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.

I agree with poster who is ward sister, you must complain, it doesn't mean you are moaning about the staff but rather the staffing, the dementia patient should be specialed, you shouldn't have to concern yourself with him and he shouldn't be keeping you awake at night. Staff can also complain by filling out forms online as well, it's the only way to get yourself heard unfortunately. Hope you make a good recovery and can get home soon

Meant to say staffing levels

I work for the NHS and have seen this first band too. It is not acceptable and is detrimental to patient care.

Unfortunately the government has blocked publication of research and guidelines about safe nurse to patient ratios. They are also making 'efficiency savings' which are cuts renamed.

Good quality care costs money. In order to have a good and safe NHS there needs to be sufficient staff, who are paid a fair wage.

The government is attacking the NHS from all sides, with the abolishment of the NHS student bursary, pay cuts for staff, and very public attacks on NHS staff by a certain government minister. All of this means there will be less recruitment and retention of healthcare professionals.

It is very sad. I'm sorry to hear of your experience and I hope you get better soon.

Sounds awful. I think the only thing you can do iscomplain and ask to see the ward manager and express your concerns. I work in a paliative care unit whichis very well staffed compared to the ward you are on but is still unsafe at times. At night we have 2 qualified and 2 HCA's for 20 patients, bu these patients are often terminally restless/ agitated/ confused. We then have patients who are in severe pain/ bleeding/ severely short of breath and those who are dying and have a lot of distressed relatives around who need support. Some of the patients are in side rooms where we obviously have to check them very regulalry as sometimes they can't use the buzzer. The confused ones are in bays. I had a situatio just before Christmas where a Paralysed lady was shouting out ech time the lady opposite tried to climb out of bed, she got no sleep but we did not have the staff to one to one her. We generally ahve very good feedback from patients about the care they receive but I do fear it is only a matter of time before a serious incident occurs and we are all struck off !!

Don't just write to the hospital write to your MP. Get your friends to write to their MPs. Write to the DoH. Get onto twitter.

Here are the 2014 recommendations from NICE about safe staffing.
www.nice.org.uk/guidance/sg1

The current moves to cut student nurses bursaries won't help with staffing numbers. Moves to reduce agency staff in London anyway just cut the number of people on a shift - the cost of housing means that many of our best nurses can't survive unless they work on agency - I've been in my current post for about 2years and several of our "regular" staff are agency. They want to stay, they want a pension but they can't afford the cut in their income from agency to salaried.

The junior doctors are already voting with their feet. I work at a major london teaching hospital.

I'd agree with all the nurses etc saying that you should complain. Make it clear (if it is the case) that you are complaining about the actual nurses on your ward (as management will first come down hard on them) but say how overworked they are, how difficult their job is, how you as a patient should not feel responsible for maintaining a safe space for this gentlemen etc.

Copy to your MP, the Chief Exec etc.

I've done plenty of incident forms in my time (I'm a doctor) but I hear from nurses how criticised and disciplined they are for doing them on unsafe levels. Complaints need to come from patients before they are properly listened to sadly.

This is actually such a sad thread. The Op can see for himself the problems and is trying to be kind and help the staff and other vulnerable patients.

This is the state of the NHS now. Staff who really want to do their best are unable to do so because of underfunding and understaffing.Then patients suffer.

When you treat a workforce this badly - by effectively cutting pay, making working conditions awful and then making those same staff responsible for the consequences - things are desperate.

On the days we had enough staff it was great. Time to look after patients properly and feel like you were doing a good job. Problem was, that didn't happen very often.

A relative is a HCP. Works on what used to be a rehabilitation ward - until they closed the nearest geriatric unit. Now effectively a geriatric ward, with many patients in varying stages of dementia. Not a single HCP on the ward has had any specialist dementia training, although they have ALL requested this during their annual reviews and been assured that it will be put in place (this is for the last three years...!)
I can see my relative burning out in front of me - so much responsibility, so much abuse (verbal and physical) from both patients and their relatives. Going in to work every day never knowing whether this is the day that you make the mistake that ends your career

I really feel for the junior Drs too. Last weekend in the unit where I work we had one Dr on call for the weekend. He was there from 9- midnight and then on call all night then back the next morning. We had acutely ill admissions coming in , numerous distressed relatives wanting to speak to the Dr ( and being verbally abusive when told they would have to wait as poorly patients being seen was a priority) and numerous terminally ill patients needing medications reviewing/ pain control sorting. Also patients falling and needing seeing. The Dr ended up at the end of his tether and traumatised by it all. I'm not surprised that Junior Drs are ending up leaving the profesion. This happened in my unit where we have a lot of very experienced Nurses who help the Drs a lot but it was still unmanageable.

