Do nursing staff not wash patients anymore or change sheets?

[keepswimming38]

My daughter has been admitted to hospital with meningitis. She’s on an infectious diseases ward. I’ve been by her side most of the day for 3 days and despite her not being able to move as she is so weak, not one nurse has asked her if she wants to freshen up, have a wash, change her sheets. I’ve done it for her. Is this usual? The nurses are sat next to their little computer trolleys, or chatting at nurses station, so not all run off their feet I would say.

My recent experience in hospital has been dreadful. The looking after the patient side of nursing has gone. Most spend 90% of their shift sat at the nurses station chatting. I was waiting for morphine, that the doctor had prescribed an hour earlier. 2 nurses and 3 patients, in a room like an add on bit for a&e. I was visibly in agony. After asking again and again. She eventually went to get the Morphine. Even when in nurses hand she’s still chatting about what they’re having for tea, going on holiday etc for about another 20 minutes. It took my husband shouting “ my wife’s in agony here” for them to wrap up the conversation.

What is actual nursing to you though ? Because it’s certainly not sweeping floors and bringing tea . Although I will say as a nurse you do end up spending half the evening and night making toast because the hospital won’t hire people to do it and you end up picking up the slack for jobs that are absolutely not nursing .

I dunno what sort of course your friend did but certainly where I live that level of training would not be adequate for nursing . I qualified in 2013 with a degree and had to go into college 9-5 for 5 days a week and the course was 4 years. It was mandatory attendance and you were monitored very closely to ensure you attended all lectures whereas other college students could just skip class. Half of the time we were in the hospital working full time as well during our training and for the last 9 months we were in hospitals the entire time as an internship like doctors. Of course no one ever complains about doctors or other allied healthcare professionals having degrees. It’s always people who know zero about nursing who seem to focus on nurses having degrees for some reason.

I think it's pot luck, there's no one seemingly in charge anymore, so if you have a ward where there is good care you're just lucky, I've seen the best and the worst, it's so inconsistent, but I think it's up to you to ask for washing bed sheet changing etc. if it's not being done routinely, you might get some huffing and puffing though depending on who you ask.

We need to raise the bar and not accept poor standards.

I am a hospital consultant of many years. When I read about poor practice by medical colleagues, I always condemn bad behaviour. I do not automatically defend doctors who get it wrong. If they have failed to reach professional standards, they must be pulled up on it. There is no excuse for rudeness or irritability. They must treat people with respect, however stressful their day has been. I also believe the same of nursing colleagues. I am lucky and have worked with brilliant nurses. They would expect patients to be fed, comfortable and clean.

Of course there is a staffing issue. Many hospitals including mine have put a ban on agency staff. However, there is still a difference between wards with the same staffing. I cannot emphasise enough the difference it makes if a war is well led. If there is a strong, charismatic but firm ward manager or matron, it has a huge impact on standards. Good leadership can lead to better care for patients, even with the same number of staff. It is not just about numbers of staff, though of course impossible workload can impact on care. It is about professional integrity and caring about patients, and that culture comes from the top. The great nurses I know, would not stand for poor quality care and would somehow make good basic nursing happen. Staff morale is everything, and matrons who work on this, have better performing wards.

Hygiene is crucial in hospitals. Without this, infections run rife which impacts on mortality and morbidity.

I would definitely raise this OP. your daughter deserves clean sheets and good care. Good nursing care is more important than all the clever meds and interventions in the world.

Unfortunately, we live in a time where patients with advocates end up getting better treatment than those are on their own. A sobering thought when we think of our ageing population.

When I was in hospital I was expected to wash myself. Beds were changed but sometimes I had to ask/check.

It sounds like OP's daughter isn't well enough to wash herself.

In a postnatal ward a day after having a caesarian a nurse told me to go to the bathroom on my own and remove the catheter myself!!
The nurse said she didn't have time to do it.
At that point my mother arrived. A retired matron with 40 + years of nursing experience. She listened to this exchange with a face like thunder.
She disappeared and then returned with the Senior Nurse on duty. Suffice to say the subsequent "dressing down" both received was done succinctly but professionally. The wierd thing was that on subsequent days the senior nurse and others actually sought her out for advice on some very basic things related to patient care. My mum was of the opinion that something was lacking in the training of these nurses. Too much technical knowledge and not enough common sense.

My mum got great care after her stroke, we did help with feeding so HCAs could spend more time with patients who had no one to assist.
FiL has had good care too.

My DD and her team constantly give great care, often in the face of violent and aggressive patients and relatives, they cannot turn people away, she recently had time off after being attacked.

You should worry about these people not the medical staff.

We only every get the horror stories in the media, all the people who get good care, aren't newsworthy.

When my husband had his stroke, a charge nurse complained to me that he wasn't eating and drinking and that he'd therefore have a hypo. (He was insulin dependent.)

His meal was brought in: a flat plate with quiche, peas and an ordinary knife and fork...

The stroke had left my husband's left hand paralysed and twisted backwards with no feeling. His right hand was shaking uncontrollably.

I caught up with the charge nurse and asked why DH hadn't been seen by an OT and provided with suitable eating implements. [Once I got him home, I purchased a special plate/bowl and fork with an edge from a company that supplied utensils for people with limited mobility.]

The nurse said she'd get a doctor. The doctor's response? "Now that you've drawn this to our attention..."

I heard myself saying "Hello?! This is the Acute Stroke Ward!"

I also queried why a member of the diabetic team wasn't involved in DH's care, given that there was concern about hypos.

After I blew my top, a diabetic nurse came to the ward and checked DH over. In actual fact, his sugar levels were too high - a common phenomenon in anyone who's had a stroke, apparently, and the stroke ward staff should have been aware of this.

