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??!

That's very worrying GirlsTimesThree. What does the future hold for the NHS.

Fight for funding for the NHS... Oppose Cameron and don't believe what you read in the papers, it's govt propaganda to hide the real problem which is funding, denigration of the nhs so it can be privatised.

Exactly Brakeover. Privatisation by stealth. If they can make it look like the NHS can't cope anymore they'll have public support to privatise. It's already happening, but is mostly going on under the radar..

Kudzu - people have a right to ask for anything they want. If it's unreasonable then you have to explain that to them - that's part of your job, it's immature to get angry with people for asking you a question. Remember they know nothing about your job AT ALL, to them you are a 'helper' in the widest sense of the word. They don't know X won't get his porridge if you stop to butter some toast.

Brake -We need to put some public information notices up about what is and isn't available and who everybody is etc. - yes. Also, it wasn't a visitor that asked for the TV to be fixed, and so what if it was, it's a reasonable question. If they are rude then that's another matter but if their question is met with impatience and irritation by the nurse then that's just as bad. Relative should be encouraged to help, as should volunteers but there's not a lot they can actually do without messing up the system and getting in the way, that was discussed upthread.

Girltimesthree - I'm glad that consultants are thinking of leaving because they actually have some power. They should have been voting with their feet before the nurses. They have so far sat back and let the frontline staff deal with the flak of the underresourcing for years when they already had the power to influence staffing, as you say? They have done nothing to make the situation better for years and taken their enormous salaries while frontline staff suffer on the basics. If they didn't take quite so much there would probably be more to go round to the nurses. Correct me if I'm wrong, this is how I see it as an outsider reading the figures.

Olympic - I think entitled behaviour is an interesting phenomenon. But people are scared, there have been so many terrible things happening, it's far worse than it ever was, and when some people get scared and feel helpless they just get nasty. It's human nature and the way to deal with that is to make them feel reassured and empowered - but I realise that's almost impossible in today's climate.

I have never got angry at a patient or client asking for something. As for the right to ask for anything they want, it is HOW they ask for it. My colleagues have the right to work unmolested, free from verbal and physical abuse and unless a client or patient is disinhibited due to organic or psychological factors, it is unacceptable. Four ambulance staff attacks a day are reported in a bordering trust. Do you really think emergency staff 'ask' for this?

Here I am not at work. Mumsnet is not a healthcare environment and I am perfectly entitled to express my opinions about people who think we should repair TVs. It is perfectly reasonable for those of us who know what the reality of NHS employment is (in addition to our own experiences of being patients) to express our feelings about it and for you to understand that what we say here doesn't transfer to how we treat our patients. Being able to ventilate means we can continue to provide a good, respectful service.

If I attend a parents evening am I being reasonable in asking a teacher to sew a button back on my skirt if they are a crafts teacher? Or ask a geography teacher about the best way to drive to York?

Or knock on the door of the SENCO and ask her if she could come toilet my child?

These are all the equivalents of what you seem to think Nurses should have to do 'because it doesn't take long'.

I am perfectly aware of what my responsibilities are and how I should discuss the boundaries of my capabilities with my clients. I am not a jobs worth- I fixed a clients washing machine, rounded up semi feral cats (among other odd tasks) but these are NOT part of my job and clients should NOT expect them.

Some members of the public actually don't care about who performs their task as long as it is done NOW. They don't care about the other patients (including C/O not getting the right type of jam when another patient is haemorrhaging all over the floor with six staff fighting to control this) - they don't give a damn about anybody else and these types of patient behaviour are sadly more common.

And just to add - even when you explain politely and reasonably to a patient that they need to use certain channels to repair TVs and that we have reported it for them- some of them don't actually give a shit about this. They ignore this and continue to blame you. They don't want to hear it because they want it NOW.