I am a physio (outpatient but have to work on orthopaedics some weekends). I am often concerned about the lack of staffing I come across and the large number of dementia patients nursing staff are expected to keep their eyes on.
I don't know how to make you feel better as I feel for you and totally understand your frustration. I feel a similar sense of responsibility when I work, often scared to leave a patient or bay because I can't get a nurse to come and help (not because nurses don't want to but because there are so few).
I have raised this with my manager and filled in risk assessment forms but it just doesn't get noticed.
Jeremy Hunt annoys me, he has no idea what he is doing and no insight into the stress he is clearly putting staff and patients under. The NHS needs investment not austerity. Increasing population, people living longer, life prolonging treatments means more expense not cost savings.
There are such things as falls alarms so if a patients moves their bottom off the chair it will trigger, cot sides for beds - are these anything you can request?
Could you discuss these concerns and the stress it is causing you with the ward sister, they will probably be saddened and shocked by the way its effecting you and may be able to move you.
I really hope your well enough to leave soon and wishing you all the best with your recovery.

try visiting a family member and then getting cornered to translate for another patient whose family never bothered to visit. nhs is over-stretched but family life has gone down the pan too.

spaceyboo It is not always a question of family not being bothered to visit. My own elderly DM was taken into hospital before Christmas and is still there. She is 100 miles away. I have visited a couple of times over the Christmas holidays but it is not possible for me to go regularly as I have caring committments here at home. She has no family living near to her so gets no other visitors. I would hate to think someone described her as the old lady whose family don't bother to visit. I would dearly love to be there to get things moving as very little seems to be happening and there is only so much I can do speaking to people on the phone - especially as it is a different nurse every time I ring. She is now one of those 'bed blockers'. "Medically fit" for discharge but not well enough to go home. There are currently no re-hab beds available for her to go to. Another problem with the NHS.

I hate the term bed blockers. It implicitly blames patients because there is not enough social care.

Bigbluebus- the lady I translated for was mentally healthy but couldn't get around, and had called her family (who all lived within 10-15 miles; I know because I helped her make the calls) & they all declined to even commit to a visit. It was awful. At least you're visiting your mum even if it isn't as regularly as you'd like. It just got me so angry.

It's the same in NHS community services. At one time my job was done by three full time members of staff. Now there's just me and I'm part time. Like the wards, we're dealing an unworkable combination of increasing demand (largely due to the cuts to social care) and dwindling staff numbers. There is constant pressure from 'above' (the commissioners rather than management) to meet targets, work faster and more "efficiently" whilst providing reams and reams of evidence as to how we're constantly improving the quality of patient care but we're not given the resources needed to achieve this. We do our best but there simply aren't enough of us.
I agree with pp that you should make a complaint. It's not about dropping anyone in it (you can emphasise positive aspects of your care and make the point that you're not looking to criticise the staff themselves, just the low staffing levels), it's about highlighting the risks to both staff and patients.

"I also think that the old-style of nurse training was better: nurses learnt on the job and were paid to do so, and also had classroom teaching and exams for which they were released from their ward work".

Student Nurses still learn 'on the job' (time is split between placements in clinical settings and classroom teaching) they just don't get paid for it anymore. Now that they're talking about scrapping the student nurse nursery, which was a pittance anyway when you see the hours student nurses put in, the level of risk and responsibility they hold in some clinical areas and how much their relied upon to provide direct care on the wards.

It is not always a question of family not being bothered to visit. My own elderly DM was taken into hospital before Christmas and is still there. She is 100 miles away. I have visited a couple of times over the Christmas holidays but it is not possible for me to go regularly as I have caring commitments here at home. She has no family living near to her so gets no other visitors. I would hate to think someone described her as the old lady whose family don't bother to visit. I would dearly love to be there to get things moving as very little seems to be happening and there is only so much I can do speaking to people on the phone - especially as it is a different nurse every time I ring. She is now one of those 'bed blockers'. "Medically fit" for discharge but not well enough to go home. There are currently no re-hab beds available for her to go to. Another problem with the NHS.

