To think that David Cameron is out of touch with the realities of the NHS?

[Lougle]

I've been listening to Prime Minister's Questions.

David Cameron wants to introduce 'hourly roundings'. That is, that each patient under a nurse's care should have a 'nurse by the bedside, at least once an hour, checking that they have had water, that they're not uncomfortable, that they don't have bedsores....'

Let's think about this. One nurse can have up to 15 patients on a normal ward now. In 2003 as a Newly Qualified (ie. 3 weeks qualified) RN, had 12 patients in the morning, then 18 in the evening.

So, working with 15 patients. Each hour, the nurse must visit each of them. That means that the nurse has 4 minutes per patient, per hour.

What happens when patients need washes, morphine (requires two nurses to sign out, check, administer), theatre prep, admission?

The nurses station is there for the nurses to use. Where are they supposed to write their notes, make referrals, sort out discharges etc? The toilet??

It's not always nurses sat there anyway, sometimes its physio's, OT's or clinical nurse specialists visiting the ward's.

I bet that most of the time when a visitor has come in and found a nurse sat at the nurses station, there is paperwork on the desk.

Also, we do have something called specialling. Where a nurse/HCA have to sit in the middle of a ward or outside a patient's room and stay there to make sure no one falls or tries to abscond.

There is a bigger picture than most of the public realise.

What is the point of HCAs if nurses are doing this?

I am perfectly capable, with my NVQ in Direct Care and years of experience, of completing these very basic patient needs.

What is your definition of good basic care within a hospital setting Chris?

Hygiene?
Nutrition and hydration?
Medications and investigations?
Falls prevention?

It's all part of basic care in a hospital.
Unless you work in that setting, you cannot really understand the time constraints with so few staff.

" MammaTJ Wed 05-Dec-12 15:50:55

What is the point of HCAs if nurses are doing this?

I am perfectly capable, with my NVQ in Direct Care and years of experience, of completing these very basic patient needs. "

They are core needs, but not basic needs. Many many times, a patient will reveal the most during the most mundane of situations.

I remember as a supply nurse, admitting a man who said he hadn't had any surgery. The next morning, as I was helping him with a wash, I noticed scarring. I said 'Fred, what's that scar then?' He replied 'That was by cabbage (CABG) in 1989.' I pointed to another scar, and said 'what about that one?' He replied 'That was my lobectomy, in 1983.' I then said 'but you said you didn't have any surgery.' 'No, they were just operations...' Now we would have found that out, from his notes, etc., but there are many things we might not find out if nurses step away from core nursing care.

What nurses don't need to do though, is be mechanised by the system, to only see patients once an hour for 2 minutes, because they have to fit in the other 14 patients regardless of how well or near to discharge they are.

I think good basic care is an absolute requirement, not a question of priorities. So if hourly checkups are required to ensure it happens, then they must happen. Tax rates will just have to go up to whatever is necessary to pay for the staff increase

Its a sad state of affairs it really is. It makes me so sad to know that people arent getting the care they need, and it's not through lack of trying on the nurses part - not to say theyre all angels, but most go into the job because they care. And some end up leaving it bitter and angry.

I've worked as a HCA in a hospital and in a private care home. Both were horrendous because of staff shortages and lack of funds. Things could be so different if there was only the money.

I sometimes think I'm mad for spending the next 5 years of my life studying to get the privilege of working in the NHS :(

This is nothing new, when I was on the wards 3 years ago they introduced "intentional rounding".

Guess what swiftly followed? An A4 landscape checklist to be signed off after you'd done each patient's rounding

there is also talk in the SW of reducing salary for newly qualified nurses to 14K, and removing the unsociable hours payment for working shifts for qualified staff

David Cameron is a fucking arsehole

Nurses should be able to exercise their judgement about who needs care, not tied to filling in another form. I can't see this improving care if staff are already overstretched.

I have received great care from the NHS, and witnessed the same for my DH and parents but when things do go wrong does DC really think a compulsory 4 mins am hour would help?

Personally I would hate unnecessary rounds along the lines of being woken at 7 am on a postnatal ward, 30 minutes after getting a baby back to sleep, to ask me if I wanted some paracetamol.

