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

[hymie]

There has to be a reason why North Manchester General has (In my opinion) disgusting uncaring staff across the board.

And Rochdale Infirmary has such an excellent level of service.

[LovestheChaos]

Just to clarify for the rest of mumsnet what HYMIE is saying...

HYMIE is saying that NHS nurses should be forced to care for more patients than they can handle with no back up or support, no say in how the wards are run and then be the ones who are pulled up for substandard care. She wants to ignore managers who freeze nursing posts, who replace nurses with care assistants, reduce housekeeping and cleaners, reduce pharmacy (causing the nurse to spend half her shift off the ward lookg for drugs), etc etc etc and simply blame the nurses for substandard care.

Yeah. That is going to improve things.

I like it over here (US) where we have a one RN to 4 patient rule. The patients get great care. No malnutrition or dehydration on my floor here in beantown. Oh and guess what? All the ward staff are RNs with degrees!

[LovestheChaos]

I know that my former hospital in england is very underfunded and for the reason they have replaced professional qualified nurses for minimum wage earning teenage care assistants who cannot really do anything but prance around in a Nurse's uniform. Even if I have ten care assistants working with me it is still going to take me 5 hours to get around with everyones pain meds in an NHS hospital ward where I was the only RN for 30 patients. 5 hours is a long time to wait for a pain killer.

Yet if you you 100 miles north to James Cook (very well funded there are lots of qualified staff).

[LovestheChaos]

ouch I posted before I finished typing but you catch my drift.

[expatinscotland]

'The vast majority of visitors shouldn't need to be tazered should they?

The "Ape" comment doesn't instill confidence. No wonder relatives get worried if an attitude like that is the norm among the nursing staff.'

Ever worked in a hospital, clinic, hospice, etc.?

I worked in a hospice in the US and, whilst the vast majority of our visitors were wonderful, we did have to call the police on occassion because a relative would turn up drunk/on drugs or both or because relatives would come visit and start to fight with one another.

I worked in a busy county hospital where people would show up with guns hidden on their person to kill rival gang members who were patients.

We also treated people who were in jail or prison whose visitors would use the opportunity to smuggle them drugs or weapons.

It's a reality, not a criticism that not all visitors are nice.

[hymie]

I'm not saying that at all.

What i'm saying is why should a relative watch their relative suffer due to lack of care in a hospital because of visiting hours?

There are some good nurses out there but equally there are some shocking ones...

As for "Minimum wage teenagers prancing about in uniforms" that's a shocking statement from you again.

No wonder public sympathy for nurses has entered stage left.

[hymie]

Exited

[expatinscotland]

I have way more sympathy for nurses than managers myself.

It was explained already that the visiting hours exist because a few bad apples spoiled the bunch and management doesn't want to pay out for security to control such individuals.

So instead, the patients and families pay for it with restricted visiting hours.

[hymie]

expatinscotland

This thread is about care for the elderly.

Most people do not have guns in the UK so the point of tooled up visitors isn't applicable here.

Just because I haven't worked in a hospital doesn't mean that I haven't got an opinion on them, I SHOULD have an opinion on them.

If elderly patients are such a burden on the hospital staff then it's the right thing to do to relax visiting times to help relatives plug the gap.

[hymie]

And the "Everyone suffers because a few a naughty" excuse doesn't/shouldn't wash with adults.

Giving a ridiculous reason isn't a validation of it being right.

[LovestheChaos]

HYMIE,

Facts are facts. The struggling trusts HAVE INDEED replaced nurses with staff who has never attended nursing school or any kind of training. At my old trust they were called cadets and apprentices.

Most of them were under 18. The trust took them on because they were only to get minimum wage. Some of them were sweet some were complete arseholes who were rude to patients and didn't want to do any work. The ones who were nice and did want to work were unable to help with drugs, emergencies, assessments and orders because they were not trained nor licensed to do so. Makes things very hard for the one nurse for 35 patients.

During my time in the NHS I had a visitor beat up an elderly patient because she talked to herself (dementia) and his own relative was getting annoyed, He actually punched her. Apparently he had mental health issues.

Another visitor brough amphetamines in to his buddy who was a patient of mine. The patient took them and attacked other patients in his bay, developed super strength etc. One of our 60 year old nurses ended up with a dislocated shoulder and a fractured jaw. It took 8 people to hold him down. The trust refused to pay for security (some hospitals have security on site, we did not). Two days later same visitor got back in and gave the guy more drugs. Management still refused to pay for security and simply told us not to provoke him. . On duty that not was me and a 17 year care assistant for 20 beds including this guy. That was it. Sorry if we looked a but gruff and grim.

There are loads more tales to tell. We have had visitors interfere with patients they don't even know and get them really, really, REALLY hurt.

Thank god for the ones who are sensible, they keep me sane!!

But the kinds of things I am describing above are all in a days work rather than unusual.

[hymie]

LovestheChaos

I'm not questioning that your daily work life is affected by unruly visitors, you're the one with experience of that.

