NHS and understaffed

[Itsmeagainandagain]

Aibu as a member of staff working within NHS to be fizzing from the ears at the lack of staff.
Another shift another hellish day with not enough staff to help us cope with a heavy ward. 2 staff nurses and 1 HAC for 20 people in various stages of pain and dementia and at least 10 fall risks. What I am absolutely raging mad about is there are nurses and HCAs walking in and out our ward with clipboards to see if we have the correct staffing levels, here's the rant, these clowns should put down the clipboards, roll up the sleeves and get their arses on the wards to do the jobs they were trained to do. It's patronising to nurses and HCAs who are on their knees begging for extra staff and these halfwits are strolling about as if on holiday.

AIBU to be mad, I'm sore all over and had not one break today. My urine was near enough brown because I held in a pee for 6 hours because I couldn't excuse myself to go to the toilet.

When is enough? Do our voices not matter in the workplace we are employed? How do we look after patients when there is 3 people looking after them.

The NHS is full of people who walk around & back and fore. I go to a clinic and there are two or three people to do one job. It is like that because a whole tranche of managers thought that they make make hospitals like car factories.

It's the same in social care. When I worked on a dementia unit there were 2 of us to 24 residents. I was in my knees and couldn't justify my health anymore so I left and glad I did

Job adverts are constantly advertised in my Trust.
Same jobs plus another 5 or 10 over and over and over.
No one applies, they can’t fill them.

There’s another 200 adaptation nurses on their way to our area from India, Africa and the Philippines.
We would have closed wards if it were not for these folk.
Staffing is still
A huge issue.

Don’t think that the clip board people don’t have shit piled on them from above, they do. They were probably you at one time…typing out incident after incident thinking/hoping that it would make a difference and incite change.
Getting nowhere, wanting to make a difference, they became clipboard people.

There’s a world out there, it’s a choice and you have options.
Vote with your feet.

YANBU to be angry about staffing, but YABU re your attitude to the clipboard staff - they are doing what has been asked of them. They are also collecting evidence to support your claims and fight for extra staff. You are "well staffed" for a 20 bedder, unless it's a morning shift of course. For a late shift or night shift 2 S/N and a HCA for 29 to 32 is the norm, on an elderly care ward. It's not enough to give the care you want to give of course and I wouldn't return to those conditions myself, after 20 plus years of it. My current role is horrendously staffed too and I work far in excess of my paid hours - however for the vast majority of the time I'm not worried about people dying, because I made a mistake or didn't get to them in time. 💐

Go on strike FGS.

Our staffing level is currently, on a good day, 60%. During August, it will be 50%. We can’t get bank staff as our service is so specialised.
We have put our poor staffing on the hospital risk register, and suggest you raise this with colleagues, and put it in writing to the Trust. That’s what we did. It doesn’t help with more nurses, there’s nothing we can do apart from carry on, but it does mean that there is a record that this is the case.
However, ours is an ongoing issue, they may not be interested in doing this if it’s a temporary problem for a few shifts.
It’s utterly pants, and we’re exhausted, but good luck , OP.

Why don't you strike? I get your job is awful and you can't do it properly but we the public are getting a dangerously bad service- eg the maternity wards where babies die that shouldn't - delayed ops etc
But as long as things limp along nothing changes.

I work as a band 6 on an elective surgical ward. Staffing and morale is at an all-time low. I was so stressed.on my last shift, patients admitted for surgery are dependent on us discharging patients ASAP.

It is a balancing act and a dangerous one, trying to discharge quickly to keep the flow going. Post op patients are at high risk and I rely heavily on my HCA to provide this care. I spend so much time dealing with compliants and complex discharges.

Yes we should do incident reports but it takes time and nothing changes. If I raise with matron how short and dangerous the shift is, a stock response is all the wards are the same. All they want is positive comments anything deemed negative is shut down. I really try to support my staff and raise concerns.

We often go for hours without breaks or using the toilet otherwise, it's the patients who suffer.
I don't know how long I can do this, we are desperately trying to catch up with the backlog caused by covid but, it is breaking us. It would be nice to get a thanks, it's always why did that patient fall? You knew he was a falls risk, you must leave one member of staff with him at all times. Never a well done.

The patient's however are so greatful and lovely and keep me coming back. No advice but I hear you, I thought as a senior I could change things 🙄.

Sorry I did put in paragraphs.

