Care of the elderly

[radiohelen]

here

Ok - dons hard hat - I know that the NHS is beleaguered and we should all be feeling sorry for the poor nurses on the front line but WTF is going on???

I have been in hospital a bit over the last five years or so and on every occasion where I have been in or around a ward with elderly people I have been pretty sickened by the treatment they have had dished out to them.

One guy was clearly finding it difficult to feed himself but his food was just left in front of him. He kept ringing the bell to ask for help to sit up but the nursing assistant who came to his bell needed help, went off to get it and never came back. He never got his dinner. I had to leave my husband (with his broken leg) on watch to make sure the chap got fed his dinner. DH says there were also difficulties with toileting.

On another ward overnight an elderly Chinese lady was having difficulties, pain I think, and kept buzzing the nurses. The African nurse who came to her aid made no effort to understand her accent and what she was saying and kept telling her off for buzzing in a thick accent that I had trouble with, let alone the lady on the bed. She just left her.

Surely nurses and nursing assistants can and should do better than this?
Just because you got a degree it doesn't mean you can't wipe someones backside or feed them their dinner. If you come to this country to nurse then you should bloody well make an effort to make yourself understood and take time to understand what others are saying to you.

Just saying.

ducks under parapet

i will make one point then walk away.

Nurses only have one pair of hands.

If you have a ward of 40 patients, 15 of whom need feeding/washing/changing and 3 nurses to admit, dicharge, wash, feed, administer drugs, liaise with OTs/physios/social workers/families, move beds, wash, dress, change, organise staffing and talk to patients it stands to reason some of those patients will wait too long for their needs to be met.

Yes some nurses are crap but this 'culture' of not meeting 'basic care' does not exist.

The fact is if there were more pairs of hands to do the feeding, washing, changing, organising etc etc etc patients would recieve bettercare. End of.

and it's not 'basic care' it is Fundamental care.

walking away.........

So atyour as a nurse, for you it is a basic numbers problem? Not enough nurses/care staff. Because the ombudsman is saying that's not it .
I've only seen it from the patient side so I don't see the pressures the staff are under.
What would make a real difference?
I'm just thinking in terms of Cameron's big society... would a volunteer WRVS ward secretary/receptionist help? Should people's families be expected to come in and feed/wash them like they do in other countries?

i doubt the ombudsman has actually been there - pulled in a dozen directions at once, knowing someone is lying in their own faeces, while someone else needs a drink, the bed manager is hassling for discharges,someone is dying alone, the phone is ringing and your staff are weeping in corners because they can't do it any more, at the same time you are trying to do your job safely, knowing you can't.

Yes. I think it is simply numbers. But that is numbers of well trained and supported staff, not someone volunteering for 2 hours on a thursday.

Families shouldn't be expected to come in and do personal care for their relative if they want it done I think that is the way the NHS is going. God help those without, they'll be the ones left lying alone unwashed and unfed.

15 comments on David Cameron's cat and 6 on here (all from the same two people)....says it all really, we as a society do not care for or respect our elderly

I do have to say though heard the ombudsman investigator on the radio this morning saying it was not about resources but attitude...and took that as a sign the soon the government will cut NHS elderly care even more and say "don't worry everyone the Big Society will take care of it, because it's not about resources it's about attitude..and volunteers will of course have a great attitude!"

I second atyourcervix, I was a staff nurse in the NHS for over 12 years - it can be hell and you are left to get on with it, do the best that you can. But that's not good enough if it's your/my mother father brother sister whatever being left uncared for.

There are most definitely nurse's that have bad attitudes as there are in all walks of life.

David Cameron and the current government has nothing to do with this! And I didn't even vote for him, be fair, this neglect has gone on for years!

Also a staff nurse for nearly 20 years, and while there are undoubtedly "bad apples", when you've got 3 patients in wet beds and 3 lots of relatives harranging you to see to them, it stands to reason 2 will have to wait, and 1 will have to wait even longer!! Not acceptable though.

