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??!

and they're complaining I mean, not the nurse.

I'm sorry about the Nursey. Are you leaving altogether?

I think the thing is they just don't know the demands of your job. They do not know how long you get to spend with each person etc. All they know about is their own needs and what they are, which does not necessarily go hand in hand with patience and consideration.

A lot of the requests are understandable, eating and washing which might be difficult. Even a bit of help with the TV, if they assume the problem is quick to fix and one which you'll know how to do.

I can't think of a job I've had, where there has been too much work and not enough staff, where others have not made extra demands on my time, often needlessly.

I'm sorry about the Nursey. Are you leaving altogether?

Thankyou Revolting. I don't want to leave the profession altogether but I;m going to take as long as my health needs (and as long as I can afford) and then see where I can go

Shit , nursey have you really ? are you going to be ok ?

frumpet

I think so. I've had a breakdown coupled with depression i've had for years. They were going to take action about my sickness, so I saved them the job and handed my notice in because I can't cope.

I'll be okay, I've got a very supportive DP

shouldn'thavesaid there is a good side, most patients are ok and so are colleagues, depends where you work and depends on the team you work with.

I'm a nurse but working as an HCA at present, it is ok but we are expected to do the job of a ward hostess as well as of an HCA. So we have to do the breakfasts and meals and put people on bedpans at the same time literally (due to short staffing) - all gets a bit confusing at times!

I wouldn't say it's the patients' faults at all - people have all their faults and flaws and you know this when you go into the job or you wouldn't do it (hopefully).
No such thing IMO as 'NHS do-gooders' - not sure what OP means by that.
What is the problem is short staffing AND poor management.

So sorry to hear that , i was in the same place as you not so very long ago and i think you are probably doing the right thing for you , its not an easy job to do at the best of times and if you are any thing like me , its difficult to switch off even when you are at home , especially when bad stuff happens .

Hope you get the rest and recuperation you need and deserve , big unmumsnetty hug and a big bottle of

Phew. I spent 75 minutes doing the last application (for a 38 bed GP led hospital) - was going to phone and say 'Noooo! They're all going to ask me how to fix televisions and ask why their toast isn't cutted up!'

I suppose you develop a thick skin pretty quickly.

Thankyou horsetowater - unfortunately it's a degenerative condition, but I do have 'better' times thankfully :)

Nursey I am sorry to hear that. I hope you are OK.

It is the system - it stinks sometimes. Patient care sacrificed to management structure and targets. All down to finance in the end of course - simply never enough.

Why did the patient want the toast cut up op? Is it because they couldn't eat it otherwise? Surely if they could have cut it up themselves then they would have done so.

You'd be surprised, Brian. Some who are perfectly capable of cutting it up want someone else to do it because, 'That's their job.'

You would think so wouldn't you brianthemole , but this isn't always the case .

Talcott Parson's role of the Patient, Nurse and organisation is something to consider here.

Certainly stripping patients of their other lives, rendering them passive through their donning night clothes or patient gowns means they may relate often to nurses as not adult-adult but rather more as a dependent child does to its Mother.

It is important as a HCP to prevent yourself from falling into the parent role in response. The organisation can help by having clearly delineated roles and a system that educates patients about who does what, where, when and why. It doesn't take a lot of time to help patients understand what the priorities are at a given time (drugs round/ward round etc) and why they are priorities.

The worst thing you can do in circumstances such as this is say to a patient 'I'll be back to do it' in a non specific way. The wait for them is ages and the only way they will interpret it is as 'I am not as important as everybody else'.

My was headbutted by a patient and he came back for more so she pushed him away. He was removed from the ward but my mum was brought in for a disciplinary. Pathetic.

We can't do toast on our ward, only bread and jam.

It does take ages because many elderly patients can't butter their bread or open the sachets of jam.

The pats of butter are always too hard to butter the bread without it falling apart so you have to stand there holding the butter in your hand to warm it up (for each patient for several minutes!) or you have to cheat and use margarine which is easy to spread but not so nutritious.

I like to make jam sandwiches for my elderly patients cos they're easier to eat but it all takes time and often the more 'well' patients complain that breakfasts are taking too long.

