NHS Ward Staffing Numbers

[TheFuzz]

Bit of a rant.

I usually frequent another part of the forum. I'm a fella btw.

Recently received a broken spine in an RTA (car driver turning across cyclist).

Been here since November so absolutely shit Christmas for me and my my family.

The staff are fabulous. Work their butt off. Lovely folk.

But:

There hasn't been enough staff on the ward. It's a spinal unit with 16 beds. There is a mix of patients. A few younger ones with serious spinal injuries (like me), plenty of elderly with falls, a few cancer patients and FOUR with dementia.

Bear in mind there is some intensive nursing needed in this mix. We've had days where only one qualified Nurse is on, nights where there are just 3 staff.

The big issue is the dementia patients need one to one care. Back injuries and dementia are a bad mix.

Cut to the chase. We have a nice old fella in our ward with Dementia, buy I am absolutely sick and tired of having to keep more or less 24/7 eye on him. I can't get out of bed but I buzz and have had to shout for nurses as the poor man is not aware of his broken back, and his surroundings.

I've been doing this for weeks. I need to get myself better too.

The staff think I'm brilliant but I can't just sit there, watch him spring out of bed and fall over as he is frail.

He has started to come round a bit more recently as we didn't know he had a chest infection. This has cleared but he is now more mobile

The good thing is that I can get him to listen to me and tell me what he needs/wants but it's a battle to keep him still until a nurse is available (sometimes 5 minutes) so you are constantly telling him to please wait and that a nurse is coming.

I'm exhausted and want out but I'm not healed enough.

To top it off I've only once seen him get a visitor. Poor bloke

The NHS seriously needs to look at ward staffing. It's madness that patients have to keep an eye on other patients. It's only because I'm now needing less and less morphine am I awake and not sleeping. My two other room mates are in a similar situation to me but are often out of it as I'm a couple of weeks ahead of them in healing.

It's just not on. I feel so responsible for him.

Thats horrific. Its mostly due to the austerity measures, but it has been an issue on and off for years. (friends and relatives in the NHS use me to let off steam!)

I attend an outpatient clinic and funding cuts have stripped it to the bare bone. I no longer get the treatments I need every 3 months as my consultant literally cannot fit me in. I have to wait up to 4 months sometimes.
I also need foam neck supports and cannot get those from the hospital OT dept any more, they cant afford them.

Tell me about it. I work on an nhs ward.

And believe me if the shit hits the fan because something is missed/goes wrong it's the individual staff who gets it in the neck. Never mind they're so overstretched.

Hope you get out soon.

Ahh sorry to hear this. I was only in two nights and we had a similar patient. Kept us all awake.. Poor nurses even had to feed her to make sure she ate. We helped out a bit because they had enough to do. Hope you recover soon and get some peace

Can you write to PALS or the chief exec?

Everything you are saying is absolutely correct, wards are stripped to the bare minimum because higher up people have forgotten that they work with people not budgets and numbers.

Another option for them would be to liaise with the volunteer department, perhaps a volunteer could come in for a few hours each day to spend time with the people with additional needs?

Hope you are OK and out soon.

Sorry to hear about your accident. I hope its an incomplete injury, or at least a low level one.

Spinal wards do require a huge level of specialist care, even without the extra complications you describe. It's awful.

Do they not have a "close observation" bay in which they could put high needs patients? Although... I suppose they would if they could.

Awful situation all round.

I would contact your mp.

The government are making cuts to the nhs and this is why staffing is low. And with bursaries for nursing students being cut too there will be even less staff as the years go on.

Your experience sounds exactly the same as my last admission in 2006 - pre-austerity/cuts and under a Labour governent. I would kick up a stink - I did and got moved to a side room. The poor dementia patient that was keeping us all awake finally got some decent care and the lady dying of cancer in the end bed finally got some peace. Mostly it's poor management rather than lack of money - the hospital in which DH is a consultant runs a surplus every year and has no such problems...

I despair of the NHS and I hope I am in France if I ever get ill again.