"From the cradle to the grave" The generation that supported the inception of the NHS and built it up, and now that they need care from NHS Hosptitals (not talking about nursing homes) let down in some instances. I don't blame the front line staff, I blame the management.

I was a carer on a ward for 4 years. Have to say I don't think I ever stopped in a shift for more than 5 minutes. There was always somebody to wash, clean, feed, comfort.

Carers frequently went off sick because they were horrendously overworked, making the problem worse.

Yes there were a few bad apples. But they were in the minority. Most of the people I worked with were extremely hard working.

I found an awful lot of my time was taken up by people who didn't really need the help, but shouted the loudest. Ringing their buzzer for me to "pass them their tissue box - which they could easily reach". Or "could you clean my hairbrush" when there were other people lying in faeces.

I will never forget the woman who demanded I "knock up a sandwich" for her husband who had been admitted onto our ward for 5 minutes before being discharged. I was the only carer with two nurses on the ward (36 patients) and could not leave to get him a sandwich. She could quite easily have picked one up on her way out but didn't want to pay £1.

Every time the buzzer rings, a carer has to leave the person they're attending to to check that there isn't a real problem.

Sometimes it was impossible to give everyone the attention they deserved.

I'm very glad I don't work there any more.

I think a lot of it is about numbers but some of it is attitude and and some of it is lack of communication. I work in a hospital and today I e-mailed our chief exec asking how we as an organisation will respond because we're kidding ourselves if we think that sort of thing isn't happening where we work.

speaking as an ex-nurse, one of the major obstacles to improved conditions for patients is the passivity of nurses and a culture of not complaining. So when the wards were understaffed and we were not able to offer an adequate service, not ONCE did anyone phone a senior manager and complain or demand more staff.

I've lost count of the number of times I made that phone call donkey.

I was regularly the bleep holder so not only in charge of my ward but also the contact for issues on all 4 wards in my unit. I would deal with people calling in sick, manage beds and decide where admissions would go etc etc. I often called the on call manager only to be told once I had called all the agencies there was nothing they could do.

If my patients complained about the service they were getting I would ask them to please put it in writing because if they didn't then as far as management were concerned it didn't happen. Although I will never forget the complaint we received about the time a relative had to wait for a vase to put her mother's flowers in. We were attending an arrest

I'm very pleased you are a complainer McDreamy. Good that someone kicked a bit of management arse. I never saw it myself - seemed like the 'yes men' were always promoted, like in all public service

Staff don't say anything when they are understaffed and struggling so patients get left!
Presumably this means there is no upward communication of the problem and it's convenient for managers not to know because their budgets are constantly being squeezed which means you don't get any help.
That's a lovely cycle to be in

Why don't people ask for help? Is it a pride thing? Not wanting to be the one who asks for help. Is it fear of losing your job or of being seen as the one who couldn't cope?

I know the idea of volunteers was dismissed but surely if things really are that bad, and it sounds like they are - a bunch of those horribly dilligent WRVS ladies/gentlemen coming in regularly during the week could take some of the admin/reception desk pressure off a ward?

Volunteers have to be recruited just like staff, screened and then supervised. They are privy to an awful lot of important, expensive and/or dangerous stuff if they're working in a ward setting so expanding the numbers is a huge project.

I think we need more care assistant type roles. Staff looking after a small number of patients - maybe 7 at most. Tasked with getting them dresed, fed, clean - over and over again all day. Wards or bays with a seperate eating area so people aren't eating by their bed (assuming they are well enough to get up) but go over to a table and eat with two or three other people. With a staff member encouraging them all and mutual example they would eat more even of hospital food. Because the care worker only has a small focused group each they could actually CHERISH those folk, feedback to relatives when they came in because they know what's happening. They wouldn't be trying to deal with 30 or clean the ward or fetch equipment.

I used to work for the BNA and I was sent to local hospital as agency.

What I found was truely shocking. Four qualified nurses and 1 care assistant. Two nurses on break, one hovering over the telephone she told me it was her job to wait for it to ring!and the care assistant smoking in the laundry room. The sister was run off her feet!

30 elderly mostly demented patients on a filthy ward with no available staff.

