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.

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

This is not true, it is the government who are withdrawing the bursaries - university heads wouldn't want to get rid of bursaries.

I'm an HCA and yeah, there is not enough staff.

I hate it when a patient messes the bed because they have called for help but the nurses are busy in the drug room or doing something urgent and the other two HCA's are assisting other patients and I'm in the middle of something that I can't just drop. It makes me feel shitty that the patient asked for help but we couldn't get there in good enough time.

Or the patient screaming out in agony wanting their hourly pain meds but no nurses are free right now and might not be for 30 minutes.

It fucking sucks, for the patients and the staff. It's not good enough but hey, we are all meant to manage on skeleton staff.

The man with dementia should be specialed for sure. My trust is pretty hot on that and the only time that doesn't happen is if they genuinely can't get bank staff or agency in. That is complaint worthy for sure that not once during your stay has he had one on one care. It's dangerous and in no way acceptable.

BTW my dream was to be a nurse. Working as an HCA has put me off. I love my job but no way in hell would I want the responsibility of a nurse in this day and age, being an HCA is hard enough and I'm not really accountable.

I hope you start to feel better soon OP and you are lovely to be looking out for that man. It isn't your job and you should be resting but thank god that he has had you, but definitely do complain

Yes its the government. Insanity really, as without Bursaries, how many people will be willing to borrow so much money for what is unfortunately such a low paid job?

It's awful isn't. I used to try to sit next to dementia patients while i did my documentation.

In reality, they need a one-on-one, but the hospital won't fund one unless they actually have a couple of falls! By which time, of course, the damage is done.

My trust ran a massive deficit last year, they're 'cutting costs' now. There's just not enough money.

Yep it's crap have left the NHS now but they have been cutting back on staff for years way before conservatives came into power regarding dementia patients I worked on a dementia ward for years but it was a mental health ward o all the trained nurse ,s including myself were RMN,s we were not trained to deal with medical issues so when one of our patients needed medical treatment they needed to be transferred to the general hospital where all the nurses are RGN,s tbh they need a unit with both RMN,s and RGN,s but I can't see that happening. A few years ago for a trial period we had support from general nurses on night duties on the mental health unit it was brilliant but it only lasted a few months sadly.

If you are in Salisbury spinal unit the head or what ever they are called now is incredibly approachable

Sorry to hear about your injury.

I was in hospital and nicknamed such patients 'leapers'. They just attempt to get out of bed because they are oblivious to the dangers. They required a staff member close by to prevent injury, which meant that we were ignored when we needed the bathroom (couldn't go by ourselves). One nurse ran in, turned off the call sign and said 'you'll have to wait'. It was pretty annoying when they'd asked us to drink loads of water and I waited hours for pain relief once as well.

I can well appreciate that you are exhausted, can you speak to the PALS service or does the matron*/other senior manager ever come around the wards for a visit?

*we got a visit from the matron one morning, although I think it was one of the nurses who told us who he was rather than him coming into the room and owning up!

It's appalling but it has been going on for years. I spent a couple of nights on a women's orthopaedic ward seven years ago. A lady in our bay who had dementia kept trying to get out of bed during the night. The nurses ended up taking her bed into the corridor right outside the office because it was the only way they could keep a close eye on her.

I can't see the situation getting any better either. There've been nursing staff cuts in the NHs for years.

x2boys - DH is RMN and gets so cross with colleagues not being able to do basic physical care. There is so much talk about holistic care but it isn't provided, people shy away from things which aren't their area. So we end up with general nurses who don't address people's mental health needs and mental health nurses who don't look at people's physical health needs. They are both so closely related that this is ridiculous!

If the RMN training doesn't give people the confidence to deal with physical health issues it needs looking at.

The issue of staff shortages is a different issue IMHO.

Staff shortages are a major problem, the Poster himself says there aren't enough staff on the ward.

If the ward was better staffed, this patient would be more closely watched and cared for and patients like the OP wouldn't have to feel responsible for other patients safety and wellbeing?

I absolutely agree that there are not enough staff on the ward (I work in healthcare - well used to and now teach on pre-registration training) and in situations like the OP described you can't make a silk purse out of a sows ear!

My point was in response to x2boys, it is not good (in so many ways) when people are moved between services when they don't need to be - the training is the issue there.

There ,s a big difference between basic physical care and dealing with drips, advanced life support all the stuff RGN,s do hence the difference in training I wouldn't expect an RGN to know the mental health act as in depth as I do or even have a basic understanding ,RMN,s and aRGN,s both are highly trained but there is a big difference in their jobs.

