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.

[HoleyGhost]

Most professionals in all sectors do a lot of unpaid overtime.

I don't understand why it is so difficult to accomodate nurses with small children. The US example above is just one of the ways it could be done. Obviously, some flexible/bank staff would be needed to cover.

Anything which improves morale and gives staff a sense of responsibility and pride in their area would be a good thing. Enabling continuity of care would do that.

[meddie]

You can have flexibility. There is self rostering systems around whereby you work 13 x 12hour shifts over a 4 week period, 8 days and 5 nights. This allows some flexibility. But it still is never a guarantee you will get the shifts you request and thats where it can causes issues with childcare.
We have staff who work part time or just 1 night a week etc to fit around children, But our area is highly specialised so our manager is more accomodating, as she cannot afford to lose skilled nurses after Mat leave.It costs to much to replace and train them up.

[GeorginaWorsley]

Unless you have family help it is very hard to nurse and have children.
I used to work every weekend so that DH could have them,but that is not ideal from many angles.
I am lucky in now I just work one 12 hr shift a week,usually mon to friday,I was accomodated due to experience.
Nothing would induce me to increase my hours.IMO ward work is a youngsters game,at 45 I just find it so tiring,I walk off the ward like a 90 year old some shifts.
To be on your feet for 12 plus hours without a break is dangerous,imo.
Most drug errors in our trust are made towards the end of a 12 hour shift.
So called 'set' days are rarely allowed so booking nursery places or childminders hard if not impossible.
Add in the Christmas's worked,breaks missed,family occasions missed due to off duty,and I wonder why people go into nursing nowadays.
Especially as some,as in Mid Stffs,don't want to 'nurse'

[HurtyGertie]

I do not see how Stafford hospital will improve at all as they have closed all but one ward now at the nearby Cannock hospital which used to take orthopaedics, elderly patient care etc. I just think it's mad.

[maleview70]

As soon as targets introduced chaos was inevitable.

Based on that I blame the government that first introduced targets

Managers paid bonuses based on targets will do whatever is neccesary to earn the bonus. It's human nature. The banks have seen it and now we are seeing it in schools and hospitals.

Politicians have a lot to answer for in this country. It's no wonder most young people don't vote. I bet if a popular celebrity put themselves up as an mp next election, the young vote would double but only I you could vote by text message. Maybe Simon cowell should be brought in to arrange it.....MP factor.....and in the constituency of Romford we have boring old right wing ex public school boy, equally boring young Blair wannabee and representing the young we have stacy Solomon. It would be a landslide.

Most nurses do a good job. They are just managed by a bunch of fucking idiots.

[stoatie]

Meddie sums it up perfectly.

"But I fear that what will happen is someone in an office somewhere will develop a set of forms and tick boxes to 'measure' good care, this will then become the responsibility of the ward nurses to fill in,
they will then employ a data collection person to collect this data and bully the nursing staff into making this their priority OR ELSE!!
They will then have to employ a few people to audit the figures then someone else to report and monitor the results.

poor results, because wards are understaffed and you are heaping more work on the nurses and leaving them less time to carry out patient care will be met with, nice new chairs in the patient waiting areas and emails about 'striving for excellence' from someone who has been employed as 'the patient experience co ordinator'.

They will then go on to produce their own set of forms to fill out to guarantee patient experience which will involve ticking a box to say you greeted every patient on arrival and offered them a cup of tea (because it will look good on their CV that they were trying to do something)
meanwhile staff will be sent on improving your customer experience courses and made to fill out 20 page reflective diaries on 'good customer care'
Am I cynical .... yes. I,ve worked too long in the NHS to expect reasonable common sense solutions."

Several people have said "bring back matrons". Matrons were re-introduced years ago. There are several well meaning Matrons and Nurse specialists who regularly audit stuff (tissue viability yesterday) - and i happily showed her the new tick box that had been introduced into our assessment tool (yay I had completed it).

