Unqualified NHS staff

My friend is a qualified nurse.
She got made redundant.
Lots of nurses did. Now there isn’t enough nursing staff

I wonder why.

I doubt it’s true OP, student nurses are very closely supervised and 1st years don’t take on much responsibility at all.

Nurses are highly skilled professionals. A lot of what people think nurses do nowadays is done by HCA’s who are invaluable and not paid enough. Our HCA’s do ECG’s and bloods, News etc.

We have RNA’s in our Trust and I think it can be a great role for up skilling those who would struggle to access nurse training through traditional means. I am a Ward Manager and the contribution my RNA’s offer to the ward is immense. Arguably they don’t get paid enough but most see it as a stepping stone to progressing to Band 5 and above with the continuation course.

I find it very dangerous. Research shows patients are safer when cared for by qualified registered nurses.
its not ok to have more unqualified staff nurses can tell a lot by taking someone to the toilet or giving them a wash such assessing their pain, mobility, breathing, skin, checking wounds and also their emotional/psychological well-being.
It’s amazing how much you get to know your patient during a bed bath or shower and the more unqualified staff that take on these duties the less the qualified nurse will be able to know about the patients and their care will suffer.

Your post makes no sense. So do you believe holding a degree is safe care? Yet you recognise the staff under the RN know more about their patient then they do?

Actually, it makes perfect sense. Nurses are taught a lot of anatomy and physiology, skin integrity, nutrition, but because they have moved nurses away from the bed bathing,feeding toiletting because they were seen as easy for anyone to do those observational skills are not being used.
We used to dish out the meals and assist with feeding. It meant you assessed your patients ability to chew/swallow. If they couldn't eat you would get them a complan drink etc, we had a kitchen where you could get soup as an alternative. if you knew if Betty hadn't been eating.
Now the meals come up on a trolley and are dished out by ward hostesses, who then come round 30 mins later and remove the trays. They arent monitoring whos eating or who is struggling. They don't place the meals where patients can access them. Thats a big chunk of observational nursing missing.
Same with bed baths. It wasn't just giving a wash, you would be looking at your patients skin condition and integrity, their mobility, it was time to talk and find out if they had any concerns. Now you have to rely on your HCA's being good and noticing these things to report them to you. Its like nursing blind

Except good nurses still do all that stuff. Lazy nurses choose not to. Smart nurses don't leave themselves vulnerable by not knowing what is going on with their patients.

Terrible idea but during the height of the pandemic, we as mental health therapists (not nurses) and admin staff were being told we would have 3 days training at uni and be expected to run a non covid ward, whilst qualified nuses and HCAs ran covid wards. Thankfully it didn't happen.

I've had mixed feelings about this. They have eroded what it means by having a nursing PIN by allowing band 4 level associate nurses to enter the register. From my experience they are glorified health care assistants and yet they are being used to do all sorts of clinical tasks (injections etc). Way to degrade the profession. That is not a knock-on health care assistant, they are wonderful AND at the same time they simply haven't the knowledge base or experience to make decisions that are rather important. I say that as a former care assistant!

At the same time, the NHS is screwed. They have 100,000 vacancies and no end in sight. They need to get bodies into jobs, and this is the one thing that has actually been helpful in filling roles.

The main problem is that it is the RNs that have overall accountability if they delegate tasks, and it goes wrong. This puts MORE pressure on RNs who are already massively burnt out.

As a nursing lecturer I can confidently say your daughters friend is definitely exaggerating.

@BadNomad no the nurses don't do it @reesewithoutaspoon is correct. The RN simply do not have time to check 14 patients skin. There's that much paper work taking priority and ticking boxes it's to hell with the rest.

@BadNomad

I agree.

Except I would swap out lazy with short staffed and overwhelmed

What do you mean 'thankfully'. Those who carry out these skills are trained and assessed. You expect a registered nursesto take your blood all the time instead of HCA's/phlebotomists?

They should be doing it. It's their PIN on the line. "I didn't have time to do it" or "no one told me" won't wash when they're asked why their patient has an undocumented grade 4 pressure sore. Patient care comes first. Notes can wait. It's shit, it's unfair, but it's the truth.