It's utterly crap and shouldn't happen. Nurses are completely overstretched and nobody cares or values what they do. It's just more and more pressure and more and more cut backs. No wonder we are all leaving in droves.

I would either complain through pals or speak to the ward sister about how you feeling. In all honestly, if I had been the nurse with 16 spinal patients on my own, I wonder have competed an incident form about safe staffing. There's no way you can keep all those patients safe on your own.

I hope you make a speedy recovery

You are right. But there is no money. NHS Foundation Trusts are forecasting an overall deficit for the first time this year. So that means it's not just a few rogue trusts who can't cope, it's everyone. The ones that are coping are trusts with huge charity or research incomes (think the more well known hospitals).

The NHS is efficient (best outcomes for one of the lowest spends on healthcare in the western world). We spend nearly half what the US spends in terms of GDP on healthcare and yet our outcomes are better.

I don't know what the answer is; this government have promised more money, but it still comes with an unprecedented efficiency target (unorecedented anywhere in the world) and has been linked to 7 day working, when really that money is needed to just stand still.

I'm sorry you're having a rough time of it. YANBU, but I'm not sure what the solution is.

You poor thing, TheFuzz, it's just not fair that so many things can go wrong to one person in such a short space of time. Do they know how long you might be in for?

Yes, I think you need to complain about what you can see going on with the staffing levels. Try every avenue, as suggested above, and try to find a way to bother the hospital trust chief exec in person.

That poor old bloke with dementia was my dad for 12hrs recently. Fortunately there was bugger all (new) wrong with him- he was sent in by the home after 2 falls at 2am and, no shit Sherlock after 4hrs in a&e flat on a trolley his BP fell when he stood up . This actually probably happened anyway at 92 but of course no one looked before.

Therefore, against my better judgement he was admitted and then spent 6.30-3pm on a ward waiting for a junior DC to decide that he had nothing " fixable" up and could go home.

I didn't leave his side. It was like a 3rd world " bring a relative to care for you " place not a state of the art teaching hospital. Like your guy he can't use a call bell and wait. He just fiddles with the blankets and tries to get up. No one would notice until hed got up and ended up on the floor. Mostly I couldn't see a nurse at all- when they pay the curtains either side all I could see was the old gent opposite for an hour or so!

We need to pay much, much more for the NHS but that ain't going to happen sadly.

It's been bad over Xmas. It was the ward sister running the place yesterday. We do also have the odd volunteer who is in for brews.

The Trust is also requiring each 4 bed ward to take another patient without the correct facilities. Apparently A&E was at double safe capacity yesterday. And it's not icy yet.

Terrifying. Hope you get home soon.

How long I am here is unknown. Depends upon how well healed my spine is as two vertibrae were snapped and crushed.

I've then got 6-12 weeks in a brace.

It's just a total mad house. The dementia patients have been hitting staff, verbally abusive and just generally hard to control as there is no one to one.

One old lady (without dementia) lit a bloody ciggy with the oxygen on. One has doubled up on meds by hiding her own medication in her bag and to top it off I blew my top at one dirty old man about how rude he was to staff. I really lost it as we had a patient critical next to me and he was demanding that docs and nurses saw him. Nothing wrong mentally.

It's been mentally hard. I haven't slept other than when on high doses of morphine.

The staff still keep smiling though.

I dont know how the nurses keep smiling op.
chin up

My care role has started. The chap is awake and was up Said morning and how are you and he repoonded with fine thanks.

I explained that breakfast wasn't here yet so we needed to wait, so he lay back down.

It's a horrible condition, as he will be up again shortly having forgot.

Yep I know where you're coming from. I'm an auxiliary/nursing student in a 16 bedded step up rehab unit, I've seen a lot of my shifts be 2 rgn and myself, one of those shifts was when I was about 7 months pregnant and it was awful. The 2rgn are so busy trying to catch up with paper work and meds rounds or dressings or family members that when someone wants something like assistance to the bathroom that needs 2 people they were waiting ages!

