To think NHS do gooders need to realise that the patient is not always right

[oggieogggie]

I've had a right few weeks of it. I'm an auxilliary nurse and my morning normally starts by taking breakfasts around the ward. Picture the scene if you will - a trolley full of cereal, bowls and milk and a pot of hot porridge.

I walk into room one = "would you like breakfast this morning?" patient (full mental capacity) says "well before all that I'd like you to fix my TV. I cant get the channel to turn over." I say "well I'll see to that after breakfast, would you like some cereal?" he says "not until my TV is fixed ... can't you just do it, it will only take a minute (so everyone else should wait until YOUR TV is functioning before they get their breakfast and you don't see that as selfish at all?) I don't say this - I remain professional.

Imagine a few more patients who decide that their TV/Slippers/Laptop chargers etc are more important and then the unfortunate patients who receive cold porridge as a result -

Next I take a tray of hot toast around = One patient demands "I want it buttering and cutting into thin strips." I explain that she will either have to press the buzzer for someone else to come and do it or wait until I have finished delivering toast before it gets cold. "But I want it NOW!" she demands. Ok, so it's fine that everyone else will receive cold toast? that's ok with you is it?

Imagine more of the same throughout the day

"I can't get my phone working!" = well I'm taking care of a rather ill patient at the moment, it will have to wait." "that's it!! I'm making a complaint!!"

"I want you to wash me." = "I will help you but you have to wash what you can yourself." = "why?? its what you get paid for!!!" no actually - I get paid to help people back to independence and to care for those who genuinely can't do it themselves ... " - "Ive had no sleep!! I want you to wash me! I can barely move I'm in so much pain!!" (well walking down the stairs for a fag 10 minutes ago must have been agony then eh?)

I'm sorry, but could it not be said that sometimes, just sometimes certain patients are not always right and that as staff members we should not live in fear of one of these people complaining that we're not jumping through hoops to keep them happy? And no I've never had a complaint against me - I do that nursey thing of taking the abuse and maintaining a smile. Just lately I can't quite shake the notion that the NHS (and Britain in general) is so bothered about political correctness and ultimate customer satisfaction that it's actually counter productive. Why are we all so polite??!

But how does that happen - how do 'truly awful' staff get recruited (via agency or otherwise)? No other 'industry' would tolerate it.

Staffing is obviously a big issue. But why would a woman who has just had a masectomy be sent home without any painkillers late in the evening, as they had none in stock?

Weighing up the pros and cons (I have to go soon) what we do receive is free healthcare, we get treatment and surgery and whatever we need generally, to make us better. As a system, it does work, in a basic way. However the thing that would make it work 10 times better would simply be to enhance the patient's experience of their service. Of course that can't happen without frontline staff having what they need to do the job to their best ability.

Surely that's where the resources need to be focussed - a massive frontline staff improvement programme, including getting rid of the less than adequate ones. Decent pay and conditions will encourage healthy competition and ensure only the best get the job.

A more holistic preventative health and care system will also save a lot of money and heartache.

I feel that I was expected to have know how to deal with my wound - it was left open (after having been opened in surgery an hour or so previously), no dressing on it, and a nurse vaguely waved her hand at me and said 'if white stuff comes out see your doctor'. I was off my head from the anaesthetic and had no idea what to do! One night in hospital and some advice would have saved them a lot of money and me a lot of real fear and pain.

I've no idea. When I queried what she was doing she told me that she worked full time in another hospital doing the same job. It was only later I discovered that the ward matron wouldn't have her back because of what she had done to me.

final point - in the 60's and 70's, I had really major surgeries and was kept in for days on end. Didn't like it then but never ever was a there a single infection, problem or re-admittance. It's so sad what's happening.

Yes MrsSippie, this isn't about money because some of what is happening actually costs more money.

My contribution - for what it's worth......

Nurses are given a really hard time by the public. There are some that aren't up to the job and should consider doing something else. For the most part though, nurses work hard and in difficult conditions. Most really do care. The press (the Telegraph and Mail in particular) seem to really have it in for nurses, which is a shame. I take the Telegraph every morning, so I'm not some sort of sandal wearing hippy

I despair when it's suggested that we should go back to the good old days of "matron" Today's nurses undertake all sorts of tasks which the nurses of yester-year would not have done. It's a very different proposiiton nowadays.