One very confused lady screamed continuously and spent all her time trying to climb over the cot sides on her bed. When I was called by a visitor I found this lady hanging head first out of the bed. This frail lady was black and blue, black eye from a fall, dressings on her arms, she had pulled at them, I buzzed and no one came.

When I eventually got the attention of the sister she told me she was too busy giving meds. I asked the nurse at the desk, she said leave the women, "nothing you can do with her, she's fallen out of bed twice already today". I asked the two on break in the office, they said go get the care assistant. When I said where, they told me where to find her in the laundry cupboard.

Do I think it's attitude or numbers. I can only go on my experience and I would say it is down to training.

It is time they brought back vocational training on the wards.

Blimey QueenBathsheba that sounds grim!

northernlurker your care assistant plan sounds eminently workable.. when I rule the world I shall implement it immediately Maybe we should send it to that bloke in charge with the new cat... maybe he could sort it out!

From my experience it's that nurses see patients as objects not people. In a factory it's OK to be offhand or downright mutinous about your work, because it's only things which get damaged. When you're working with people, it's people. There is something very wrong with the recruitment and management of nurses.

I'm sorry to say this but not all nurses are angels.

When my dad got ill he was taken to the local hospital. First ward he was in was fantastic. Staff understood care of the elderly and their needs.

He was then sent to a rehabilitation ward at Stobhill Hospital.

This ward had "nurses" who, quite frankly, were there to make up numbers.

While in there my dad had two really bad falls, didn't eat in the most part, lost nearly all of his belongings. I was told that this was not their concern and we should put his name in his clothes, which we had. My mum was told that she needed to provide him with replacement clothing - they are pensioners.

Now what made the first ward (with less staff than the second) able to cope better than the second? Attitude. The professionalism shown shone through. The second ward decided to terrify my mum on more than one occasion by telling her that my dad would be sent to an old folks' home that was so out of the way it would take her nearly 2 hours on a bus to visit him. When asked I was told that the doctor in charge only visited on Tuesdays and no visitors were allowed then so no, I could not speak with him.

To be honest it was so bad I complained (and in the complaint letter I noted the wonderful staff of the first ward should perhaps train those in the second to have a heart.) My dad ended up so ill, the second fall resulted in a broken hip, he went back to the first ward but it was too late. I know he would have only lived maybe another year or so at most but the second ward fast-tracked my dad to death. Pure and simple. Don't tell me those nurses were stressed or understaffed any more than other wards that manage.

They complained my dad had struck out at a nurse. He was in so much bloody pain, had dementia, I actually asked the nurse if this was the first time she had dealt with the elderly. I got so damn angry that they would act like he was this nuisance. They obviously knew very little of dementia and how it makes people act. Again, the first ward mentioned, didn't moan at us, mentioned at the start of his visit that he had done that when they were trying to examine him but said it was expected and they were trying to find out what the initial illness had been.

Add to that the fact that on numerous occasions I would go in to the ward and my first job would be to change his sheets, clean around his bed (including a milk spill that had evidently been there for a few hours). Plus the other people in the room (4 beds) told me on the two occasions he fell that he was lying there for some time before they were able to get someone to come and even then he lay on the floor for a while more.

It was notable that the medical notes were accidentally left on the bed after he was transferred back and the second ward lied outright about his injuries.

I began to train as a nurse but decided it wasn't for me. I've been in wards and there are two types of nurse. The ones that really are dedicated to caring for others and the ones who like the kudos of saying they are nurses.

One of the great taboos. Mustn't criticise the nurses. That is how they get away with it.

I agree about the taboo. Mad.

I have read and heard Doctors and Consultants state that Dementia is a terminal disease so Dementia patients should not be in wards but hospices/nursing homes. Do the MN Nurses agree?

Can I just say thank you to Rochdale infirmary for giving my Mother brilliant care when she desperately needed it. The Nurses were fantastic and the Doctors did all they could.

And a kick up the arse to North Manchester General who couldn't give a toss from the Nurses to the Doctors.

Do policies in individual hospital trusts make a difference in the care of patients?