But what i'm questioning is the fact that some elderly patients are not being cared for, some are actually dying through lack of care.

The only solution given the restraints placed on nursing staff is to allow relatives to do it, or the elderly patient suffers.

We've not even touched on the hospital food issue even if elderly patients can stomach it.

[expatinscotland]

Yes, hymie, I can read. I was responding to your post on this thread about restricted visiting hours and why they are there.

'And the "Everyone suffers because a few a naughty" excuse doesn't/shouldn't wash with adults.

Giving a ridiculous reason isn't a validation of it being right.'

What is ridiculous about the reality that the reason visiting hours are so restricted is because a few of the visitors are not very nice but trusts don't want to pay for staff to police visitors if need be, so instead just puts in strict visiting hours and chucks everyone out?

[LovestheChaos]

I am all for open visiting but only if the visitors promise to follow rules that are clearly communicated to them, promise to not harm other patients (i.e. not interrupting nurses when they are in the middle of an emergency to ask about discharge plans) and security on site. If we get that then I dont think any nurse would have a problem with open visiting.

As I have explained before hymie, it isn't that the staff doesn't care about the older patients, they simply cannot help them due to factors out of their control.

When my granny goes into hospital I special her...I either stay with her or hire a carer. I know damn well that her nurse will have 20 other patients and will not be able to provide basic care. The Nurses let me stay no problem.

[expatinscotland]

'But what i'm questioning is the fact that some elderly patients are not being cared for, some are actually dying through lack of care.

The only solution given the restraints placed on nursing staff is to allow relatives to do it, or the elderly patient suffers.'


And it's already been explained why that's not happening. Because in order for this to occur the trust needs to be for security and they don't want to.

[hymie]

Expat

You don't punish the majority because of a bad minority,life doesn't work that way does it?

LovestheChaos

I'm pleased you could attend to your granny in that fashion.

I couldn't/wasn't allowed to tend for my mother in the same way in North Manchester General Hospital. This impacted on her health and without going into detail her condition deteriorated and she never recovered.

The excellent care provided by Rochdale Infirmary wasn't enough to reverse it.

[hymie]

expatinscotland

And it's already been explained why that's not happening. Because in order for this to occur the trust needs to be for security and they don't want to.

__

And THAT needs to change.

The reasons why do not supersede the need for the trust to initiate a ban on visitors caring for elderly patients.

Elderly patients should be treated like patients on children's ward with visitors allowed access.

[LovestheChaos]

Patients are actually in more danger when visitors are on the ward. Did you know that over 80% of fatal nurse drug errors occur during visiting hours?

Unfortunately mealtime and drug round is the exact same time and that isnt going to change unless we convince the medics to completely redo how they prescribe drugs.

But saying that I have never banned visitors at mealtime. I can understand the nurses that do though.

[LovestheChaos]

The nurses also get less work done during visiting hours even with the "help" that visitors provide. At visiting time I would have the relatives of 35 people queing up wanting to speak to me whilst I had patients going off with fluid overload, GI bleeds, insulins due etc.

It is scary when you get a stat order or drug or something else that you know requires your total attention at visiting time. Your first thought is "oh shit the patient wont get that blood or whatever on time because this is all happening during visiting hours"

[hymie]

I can't really comment on your personal experience LTC but fair play to you for allowing visitors on wards in certain circumstances.

Sadly though it isn't always the case where care is given by caring nurses even though I would agree it's a minority of nurses.

Clare Raynor worked as a nurse and here's her opinion on the state of SOME caregivers that taint the rest of nursing.

LINK

[LovestheChaos]

The problem with clare raynor is that she hasnt worked on a ward in decades. Therefore she doesnt (didnt) understand the reasons for poor care.

In Clare Raynors day a ward had less complicated patients and less throughput. They also had more qualified Nurses, nurse leadership on the wards and great housekeeping, good support etc. We have none of that now. Nurses who haven't worked in a hospital in awhile don't really understand the current situation. They certainly are the first ones tho shoot their mouths off though.

[hymie]

Shooting her mouth off in relation to patient deaths ?

Patients and users of the NHS have a right to an opinion and she voiced hers as a high profile person.

This isn't an isolated case of systematic abuse though.

[GrimmaTheNome]

I'm sorry I've not had time to read the whole thread, but was just wondering if geriatric wards have higher staffing levels than general wards - not necessarily nurses but people more like care home staff?

My 92 year old MIL is in hospital, and has been receiving good care but she's in a gynae ward so its a mix of ages not all old people. It doesn't appear that the staff are overstretched.

Oh..just saw LTCs:

As I have explained before wards that have elderly patients receive less staff and resources than wards that take younger patients

Completely wrong! Of course they need more staff.

[LovestheChaos]

no they have less staff all around on wards that take older patients

[Newjobthankgod]

And that lack of staff is down to vacancy freezes and retention failures from managers who don't want to pay for staff. Lots of newly qualified nurses over the last few years in the UK are unable to find a job. And degree or not, they really need to start off on a general ward to perfect their skills.