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??!

[oggieogggie]

Also, I'd never leave someone without a bed pan. Even in the case of:

"I need a bed pan." 5 mins later "I don't think I do actually." - just as I'm walking out of the room "oh yes I do! bring it back." - a few seconds later "no, I can't go on this, I need you to take me to toilet." ... in the meantime "you nurse have been faffing in that room for nearly half an hour!! I asked for a cup of tea ages ago! it's disgusting!"

This is a situation of two auxilliaries on a ward of 33 patients so maybe my judgement is clouded.

[LaGuardia]

OP, do you work on a private ward? Those patients who pay are much more 'entitled'. We have housekeepers on our ward who give out the food so I am fairly lucky there. I agree with what you say about the smokers. It amazes me how many people maintain how very poorly they are but manage to nip out for a fag every hour. I love it when they miss the doctors' rounds, and the docs discharge them when they find out the patient is outside smoking. Love, love, love it. And if a patient is well enough to watch TV, they can bloody well go home and free up the bed for someone who is actually ill. It isn't the bloody Ritz. YANBU.

[cory]

I don't see why your awkward patients who ask unreasonable things have anything at all to do with NHS do-gooders who try to ensure that patients do not die from dehydration or wet themselves for lack of a bedpan.

Or is it really changing TV channels that the do-gooders worry about?

MIL believes that FIL's death was hastened by dehydration and malnutrition; the nurse used to just dump his jug on the table- FIL was deaf and blind and wouldn't have known it was there, let alone been able to reach it. MIL herself was being treated for cancer and couldn't sit with him all the time.

Are you saying do-gooders shouldn't worry about this situation because you have unreasonable patients who grumble about the TV channels?

hazelnutlatte is spot on: patients don't know who is supposed to do what.

[neverthebride]

This is what happens in any sector who are working with the 'general public'.

I'm a nurse but don't feel that people should be grateful for whatever they get on the NHS despite me knowing precisely what is going on 'behind the scenes' in terms of low staffing, lack of resources etc.

I have seen ridiculous complaints investigated. One particular sticks in my mind of a gentleman complaining his personal property was confiscated on an acute MH ward. His personal property being a knife which was returned to him on his discharge (because it WAS his property which had to be returned).

These complaints do take up time and resources but we HAVE to have a system where complaints are taken seriously and investigated.

I have sadly seen shockingly bad care and events at times which have led me to almost beg service users or carers to make official complaints and they have declined to do so.

Unfortunately in a very stretched service with limited resources (MH services particularly suffer) it is often only through complaints that senior management will take notice and effect change.

I see some posts on MN where people are talking about MH services 'refusing' to admit someone to hospital. I don't know the individual case that they're talking about so it may be that that individuals care team don't think admission is appropriate but I do know that sometimes there are literally NO mental health beds in the entire UK!.

I was seriously physically attacked by a service user last year who felt I was ' withholding' a hospital admission. I was not. That day there were no beds anywhere and that includes in private hospitals who will hold NHS patients at a cost for the local NHS trust of thousands of pounds a week.

The short-sightedness of hospital trusts closing NHS beds over the last 3 decades and building new hospitals with less beds but at enormous cost through PFI has led to this.

People complaining is the only possible way that things MIGHT change. If we have to waste time on 'non complaints' while doing so; so be it.

[lottiegarbanzo]

I don't quite understand. You don't have to think or act as if 'the customer is always right' in this role, you do have to be calm and polite while you get on with your job, as you are being.

Where has the idea in your mind, that 'the customer is right' applies in this situation, come from?

If your bosses have told you that this is the case and indulging people's whims while ignoring medical priorities is what you should do and what your performance is being measured against, then there is a problem.

If not and you and your bosses are clear on your job role and priorities, complaints won't be a problem, as silly ones will be dismissed for the nonsense they are.

So yes, people can be selfish and demanding, especially when they feel powerless and uncomfortable. Grin and bear it while getting on with job. Yes, it must get very wearing some days, for that, sympathy.

But railing against political correctness is meaningless nonsense in this situation. Political correctness in real life = acting with consideration and lack of prejudice = good manners. What you are complaining about but haven't made a case for, is the idea that the NHS management has made a decision to prioritise indulging patients' whims over treating them. I don't think I believe you.