I do think that the move to an entirely degree educated workfoce might prove to be shortsighted. I'd like to see the training move back "in-house" with post-grad degrees introduced for specialisms. I probably wouldn't be adverse to seeing all midwives first train as nurses (though it's not a big deal I guess)

Most nurses do a great job. Keep up the good work! I'm married to a nurse and know how hard most of you work!

There are going to be changes, HCA are going to be able to train to be nurses in house.

I'm not sure how it's going to work, but if they don't do the degree they're going to miss out on a lot of knowledge that is the ground on which we build our nursing models, the foundations on how what when were why, A&P, prevention etc etc.

It's all well and good having basic care skills, but learning the knowledge in an academic environment is really important too IMO.

We learn a lot of indepth stuff which is why I always get frustrated when people say 'they're just nurses'.

I think that it would be a good idea if all people wanted to go into nursing, first did a year or so as a HCA. But then there's just not enough jobs for this and the turnover would be massive which isn't good for patients.

I was in hospital for two weeks after ds was born. I was put in a private room - I think so ds and I didn't traumatise the other mothers... Anyway, the staff would talk to me quite a bit and one student nurse came to do her work in with me.

All the doctors complained about the nurses, the nurses complained about the porters, and all the porters were really cheerful!

Nursey It's not an either/or things though. The first year of formal training should be as an HCA. Years two and three should then be a 60:40 mix of practical and theory - in an academic setting as you suggest.

It's currently 50/50 in all 3 years and I think that's the way it should be. Most of us in my cohort already had previous experience as HCAs, either because it got us wanting to be nurses or because it gave us a better chance of getting into university.

Hunt has already said he wants people to do a year as a HCA before applying for university, which I think is correct www.nursinginpractice.com/article/student-nurses-must-work-hcas-hunt-says

Good point mrssippie. The rate at which they discharge you is frightening. When I was in hospital the second time I was opposite a young lady with appendicitis. She was taken (sobbing as she was so petrified) for her operation in the afternoon and I was transferred to a different ward before she returned. The next day I popped down after lunch to see how she was, and she had already gone home less than 24 hours after her appendectomy.

I was told I would need to be in hospital for a minimum of 3 nights after my c section. I was actually discharged after around 40 hours- not even 2 full days- DD was born in the evening, I stayed one full day and was discharged on the second morning even though I could barely go to the toilet by myself!

Hunt has my support then.

Chronically I'm actually in favour of enhanced recovery regimes. The outcomes are (I'm told) generally better. I certainly wouldn't want to be in hospital for any longer than was necessary.

My wife was also discharged "early" having had an emergency c-section. The staff reasoned that they wouldn't do anything for her that I couldn't. I imagine it'd be different if you were on your own.

I think a middle ground sort of is needed though. I think in the 'olden days' you probably were kept in hospital too long, and probably contributed to my grandad's death in the 90s. However, 24 hours after an appendectomy, when you've probably only just been weaned off the morphine pump seems just too early to me.

With my c section, I was originally told I wasn't a candidate for early discharge due to my health conditions- some which were pre existing and some which came about as a result of pregnancy. But I was sent home early, I think due to me having baby blues, and was in agony during the car ride as I felt every little bump. I couldn't bath or shower at home because the shower is over the bath and I couldn't get in or out, even with support from my DH, I needed a walk in shower like at hospital. I hadn't even had my first postnatal poo (which again I struggled with as our toilet seat is lower than the ones in hospital). Oh, and my daughter wasn't feeding effectively and ticked several of the warning boxes on the assessment sheet in my red book. So really neither of us should have been let out so soon.

All you have as a patient is your bed. Your whole life is in that bed. So why wouldn't it be a priority to ask where it is?

Getting a patient settled into bed, clean, assessed and in possession of the knowledge about what might happen and when is part of the nursing process.

It is not basic care. It is fundamental care.

(((MrsDeVere)))

When you are the patient, help with "small" things is very important because you can't get them any other way. It's not like expecting people to bring you a glass of water instead of saving someone's life when you could just get it yourself or wait half an hour. It's that you just won't get the water, you can't get up, you can't do anything, and you will get so thirsty that after getting very uncomfortable you will get ill.

