to hope that the report on mid Staffs hospital will shake up the NHS?

[grovel]

It was just awful and everyone from the then government through management to clinicians and nurses come out of it badly.

I don't for one moment think it reflects all (or even much) of the NHS but it does suggest a direction of travel which needs to be reversed - from caring service to self-obsessed bureaucracy.

[x2boys]

just read your post i like tea and completeley agree degree level ,diploma level traditional training makes not a jot of difference to how compasssionate somebody is i am saying this as a project 2000 trained nurse one of the first diploma level nurses.The same thing was said about us not enough time on the ward etc but if thats the only training available to you its hardley the nurses fault that they have to now have a degree to be a nurse you are either a compassionate person or not. I have recently moved from a dementia care ward where patients where looked after well mainly by the HCA,s as the nurses were to busy doing paperwork however as it was totally dementia emphasis was placed on getting people to eat persoanl care etc on abusy general ward with medical emergencies wether somebody has eaten can be overlooked

[bemybebe]

Being a foreigner I would love to know when people think this mythical time was when NHS was great and caring and wonderful and no managers in sight. In my vast NHS and private care experience, the care is only as good as the clinicians in direct charge of your case and the hospital management overall. Unless I am missing something obvious.

[whimsicalmess]

I watched the Stafford doc the other day, was horrendous obviously rotten from the top down.
Unfortunately I know it is an NHS problem, I recently gave birth, was left screaming , by the time they came I had given birth, only to have no examinations at all until my postnatal, very lax on giving out food , which especially when breastfeeding is not good.

[x2boys]

i think most nurses do care i certainly do as do the vast majority of my collegues, but there is a vast and i mean huge amount of paperwork to do mostly on acomputer. AS someone who went to school in the 80,s and is not paticularly computer literate this can take up huge parts of the working day if we dont do it properly our jobs could be on the line i personally would like to spend most of the day with my patients i currently work on a psychiatric intensive care unit so my patients certainly need me more than the paper work does but i have a mortgage to pay and am the main earner in our family so i need my job what can i do ?

[iliketea]

You don't need specific training to see that someone needs help with eating etc. But, as with everything thought of as "basic care" ; it is a time to assess what's going on with a patient - are they able to use cutlery? is there a problem with dentition or swallow? You need at least some training for that.

I love care of older people, but there I value my NMC registration too much to work in a hospital care of the elderly ward. The thought of having 8-12 high need patients to provide high quality nursing care for, with assistance of 1 HCA, leaves me terrified - because it is a physical impossibilty. Even something as simple as making sure everyone gets lunch would take 20-30 mins per patient for those who need assistance. If half need help, that's 90 mins of time to ensure everyone is fed and hydrated, by which time meals have gone cold (excluding any added time for other patient needs such as toileting). Add 30-40 mins per patient for personal care, 5-10 mins per patient for medication (x3 in a 12 hour shift) plus TPR and BP - 5 mins (x2 minimimum per 12 hr shift).
Then add all the other stuff - chasing up discharge plans / completing documentation / participate in DR round / referrals to other HCPs / medical emergencies which will happen / patients needing personal care during the day; there is just not enough staffing time with 1 nurse and 1 HCA to achieve that.

There are a minority of nurses who lack compassion, but the majority just try to give the best care possible. I read some of the stafford report and there were around 200 incident forms submitted that identified poor staffing - and the management team did nothing.

Also - I would like to clear something up - it is bollocks that the extra training to degree level has made nurses less compassionate - my two degrees have not made me have less compassion but they have made me more confident in challenging poor care because I have the knowledge and understanding of the rationale behind the care to support my arguments when I advocate for my patients, rather than just blindly following orders.

[ajandjjmum]

But edam, do you really need significant training to see that someone needs help with eating, or needs their water glass filling up?

[edam]

Sirzy - presumably your hospital also has enough staff to look after everyone. Many of the scandals are happening in hospitals where there simply aren't enough pairs of hands.* Or there is one nurse and a couple of unregistered unqualified healthcare assistants, who even if well-meaning don't have the training to recognise when someone needs help or to care for someone with dementia.

My sister's worked in an assessment unit which is on a different site to the acute hospital. She's had patients who deteroriate and need 999 ambulance to A&E - a nurse is supposed to go with them but she couldn't as she was the only registered nurse on site.

*Mid-Staffs was running woefully understaffed because the management were chasing Foundation Trust status and so determined to cut costs and never mind the impact on patients. The current NHS chief exec was in charge of the strategic health authority at the time, so responsible for ordering Mid-Staffs to cut costs.

[Eliza22]

Jeremy Hunt on bbc1 ten minutes ago, coming out with all the usual guff and ending with his hope that "this (scandalous situation)won't ever happen again". He, who was found to have swindled expenses in that other scandal not so long ago and had a lodger in one of his taxpayer paid for homes. How does this man, get to be in the position he's in?

He should be made to spend a fortnight in an NHS hospital. He wouldn't sit there smiling then !!

[Sirzy]

How do you measure someone sitting with you and holding your hand and helping you come to terms with your illness? Its not measurable. Therefore its not valued and it takes time. Time which we no longer have to give.