I had this with my father too - he was in hospital after a fall and could have been discharged after a couple of days if a care package could have been put in place quickly. As it was he stayed in hospital a month and had very little therapy so actually came out of hospital in a less mobile state than when he went in. Having read this thread I now understand why - not enough staff to get anything organised for him. He moved into a care home before Christmas but they say his care needs are too great for them so in the medium term he needs to move into a nursing home. I am 150 miles away with a 13 year old. You can't drop everything and visit all the time especially if you work and your partner works - not everyone has an understanding boss (I do, but I can't expect my husband to keep taking time off work as well to be at home for ds). My mother (who divorced him in 2002!) has now stepped in as she is close by and is looking at nursing homes for him!

At least he had visitors when he was in the third of the three hospitals he spent time in as he was close to home so some of his neighbours visited.

This is exactly what the govt wants. Services get worse due to insufficient money. Then instead of saying "actually, we need to fund the NHS properly", people say, "the NHS is terrible, it needs a complete overhaul". The last thing it needs is yet another overhaul! It needs enough money to keep giving the service people expect. It's a matter of priorities.

I lasted 6 months on the wards after I qualified. What I experienced was very similar to what you describe...and that was 25 years ago. I now work in primary care (with its own stresses) and would rather quit nursing altogether than return to work in a hospital again. I particularly remember 3 dying people in wet beds waiting for help one day, with only 3 staff to cover the whole 30 bedded ward. The discomfort and indignity of lying there for up to an hour is dreadful.
I agree with the poster that said dementia particularly, is an NHS time bomb. Modern medicine has the ability to keep people alive and in good health for longer than ever before, less so the brain it seems.
I hope you're soon feeling better.

spaceyboo thats awful but maybe they were scared to take time off work because they are in fear of their jobs. Employment rights are being eroded.

In other cases ppl are being told to move away to find work If ppl follow the advice that got voted for ..yes VOTED FOR then as a society we had better get used to the consequences.

On the council homes for life thread there are plenty of posters saying that ppl have no right to stay in their home town or city if they cant afford to and/or have to claim tax credits to do so. Plenty of people have already been socially cleansed out. Communities are being split apart. Too many ppl want it both ways and you cant have it both ways. But this is a lesson that never gets learned.

I'm sorry you are having such a rough time The Fuzz, and I hope you get well enough to go home soon.

I work as an RMN in a dementia unit. Most of our patients present with 'challenging' behaviour like aggression or restlessness. By the very nature of the client group many of the patients need personal care, support to eat / drink or just general supervision. Honestly I contemplate on a regular basis leaving this for a different career. It's thankless and soul-destroying. I work 14 hour shifts, regularly work through my breaks, and run around like a headless chicken and still only manage to scratch the bare bones of what needs doing some days. Then you have to deal with an endless litany of managers complaining about why random bits of paperwork haven't been completed, and complaints from relatives about why patient x hasn't had a bath today, or why patient y had to wait to be changed after she had wet herself. I am, always, professional in my replies but sometimes I just feel like screaming 'I would love to bloody have time to change every patient the second they wet themselves, and give every patient here a bath each day, and GOD FORBID actually TALK to some of them (especially those that get no visitors), but there's just not the staffing resources to do that and I am only bloody person'.

[Feels relieved to get that out]

How are you feeling today thefuzz?

You're so right, KitKat. My dad was in a bad state a while back; the ward was so understaffed that I felt terrible for the nurses. On one particularly bad day he hadn't been washed for a while, he was also shivering and needed extra blankets. I offered to do both of these - they're not skilled, I just needed to know where the blankets and flannels were - but was told I wasn't allowed to. I didn't want to add yet more pressure to the nurse on the ward by insisting they drop everything and attend to Dad, but couldn't bear to see him so cold either (and had already improvised with my coat). I do wonder now if they'd had to ration the blankets - which I've also experienced before.

It turned out that a local A&E had been merged with this hospital's A&E; since there weren't enough A&E nurses in the hospital, all other nurses had been called to cover A&E while a single nurse dealt with 30 beds in Dad's ward. It's almost worse than a 'bring a relative to care for you' as the relatives aren't technically allowed to do anything other than sit and look sympathetic! (or complain)