Problem is everyone seems to think the solution is another form/tick box or sticker - the standing joke is they will introduce a sticker saying "nurse/midwife nipped off to the toilet" - however that sticker will not be used [grim] - reality is we are overworked (I did 4 night shifts last week - supposedly 2000-0800, not once did I leave on time and on 2 nights I (and rest of staff) had no break at all - not even 5 minutes.

Sadly when we complain to matron about staffing we are invariably rebuked over somthing we haven't done (because not enough time) rather than Matron rolling her sleeves up (well obv she has no sleeves - remember "nothing below elbow") and actually offering to help on the ward etc.

Sorry for mammoth post and cynicism but after over 25 years in the NHS........

[ZolaBuddleia]

A relative of mine was in ICU in Stafford hospital. When she was no longer so gravely ill, the nurses colluded with her relatives in presenting her as healthier than she was in order to get her discharged directly into family care at home, They were so sure that staying in the hospital and moving onto another ward would likely cause a potentially fatal relapse.

[grovel]

ZolaBuddleia, how terrifying is that!

[ZolaBuddleia]

Yes, awful. There was a good outcome in the end, and luckily my relative had close family who could have her live with them and care for her constantly for weeks. Speaks volumes about the culture though, doesn't it, that nurses felt they couldn't trust other parts of their own institution?

[GeorginaWorsley]

Stoatie I share your 25 plus years and your views completely!

[Eliza22]

hurtyGirtie. It's an impossible logic isn't it? Staff/bed/equipment/resource shortages..... "Let's put more pressure on..... Lets close a few hospitals". Madness

Also, bottom line, were all bloody living too long in an incapacitated and "requiring greater care" sense.

[sarahtigh]

NO brief for David Cameron etc, but no Governement at all in past 20years I have worked with NHS has really sorted the basic problems in fact in many areas have got worse, in some areas big improvements like waiting times but there is a huge amount of politics done there to meet targets including cancelling urgent (not emergency operations to get patients seen that are on 17 weeks, people being made to wait 17 weeks even if space in 12 weeks so money not used up to fast

when DD was born had EC at 8.30am ( maternity theatres did not open till 9am) so was done in main theatre, I heard theatre manager complaining about IT not waiting until 9 as now his theatre list would be late all day, it did not upset me as I knew set up but I guess lots of mothers would have been upset to hear that their EC was a source of irritation as it would mean they missed targets etc

I work as a NHS dentist in own practice we carefully budget make sure gloves etc are from cheapest supplier at the time ( just like supermarkets the same brand is on offer cheaper at different places at different times so this moth company x is selling gloves at £4 a box next moth company Y will sell same gloves at a discount when you buy thousands and thousands it matter even in 1 small dental practice this saves over £4000 a year imagine that multiplied up but no they just buy from same person all the time that has special price for bulk buying ( I just could not believe that this super duper deal for whole NHS was about 33% more than we would pay even without special offers and so it goes on and on

so much money is wasted in admin, red tape etc if red tape was cut and 3 people doing same thing in triplicate 10-15% reduction could be made without affecting patient care but will all know it will not happen as it is the admin staff that are so wasteful that decide were to cut and it is just never ever their own budget or staff, the whole NHS is just so so badly run

[WhenLifeGivesYouLemons]

We should have a fixed national number for a safe ratio between poorly adult and nurses- for far too long i've been looking after far too many patients only to be told that this is the safe number of staff that a bunch of people in an office deem to be safe...people that have probably never worked on the front line at all!

And sarahtigh is right. I've never known any other profession spend so much time and money on paperwork. The saying is in nursing 'If it isn't recorded then it isn't done'- to the point that records have to be dublicated. And after doing 12 hour shifts without a break people then wonder why 'boxes aren't ticked' correctly :s

The sad thing is that a lot of people are looking at the Staf report and assuming that all the staff don't care when in reality a lot of them will be overworked, underpaid and blamed when 'paperwork' isn't don't correctly when patient contact should be a main priority. It's physically and mentally draining.