This is so true. The hospital my son goes to is fantastic and part of the reason for that is the staff do make the time for hand holding and to do the little things which help for patients.

I think part of the reason to do with that is the fact that every member of staff on the ward chips in and nobody appears to think they are "too qualified" to do the little jobs. I have seen a Senior sister changing a bed because it needed doing and she was free, the Matron once went down to pharmacy herself to pick up our drugs so we could go home rather than wait hours for pharmacy to send them up. Because everyone does their bit it means that the ward is generally a nice place to be and the staff really do seem to care for the people they are looking after.

[meddie]

Fakeplasticclobster thats appalling. My heart goes out to you and makes me ashamed to be part of the NHS, I cant even imagine the pain your family went through.

Its sad that that it should need legal action . I don't want to work with nurses with bad skills and bad attitudes towards patients, but there should be a way to get rid of them without resorting to legal action and its shameful that it is so difficult to do this in the first place.

When they announced last year a friends and family test I was cynical, it seemed like just another PR exercise to be seen to be doing something without actually investing in what was needed, which was safe staffing and resources. But now I welcome it.

But and this is a big but. they need to implement penalties for managers in charge of hospitals who are failing the friends and family test otherwise what will happen is wards will remain understaffed, patient care will be poor and complaints or failing of the test will result in nurses and frontline staff being beaten with it. Especially as Cameron seems to be latching on to performance related pay for nurses.

Nurses should NOT be rewarded for 'compassion' for gods sake, thats a basic part of your job and goes without saying. Who will decide which nurses will get their increments? how do you even measure 'compassion' will it be the yes wo/men or managers favourite, or god forbid will it be related to hospital performance?
because if you are doing the job , but have no control over the staffing or resources, well you could be the best nurse in the bloody world, but if there's only 2/3 of you for 25 patients, there's no way you can have everyone washed, cleaned, fed and comfortable, receiving treatment on time, monitored correctly, in a clean safe environment, its just not possible,
I have a horrible feeling that this report will be used to drive down pay in the NHS rather than what it should be doing and driving up standards.

[drizzlecake]

Hopefully there are lawyers champing at the bit to represent some of these people and get justice for them via the European courts or wherever they need to go.

How can hundreds of deaths go without anyone being prosecuted. Jeremy Hunt is calling for a police enquiry. Hopefully something will be done.

[edam]

Sadly nurses and doctors who DID try to complain, who did try to object and who did point out that things were going very badly wrong were bullied and harassed and driven out of their jobs. There are people in mid-Staffs who tried to blow the whistle. They were ignored, at best, more often threatened, bullied and browbeaten. The current chief exec of the NHS sneered at Julie Bailey and the patient protesters - there are meeting minutes proving this. It happens again and again - whistleblowers lose their jobs, are subject to vindictive made-up complaints, or go mad trying to raise the alarm.

Senior managers, including those at the regulators such as Monitor and the CQC, in the Dept of Health and the NHS Commissioning Board and at every sodding level of every sodding layer of bureaucracy this government and the last has dragged in, need to be held accountable for patient complaints and legal action. They - the people in charge - must be forced to pay attention to patients, not just the latest bureaucratic or political imperative.

If you are running an acute hospital, it is very little skin off your nose if short-staffing means a patient is killed or left permanently disabled. Even if their family sues and wins millions of pounds in compensation, it doesn't come out of your budget and does your career no harm. Reports into serious adverse incidents - the sort that should never happen - get put on a shelf. I was at a conference on patient safety where someone admitted they were the managed in a Primary Care Trust responsible for reading those reports, and that's what happens.

[bassetfeet]

Eliza22
Every post you have written echoes my own nursing life . And Meddie speaks for me also .
I am horrified at what has happened to these beloved and vulnerable people . And truly cannot understand how any human being.. never mind a nurse ..letting this utter cruelty occur .
I resigned at age 54 because I could no longer cope with the lack of staff and support . A nurse since 1973 . Seen lots of change in those years and am not a dinosaur of nursing who hated new ideas at all . Went with the flow and enjoyed the good inspiration .
One of my job loads [ha no patient contact again ] was to order our supplies from the catalogue. Absolutely ridiculous prices . I had to order new office chairs from this book........the price would make you faint . Give me a cab and I could have got them at Ikea for quarter of the price quoted and for sure they would have got through health and safety . Doesnt matter now as dept moved a year later and new stuff bought again . WTF?
So so sad for those who have suffered .

[FakePlasticLobsters]

Blackberry it's not about compensation culture. My friend lost four members of her family in that hospital, within the space of eighteen months, her baby daughter, her sister, her uncle and grandmother all died there.

You will have seen her daughter in the news, her photograph is everywhere. And my friend could have died herself after midwives at that hospital tried to inject her with something she is allergic to, something clearly written in her notes, plus she had an allergy wristband on to warn them.

Her daughter wasn't breathing when she was born and they discharged her while she was still blue in colour, telling my friend she was worried over nothing. They missed a problem with her heart and she died a few days later.

My friend and her family have not asked for a penny in compensation and have not been given one.