It's no good and it's not going to get any better as a poster pointed out upthread that the bursaries are being cut as some university heads got some mad notion that that would attract more people to train

What you describe has become an accepted norm.
Yes, you read right, accepted and the norm.

I am a nurse, looking for a job, no way on God's green earth would I ever apply to work on a ward because I know for certain that I would be given the keys and left to it with possibly 2 other members of staff and told to get on with it.
In other words, dumped in the shit and left in the shit every single working day, until something goes wrong, then I will be struck off and sacked.

I cannot tolerate knowing that I cannot nurse at the 100% that I need to and want to to do the job I love because I am put in this situation.

So, I am looking at jobs in tesco or asda as there are few suitable jobs available in nursing.

I work on a 30 bedded ward, I've had days when we've had 2 qualified nurses and 2 auxiliaries for those 30 patients. It's quite scary at times, and demoralising as you go home knowing you haven't done everything you wanted to. I would like some days to just be able to sit and talk to my patients, I think that's hugely important to recovery, but we very rarely get the time :(

Management don't have a clue - I did a course for safe moving and handling and the lady in charge said if a patient needed assistance of 2, a third staff member should always be present - e.g. if we were going to the bathroom you have two to help walk to the toilet and support balance , 1 to pull down trousers etc. If you did that , on a lot of days you'd have no one else to answer the other buzzers! But if the patient falls and there's only 2 of you, we'd get it in the neck for not doing things safely. And if yoy play it safe with 3, and a buzzer had to be ignored, we'd all get in trouble for that too.

You keep going though, because there's nothing better than seeing someone get even slightly better. It's a feeling unlike any other.

Staffing is a major issue in the NHS. It's a vicious cycle: working conditions are bad, recruitment and retention get harder, conditions get even worse due to understaffing...

After the mid-staffs scandal the Francis report recommended the implementation of minimum staffing levels on wards. Predictably enough, the department of health have avoided doing this.

Dementia is a timebomb in the nhs.
Very difficult to care for patients with dementia on an acute ward. Your gentleman should have had a supervision risk assessment completed and should be specialed 24/7 if he is a risk to himself or others. Complain and make sure you mention the Francis Report and safer staffing.
The ward should have a board which shows how many staff they planned for and how many they have on display for everyone to see, ask what their safe staffing is and if they are meeting this.
Research shows the best outcomes for patients are if staffing doesn't drop below 1 RN to 8 patients. Your unit sounds dangerous and I'm sure the CQC would be concerned, please please complain, it will help the staff on your ward.

I'm sorry thefuzz your having to endure this. You shouldn't have to keep an eye out for the other patients, but as a healthcare assistant, I am always grateful for it. The main problem where I work as a specialised unit, because we are fully staffed, we are often called to fill other wards who are not.

I hope your not too bored, and your injuries are healing well.

From what I hear on the demtenia wards, a doll might help him calm down.
Yes, I'm looking at other jobs not in the healthcare sector.

Get well soon the fuzz, I could say the old gent isn't your problem but I know in your position I would be unable to 'turn off' to him too but you must concentrate on your own recovery. I'm currently on mat leave but usually work on a critical care / coronary care unit. When full we should work on 8 RNs and 2 HCAs to allow us to provide the adequate level of care to our patients who are the sickest in the hospital. Unfortunately we are often taken down to 4/5 staff ( half what DoH says is required) in order to support other wards in a worse state than us. I don't know the answer but it gets worse every year. My trusts bed levels have been black for months and we haven't even had a cold snap yet.

Sorry to hear this, it must be awful when really you need to just concentrate on getting yourself better and getting home.Could you ask to be moved to another bay or side room?

As others have said, this is sadly the reality of the NHS now. Wards are so shortstaffed, the workloads so heavy -Yet when something goes wrong, it will be the Nurse who is blamed, hauled up before the NMC and struck off.

Sadly I don't see things getting better as there is such an exodus of qualified staff...........

Hope you get better very soon.
This is not a new issue sadly.
I was in a ward about 10 years ago and had to get out of bed still attached to my drip to help an elderly lady who had pulled her catheter out :(
You sound lovely btw X