I have witnessed what you talk about 1st hand - not on a spinal injuries unit but in a general hospital. My DD, who has multiple lifelong disabilities has been on adult wards twice since she turned 18. On both occasions I have stayed with her 24/7 as she cannot communicate and definitely couldn't press a call button. It would not be safe for her to be left on her own on a hospital ward.
Last time we were in I witnessed another patient doing exactly what you are doing - being the eyes and ears for the dementia patients on the ward. I witnessed an elderly chap get out of bed and walk off with his catheter bag still attached to the bed. He did this twice - the 2nd time the nurses didn't get to him in time when the other patient called and the result was a snapped catheter inside the patient. I heard a staff member saying they weren't even aware that the patient was able to get himself out of bed - let alone walk. On the same ward, in the same week, another patient broke his hip when he fell getting out of bed unsupervised.

Staff numbers have reduced dramatically over the years and combined with the fact that the people actually in hospital are much sicker that they might have been in the past it has created an unsafe environment. Wards can order 'specials' to supervise patients 1:1 where required but are reluctant to do so because of cost. The 'specials' are usually agency staff who basically just 'babysit' the patients and try and herd them back in to bed if they get out. I wasn't the only 'carer' who stayed with a relative in the ward although I was the only one who stayed overnight. Many of the dementia patients come in from nursing homes who are similarly short staffed and won't provide anyone to supervise their own patients even though they are no doubt still being paid to care for them whilst they are in hospital.

OP, can you ask to speak to the ward manager and explain what is going on and tell them you are n longer prepared to take on this role which is hindering your recovery and affecting your health and tell them that if they don't sort it you will file a formal complaint.

Wishing you a speedy recovery and hope you get home soon.

Yes people who stay in hospital are much much sicker than they used to be. I have been treated at home for an illness that used to require a 2 week stay in hospital only 10 years ago. This means staffing ratios in hospital should be increasing, rather than the other way round.

I'm sorry you're having such an awful time TheFuzz.

As a Ward Sister myself I would advise you that the best thing you could do, for the staff, yourself and the poor gentleman with dementia would be to complain.

The ward sister you previously mentioned has probably complained to the Trust management several times but the prevailing attitude is usually that if none has died, fallen or complained then everything is OK.

You are clearly an articulate chap with Internet access so I suggest you email the PALs dept telling them what you have told us.

The complaint will land straight on the poor Ward Manager so please ensure you make it crystal clear that you are not 'blaming' the individual staff members, just the lack of them.

The gentleman with dementia should warrant additional staffing due to his need for increased supervision.

Good luck with the rest of your stay and I hope you get well soon.

Bigbluebus, who does the formal complaint go to ?

footle It can go through PALS or straight to the Chief Exec.

Well it starts again. The chap has been OK most of the day and has listened to me but tonight he has been up and down and is very restless. Can't sleep.

The ward is aware of the impact it's causing me as I'm not on many painkillers. I've got friendly with another bloke my age who also broke his back but by slipping down stairs when rushing. He is a few weeks behind so still on lots of drugs and does sleep It's boring enough with only one person you can converse with. I'd go stir crazy in a room as I'm not that type of person.

They have asked if I want a room but I feel as though I'd be deserting the other guy and his girlfriend hardly ever visits.

We've got another very old chap in, but he isn't spinal but so far quiet as he is just out of theatre.

If my x-ray is ok this week I'll ask to go ASAP. I'm a fit bloke and just wasting away. Lots tonnes of leg muscle. I'll recover quicker at home as I'm not a falls risk now.

Get well soon Fuzz I hope you can get some sleep soon. You sound very kind btw

Sounds awful for everyone involved. My nan passed away in a NHS hospice 6months ago. There were 2 'wards' which each had 12 rooms. At night there was 1 nurse for each ward. It really was awful and at times we would be waiting 45minutes for painkillers while my nan cried in pain. People would wet themselves as they'd had to wait to go to toilet, people not getting changed straight away after soiling themselves etc.

I feel for the nurses. There's only so much they can do. Really not fair on you either though. Bet you can't wait to get home for some proper rest.

Fuzz, I think the sooner you can get home the better.

I fractured my L1 or possibly my L5 ages ago, 20 years ago now, so details are hazy. Complete but stable fracture, didn't need surgery. Did it on the Saturday and discharged myself on the tuesday. Didn't even need a brace. Sounds like yours is worse than what happened to me but if you're at a stage where you just need to rest and have some painkillers you can do that at home.

wishing you a speedy recovery, I am a student nurse, all I can promise is there are still excited and enthusiastic people waiting to join the ranks. Please don't go home before your rehab is done, you won;t get the same level of therapies at home and if you are still needing them then please put your long term health first, I do understand how hard it must be for you.

I absolutely understand. I was in hospital for a week after a hysterectomy where I couldn't get out of bed, in a similar set up with an old lady with dementia and it was utterly exhausting. It must be even worse for you after all this time.

Bigbluebus, thanks, I like to know these things.

None of this is new. It's gone on during multiple governments. The NHS needs a complete overhaul. When there are lots of anecdotes about slightly stronger patients overseeing vulnerable ones, something is clearly wrong.

Feel so sorry for the dementia guy getting no family visitors. I bet they'll be swooping in a few years' time when the Will is read though.

Best wishes OP.