AIBU to wonder WTF has happened to nursing “care” in our NHS?

[AnnieGetYourPun]

And don’t tell me it’s all Covid/staff shortages/staff illness related.

My niece was eventually admitted to hospital after being sent home twice from A&E (in agony) and is now on a gynae ward. It’s just her and an elderly lady on the ward. The elderly lady was getting agitated as she needed the toilet. The nurse came and said, and I quote “it’s alright, use your pad and we’ll come and sort you out later”. This has really upset my niece who’s dodging sepsis now, on the ward, on massive IV antibiotics/anti-emetics and IV analgesia. She has narrowly avoided a ruptured uterus as there was no one to do a scan on her, after a 12 hr wait in A&E. She is 32.

Nurses now... all of ‘em have degrees. All dead clever. Very few of them have an ounce of “caring” in them.

Fry me on here. I’m past fucking caring.

Should add. I trained in the NHS. Was a student/junior staff nurse/senior staff nurse/junior sister and G grade senior sister before retirement. Never, in my f***g life have I seen such lack of basic care and maintenance of human dignity than I have witnessed in NHS hospitals, in the past two years.

Shove your clapping and rainbows.

Sorry that's long

Tbh when I was in I couldn't work out who the frig was supposed to be doing what. I don't think they could either, but a fair few of them were quite vocal about what wasn't their job.

@albertcamus

YANBU at all, in your situation I agree with you 100%, but I would like to say that the situation has been getting bad for decades. The worst moment of my life was in November 1989 when a bunch of 'caring sharing' nurses in 'wonderful Great Ormond Street' children's cancer ward summoned me from the rat-infested basement to which my husband and I had been sent saying: "Your child needs you NOW" (he was on heavy chemo and had an extremely low white blood count, and was fighting an infection) ... as I ran up the stairs and along the corridor, I didn't think he would be alive. He was actually OK, he had been awoken by the noisy racket of the nurses watching a war film on the TV. Yes, at 3am in GOSH Oncology Ward. This was one of many shocking experiences we had in that place which was characterised by shockingly low standards of care, particularly nursing. I don't believe ALL nurses don't care about their patients and behave badly, but IME far too many do not meet the standards they should.

I finished my Nurse training in 1989 ( not GOSH) but the standards then were appalling. I still have nightmares about some of the awful situations I was put into as a 20 year old with little life experience. I will never encourage my dd to become a Nurse , ever.

Just a quick reply to @LaMarschallin... apologies to you. My wording and auto correct made my reply gobbledegook. What I was trying to say was that your human dignity was not maintained. You were forced to wet yourself, for lack of attention. And yes, it WAS you at the end of poor care.

And the old psychiatric hospitals may be gone but I’ll give you one reference to “modern” psychiatric “care”. Look up Connor Sparrowhawk. Just one young man neglected, in a very long list.

Will return, with more replies.

It seems yo me that, since new entrant nurses have been required to have a degree, we've had to employ huge numbers of healthcare assistants to do the very basics of nursing. Is this because the likes of making beds, emptying bedpans etc is now seen as beneath anyone with a degree? I don't understand how and why the role has diverged so much.Have nurses taken on part of a doctor's role?

No one goes into nursing for the money. It would be hard to find a career which requires a degree and professional registration and requires 24/7 flexibility (including Christmas) that pays less. Poor care happens for a wide range of reasons and while I don't think it is that common, sometimes loss of compassion is part of that (see Mid Staffs). However, we need to consider why people who choose to go into a caring profession end up feeling this way and how we change that.

This isn't a new problem but what's been asked of front line healthcare staff over the last year is unsustainable and if we keep blaming nurses for poor care rather than looking at what they need to do their job safely we are going to have a serious problem.