They want people to be held responsible for their actions or inactions, leading to those five deaths. They don't see this as some kind of get rich quick scheme, it's about justice for a newborn baby and a woman with cancer which went undiagnosed for months despite clear warning signs, and her other relatives who died when they might have lived and who she feels were neglected in their care. Her grandmother was dehydrated and hungry when she died, her uncle died when his bowel was pierced during an operation.

They are seeking justice for those who cannot fight for it themselves, not seeking a payout which will make it all go away. It won't ever go away. And they are fighting to make sure it doesn't happen again, to other families in your town or any other hospital in the country.

And I suspect the other hundreds of families whose relatives have died in that place are fighting for the exact same thing. They are certainly not part of the compensation culture as you call them.

My friend has been hounded by the media for weeks and has virtually gone into hiding to avoid being a 'poster child' for anything. She just wants the doctors and nurses responsible for those deaths and negligence to actually take responsibility for them.

[grovel]

Meddie, your posts are really helpful.

If I came onto your ward would I know who "owned" the ward from a nursing point of view? And would I know which doctor "owned" my treatment/care?

[Eliza22]

Meddie...very nice summary. I be walked away from people who wanted my attentions. I've also RUN from the ward at the end of my shift, thinking 'thank God, that's it, for today!' I cared about my patients but having only one pair of hands is the problem and that, was utterly soul destroying. I'm glad I 'retired' after nearly 3 decades in the job. I'd had about as much as I could stand.

[ajandjjmum]

Sorry Blackberry - misread. I don't think it's the responsibility of this group to provide the solutions though - but they've certainly highlighted the problems.

What you say meddie makes so much sense - I can't believe that anyone enters nursing thinking 'I really couldn't give a toss about the patients', but the culture drags many down to the base level.

I just hope that the Government will act effectively, and we'll start seeing the caring aspect take priority, rather than the target ticking.

[Blackberryinoperative]

I didn't say real situations. I said real solutions. I feel cure the nhs lacks them.

[meddie]

There are crap nurses like there are crap people in every job and I personally could not walk past a patient if they were in distress, I have absolutely no defence for that,

we dont know what staffing levels were like, we just know they were dangerously low and the majority of staff on the wards were untrained and not actually qualified nurses.

I can see there would come a point when you are constantly firefighting and you have to prioritise, when you become so burnt out, frustrated and demoralised that you give up caring, you become snappy or irritable and thats reflected in your attitude.When you just give up because those who are supposed to be managing and supporting you to perform your job turn their back and ignore your pleas.

Those who dont care, carry on not caring and the bad ones are not reprimanded, they become the prevailing culture.

There is so much wrong with the NHS due to constant reforms and trying to run it on a business model, which just doesnt work.
You can monitor the quality of sausages produced or how many you sell, unirformity in taste and texture etc.

How do you measure someone sitting with you and holding your hand and helping you come to terms with your illness? Its not measurable. Therefore its not valued and it takes time. Time which we no longer have to give.

[RedToothBrush]

Do I think it will shake up the NHS?

Not a chance sadly.

Instead, hospitals will continue to ignore problems if it suits them.

[Eliza22]

I agree about staffing levels. When I worked nights there was often me (staff nurse) and two auxiliaries. Sometimes, we'd "share" a pair of hands from another ward, though it was often an agency nurse who had little experience of that particular ward before and the fuss from the night duty matron when we had the audacity to say we 3, couldn't cope with 36 patients !! After every 12 hr shift I'd go home and KNOW I'd left so much undone or oly half done. It was a mess and not a one off mess either. It was every shift, every ward, ever day.

[ajandjjmum]

But that's the point Blackberry - things wouldn't have been improving if Julie Bailey et al hadn't made things happen. No-ones grief should be a catalyst for the destruction of the NHS, but to my mind, to use grief as a catalyst for improvement can only be a good thing - and that must be the ultimate aim of 'Cure the NHS'.

And in my opinion, to say that a report of this magnitude has been prepared that 'can't be backed up with real situations' is ridiculous.

[Springdiva]

But I get your point that nurses could have fought, which is why I was suggesting a few pages back that they go on strike, or at least get publicity for the problem by picketing outside hospitals, and surely medical staff would join them.

If staff had picketed a hospital for several weeks/months and then were accused of not caring (due to understaffing) then there would surely be more sympathy for them.

[Springdiva]

I don't think you have cared for an elderly person social climber - feeding an eldery confused and, probably, not very hungry elderly person can take best part of an hour. Then no doubt they will need the loo, so help to sit up, help into wheelchair (at a frail elderly person's pace) push to loo, help off chair onto loo, stay with them (if confused), wait til done (could be any lenght of time) .......... anyway you get my drift.

For a patient like that a ratio of one staff to 2 patients is prob what's needed..... and that's the personal care, if they need medical care too that's yet more time.

I can't see any way of coping with these patients unless family are allowed in to help.

[HoleyGhost]

If the required paperwork is excessive, why are the unions not addressing the problem? When I had my dd, every word said to me by a midwife was written down. The spent far more time writing down what they had said and done than they did speaking to me.

To what end?