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??!

frumpet Your post is partly why I wish I could go into being a HCA again, but the pay isn't good enough. I had time to actually talk and engage with the people I worked for. We'd reminisce, I'd go through photos with them, have a chat whilst painting their nails, put some songs on and have a sing with them. I also had one man who liked me watching Emmerdale with him so I'd work at extra 30mins past my shift end so I could do that.

Nursing.. pah. Never even get the chance.

Perhaps that what we need, volunteers to come into hospital and just sit and talk with the patients.

shouldhave that's exactly how you should talk to a person with dementia. Unfortunately, ward staff just don't have the time to spend with them. They, as patients, are seen as difficult, uncooperative and often violent when really they just need time spending with them. They are disorientated, away from their norm and don't understand what is happening as they have poor short term memory. As a student, I have valued the time that I have been able to spend with patients especially the specialised patients such as those with dementia. I'm about to head into my management placement and just won't be able to anymore.

I'm not trying to put you off being an HCA. Honestly, it's an amazing job. I am bank HCA as well as a student and I love both roles (it's nice to not have the responsibility sometimes). It sounds like you are the perfect person. But beware, it's a hard job to get into without experience too. I tried for 10 years before I started my training hoping to be sponsored with no luck.

It was so hard at the time, because I knew she needed more than I could give - she needed a wash, turning and I think different blankets/bed. She had no proper leg muscles (atrophy?) and I worried about what continually lying on them might do. But I couldn't drag the nurse through and say, hey what's going on with her legs, is this safe for her skin, etc. Wasn't my place.

She couldn't understand the tv, obviously, couldn't read (didn't even have books), the radio up there isn't much cop.. I did see a visitor go to her one day (the day before, mum was there 3 days) and I appreciate her visitor must have known all her stories but they sat in silence. It was hard to see.

The woman next to her did admit to offering her chocolate sometimes.. She kept getting tea cakes and kept offering them. Poor lady (I do know her name but won't type it) kept getting marshmallow goo everywhere. I worry even now that for days on end that might have been the only nice thing that she experienced. I mean, she was very obviously dying, slowly. I don't think she was in pain but she was just tired I think, like a machine coming to an end. I hate to think of the fact that she could have spent precious time just lying there distressed and waiting for the next face to give her meds, or wash her. I wish they'd had more time to sit with her - I hope they maybe did in the evenings, but I doubt it. I know day to day she wouldn't have remembered but she would have been upset, lonely.

You can thank God they often get transferred to nursing homes, patients in her case, but really are things going to get better there..

And then you must get the patients who WILL remember, who do know, who aren't confused - and who are probably left in the same manner, especially if no one can visit.

It's difficult. But what I'd aim to do, is even balancing all those other tasks, is make people smile at least once if I could.. I can't imagine how hard it must be 12/1 or even 7/1 though.

hotdog you say you can't ban someone from getting medical help but when I was on my a&e placement we had a patient who was bought in by ambulance that was banned from being bought to our a&e as she came all the time and just wasted their time. She was allowed to other hospitals as she was on dialysis (ours doesn't have a kidney unit) but not allowed to come to us. She got sent to another hospital by us.

Meerkat that's what I thought - all I can offer is stuff I've learnt from caring for mum (still, I'm going to be the same with most jobs as have never had a job worth remembering apart from low level volunteering). Have filled out the application(s) as best I can though. Spoke to a charge nurse today about the job and she said I can but try, and see what they think of my application.

I can see both sides of this as I work in the NHS (though different role) and have seen some instances of appalling and negligent nursing in which the patients were quite right to make demands for better. However I see, on a fairly regular basis, dreadful, unreasonable and self-centred demands from some patients.

Unfortunately we seem to be in a cycle of each of those things making the other worse and justifying it. Some nurses get impatient and demoralised in the face of apparently unreasonable demands and patients get more demanding as they see their needs as not being met.

It makes me so mad hearing stories like yours shouldnt

The ward I worked, we had regular dementia study days given by psychiatric liaison nurses. We had these because any medical patients coming through admissions with a history of dementia or presenting with confusion due to infection, were admitted to our ward. We were not mental health trained (we would have gone up a pay band but they provided on day a year for a study day.

It's actually quite shocking the number of HCP's who think caring for someone with dementia is like caring for an adult baby

I hate that way of thinking. I would challenge anyone if I ever heard that.

Patients with dementia are people with a lifetime of memories. They are individuals and should be treated as such. We are taught to allow them to be open and talk about whatever it is they want to talk about. If the patient wants to find their mum, we distract them from finding their mum with a conversation about their mum IYKWIM?

It takes a hell of a lot of time and patience. Unfortunately, not all HCP's are cut out for it. They may be great at other aspects of the job, but dementia care is a speciality.

Trying to get rid of the bad staff is a big problem.

you say you can't ban someone from getting medical help but when I was on my a&e placement we had a patient who was bought in by ambulance that was banned from being bought to our a&e as she came all the time and just wasted their time. She was allowed to other hospitals as she was on dialysis (ours doesn't have a kidney unit) but not allowed to come to us. She got sent to another hospital by us.