So what's your solution then ? I have mixed feelings about this thread and really don't know what the point of it is. If it's to wind up already demoralised stressed out but hard working, diligent and caring nurses, well job done. Good on you.
I've been qualified just over 30 odd years. First 5 years spent on an elderly medical ward, the rest on ICU. I've come across several lazy, thoughtless unmotivated nurses. They do the bare minimum so basic but vital stuff like eye and mouth care, positional changes etc are skimped. Unbelievably that's on ICU which is one of the few places where we on the whole can give high quality nursing care. I often wonder how I'm running round like a madman and others have time to sit chatting (and it's certainly nothing to do with poor time management on my part). I see a line dressing hanging off so I replace it. A patient's skin is dry and flaky so I put emolient on. Some wouldn't. That's the way it is and I don't know the solution. It's a personal moral imperative I suppose but those individuals are in the minority thank god.
So much of nursing now is just tick boxing. So much of it is sat at a computer tick boxing. If you've not documented it, you've not done it. It covers the trust's arse. We spend probably several hours a day nursing a computer. During the pandemic high point our managers allowed us to use paper documentation which says it all. We have a computerised drug sheet which is confusing and time consuming to the point of being unusable but cost millions.
Wards have been run on a skeleton staff for years, reliant on agency nurses.
You want decent care you need more staff that aren't run off their feet, are offered decent educational training that's not in their own time, are treated with respect by management.
As an example, my attenance record has always been good. Worked throughout the pandemic in full ppe despite having asthma, albeit mild. I caught covid which turned into long covid. I was off work for almost 8 weeks. I'm on an official warning. That's the thanks we get. I will almost certainly retire next year

@Pinkfreesias I've never met any degree educated nurse who thought emptying a bed pan was beneath them. Urban myth. Fewer doctors means nurses have had to takeover certain formerly medical tasks like cannulation, venepuncture, ecgs, iv drug administration and nurse prescribing. Advanced nursing practitioners, nurse consultants are there solely to supplement the medics also.
Trusts demand defensible documentation, literally everything we do is documented which is obviously time consuming. Hence HCAs now undertake a multitude of tasks previously done by nurses. We depend on them to report back alot of the time and they are only as good as the training they receive.

@albertcamus... good grief. Appalling. So sorry.

Some excellent points made re. poor pay, staffing levels, Covid, conditions worsening over decades. What to do? Beats me. I’m glad I’m out of it and no, I wouldn’t encourage my daughter to go into nursing. My sister works front line and has been ill recently. Management have mithered the crap out of her re. “When are you coming back”. The culture of staff being treated abysmally is also rife.

On the subject of “ticking boxes”. When I requested my mums notes after her death, I was astonished by the standard phrases, ticks, numbers relating to care given. One phrase which kept cropping up was “Patient dignity maintained”. Really. It wasn’t. I’m still waiting nearly 18 months on, having gone through all the correct channels with our family’s complaint to hear something...anything in response. PALS have said they’ve no idea why we haven’t been allowed to see the hospitals’ response, thus far. I think there’s a good change we’ll die waiting. So, for us, even that has been a shambles.

@Pinkfreesias... I think you make a very good point. The HCA’s were the ones giving the care to my mum. I have no idea who the named nurse was, indeed, the day my mum died, having been on that ward almost a week, they STILL had no clue who I was talking about when I went to the desk to ask about my mums condition. This was because they kept getting her name mixed up with someone else. I had to explain which bed she was in and practically lead the nurse, by the hand, to my mother’s bedside.

My dad received amazing care last year with being diagnosed with cancer and the end of life care he received.

My husband has been in and out since January and only one nurse was ever rude to me on the phone and hubby said she was a right crabbit one. His care has been fabulous on the wards.

The GP surgery on the other hand...

Maybe they've been taking lessons from mental health nurses, who have refined Not Giving A Shit to a fine art.

Nursing is like teaching imo. It attracts all sorts. Some are lovely compassionate souls who go into the role for all the right reasons. Others are in it for the paycheck alone, possesing all the compassion of a pet rock. Anyone who thinks every single nurse is great is incredibly naive. I left the NHS as a whistle-blower so obviously don't want to say more but it's safe to say I've seen my fair share of bullies and the utter cruelty some people possess.

@Eskarina1

No one goes into nursing for the money. It would be hard to find a career which requires a degree and professional registration and requires 24/7 flexibility (including Christmas) that pays less. Poor care happens for a wide range of reasons and while I don't think it is that common, sometimes loss of compassion is part of that (see Mid Staffs). However, we need to consider why people who choose to go into a caring profession end up feeling this way and how we change that.