Yes horse you are wrong. No one has sat back and done nothing, but it's naive to believe that consultants have any more power than anyone else in this. They are on the frontline too! He doesn't see himself as separate from the nurses and other support staff, they are a team. He just happens to have taken on yet another extra level of responsibility (all unpaid, just so you don't make another assumption) which means he's in a position where he should have some clout, but it's not so. No one listens - budgets are being cut across the board and it seems that if that affects patient safety then so be it.
Everyone is in the same boat, it's not about them and us - we should all, public/patients and all staff be saying it's not good enough.
He does get a decent salary (although much lower than he was getting 2008. That's a statement of fact, not a whinge), but I don't believe that's the reason there's no money in the pot. The waste of money in the NHS is truly shocking, but it's on inefficiencies, constant restructuring/rebranding etc. rather than salaries. You need to apportion the blame where it really lies which is at a much higher level than anyone working with patients.
Sorry, this off topic.

If someone asks me to fix the TV, I obviously say I'll report it (as that's what we have to do) but it's generally last on my list of priorities. After medicines, collecting from theatre and post OP care or getting discharges sorted. Or, I'll try and fix it if you like, but then don't complain that your medicines are late.

I remember once a teenager buzzing to ask me to change the TV channel (portable TV). There were five relatives in the room with him.

Just a question, what is supposed to happen to people in hospital for a while who have no clean clothes? I was in hospital for a week and there was an elderly lady next to me who seemed to have dementia. She had no visitors at all the whole week. The only clothes she had is what she had when she came in - 1 dress. And I think she had already been in at least a week.

She was agitated most of the time as she wanted to get dressed, but the nurses kept telling her she couldn't, as her dress was dirty.

I am not blaming anyone, but she would have been much more settled and less work, if she had had her dress washed and being able to get dressed, instead of wearing a hospital gown.

And I wondered if it was someones job somewhere to deal with this kind of situation?

Also I don't understand those who want patients to learn whose job it is to do something. I think this is unrealistic. I don't have to learn whose job it is to do things when i get my car repaired. I talk to the mechanic who comes out and say what the issue is. I know there will be people there of differing levels of experience and responsibilities, it is not my job to know who is being trained and so will only do simple repairs, who is trained to do MOT's etc.

Grennie, no if there's no relative to bring in clean clothes then a patient would just be put in a hospital gown. Laundry is just for bed sheets and I think that is sub contracted out and off site now. We often get sheets with a different hospital trust come back to us.

I agree that I don't think you can expect patients to know who does what role. Someone came out a room and asked me for a knife the other day. Its not my job, I'm office based now but I went and found a knife. If I hadn't had time I'd have found a HCSW and asked them to get her one.

And if for example I'm on a ward I don't work and I'm mistaken for a nurse (I'm a midwife) and someone asks me something. I wouldn't just say that I don't work on this ward (though I would say that to explain why I can't help) but I'd also tell them I'd find someone who can help and go and get someone/tell someone/

Consultants are frontline staff

You wouldn't ask the garage to tune your radio during an MOT would you, or demand that the lady in the office booking in the MOT come out and open your bonnet for you? No, you let them get on with their own pattern of work as they must without making excessive demand ( that obviously they would refuse to do and you would accept that refusal)
The nhs has become something which is generating more and more expectation and partly the press is to blame . If the future is as this thread perhaps private IS the way forward.. Too much of something for nothing can make some people grossly ungrateful and wanting ever more free bies. People don't know how lucky they are, free treatment even for self inflicted illness such as alcoholism smoking etc,because hcp and nhs is altruistic ...free food, free ambulances . You will miss it when it's gone. And soon it will be gone. Just respect the work doctors and nurses do without much remuneration and without much control of their workplace staffing levels etc. There is already a huge exodus of doctors to Australia and NZ for better work conditions and few want to work in hospitals anymore compared to GP because of the intensity of work ...so when we need surgery and need emergency treatment in ten years time God help us.