She may have been banned from A&E, but as you said at the end of your post, she was still sent to another hospital, to another ward. Other staff in another hospital deal with it thats all.

shouldnthave I find the best time to spend with a pt is when you are washing them. It is very intimate but also you can usually have a laugh and a joke and really get to know someone. It's often the longest time you will spend with someone (it's really sad that's the case but it is).

Also we have 2 hourly paperwork that has to be filled in. Some is done by the hca's but some is nurse only so often I make sure I have a chat with patients then. It's not a lot of time but I think it makes a difference. We are lucky we have the lower ratio (although the HCA ratio can differ depending on ward).

iCan I asked that one, hospital refused. They fund play workers for children (rightly so) - I would gladly support a similar scheme for general/adult hospitals.

Looks like dementia is becoming a really big problem .

From what you have put here shouldnthave I would love to work with you

No, it wasn't Aberdeen shouldn'thavesaid, it was a lot further south than that. You sound lovely, it is such a shame that there isn't enough time , and people, for nurses and HCA to devote to the patients that they need. No patient should be made to feel frightened, or to feel like a burden, or to not be fed, or the HCPs shouldn't be so frazzled they don't know which way to turn.

It is hard , i can tell you now the biggest complaint you will hear a nurse say when a shift is finished is that they didn't have time to care properly , that they walk away feeling inadequate because what they should do and what they can actually physically do are polar opposites .

There is a lot of research to suggest that the 1/8 ratio is the best for patients , they get better care and are less likely to die from preventable causes especially post op .

I dont mind the people who shout or get snappy with me when they are in pain / are upset / have a legitimate complaint , i accept that i am their first port of call and it is horrible being in hospital as a patient , been there done that . To be fair i would say that only about 1% of people i look after are just complete arses , i just keep smiling sweetly because it annoys the fuck out of them

there used to be two people doing breakfast when i was in hospital that way if there was a toast needing cutting up the other lady did it personally if its fix my tv just say i will send someone in xx

ive seen really bad nursing in my time but its not the norm despite what the government would have us believe competent staff do exist

It is expat

Our hospital has many, many patients with dementia on most wards.

I started a monitoring form once. Done weekly to try and get our staffing levels increased. Most of the time I counted between 20 -25 patients with dementia out of 30.

We requested a HCA for 1:1 for the highest risk patients, quite often refused by senior management because there was no budget for it.

When we did get the authorization, we'd have 1 HCA to look after up to 3 aggressive patients. It's shocking actually.

I think as others have said, volunteers would be extremely welcome. You do get some that do a tea round sometimes, but it would be great to have people with a little more autonomy that could go and buy a magazine for someone, or help them use the phone, or chat with them for a while. I can only assume that the NHS Dinosaur doesn't want voluteers with autonomy as it wouldn't fit in with their system.

I think most of us, patient or staff, will agree that it's the system at fault, not the people working within it.

That's why I get so angry about it - the system can be changed but only if the staff are listened to and that's why the NHS will never change, because it's a top-down system and those at the bottom suffer the most.

And that's why it will meet its demise over the next few years.

I do have some reservations about the volunteer thing.

In theory it would be great for the patients and the staff.

But they would have to be vetted, supervised by the staff. Someone would have to take responsibility for them. There are too many vulnerable people on hospital wards. The qualified staff are already overseeing the HCA's, the ward sister already overseeing the qualified, HCA & housekeeping.

I suspect they would then become too relied upon and do away with HCA posts.

Why pay for it, when you can get it for free eh?

I don't trust any government not to do that.

Some people just like to complain about everything.

A friend was working in A&E once and said they had a man in with some minor injury who just kept on ringing his buzzer constantly demanding stuff, wanting to know why he was being kept waiting every ten minutes. He was just waiting for test results to get back and so couldn't be discharged. It was a particularly busy shift so nurses were all busy treating 'real' problems. On that day a two year old child died in A&E, of course nobody was attending to his buzzer will trying to save this little boy. My friend told me in tears though that nobody was able to sit with the mother afterwards because of this man. Okay, the mother was medically fit, and wasn't even a patient, but she needed care a lot more than he did.

This was in France so you can't even just blame the NHS, it even happens in France despite the UN saying it has the worlds best healthcare system.

Loads of hospitals won't even accept volunteers, it's a joke.

My local one won't, except in the tea shop

Another vote for you to leave.
An ill patient cannot hope to think about you and everyone else, when they are quite or very ill themselves.

Nursey Even our 'tea shop' which is staffed by WRVS volunteers (elderly ladies) close on occasion because of abusive visitors.

It's situated in the outpatients department. I know people working there. I've heard of some disgusting behaviour directed at them. For the price of the tea, not having the right sandwiches, not having enough change in the till etc.

archshoes If all staff who were fed up of daily verbal abuse and threats of complaints took your advice, the hospitals would have no-one working in them