The following day, DH had gone from speaking sensibly to speaking gibberish. No one on the ward had noticed. I alerted the nursing staff.

It turned out that DH had a UTI.

This was Victoria Hospital, Kirkcaldy, Fife.

I later found out that the Vic had done badly during inspections of elderly care.

You're a rare breed! Shame we can't clone you!! 💕

I am a nurse, no interest in being a manager. Generally HCA's change beds and wash patients and I am surprised your daughter hasn't been asked if she needs assistance, please speak up.
To those saying nurses sit on computers chatting. They are completing care plans, assessments, checking doctors plans, typing notes, making referals, updating handovers and having to document every single thing due to the blame culture. Give me the hands on stuff any day of the week.

When my elderly Dad was ill in hospital for 2 weeks (doctors assumed he wouldn’t make it) there’s was always someone from our family (me, my mum or sister) with him. We helped him with his meals but otherwise the nurses or HCA team helped to wash him and change his sheets. They never expected us to do it and the always asked if he or we needed help with anything.

He was discharged and went home and passed away at home a year later.

Healthcare really has changed.

If I was a 20 year old woman, I think I'd prefer an hcp to do personal care than my mother anyway

I was in hospital a few months ago. The first couple of days, despite being immobile, I was helped up every morning and offered help with washing but I managed by myself once I was in the bathroom. Whilst I was washing, my bed was stripped and remade every day. The day after both of my surgeries the nurses helped me wash and clean my teeth and go to the toilet and again changed my bed each day.

My mother has been in hospital for the last couple of months, on different types of ward in several hospitals. The staff have all showed her the utmost care and respect and have washed her, changed her clothes and
bed and repositioned her in her bed several times every day, whether we could be there or not. Sadly she deteriorated rapidly on Saturday. Although we were always by her side the nurses constantly checked on her - and us - and couldn’t have done more to ensure she was comfortable and her dignity was preserved right until the end. After she passed they were incredibly kind to us and made sure we understood everything that would happen, brought us drinks and offered food and asked if there were any religious rituals they could carry out for us. If the washing/changing/repositioning etc hadn’t happened I’d have asked for it to be done. You’re by your daughter’s side - be her advocate and ask for whatever it is you think she needs or ask them to provide you with the items you need to carry out her personal care

I'm a qualified nurse and no this is not standard care. At 20 years old we would normally bring water in for the patient to wash themselves but if bedbound and as poorly as your daughter we would assume it's a given she needs to be washed by us. The only thing I'll say is if you're there then they may have thought you would be doing the personal care yourself as at 20 she wouldn't want nurses to be washing her. The nurse getting shitty with you over the sheets is bizarre that's not okay at all, I think this ward is not a good one! You need to escalate to PALS.

A few years ago my DD28 was in for a hip replacement(not a routine op was quite complicated for her), myself
or her DP were there most of the time, not once did a member of staff come into her room unless it was for meds or we buzzed, even buzzing was ignored unless you went out and asked for help and was fobbed off repeatedly until one would huff and come and help her.
Every member of staff sat at the station for hours on end and not all doing admin, I’ve never bought into this nurses are angels rushed off their feet, same with A&E so much time wasting.

What is your problem with nurses? You’ve so far stated that since they needed a degree they don’t nurse, and now all they want is an admin job

What has happened that you have such a low opinion of nurses?

The nursing degree is a minimum of 2300 theory hours and 2300 practical hours.

On qualifying nurses then (usually) have to complete a preceptorship

Nurses have been doing this since I qualified in the 80s, except it was handwritten notes. We still had time to make beds, help with personal care, look after sick patients, attend doctors rounds and help out at meal times.

Because of my particular experience when I have visited wards.

I have seen groups of females sat in circular ?Ward Stations looking at computers and ? inputting information. All in very similar navy blue small checked uniforms. Name badges and function on lanyards too small to read, so no clue who they all were. No-one available to help visitors and just got ignored unless I leaned over the 'counter'. Asked if one female was the Ward Clerk as I needed some info on a patient and was told haughily- "I'm the Nurse in Charge".
No-one attending to the patients on this (geriatric) ward despite requests from visitors. No nursing being done as far as I could see.
Signage poor (not the fault of staff I know)

I could go on.

You are not being unreasonable. My mam was a nurse all her life. She hated the decline in hygiene and the recognition that cleanliness is your first line of defence. When she was admitted to hospital she asked me to regularly disinfect her area for her.

When I was training at that time in another AHP role I shared a bedsit with a girl training to be a Physio at a big general hospital nearby.
For the first 6 weeks of her training, she was working on the wards helping with patient personal care, feeding, washing and transporting them. Cleaning the ward, changing beds, taking soiled linen to the laundry, serving meals and just general 'dogsbody' tasks - even helping to 'lay out' patients.
It was just cheap labour for the hospital but she got loads of hand-on experience
It was 6 weeks before she saw the inside of a Physio Dept.

Yes, I complained to the Chief Exec of the last hospital my late husband was in. They acknowledged his care was less than adequate.

He was on an appalling ward for a week - after me having ructions on there, he was moved to another ward, where the care was 💯.

The first ward was due to nurses just not wanting to do much. Different ethos on the second ward.

I work as an HCA...all patients are offered a daily wash or shower, hair care, shave, oral care, with appropriate assistance if they require it. Sheets are changed when dirty, colleagues, nursing staff and ward managers all pitch in to help when it's busy. It's part of basic nursing care. It's busy so it may not be first thing in the morning. At mealtimes we're expected to position patients appropriately and assist with meals if required. Having been on the "other end" with a family member, I'd certainly speak to the ward manager if possible or go to PALS. (My elderly disabled mum was left in wet sheets with food and drink out of reach). I've seen examples of excellent care and awful care. I hope your daughter's on the mend soon OP.