When I had babies I was quite shocked at how horribly you can be treated when you ask for things. I hated being treated as such a nuisance. it made me very ashamed as I am usually the one getting on with things and looking after myself and other people. It is humiliating to have all capacity to be doing things taken away, and then people being snotty to you for asking for things, when you would otherwise be completely ignored.

Silly

I don't know what to say to you other than that I am very sorry that happened to you and that not all MH staff are like him. Sadly that doesn't help you because nobody stood up for you. Please, in future, ensure you have all the details of your nearest patient advocacy service and contact them if you feel you are not getting the treatment you deserve.

I know it is hard to complain when you are tired and ill (especially with mental health problems because they do so much damage to your self esteem and volition) but please do so and don't be put off by this event. It may not be the same next time. There are some appalling Psychiatrists in the NHS and some very very good ones. I am sorry you got the former.

All these stories have got me thinking.

Without outing myself completely (I've already said too much )

Leadership is the key here.

I've gone from one extreme to the other. I've recently moved job. Gone from one service to another. My old manager was amazing. She turned the ward around from the previous manager, who was only really interested in securing a senior nurse manager post.

The great manager was highly skilled, dedicated to the ward, supportive of the staff, just really genuinely cared about delivering excellent care. She made huge changes to the way we worked. There were a few grumbles from old staff but she stood her ground and enforced the change. She worked as hard, if not harder, than the rest of the staff. She showed everyone what she expected of them. Ask her a question, she would have the answer, or if not straight away, she would find out within 5 minutes.

I really miss her. I always said, if I knew my family would be in her care, I'd be happy they were being looked after properly. The staff who couldn't hack the pace left. Thank god.

The only problem now is, although the standards are as high as they've ever been, management want the same standards while they continue cutting staff levels.

In my new job?

My manager is a nice enough person, but quite frankly, he's lazy. I've been stunned by the lack of direction. I'm lucky enough to know the basics from my old job, but because it's a different directorate, I need additional training. I've been there 8 weeks and still no training.
You ask him to do something for you i.e get important information, you have to hound him for weeks.
There was a meeting recently where he said he wanted the staff to start doing X,Y,Z with the patients. Nothing has materialized. He hasn't once made the staff do anything!

Every day I get angrier and angrier at this so called 'care'. The staff are frustrated. We can't implement anything without his say so, but we can never find him.

Poor leadership leads to poor care IME.

I don't know how much longer I can take before I walk tbh

My mother (wise woman) said many years ago that it took a special sort of bitch to be a nurse and I have found she wasn't wrong in 80% of the cases.

Both DSs had extended hospital stays when they were young and I have been in 3 times myself. Plus both my parents were in and out of hospital a lot before they both died. The arrogance and sheer cruelty of some nurses beggars belief. The way they speak to patients young and old when they think no one can hear is sometimes horrific.

I feel so sorry for the dedicated, compassionate 20% having to work with such dreadful people.

The treatment my son received when he was in scbu was an absolute disgrace. His charts were falsified because the staff couldn't be bothered to do their jobs meaning I took a very poorly baby home thinking he was getting better. He was supposed to have a normal feed and then a tube feed but through the night when I was tending to his twin sister the staff just gave him tube feeds to save them a job and wrote them up as normal bottle feeds. One of the other mothers who spent day and night on the ward told me that they did not give him one bottle feed through the night despite them writing and ensuring me he had. Basic care and attention was nowhere to be seen, I went down one night to find my son hysterical covered in vomit and choking and pulling out his tubes. I went to find a nurse and found six of them sitting round their nurses station tucking into cream cakes and heeing and hawing about their weekend escapades, when asked if someone could give me a hand, one flung her magazine down and stormed to my sons bed muttering under her breath, she couldn't even be bothered to change his sheets. She went to walk away without even looking at me or saying a word until I asked her if she would like to lie in her own vomit. Only then did she change it after drawing her eyes off me.

Overworked? Don't make me laugh.

I'm fairly apprehensive about ever having to go into hospital, given some of the stories I've read.

When DW was last in hospital, for about a week following planned CS, her mother stayed with her 24 hours a day for the whole week to help look after her and babies. (NHS gave DW a private room, for reasons I can't remember.) MIL slept on a mattress on the floor, the nurses supplied the mattress.

Given the liberal visiting policies of modern-day hospitals, I suppose if I went into hospital I could pay someone to stay and look after me in the way MIL did for DW? Has anyone heard of people doing this?