This isn't a new problem but what's been asked of front line healthcare staff over the last year is unsustainable and if we keep blaming nurses for poor care rather than looking at what they need to do their job safely we are going to have a serious problem.

I actually disagree with this because once trained nursing can be very flexible particularly for working mothers who have partners / husbands that work . I gave up nursing at 48 due to a variety of health issues and that was 8 /9 yrs ago but prior to that for about 15 yrs I had worked 1 night shift per week , so 11 hours . For that , at that time I took home around £700 per month , got 7 weeks holiday and 6 months full sick pay / 6 months half pay when I was off for a year prior to my resignation . I never needed any childcare when my children were small and the only inconvenience was having to work at Christmas or new year and 1 night really wasn’t that much of an inconvenience .

@AnnieGetYourPun what's the answer ? We need educated professionals. Patients are sicker, older, more complicated comorbidities, more demanding and opinionated. They and their relatives are far more questioning.
Many of the stories upthread seem to be concentrated on elderly medical wards. Sad to say but many young motivated nurses don't want to work there.
It's physically hard work, emotionally challenging and a place where you quickly become clinically deskilled (hate to say it but true). It really doesn't receive the same acolades as ICU for example even when the care is good.

floralnomad thank you for stating that.

It varies. My experience of DS1's birth and post natally were horrendous. My 23 year old hv now teaches nurses on degree courses - someone who was completely incompetent and totally uncaring in practice. DD's birth however was marvellous. They are grown up now.

Factor in their stays as dc (2 x grommets privately I super nurse, one horrendous) (2 x broken bones - one stay OK, one shocking) (2 x bronchiolitis - one stay exceptional, one shocking).

Outpatient nurses, I have found completely beyond the pale in the context of capability and manners

It boils down to communication and often it is poor. There is also a smattering of constant complaint to the patient about their lot and far too often a loud cackle from the nursing station at 2am about boyfriends, holidays and other extraneous nonsense. That is really just so inconsiderate.

Just a couple of years ago I had to have a very personal test and was having it at our local private hospital. I had my pre-op stuff done my a nurse beforehand. A few days later I saw that same nurse in Sainsbury's and she saw a man she knew, hunkered down and belted out "nah, xxxxx, you f*ing ponce". It was vulgar and wholly unacceptable behaviour. That it came from a nurse, a member of our local community, was horrific and is the sort of conduct that brings nursing into disrepute. I contacted the hospital manager and requested that nurse came nowhere near me when I was admitted.

Whilst I think private care is a little better nursing remains very variable even when one pays. Somewhere standards must have slipped.

The system has to change and too often I have felt that nurses are abrupt and rather rude. I shall never forget the coarseness of the first community midwife who visited me after ds was born. She shot into my house before she was invited in and just didn't listen. She embarked on a directive about contraception and sex and when I said "thank you but I discussed it at the hospital, had a baby only a few days ago and am not discussing it again" completely ignored me and held her left elbow in her right hand and belted at me "well get the pelvic floor exercises done otherwise your man will say the sex feels like this" and waved her arm backwards and forwards. Vile, vulgar and wholly reprehensible.

There are good and bad in every vocation I agree, but in nursing too often there seems to be a little too much bad.

I also think it would be helpful if there was a clear explanation, visibly so, in every department about what the role of the different uniforms is. There are people in dark blue, pale blue, pink, green flowers and scrubs in many hospitals there needs to be absolute clarity about their roles.

@Pinkfreesias

It seems yo me that, since new entrant nurses have been required to have a degree, we've had to employ huge numbers of healthcare assistants to do the very basics of nursing. Is this because the likes of making beds, emptying bedpans etc is now seen as beneath anyone with a degree? I don't understand how and why the role has diverged so much.Have nurses taken on part of a doctor's role?

Well qualified HCAs do the work SENs used to do so the same role another name. Yes nurses do many things that used to be a doctor's role, which is why they are trained as they are.

If you had been watching me on the covid ward last night, you might have seen me fiddling with a computer.

I was reviewing my patient's medication chart to see what medication they had taken to address a critically low blood result, and looking over their previous blood results, observations, and most recent medical plan, so that I could bleep the junior-junior doctor who had never met my patient and hand over enough information so he could prioritise this issue in relation to all the other issues on all the other medical wards in the hospital.