Yes, most of the time. But there are some lazy nurses. Too posh to wash nurses. I-didn't-spend-3-years-at-university-just-to-wash-arses nurses. We all know at least one.

@BadNomad

I hear folk saying it but I've never really met one.

Or if I have they're no longer ward nurses anyway.

@BadNomad they should yes. I've met and heard nurses mainly band 4s say they haven't gone to uni to wash arses.

My old manger at band 6 said to us we are all health care workers and that is the truth but for some reason there's hierarchy to high heavens.

Absolutely it's their pin on the line and it's the RN who would have to stand before the NMC

I don't scrutinise the qualifications of who does my health care.
A lot of the activity listed here (like taking bloods) sounds like it's not super challenging to learn to do it to a high standard, someone doesn't need a 3+ year degree to do it competently.

What worries me more about the delegation of tasks isn't the competence of HCAs/NAs, it is a way to "cover" the chronic lack of nurses. Safe nurse to patient ratios are key in safety.

I've left nursing now, but when I first qualified, I took a job on an acute medical ward. We were meant to have 8 patients per nurse. I was regularly assigned 12 during my preceptorship!

We had a fantastic Band 4, but at the time she wasn't allowed to administer meds. The solution was to assign her a cohort of patients and we had to do her meds. So sometimes 16 sets of meds in the morning for 1 nurse (with IVs and PRN pain relief, that is a lot!)



So it was bad then. I am told my friends still at the same trust that it is worse now.

We weren't allowed emergency/complex placements until year 3 of training-we all did a rotation on A and E/Surgical Triage/ICU/HDU.

Oh, also, I did the degree. The best part of the job was always and will always be hands on care. I loved doing the things that really mattered to people, helping them wash/dress/use the loo/spending time listening to them/making sure they have enough to eat and drink etc.

Not all degree educated nurses shun this part of the job, but if you make people legally responsible for too much they literally do not have time. If I could go back to nursing knowing I would have the time to give proper, full and comprehensive care to every person I was assigned to look after I would.

It causes a lot of personal turmoil and professional dissatisfaction when you only feel like you are a medication administrating/note writing robot.

It doesn't matter whether they should. they don't have the time. If you have 15 patients you have 4 minutes per patient per hour.

They have reduced staffing ratios, they discharge anyone they can so the wards are full of sicker, more dependent patients and they replaced nurses with HCA's so all the stuff the HCA's aren't allowed to do falls on the RN's shoulders. Often there are only 2 per ward. They literally do not have the time to spend 15 to 30 mins per patient on basic care, because they now do a lot of jobs the Junior Dr's used to do,

Not read the whole thread. I'm band four doing what is generally accepted as a band five role at the coal face of mental health.

I'm master's educated. I'm exploited

They have reduced staffing ratios, they discharge anyone they can so the wards are full of sicker, more dependent patients and they replaced nurses with HCA's so all the stuff the HCA's aren't allowed to do falls on the RN's shoulders. Often there are only 2 per ward. They literally do not have the time to spend 15 to 30 mins per patient on basic care, because they now do a lot of jobs the Junior Dr's used to do,

My friend is a nurse who works on a stroke patient where there are 30 patients. She said the maximum number of nurses there will be on shift is three, and then they have about six HCA’s per shift to do call the care.

My nurse said that all she and the other nurses do is medications and documentation and she hates it.

I know plenty of these!

I am a band 2 in an unrelated role. I am in my 50's and want to progress my career.

I can't afford to train as a nurse so I am looking at an "associate nurse apprenticeship" roles. Even within my own trust there are variations on what they will pay you. One is offering £9,400 another is offering band 3.

I perceive the "associate nursing role" as a way for the NHS to get cheaper "nurses".

In every other trust, my role is band 5. But my trust don't want to pay band 5 wages.

I'm called a nursing associate. It's a very niche role. When I know a person is Ill and above my skill set, I escalate to a band 6 as that is the next band up in my job. I'm not expected to do anything above my paygrade or knowledge. Band 4s aren't entirely useless 😆