Disclaimer - I work in a care home, not a nurse.
Regarding the being told to use a pad instead of the toilet, on the face of it, not acceptable.
However, how would you feel if I left a relative of yours in a dangerous situation, to take someone else to the toilet?
Because in a home that's sometimes the choice we face, which is a less stressful and obviously non medical environment, with less going on. If we're dealing with someone who needs two for safety reasons, and someone else needs the toilet, well they need to wait unfortunately, we
have to prioritise safety over anything else, and yes, I will reassure and say it's ok, you can use your pad, I can't discuss where I am or what I'm doing in detail because that's confidential.
Also, you know, someone has to go first, and someone last when people want or need help at the same time. Unless there's a massive investment in healthcare in general, to enable 1:1 (or 2:1 if needed) care across the board, someone's always going to have to wait. But then no one wants to be the one who waits.
We're not technically 'short staffed' either, in fact legally we've probably got more staff on some shifts than the guidelines state as a minimum, but we're still outnumbered (for want of a better phrase) by residents.
That's the practical side of things, and unfortunately there's no getting away from that.
That said, I have experienced some poor care, both as a patient (less so) and as an escort to residents that have needed to attend hospital. Dementia patients are particularly at risk ime, possibly due to lack of understanding and training, and also probably because they take up more time than an average patient with the same condition or injury due to the nature of dementia. I've been told to 'do something!' by medical staff - what they expected I don't know, I could no more force compliance than they could, I was there to basically stop them wandering and putting themselves further at risk and offer the constant reassurance dementia patients often need, working in dementia care doesn't mean I have a magic answer.
While there are definitely nurses that are poor at hands on care and dealing with patients as people, I don't think that can be purely put down to them having a degree, though I do think that maybe longer on the wards as well as the classroom might help with that. I've worked with care workers who weren't in the slightest bit caring too.
I think the poor care, like poor customer service stands out more, and poor management and poor resources contribute in no small way. I also feel that the social norm of presenteeism has a lot to answer for. We expect 100% performance all the time and no mistakes to be made, well apart from being unrealistic when you're dealing with humans, there's also the fact that being ill is detrimental to performance, yet you are often given a hard time, pressured to work when ill and can be disciplined for being ill too often, or for having a family crisis etc. So apart from having humans with faults at the heart of this, you've sometimes got humans that could be ill or in the middle of something going really wrong, who are being overworked and treated poorly by their employers and also sometimes by the people they're trying to help. It's no wonder that some lose their caring side sometimes or all together really.
I think we need to look long and hard about why it's being perceived to be getting worse, and what we're asking of nurses and other HCPs because they're human too.