20 patients by myself. I will have 10 family members waiting for me etc etc etc and I will have 5 health care assistants at me wanting my help with the basics because just having to deal with the basics only and nothing else stresses them out. Yet they cannot assist me with meds, orders, families, emergency transfusion sheets, critical lab values etc in order to allow me to have time to deal with the basics too.

So really I have to do the RN only tasks and the health care assistants job even if their are 5 health care assistants and only one RN staffing the ward that day. Otherwise the care assistants start running around accusing nurses of not wanting to get their hands dirty.

The health care assistants do have a huge lack of understanding regarding what the job of a qualified nurse involves. This is because health care assistants do not deal with doctors' orders, meds, assessments etc. That stuff goes right over their heads.

Well that would explain why hcas can be gossiping while there is lots of patients needing help.

No one yet seems to have addressed the intrinsic meaning of a lack of empathy

as i mentioned earlier, the level of uncaring suggested by some posters especially mrsh, suggests quite a sinister psychpathic edge. After all, a lack of empathy is indicative of sociopathy

so are we really suggesting nurses have a predisposition to personality disorder?

Exactly Lesley33.

I made some comments about HCAs being employed instead of RNs near the top of this thread, and got jumped on. It is not the HCA's fault that they do not have the knowledge or training that the RN has. 30 years ago we had auxiliaries who were a fantastic help on the ward, but they were not doing the work of qualified nurses. Now they are dressed in similar uniforms, and are carrying out duties that would have been done by the RN previously.

Meanwhile the one qualified nurse on the ward is run ragged doing the jobs that used to be done by the doctor.

I am a clinical nurse specialist. I do a job that would have been done by a doctor ten years ago. I am very highly trained and have to do refresher courses and pass exams every 2 years in order to continue to do my job. But I work in General Practice, where there is heaps of cash and plenty of resources.

It is a very far cry from the average medical ward.

Didn't realise this had turned into a Hca bashing thread, nice!!

Lesley, I can remember one of my last shifts in the NHS. I was the only nurse for an entire ward and I only had 4 health care assistants working with me. T

There were so many patients needing pain meds. HCAs cannot give pain meds. Every 5 seconds an hca would come and tell me that yet another person needed pain meds and then he or she would go and sit down back at the Nurse's station. I was trying to handle a lot of other RN only tasks at the time as well. And in addition to that the 4 health care assistants would demand that I assisted them with the tasks that they are allowed to do.

Its not HCA bashing. Most of the HCAs I worked with were nice hardworking people but that doesn't help me when i am swamped in RN only jobs. I think that HCAs are put in a terrible position by management. The hospitals brought HCAs on board merely as a cost saving measure. It was a huge mistake, and everyone knew that it would be. The situation is certainly NOT the fault of the HCAs who have a huge lack of understanding and training. They are being put in a position that they never should have been put in.

I am not bashing HCAs. I have a team of HCAs and nurses that I supervise. Some are excellent, one or two have to be watched very closely, all the time.

What I am "bashing" is the way they are exploited, and given responsibilities that they are not trained for, and do not have the knowledge or education to carry out safely. This is very unfair on them, and on the RN who is told that he/she must take full responsibility for everything the HCA does, whether the RN considers this to be safe practice or not.

A person with responsibility for caring for sick vulnerable patients is dangerous IF they don't know what they don't know IYSWIM.

Boglach after years of working in hospitals dealing with the public I think that most people in the world have undiagnosed personality disorders.

When I would call management and say that we weren't staffed, the patient's are suffering, the situation is unsafe, the hcas cannot help with most of the tasks that need to be completed and that I needed more qualified nurses I only ever got the following responses:

"tough" "deal with it" "not managements problem" "grow up and deal with it" 'we aren't payng for more staff" "stop being such a baby" "stop whinging" 'too bad, nursey" "that's just how it is, learn to manage" etc etc etc.

and then as payback they would slam us with 10 admissions even though they were told we weren't coping with what we had.

Now who is uncaring in that scenario?

This thread is not tempting me back to the profession i tell you

Management wants to cram the ward full of as many patients as they can with as few qualified nurses as possible. They don't have registrations to protect and they aren't the ones who get held accountable when the care is horrific.

Boglach, the situation is way worse than what we can describe here. I have had a manager at the staffing office tell me to fuck off when I begged in tears for help. They simply do not give a fuck about anything except for budgets. And they get away with it because the public blames the Nurses. They are getting big fat salaries as a result of short staffing the wards.

That is awful newjob. sad to think i went into nursing so full of positivity

We all went into full of positive energy about helping people Boglach.

And then you qualify and get beaten over the head and screwed up the ass from everyone from the cleaner and kitchen staff on up to the porters, the patients, the families, pharmacy, doctors, and management so consistently that you become numb. Its the total responsibility but no control thing that causes Nurses to quit. It's all about money, everyone wants good nursing care but no one wants to pay for it and then they beat up the nurses over it. That's why care is shit.

Me neither Boglach, I just can't see the attraction to going back at the moment.

I agree completely Newjob - you get drummed into you when training the concept of responsibility and duty of care [fair enough and what most of us signed up to].

But the lack of any control over your working life and the apathy and disrespect you receive from everyone from management to catering staff. I wasn't prepared for that and didn't sign up for it.

I kept thinking to myself "I am bright, motivated and proactive. I should be enjoying and prospering in my career. Why do I feel so downtrodden and powerless?"

It actually felt somewhat akin to being in a abusive relationship, where I was told any potential mistakes were my fault and a result of my incompetence or poor work ethic but I was not given any control over the issues that were impeding my ability to perform effectively.

Every day felt a battle and I felt less and less proud of being a nurse and more and more resentful. I don't think I ever consciously took my resentment out on my patients but it is very possible that I may have seemed tired or depressed and was not as smiley at times as I normally could be.

This was on top of being paid a low salary compared to my peers in careers with similar academic and training requirements.

So one day I decided I had had enough. I retrained in a different profession and have never looked back.

You would not get me back on an NHS ward for anything. The staff that carry on in the conditions I remember deserve a medal and it makes me cross to hear them being criticised as a whole due to some experiences with staff who may have been terrible or may actually just have been short staffed and struggling themselves.