[alcibiades]

I worked in our local DGH for about ten years as a secretary, mostly as a temp. During that time, the "systems" took over, and it was depressing to see how much control went from the practitioners to management. I worked for nine months for one of the nicest and most dedicated surgeons, and at the start of that placement, if a GP phoned up with a concern about a patient, that surgeon would take the call, and, if he thought it necessary, he'd ask me to book that patient into his clinic as an "urgent", even if that meant a double booking. But in the short time I was working for him, the system went from consultants being able to make those kinds of clinical judgements to it all having to be done via the computer system. Choose and Book might be useful in some cases, but it became the only way, and in the end that consultant was powerless and all he could advise those GPs who phoned with concerns was to send the patient to A&E.

sarahtigh - In another department I worked in for quite a while, the admin secretary was brilliant at ordering in stocks. Like your practice, and also like many other admin secretaries, she did her research, and prided herself on keeping within her budget. Then it went to one permitted supplier only. One year, the Trust was facing a possible deficit as the year end approached, so all admin orders were suspended for the last couple of months. Secretaries who ran out of paper to print clinic letters had to spend time going to other departments and beg for paper, with notes being taken of who had borrowed what from whom, in order to return those borrowed stocks once stationery orders were once again permitted. As the one permitted supplier was then inundated with orders once the embargo had been lifted, they had to ration the supplies initially. Overall, there was probably about four months of upheaval, and goodness knows how many woman-hours were wasted going around and begging for paper. But, hey, the Trust achieved its budget target at the end of that financial year, and that's all that mattered.

[Eliza22]

If it isn't recorded, it didn't happen. In principle, recording what we "do" to the patient is essential. Problem is, so much time was spent writing care plans (in my nursing heyday) and filling in charts, that implementing the actual plan was nigh impossible. And filling in charts relating to fluid intake/output or pressure relief or nutritional charts? If the staff didn't complete this and questions were then asked.... The chart would be completed post shift. Madness.

[girliefriend]

Hello I am tired so not read all the thread but was talking to colleagues about this today. I am a community nurse and have worked on the wards, now have nearly 10yrs nhs experience.

I have never yet met a nurse who didn't care about their patients. However when I worked on the wards it was usual to have one nurse to 12 patients - all of whom were high need. It is an impossibility to do a good job, you fail before you start because you can't be in 12 places at once.

Its the old saying of too many chiefs and not enough indians and that sadly has always been the case in the nhs and if anything that is getting worse

[amothersplaceisinthewrong]

Bring back the State Enroled Nurse.... in large numbers, so that the elderly can be fed, changed, hydrated and treated with dignity.

[Eliza22]

But, isn't that kind of what they have now amothersplace?

When my dad was in hospital he rarely saw the qualified nurse. She admitted him and her name was given as his prime carer but it was the nursing aids who cared for him and took his observations etc. In a practical sense, the qualified (with a degree) nurse did NO hands on care whatsoever. She "supervised" a team of what were, in my day, auxiliaries.

My dad died in Wales. He had lung cancer with spread and he knew he was dying. He'd gone in to hospital to have his lung drained of fluid. He'd (over the years) had 2 lots of separate by-pass surgeries (the last one privately as the NHS told him, there was nothing else could be done, he lived for a further 14 years) and kept himself fairly fit.

The last time I saw him, he was sat on his hospital bed concerned that the nurse wouldn't give him his medication at night. He said he never saw anyone and he didn't like to 'buzz' cause they were so busy! There didn't seem to be any continuity and the nurses barely knew their patients. They phoned my mum at 0610 the next morning and told her to come in as his condition had "worsened" When she got there at 0650, he was dead. Now, he was not only dead but he was stone cold. They had attempted to resuscitate him (a man of 74 with a total of 12 by pass grafts and lung cancer with metastases). I was still working as a nursing sister then and I was livid. I think what actually happened was this.... The nurses found him unconscious or newly deceased. They didn't "know" him and put out a crash call for resuscitation on a man who had final stage cancer and a buggered heart. They, as a later report said, "worked extensively on him" but he could not be resuscitated. No one, I think, had checked on him on the night shift and it turns out, he was trying to get to the toilet and fell. It was later found that his medication HAD been omitted as he was asleep by the time the qualified nurse did her drug round.

I can only imagine his fearfulness and no one being there for him.