@Rupertpenrysmistress

Do you have discharge chairs? It's this fabulous idea our trust introduced which means we who've anyone who might go home that day into a day room, we then admit patients into their beds and sometimes end up with an extra 5 or 6 patients on the ward in a day but no extra staff to care for them. We then have patients in the day room who are elderly and frail sat on a chair for up to 7 hours while we try desperately to sort discharge papers, medication, transport. Catastrophes happen, patients become unwell again, but can't be put back into the bed they previously occupied as its now full, I'm sure you can imagine the much more serious scenarios that have happened.

We report it through incident reporting and nothing is done.
We escalate to matron, deputy of nursing, director of nursing, still nothing is done.

I could have written this post! This past few weeks have been horrendous. 24 bed ward some of patients are palliative and most are very high need.
I feel completely exhausted, physically aching all over and emotionally battered.
I offer you my hand in solidarity

@Weebleweeble

Because we have a duty of care to our patients. How many people would be harmed or die if all nurses went on strike. We genuinely really care about our patients and the idea of doing anything which may put them at danger is against everything we do.

My ward were treat appallingly by one manager who had no respect for the staff and expected us to go above and beyond our duties as normal, there was never a thanks. In the end we all started to take our full breaks, we started to arrive on time and leave on time, just doing that crippled the ward. Imagine what would happen if we went on strike.

@Weebleweeble

Why don't you strike? I get your job is awful and you can't do it properly but we the public are getting a dangerously bad service- eg the maternity wards where babies die that shouldn't - delayed ops etc But as long as things limp along nothing changes.

People won't strike because they can't afford to lose pay.

[quote EverdeRose]@Rupertpenrysmistress

Do you have discharge chairs? It's this fabulous idea our trust introduced which means we who've anyone who might go home that day into a day room, we then admit patients into their beds and sometimes end up with an extra 5 or 6 patients on the ward in a day but no extra staff to care for them. We then have patients in the day room who are elderly and frail sat on a chair for up to 7 hours while we try desperately to sort discharge papers, medication, transport. Catastrophes happen, patients become unwell again, but can't be put back into the bed they previously occupied as its now full, I'm sure you can imagine the much more serious scenarios that have happened.

We report it through incident reporting and nothing is done.
We escalate to matron, deputy of nursing, director of nursing, still nothing is done.[/quote]
omg I'm completely aghast & outraged to read about your "discharge chair system", this is highly unsafe practice. If I was on your ward I'd simply refuse to use it.

At my trust we have a "discharge lounge" for patients that are medically fit for discharge, but awaiting medication. They are taken to the discharge lounge, which is staffed with a band 7, one SN and two HCA's. The discharge lounge team collect the patients, they chase medication, they organise their transport and liaise with family/care homes/nursing home.

You're blatantly being exploited & overworked by your management. You're unwittingly creating capacity for up to 6 extra patients to care for with no additional staffing and unsuitable facilities. I urge you to simply refuse to facilitate the use of the "discharge chairs".

It sounds awful ; I know a young lady about to start as a junior doctor and I don't envy her as you know it's going to be grueling.
Having had many elderly relatives in hospital in the last ten years I can see how downhill everything has got and I guess covid has just made it all worse. Too many chiefs around and not enough people doing the basics is my own assessment.
I feel for the staff. I also dread getting older myself.
An overhaul is needed , but where would anyone start ?
I'm just sorry it's got this bad

@Itsmeagainandagain

Aibu as a member of staff working within NHS to be fizzing from the ears at the lack of staff. Another shift another hellish day with not enough staff to help us cope with a heavy ward. 2 staff nurses and 1 HAC for 20 people in various stages of pain and dementia and at least 10 fall risks. What I am absolutely raging mad about is there are nurses and HCAs walking in and out our ward with clipboards to see if we have the correct staffing levels, here's the rant, these clowns should put down the clipboards, roll up the sleeves and get their arses on the wards to do the jobs they were trained to do. It's patronising to nurses and HCAs who are on their knees begging for extra staff and these halfwits are strolling about as if on holiday.

AIBU to be mad, I'm sore all over and had not one break today. My urine was near enough brown because I held in a pee for 6 hours because I couldn't excuse myself to go to the toilet.

When is enough? Do our voices not matter in the workplace we are employed? How do we look after patients when there is 3 people looking after them.

Please start submitting the incident reports and work to rule. We have to stand up for ourselves, take care of our mental & physical health and stop attempting to cover the cracks in the system by making personal sacrifices. Take your breaks, go to the toilet when you need to and leave on time.

I'm a nqn and I've already learned that you get no thanks and no extra £££ for missing breaks and working late.

