Legalised nurse/midwife to patient ratio

[agedknees]

Isn't it about time that the number of registered nurses/midwives to patients on a ward was legalised?

I have just retired from nursing after 36 years. Part of the reason for retiring early was due to not being capable of doing the impossible. We used to think it was our birthdays if we got a lunch break. Management would just mumble about time management skills, but how is it possible to leave a ward/department if you are the only qualified?

Planes cannot take off if the required number of staff are not present due to safety issues. Well how safe is a nhs patient if their nurse has another 15 dependent patients also to look after.

YY Polarbear. Absolutely normal behaviour towards healthcare staff from patients and relatives.

I left last year. My health is better and I'm not exhausted all the time.
Occasionally I think about going back, but things seem to have got even worse lately.
I don't hold out any hope that pay and conditions will improve. Nurses won't agitate for better conditions, they vote with their feet and leave instead.

Hedgehog, I agree they just leave (I can't argue with that, I did). The trouble is the last large scale attempt for better conditions by the doctors with huge union support didn't do much and the public (in general) did not support them . So I don't know what the answer is. There is a complete lack of respect for HCPs these days.

BollardDodger

Open visiting isn't a good idea and I'm saying that from the perspective of a nurse and a patient. I had a period in hospital as a patient. I was in a side room and the ward was very relaxed about visiting. Id been very ill and friends obviously wanted to show support but I had loads of visitors sometime for hours. I was knackered and needed to rest but didn't feel I could ask them to leave as they'd made the effort to see me. Enforced visiting hours would have stopped that situation happening.

Working conditions are unsafe to the extent that more errors are being made.
Nurses will get the blame for these courtesy of the NMC - you will not find managers disciplined for overseeing unsafe staffing levels.
When I phoned one night to relay my serious concerns about safety, I was on my own. The manager didn't want to know, I was expected to cope.

To be fair to managers , their hands are tied to an extent with budget cuts meaning they must reduce agency spend and cannot just hire extra nurses. I'm sure there are many more things they could do, e.g. why are some wards more flexible than others for staff? However the constraints are at a higher level than just management. The fundamental problems with the NHS would require huge change to fix them. I'd like to point out I am not a manager!

Although I think if managers could streamline systems and paperwork nurses would have more time to nurse.

I think it's dreadfully sad how undervalued nurses and midwives are in this Country. I was in for a week when having my child, one midwife had no loo break, food or drink when she came to me at around 2pm, she had been working since 8am and frankly that's barbaric. Another midwife was almost crying when she came to apologise that she hadn't been able to care for me after getting to the ward and baby having to get emergency transfer to scbu. It's no wonder so many wonderful people are leaving the profession.

Is bollard Jeremy Hunt?

I left nursing two years ago after a 26 year career, it was the underfunding of the hospital and understaffing that broke me in the end. Not enough staff and outdated equipment, I was starting to wonder if I was in the third world!

I've said for years there should be a legal minimum staffing level. This Government will never agree to that.

I'm currently a student nurse and I plan to go directly to community/primary care when I qualify. So many wards are understaffed to unsafe levels and it is only getting worse. I am a mature student with a family and there is no way I could handle the stress...

"But then you ask about any degree of flexibility or set shifts and the answer is no."
Another significant issue for many nurses. Your the biggest employer in Europe in a female dominated professionally you run a 24/7 service but you won't or can't offer a degree of flexibility!
A colleague was thinking about moving to A and E (where the staffing crisis is particularly bad), she was told she can only request two shifts a month but she has to work opposite shifts to her husband so as not to have to pay for childcare, so for example she works every Sunday they said they couldn't accomodate this. So she didn't take the offered job.
Our work place nursery opens at 7 am we have to be on duty i.e. on the ward at 7 am and shuts at 7pm our shifts end at 7 45 pm. Some wards will only let you take 1 weeks annual leave a year during school holidays.

I totally agree that the NHS is shooting itself in the foot with regards to retention. I'm returning from mat leave, and have had my flexible hours request rejected. All the department's I'm suitable to work in would rather recruit preceptorship nurses who are (mostly) flexible to work a full shift pattern and wouldn't dare ask for flexible working.

The place we live isn't particularly exciting or hip, so the younger ones will inevitably be off to one of the more exciting nearby cities once they pass preceptoship (happens every year), leaving gaps again. Meanwhile no wards are able to give me 3 set days a week (and have just scrapped 12 hour shifts, which for the most part nurses loved), so I'm off to the private sector to work. It's not a decision I wanted to make, but it's the only was we can afford childcare.

I don't disbelieve you and want you to have the best conditions you can possibly have as you do a valuable job.

Unfortunately I have had a lot hospital stays where I've been very poorly over many years. From the nhs ones I can remember the 2 nice nurses so clearly, their kindness was so appreciated.

There were so many god awful terrible ones that I couldnt even distinguish their faces in my mind anymore.

It's alright you saying that money and more help is needed. Its hard for people to be sympathetic when they get awful treatment which they can see with their own eyes is not due to staff levels.

It's why nurse specialist jobs are hung on to and don't come up very often.

I've worked in primary care for 17 years and wouldn't work in a hospital for all the tea in China.

Don't get me wrong, primary care is busy and stressful and we are doing way more than when I started practice nursing in 2000; however we are not anywhere in the same league as hospital/ward nurses. At least I have some degree of flexibility and work between 0800 and 1830 with a scheduled lunch break (taken at my desk but at least I have no patients booked in routinely).

My ward/ED based colleagues are on their knees. My DP is an NHS manager and works 10-12 hour days 5 days a week and works at home on the weekends remotely. The amount of bureaucracy and red tape he has to cut through is unbelievable. He has no say in staffing levels or admin numbers. He has to write proposals to replace essential staff and present them to the divisional directors and finance directors to make a case for replacing staff that have left - it's not automatic!

I don't think the crisis is primarily nurse numbers - you could recruit thousands of nurses but unless you offer them support, shifts that fit around their families, regular breaks, CPD and time to do it, and flexible leave then they will leave as quickly as they started.

Bollard for info, managers aren't responsible for the nurses professional registration. We are autonomous practitioners and responsible for our own performance and registration. Walking off the ward to take a break leaving no other qualified staff is gross misconduct and breaks our clinical code of practice, leaving us open to being struck off. I worked damned hard to attain my qualification and registration and wouldn't risk losing it (and harming my patients of course) to make a point to a manager. The NHS runs on the goodwill of it's staff and that's why nurses are so vulnerable.

It's one of the reasons I'm moving away from acute care.