I supported my mum in her trying to find out exactly how he'd died though i knew, shed get no where. It wasn't pleasant reading and after 2 years and a lot of meetings and some condescending "he was a very SICK man, Mrs S) (yes we bloody KNOW!! - so why was he not checked and why didn't he get his heart tabs and whose good idea was it to go through the physically traumatic resus procedure?) there was an apology.

I have no idea how they can fix the NHS but it should start maybe with Mr Nicholson going. I bet he doesn't use the NHS.

[Blackberryinoperative]

Stafford hospital saved my life, my baby daughters life, is not half as bad as some other hospitals and employs hundreds of people in my home town. If Julie bailey has her way, it will close, and the next time she or one of her family needs a hospital it will be twenty miles away.

Nowhere have I seen practical, constructive advice or measures suggested by cure the nhs, only bitter calls for resignations. Yes, those at the top need to be held accountable, but to "cure the nhs" we need to start from the ground up. I fail to see how doggedly requesting apologies and costly investigations will trigger basic care improvements. Stafford has vastly improved in the last four years anyway. Cure the nhs has given the dog a bad name and now Stafford will fail to recover - as a result the people of Stafford will lose their hospital. Thanks Julie bailey. And I wouldn't eat in her cafe, I think she needs some health and safety advice there.

[ajandjjmum]

Maybe if Julie Bailey hadn't fought as she has, Stafford would not have improved sufficiently to save yours and your DD's lives Blackberry.

Having read the experiences she had with her mother, and having experienced some of the NHS 'care' with my own family, I am full of admiration for her and the other relatives who wouldn't let their concerns die along with those they loved.

There are some excellent NHS staff, but I have come across far too many nurses who are clearly there just for their wages, and don't give a monkeys about their patients. Hopefully this will start to change.

I don't think her cafe has had the focus of her attention of late - I think she's been working on more important things. Nasty comment Blackberry!

[SocialClimber]

"I've never known any other profession spend so much time and money on paperwork. The saying is in nursing 'If it isn't recorded then it isn't done'- to the point that records have to be dublicated. And after doing 12 hour shifts without a break people then wonder why 'boxes aren't ticked' correctly :s

The sad thing is that a lot of people are looking at the Staf report and assuming that all the staff don't care when in reality a lot of them will be overworked, underpaid and blamed when 'paperwork' isn't don't correctly when patient contact should be a main priority. It's physically and mentally draining."

I am starting to lose sympathy with the excuses. As I said earlier in the thread, this is how it is in SO many professions, especially the big companies. What you said above is exactly what happens in my industry. We all complain that the people at the top care more about paperwork than they do about getting the job done. Nobody lets their job slip, or doesn't complete an essential peice of work just because pressure is on and paperwork is endless.

Those nurses walked on by when they should have stood up and fought. Not because they were too busy, but because not enough of them cared. And I am not tarring all nurses with the same brush here, many are excellent at their jobs and feel frustrated at the system. But for every nurse that complains about lack of care, there are others who couldn't give a monkeys. Those people should be held accountable. You don't "walk on by" if you care, no matter how busy you are.

[Blackberryinoperative]

She is the poster girl for compenstation culture and she will ensure our town loses its hospital. It's not going on in your backyard so it's easy to look on her as a saint. As far as I can tell she can't back it up with real solutions.

And another thing, clinically trained medical staff are not carers for elderly lonely confused people. They are there for medical purposes and to treat medical conditions. They are simply not equipped for the ever expanding generation of elderly and infirm people whose problems cannot be solved with a drip, some medication and a well qualified consultant. we need a return to focused geriatric wards, like Cannock hospital had. Which is now closing. Thanks again cure the nhs. Draining the health service of money, now we are seeing Cannock hospital closing and more pressure will be on Stafford which is already oversubscribed.

And yes, I've had an elderly relative die at Stafford. There had to be an inquest and apology. But I accept that things are improving and I will not allow my grief to be a catalyst for the destruction of my local nhs services. There is very strong feelings around here about cure the nhs and I would say only 50% are supportive.

[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?

[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.

[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.