I also turned and cleaned and wiped and gave mouthcare and weighed urine bottles and cleaned commodes.

Going back tonight to do it all again.

I have a degree and it never stopped me doing the second group of tasks, just enabled me to do the first skillfully.

But I'm probably going to leave nursing. I qualified into a pandemic and have put myself and my family at risk for the past year. Hope y'all can find someone else to fill my post, because even the imperfect care I give is better than no care at all. But apparently nurse retention is too radical an idea for this country.

@SirenSays... I too have unfortunately been on the end of “whistleblowing”. It took over two years of RCN CQC involvement but my complaint about a more senior qualified nurse was upheld. I remember getting a letter from management basically saying well done, thank you for bringing this to our attention and there then followed months and months of ostracising (of me) and it was at that point I felt retirement looming.

Perhaps nurses now are so busy doing additional medical care and are supervising HCAs in actual care and this is where it has changed and IMO has led to qualified nurses being out of touch with their patients. Maybe, the nurses who had no real clue who my mum was hadn’t actually “hands on” met her? Don’t know. Either way, something is going badly wrong.

@RosesAndHellebores... really?! 🤦‍♀️

@Babylonberlin... sad but true. Your last post explains much. So sad. And yet surely, nurses are getting more clever. Entry to training requires decent A Levels; there’s the actual degree qualification and seemingly endless updating/post grad courses etc following qualification. Surely nurses are better train now than ever before?

@ClockworkNightingale... if you’re giving up after one year, albeit an absolutely horrendous one, no one would deny, you might be better suited to another role. I wish you success in your future.

I assume that was in response to the arm waving? @AnnieGetYourPun Yep really. St George's community midwives more than 25 years ago. It's the sort of thing one never forgets. To be fair a few years later when dd was born, it was much much better!

I work in a nursing home which is obviously staffed with nurses. There are usually two nurses per shift for around 30 residents as well as around 6/7 care assistants. They see their role as purely clinical and will never, ever answer a buzzer or change a pad. They will come and get a care assistant and tell them that so and so needs a pad change or needs assisting to the toilet or needs water. I've worked there a year and can count on one hand how many times I have seen one do any personal care. I can quite believe that in the hospitals they see these jobs as beneath them too. If we are short staffed then they will not muck in and help. The other night there were only 2 care assistants on the night shift and they left them to struggle on there own rather than help. They are also trying to persuade the care assistants to take on training to do blood pressures and observations and we are resisting as it will stretch us even further and take us away from caring and we are only paid 8.72 an hour. The nurses are not happy and said we are 'protesting'. Damn right we are.

I've no experience of working with hospital nurses to know if the situation is the same, however my experiences in hospital with nurses have been fine 🤷🏼‍♂️

My DM was shouted at by staff for not reminding them, that she needed her pain medication, shame she was unconscious at the time.
If was happening now she would be dead, everything was put down to her age.

You want decent care you need more staff that aren't run off their feet, are offered decent educational training that's not in their own time, are treated with respect by management.

That's the answer right there. More staff - nurses to nurse and doctors to do doctoring, or if you insist on turning nurses into junior doctors then more HCAs to nurse, with no more responsibilities passed downwards and a clear recognition of the limits of different roles and that they are needed. Cleaners too. More flexible training options without ludicrous price tags are needed too, with transferability training between the roles if individuals want to take on more. It will cost. It is worth it. Worth it to patients, for the staff who save lives, to the country (it won't happen overnight either).

While I do not doubt that you and your niece have had a bad experience of Nurses, you cannot tarnish all nursing staff with the same brush because it just isn't true.

The foundation of my nursing degree is person centred practice, all knowledge is built on this. Regardless, there Will be some that cannot learn compassion because it is not innate to them, but having an understanding of the macro structure which may lead to poor health can help people be considerate.

I also don't understand the blame towards soley nursing staff as they do not work in isolation. I also don't think many patients (as I didnt) understand the role of nurses now. A lot of what people have described would fall under CSW or HCA, some physio, some consultant. Even when someone's obs give a higher NEWS2 score, sometimes you really have to pester to have the patient looked at again. These are all relevant.