The NHS is weighed down with office staff and “managers”. When I started as a junior doctor in 1980, administration accounted for just 5% of the total NHS budget. By the time I retired, it was 12% and rising.
Personally I think the NHS is no longer fit for purpose, despite the overworked and heroic efforts of the clinical staff.
We should move to the European model of an insurance based, efficient, privately run system with decent wages, better staffing and lower waiting lists.
Our NHS is not “the envy of the world” - it is regarded with pity and amazement that we put up with it, by my European relatives. My surgical colleagues said they were embarrassed, when attending conferences in Europe, at how far behind them we were.

@MadisonMontgomery

If it makes you feel better, it’s the same elsewhere in the NHS! I work in a GP practice, we now have 4 practice managers, 3 people doing QOF, 2 people dealing with complaints… most of the complaints are from patients who can’t get through due to the lack of receptionists, yet it never dawns on them to muck in & pick up a phone themselves 🙄

GP practises are private businesses. You can’t blame the NHS.

I'm retired now thank goodness, I dont think I could cope working on my old ward now. I tried raising staffing, infection, dependency levels with management and filled out numerous incident forms but nothing ever changed, we never even got any feedback. You get swiftly moved to another area , usually completely outside your speciality or area of expertise, if you speak up despite all the talks about transparency and the whistleblowing policy, its laughable. I think this is why patients, visitors and staff resort to going to the media, they are so fed up.

I have been nursing for 35 years now and while staffing levels in that time haven't changed, the complexity and dependency levels of the patients most certainly has. Nurses have also had to take over many roles traditionally done by medical staff while the 1 or 2 HCAs have far too much of the hands on care to do ( for very crap pay!). We're also supposed to be "paper light" when in fact this just means we're "computer heavy"! OP, you have my deepest sympathy but I doubt it will ever improve.

Striking doesnt always achieve much, you cant just magic up lots of registered nurses or HCA. The staff are just not there anymore, in the olden days students and pupils were counted in the numbere so it seemed like you were overstaffed ar times. What needs to change is the non clinical roles who need to be back on the wards helping with patient care, how many ward managers and matrons turn round and say no sorry I cant come ro this months budget meeting I have patients who need looking after and a tea round to do.

@NurseButtercup

If only it was that simple. When it was first introduced we point blank refused, we were taken one by one into the office by our ward manager, the matron and some very senior staff, it was explained that we simply had to utilise this system, if we didn't they would take us to a disciplinary panel. Even after we continued to refuse but they just started bringing patients up anyway.

Theyve not unwittingly done it, they purposefully make us overly full using the chairs to prevent accident and emergency backing up and patients breaching the 4 hour limit.

Totally agree that the situation is awful and unsustainable.
I experienced some awful scenes in resus on Saturday as a result of visible under staffing and staff trying to draw things together without enough resources. I didn't want to be taken there, I didn't want to come in on blue lights and siren. I feel awful for adding to their impossible situation. I totally understand that there's no time for them to tell a patient what's happening to them. I was (rightly) kicked out to a&e as soon as possible.
A&E weren't happy about it, they were overun and didn't need me adding to their problems.

X-ray where running a factory line with high speed turnover and a wheelchair patient messes up the system. Not their fault, but embarrassing when you're it.

I then spent fifteen hours in A & E trying to be as low key as possible as it was made clear that questions were not appreciated.

Staff mainly came in and performed duties on me silently, and I did my best not to add to their problems, but did ask a couple of times for basic information so I could make any plan, but was informed they didn't have time to tell me anything, so I shut up and put up.

Late on a nurse wanted to know my days food and fluid intake and got annoyed at me for not telling them I'd not been offered anything to eat or drink all day. (I didn't know I was supposed to)
I automatically said thank you when I was given a sandwich and a coffee, but was asked if I was being sarcastic. I assured her I wasn't and she said she didn't know how she was meant to react as she wasn't used to it. I sympathized and got told how hard her job was and how ungrateful and nasty patients are.

I refused admission eventually because so much fuss and drama was made over how much hard work it was going to be for everyone to try to find a bed, and I was too ill, exhausted and demoralized to deal with it all.

I guess the Gov need the system to collapse then they can bring in 'emergency services' that mean those that can afford it buy insurance. Or some other scheme.
We are becoming a third world country.

Op, to answer your question, nurses voices do not matter and are not listened to.

The situation will not improve- Nurses do not have a union - the RCN is a joke. If you can, get out, look for something a bit easier. Don’t let the job wreck your health like it did to my friend who ended up off with stress, then unable to work at all.