I have been away from ward nursing for about 7-8 years now. The majority of people that I trained with have also left the NHS, and have left a gap of what would be considered middle management i.e.: qualified, but not interested in being charge nurses/involved in hospital politics, but highly experienced in hands on care and patient management. Experienced in teaching on the job skills to students.
It may sound a bit cowardly, but we could all see the way it was going more and more paperwork being put in place that ?only? staff nurse can do and that you would be disciplined for not doing less and less time to actually spend with patients.
Our ward manager actually banned the staff nurses from accompany the doctors rounds saying we needed to prioritize the paperwork.
That the patients could tell us what the doctors had said
So that would be the patient with dementia then, and the one who thought that eating a pound of chocolate followed by a half bottle of whiskey was a good diet.
And the little old lady who needed everything doing for her who cheerfully thought that her daughter would help look after her and of course she could manage at home, yes doctor do discharge me. no she didn?t need transport her husband would pick her up. (Daughter dead and buried many years as was husband).
This being the same place where a doctor refused to prescribe extra pain relief for a patient in the end stage of cancer in case they got addicted. . . and accused me of trying to kill the patient off to free up the bed. (Patient son had to be held back from punching the doctor on this occasion).
We frequently had patients in pain but as a nurse you cannot administer medication without a prescription. To a relative it may look as though we are just sitting chatting on the phone, in reality they may be chasing a doctor around to write the prescription, and then ringing every ward to located the drugs (as the hospital pharmacy closed at 17:00).
Yes the nurse might be late with your IV drugs but as was frequently the case for me I would be the only nurse qualified to give IVs on shift on my ward. I frequently had 20 patients all requiring 2 or 3 IV drugs each of which take 5-10 minutes to administer all due at the same time. It is so surprising that sometimes I was late?
90% of the people in uniform on a hospital ward will not be qualified nurses, the day they put the house keepers in a uniform that was about 2 shades lighter than the qualified staff was the day I started seriously looking for another job.
As a qualified staff nurse it was the norm for me to be in charge of 30 patients, I on a good shift would have 1 other staff nurse, and maybe one newly qualified and 2 HCAs. Now a good HCA is worth their weight in gold, but at the wages and chance of progression in the job sadly good ones are hard to find.
As one person I cannot be at every bedside all day, a good HCA knows when a situation is starting to get out of control and alerts you. An untrained/unsupported HCA does not have the knowledge or experience to understand that they are out of their depth.
Research has constantly shown that the best ratio of qualified nurse to patient is 4:1 I was working on a good day 10:1, most days 15:1
I am a degree trained nurse, my degree did not change my ability to care properly for patients, lack of time affected my ability to care, lack of resources affected it.
i agree that money is been spent on the NHS I would question where it is been spent.
It was common to run out of fresh bed lined (hospital contracted out) decent pyjama trousers were like good dust.
We were not allowed keep any food in our ?kitchen? meaning if patients had been admitted in the middle of the night all we could offer them was tea, and a lot of time we would have run out of milk.
We ended up paying our own money in to a kitty from which we bought cornflakes/ biscuits/ breakfast bars to give to patients.
Cleaning was also contracted out, between the hours of 19:30-08:00 we had no access to any cleaning equipment, we did buy our own dust pan and brush but it was confiscated under spurious ?health and Safety? rules.
( I was qualified to administer Class A drugs but not to use a mop).
We never had toiletries to give to patients who had come in without and had no family to provide them. Again we bought a small amount out of our own money.
Even though I was ?in-charge? of the ward on my shift I was not allowed to discipline junior staff, when I pulled a HCA up for using inappropriate language I was accused of bullying and racism (even though I was of the same ethnic background and nationality), my sin?
I had said ?Please do not swear in front of patients it is inappropriate and unprofessional.?
Like any profession there will always be bad apples, sadly when I first went in to nursing over 20 years ago it was easy to spot them and deal with them, be it through better support, extra training or if need be sanctions.
Now it is practically impossible, I was expected to work alongside a colleague who appeared on the ward drunk and when they refused to leave became first verbally and then physically aggressive towards me. Even though the situation was serious enough to end up involving the police, this person was allowed to continue working with patients until the end of the ?disciplinary process? I myself reported them and the hospital to the NMC and got nowhere.
Please don?t read this as defending bad and poor treatment; I am passionate in encouraging friends and relations to complain, but please don?t have a knee jerk reaction of assuming that every person in a uniform is a Nurse.
And never assume that the money is being spent on patient care.