Brakeover, my instinct (having no other first-hand NHS insight) is to believe you. Must be pretty frustrating. If the general public that I encounter is any reflection of the public you're serving, it must be pretty bleak at times.

Grennie we used to have washing machine in the sluice which was ideal but infection control took it away.

Occasionally staff will actually wash a patient's clothing themselves at home (sister tends to do this) but otherwise it's hospital gowns I'm afraid if they have no family. It bothers us all. :(

As for COPD and smoking - I didn't say they all used to smoke, but I know from what the patients say that the vast majority did and it is the main cause of COPD.
Brittle Asthma can also lead to COPD.
But I would definitely say to people never smoke because I'm seeing so many health problems of which COPD is one of the most distressing caused by smoking.

Most people are lovely and if they are unwell can't help their behaviour we don't mind about that. The problem has come from the bias in the Press from papers such as the Daily Faill which really scare people.
We are kind , we care and we will go the extra mile we do so every day, but wehave to treat the sick over other issues that relatives might have( it's usually rellies not patients ime)

While we are on this thread, I got a complaint yesterday from a poor gentleman who has Parkinsons and has been assessed as needing a 'soft, mashable diet' and 'syrupy' fluids.

He was desperate for a digestive biscuit with his (syrupy) tea. He kept ringing the bell and complained to sister as well who explained to him why he could not have his biscuit - he can hardly speak but managed to say the word ''rubbish!''

It's such a shame and there was nothing we could do to cheer him up, he had to have his cuppa without a biscuit, then his puree meal and soft sloppy custard for supper.

There's no answer to that kind of thing but I think my heart just broke a little bit more last night with him, and the COPD gentleman who couldn't breathe, and the young woman who has lost the movement to her left side but never complains (I would!!), and the dying lady with her last ever mother's day cards.

I think I'm too soft for nursing sometimes but so are most of my colleagues tbh we all get too close to the patients. This job makes you realise that you are lucky when you are healthy and to try and enjoy the time you have with your family.

Latara - Yes it bothered me. I do think there should be a washing machine and dryer for those occasions where patients are in for more than a day or two and have no one to bring anything in for them.

I just felt so sorry for her. I know when my mum was in hospital, my dad ended up bringing in things for an elderly lady on the same ward as she had nobody to bring her anything.

Last time I was on a ward after being at A and E, they seemed very set up in some ways offering me slipper socks and paper pants. But it is the elderly patients in for a few weeks or more with no one, who seem to suffer most.

I complained to the 'patient experience' team about my mother's nursing care last week, and now have to get her to sign a consent form for them to investigate any further.

that's fine, she's compos mentis, and although reluctant to complain on the grounds that it will do no good I have convinced her that if we all thought like that nothing would ever change.

what if she wasnt of sound mind though? I assume they could just refuse to discuss it with me.

Grennie

I regularly take home clothing and wash it for clients. Means their clothes have that home washed/ line dried scent (sensory input VV important for clients with cognitive decline) and I have also (as have colleagues) bought clothing for clients too.

Kudzugirl - That is very kind of you. But systems should be in place so patients don't have to rely on the kindness of staff.

It should be the managers job to improve communication via notices like ' please keep to the left' and visiting times , maybe make a communication leaflet describing how the nursing and medical teams work so that when Drs are not on the ward it's not assumed they are not working and demand they return etc. Nhs staff are the least assertive workforce ever and they get walked all over.

There is. Hospital gowns.

Brake - I was talking about an elderly woman with dementia who was in a hospital gown which frankly are pretty undignified. She spent a large part of every day constantly calling over nurses or visitors to the ward to try and help her get dressed. The nurses constantly told her her one dress that she was brought in wearing was dirty.

So what was being offered did not really work. It created more work and she was fairly constantly distressed and agitated. And patients next to her like me, spent every day listening to her begging us to help her get dressed.

That's pretty horrible, Grennie, but it seems like that should be managed by one of the charities related to the hospital.