[CrohnicallyChanging]

if a patient is well enough to watch TV, they can bloody well go home
How well do you need to be to watch TV though? It's certainly easier than reading a magazine, doing puzzles or chatting- all of those require you to do something, whereas with TV you can be passive and just lie there. It's boring in hospital, you need something to pass the time even if you don't remember anything about the programme you just watched. Watching TV is something I only really do when I'm not well and can't be bothered with any sort of interaction!

[ChestyNut]

Damned if you do, damned if you don't.

In my 15 years I've learnt what I can do will never be good enough until someone enforces adequate staffing levels.

[horsetowater]

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?

I think this is the nub of your post - why the NHS service culture has not moved on since the War and acknowledged that some people aren't needy gratefuls, they are greedy ungratefuls.

It's YOUR NHS. You, as a worker, need to sort this out, tell your bosses, tell whoever you need to to get this to change.

I recently sat in a renowned hospital while a surgeon spent hours to-ing and fro-ing between a child who had no consent from his parents to have the operation and the 'back office'. Why didn't they just say sorry - come back when you have signature and parental ID. No. They sat there chattering politely making jokes with his carers who thought they could swan in and over-ride all the protocol because of their 'exceptional circumstances'. It must have cost the taxpayer hundreds if not thousands of pounds and wasted a hospital bed.

If the NHS didn't waste so much money on health tourism and fraud perhaps you, dear nurse, would be a little more willing and able to butter someone's toast for them and fix their telly. I can't stand this pseudo martyrdom that the NHS feigns, when they are perfectly capable of changing things.

The amount of times I've had people say 'your dd isn't poorly enough, there are many more worse off than her' etc etc and use that as an excuse not to provide support. 'It's terrible, there just aren't the resources to go round'. Well make sure there are then but please don't turn round and tell me you won't help my child, whose care has been paid for by generations of her family paying national insurance for decades.

Grrrrrrr.

[justkeeponsmiling]

Hahaha, I'm a nurse, I know exactly what you mean.

I usually say to the really unreasonable patients something along the lines of "well I guess you won't be coming to this hotel again, will you?" (nicely and with a laugh - no need to be rude or nasty, even if they are!)

[expatinscotland]

A lot of people don't understand that a hospital is not a fucking hotel.

[AgaPanthers]

It can be. If you are willing to pay.

[Binkyridesagain]

Understaffing is the reason why I spend my days at the hospital when DD is relapsing. When relapsing she is often immobile from the neck down, so unable to do most things for herself. The ward staff are often too busy to help and in some cases they couldn't give a shit. If I am not there to help then her only choice is to lie flat on her back looking up at a ceiling until someone can spare the time to help her.

[SaskiaRembrandtWasFramed]

YANBU - I'm astonished by how rude and entitled some people are. I think worst example I saw was the time I was in A&E with DS, everyone got bumped back because of a major road accident, yet a woman with a broken finger made a complaint because she wasn't considered a priority.

[MexicanSpringtime]

You sound overworked. It is the nature of things that some people are bad patients, but they still need loving care and attention, unfortunately there are just not enough nurses, etc. to go round.

[HotDogHotDogHotDiggityDog]

You see OP, you will never get your point across on MN. There will always be posters justifying bad behaviour of service users, even when they know nothing about that patient, because, you know, they've seen evidence of poor care so the patient must have too.

Didn't you know the TV is your fault? If you report it or fix it yourself, your doing a good job.

You should cut up that piece of toast, because, you know, someones relative didn't have their toast cut up. Even if the patient you're referring to was doing a crossword 5 minutes ago, her hands must be too painful to cut it up herself.

Do you know, that you, yes you can change the whole culture of the NHS all by yourself if you just tell your ward manager?

Why didn't anyone think of that before?



I know exactly what you're talking about OP, but this thread will not end well for you, because you must be doing something wrong in some peoples eyes.

[horsetowater]

I still think the NHS can do a lot lot better at saving resources. There could be a lot better preventative healthcare for instance, more therapies. Mental healthcare is abysmal and crises could easily be prevented by better more timely care.

And all the faff about A&E. Give people a GP then, if they need help they need help, they can't wait for two weeks while the GPs shuffle their waiting lists to meet targets.

And please don't fill childrens wards with TVs (and no headphones) so nobody gets any rest. And why bother with TVs at all? We're not all going to suffer some kind of brain failure if we don't have a screen in front of us.