^

Seriously???? At the moment I'm on a 2 year access course, in 2014 I'm wanting to go onto study midwifery, or Critical care nursing. 5 years it will take all in all, for 14k? It can't happen. Surely not. I hope not!

sorry x post

ghost

www.nursingtimes.net/nursing-practice/clinical-zones/management/south-west-trusts-set-up-regional-pay-cartel/5045367.article

www.nursingtimes.net/nursing-practice/clinical-zones/management/south-west-trusts-set-up-regional-pay-cartel/5045367.article

i dont know where you could find the wages figures officially; my friend is in her final year of nursing degree, and it is well known in the uni/on the wards...

Thanks for that Takataka. I'll have a read now

I think the pay consortium cartel has agreed to stick to nationally agreed pay bands now, but if you are at uni I would have thought this would have been discussed at length in lectures? It's been going since the summer.

Access course is college. :)

Sounds like a great idea!

Now, how is he arranging the funding required?

I've noticed that most job vacancies within our trust are lower bands than what they used to be.

That's if you can get a qualified post that is.

As for HCA salaries, in our trust they are on the same band as ward based caterers.
One bank nurse I worked with today started in October. Our caterer earns more money than she does because the caterer has been there for 3 years.

Without meaning to offend anyone who works as a ward based caterer, but its fucking insane. All the caterer does is dish up the food that comes from the kitchens, loads the dishwasher, makes cups of tea and refills water jugs.

How is that justified?

I don't think DC or even a lot of the general public realise the immense pressure and poor staffing hospitals are currently experiencing, specifically on care of the elderly wards. As that area isn't 'sexy or exciting' so they can get away with the cuts no one really cares enough to protest march over it. No one would tolerate it if it was a childrens ward.

if anyone really wants to see what its like to work on an elderly care ward. google militant medical nurse and check out her blog. Unfortunately she finally gave up working in the NHS and now works in the states,so doesnt post regularly anymore but its a real eye opener. specifically read about why patients aren't fed etc.

The language is a bit choice, but I assume that is from frustration, you have been warned...

Also for anyone who wants to see what the government is doing behind your backs to dismantle and privatise large areas of the NHS then 'The green benches' has a lot of information that is very interesting reading.

Absolutely out of touch and quite frankly he has no idea and neither do a lot of the public as proved by the silly "nurses station" comment.

Maybe that's during their unpaid break when there catching up on the reams of paperwork that it is a legal requirement to complete, because they haven't had a minute free.

Not only are the staff overworked, ridiculously stressed as they are physically incapable of fitting the work load in on current crappy job freeze induced staffy numbers and leaving most shifts in tears, without a drink or food or a pee but some people think theyre sat at the nurses station twiddling their thumbs?!

David Cameron wants to take himself ( and the managers) and follow a nurse on shift and see the realities of what goes on.

I am a midwife with a background in emergency medicine as a staff nurse.

Things were bad when I started in 02. They are gradually getting worse.

Our nhs is in serious trouble imo. Budget constraints, lack of staff and an increasing demand are crippling it.

Staff morale is horrendous atm, everyone is exhausted and demoralised. Talk of hospitals shutting, pay cuts, redundancies, lack of breaks, unpaid overtime and an unworkable workload but to name a few.

I see it from the other side too. I received substandard care as an acutely unwell surgical patient 7 years ago. I am concerned about giving birth in my local trust as I'm aware how busy we are

Our trust has been doing hourly rounds since August. We alternate it so a HCA asks one hour and then the nurse asks the next hour and so on.

I have been told I am stupid, incompetent, to go away and been sworn at by patients for asking the David Cameron questions.

One of my colleagues wrote to him inviting him to come and work a shift on our busy acute surgical ward, we are still waiting for a reply.

I love my job and don't regret my 3 years of training but sometimes going into work and filling in endless piles of paperwork makes me want to cry!

Seriously why would anyone bother studying nursing [3 year degree]?

For £14,000?

When a newly qualified tube train driver [16 weeks training] earns £30,000?

FFS.

David Cameron and his gang are beyond out of touch. why anyone voted for them is beyond me. did they all have amnesia? did they forget what conservative governments do? he is indeed a spam robot as caitlin moran says. spamamatronic

Lougle, had I had that conversation with a patient, I would certainly report it to the trained nurse.

Like Ghost, one day I hope to be a trained nurse, I am currently doing an access course and in the process of filling in my UCAS application for next year.

I'm sure it's just the way it's edited but the Midwifes on OBEM appear to do shag all other than chat, drink tea and eat biscuits most of the time

I'm surprised they haven't complained about being portrayed that way.....