And of course theory into practice is another thing altogether

Surely it's not a question of who is right (as in ..." the patient is not always right")? A small drop of human kindness goes a very long way towards helping people get better. Is buttering a piece of toast and cutting it up for a patient really too much to ask?

Your post has made me very sad and says it all about the state of "care" today.

Miaow when we have relatives helping with feeds (of elderly patients) then we always offer them food as well if there's any available. And cups of tea, cos we're very grateful for their help.

It must be hard having to tell people you can only do it later? I want to do the job because I really, really want to be able to help people (alongside gaining proper experience for a degree I want to take) - I think I'd find it hard having so much to do and constantly saying that I'll have to do xyz later.

I did ask someone who works in primary care - said I wanted to do the job to help people, to talk with them, make them comfortable etc. She half laughed and said I'll have barely 2 minutes to stop, never mind sit and talk or make them comfy beyond basics. I half hoped she was exaggerating. From this it does sound like that's the case, though.

The people where are talking about Brian are the same people who are difficult in any situation. The ones who kick off in restaurants, shops, in the street etc. The problem is, because our wages are paid through their taxes, we should just suck up the abuse and do whatever they tell us.

It's not the ones who ask for help. It's the ones who, despite being told we are busy with a patient or a drug round, give us abuse and threaten to report us for not passing them their box of tissues.

Or the charming wife of a patient who had a meeting arranged with the doctor regarding discharge planning. The Doctor was attending a cardiac arrest opposite her husbands bed. Even though it was behind the curtain, you could clearly see it was an emergency. She was told the meeting would have to wait. The 4th time she shouted at me that he was 10mins late (yes, 10 mins) I did snap at her. Not only because the above, but because her ranting and behaviour was making her husband anxious (he had dementia).

It's those people who are a problem, and there are many of them.

I have noticed though, in the 13 years I've worked the wards, it seems to be getting worse. The abuse.

I still do ward work, although now admin and in mental health rather than general. So far it's not as bad, but only time will tell......

Shouldnt

There are ways in which you can transmit a caring attitude and professionalism but probably not in the manner you imagine sadly. One of the most important ways HCPs can show this is by using good active listening skills. When you have very little time allocated for direct time with patients, this becomes even more important. People want to feel listened to. People like to think they have all the time they need to tell you what they need. Managing precious and short time without making patients feel harried and 'processed' is a great skill that is hard won, over time.

There is a reason why some HCPs are better regarded than others yet they all work within the same system. Study the ones that are good, work out what makes them good and use them as role models. You will find people who can inspire you. But cynicism and dark humour is a therapeutic tool for staff- it bonds us together and it sees us through. Despite your friends cynical comment, there will still be something about the job that keeps her there I hope other than fiscal factors.

I don't see why the toast can't be buttered and cut as it comes out of the toaster. To me it seems quicker. That way breakfast gets done faster.

simple things like that can improve patient care so much.

Why is the porridge and toast getting cold, perhaps the trolleys need looking at..... Perhaps a hot plate.

I have had experience of being an adult inpatient three times now- twice were as a result of my then undiagnosed Crohn's, and the other was after my c section.

The latter one was a stay from hell. Probably due to the fact that DD disturbed everyone the first night, we were put in a private room the second night (just over 24 hours after delivery). I was incapable of getting up to reach DD on my own, and had a horrible midwife who moaned every time I rang the bell for assistance. She told me I shouldn't have been put in a private room if I wasn't mobile, as she had further to walk than if I was on the main ward- fair enough but I wasn't consulted about it, I returned from a compulsory shower to find they had moved all my things (and DD- resulting in me panicking that she had been kidnapped). And I was told I shouldn't be in pain (bear in mind I can't take the painkillers they usually prescribe due to Crohn's and had to manage on less effective ones).

So yeah, miaow is right that some staff seem to resent their patients.

Oh, and I still don't know what colour uniform goes with what role, and what each role actually is (is a staff nurse higher or lower than a charge nurse) so if I need pain relief in between medicine rounds, who should I be asking? Or if I'm hungry due to missing a meal due to being off the ward having tests done, who do I speak to then? And how do I actually get to speak to them, seeing as ringing the buzzer means that the same person that brought the toast round answers it?