[Cookiepants]

OP there are awkward buggers in every walk of life, and they don't get any less awkward because they are ill (probs more).

It's not very politically correct to say but I think being ill gives everybody the mindset of a 5 year old and nurse is "mummy". They are tired, hungry in pain and frightened and that tv/phone/toast IS THE MOST IMPORTANT THING IN THE WORLD. They aren't aware of the other patients needs / your workload and so don't consider it.

All you can do is apologise for how busy you are and say you will be back as soon as you can.

As for meal times our ward has a 40 min meal service (no ward hostess), you have to pass out, help feed and collect in at this time. If there is one of you and you have 4 -6 people to feed - someone's getting cold porridge aren't they?

On another note people who ask for cups of tea / extra blankets/ a breakdown of auntie Mabel's day during another patients CPR (true story and not just the once). I'm afraid they can sod right off and the complaint they put in against me for (politely) telling them so was thrown out.

[Nennypops]

YABU to suggest that this is anything to do with "political correctness". What is political about any of this?

[ICanSeeTheSun]

I am only a hospital cleaner < hides we always gets the blame>

I see stressed out nurses and NA who try their best but juggling everything they need to do, people do have to wait.

[DebbieOfMaddox]

I suspect that part of the problem is that (at least in our local hospitals) patients are charged to have TV facilities -- £3 a day at ours. And if they are paying for a service they expect to get it, and it's not at all clear who they ought to be asking in order to get it fixed. Pretty much any time you see anyone official on a hospital ward they are in the middle of doing another job, so if there's a fault with your TV then in order to get the service that you are paying for you need to interrupt someone who's doing something that is, in the grand scheme of things, more important than your television service. If there were no televisions or we went back to the days of free TV then patients wouldn't care as much.

"if a patient is well enough to watch TV, they can bloody well go home" -- being able to open your eyes and point your head in a particular direction is a pretty low bar, but it's encouraging to hear that the awesome power of television can apparently heal wounds, clear up infections, perform diagnostic tests and monitor O2 sats, among a host of other things. The last relative of mine who was watching TV in hospital was suffering from terminal multiple organ failure, but it's interesting to hear that he was actually well enough to go home. Perhaps someone should have told them that before they cremated him?

[RedToothBrush]

So because you get patients not knowing or understanding why something isn't possible then and there (bearing in mind at home they would be able to just do something so being dependent on someone else can be a shock and they don't necessarily know the correct channel to get the assistance they require), you think they are just arseholes?

By mentioning 'NHS dogooders' you are very much suggesting that people who complain or are fighting to improve services don't have good reason to and the culture should be to ignore patient requests as they are simply too demanding or rude.

That attitude is not constructive in encouraging legitimate and important complaints. In fact it encourages a put up, shut up and be grateful for what you get culture. Its not healthy and this is what people are fighting to change because legitimate complaints have been found to be systematically ignored.

Nor are you employing even the slightly ounce of empathy at why patients may be frustrated or whether there may be something more to why they are asking for certain things which you should do before you go round bitching about patients on a public forum.

I very seriously question, if you are in the right job, if you can not cope with these requests and can not appreciate that your comparison between patients who may be rude has nothing whatsoever to do with people who are trying to improve the service and ensure that basic levels of care, respect and dignity are being met.

You MAY have a case to say that some patients are being over demanding, but the problem is you loose your argument by also throwing the 'NHS dogooders' comment into your debate, as its is belittling to those who should complain.

[JerseySpud]

Patients don't have to be private to be like this.

I remember 10 years ago when i was an auxillary i was helping a lady to the toilet and a man came to the door demanding that i fix the phone for him at his bed. I politly told him i would be there as soon as i had assisted this lady to be told 'I fought in the way for people like you and you don't even want to help me now do you?' and stood and watched and glared at me the whole time i was assisting another patient. When you have worked on a ward with 4 auxillaries to 3 staff nurses in a 36 bedded ward dealing with mainly elderly you understand.

[DebbieOfMaddox]

And you are told to "ask a nurse" about TV services. Obviously when management introduced this policy they increased nursing staffing levels accordingly, because... no, sorry, I can't keep a straight face and deliver that line.

You have a patient body who are increasingly being charged for "extras" to raise cash, and a management structure that's decided that nursing staff have nothing better to do than to administer those schemes. And you, stuck in the middle. Which is shit, but not entirely the fault of the patients.