What are *you* going to do about the poor standard of nursing care in hospitals?

[tirednurse]

I've changed my nickname to hide my identity I post on other areas. I am a nurse with nearly 30 years experience. Everybody needs to be aware that the standard of nursing that your family will receive if they are admitted to hospital is is at best sub standard and at worst life threatening. If something is not done soon then the situation will only get worse. Nurses have never been angels but now they are in many cases actually putting patient lives at risk. YOU the general public need to speak out because it could be your mother/father/son in hospital receiving this so called care,

[MrsConsultant]

Linerunner - if the consultant, who is technically responsible for diagnosis, treatment and management of the patient, is unable to express an opinion regarding the nursing care of that patient, I wonder who else can?

All that matters are tick boxes and spread sheets. Cost savings are the most important thing in the current climate, not patient care.

[Erebus]

Mrsconsultant- one I know was suspended for taking a paracetamol or similar from the ward drugs for his own headache.

Indeed.

Though the harsh reality remains, consultants could be both the death or the saviour of the NHS...

[LineRunner]

I said nursing care standards.

[MrsConsultant]

When a consultant neurosurgeon can be suspended for weeks for allegedly "stealing" a spoonful of croutons from the staff canteen, requiring several life saving operations to be cancelled, you get a rough idea of just how much respect NHS trusts and their chief executives have for consultants.

Most of them are just watching their backs and hoping to retire asap.

[Erebus]

But consultants can 'challenge' all they like- that won't miraculously conjure up the required number of qualified personnel on a ward, will it? That remark is up there with nursing managers telling coal-face staff who have gone to them saying they are dangerously short-staffed, that they must be 'more imaginative' with their workload management

[LineRunner]

I thought AtoZ's post above was interesting, as are yours, MrsConsultant.

I think more challenge by consultants of nursing care standards can only be a good thing - at the top as well as in the wards.

PFI - don't get me started.

[MrsConsultant]

A few years back DH did report a serious drug error made by a nurse. He realised it was probably a combination of staff shortage and delegation of innappropriate tasks, but as the patient could have died, he couldn't ignore it.

He was treated as if he was deliberately undermining/criticising the nursing staff. You can't win.

[MrsConsultant]

My dh is a consultant in a busy hospital in a challenging/very busy/economically deprived area.

He is in his late fifties, and is of the generation that worked hundreds of hours unpaid overtime for many years in order to qualify and pass post graduate exams.

He works every week day from 8 am to 8 pm. He brings paperwork home and works till 10 or 11 pm every evening. He is on call every fourth week, meaning he works his usual 12 hour day all week, and then the weekend as well. He goes in to the hospital and sees every one of his patients on Saturday and Sunday. This week he has had 4 emergency calls at around 3 or 4 in the morning.

The European Working time directive does not apply to consultants.

Recently the Trust informed all the consultants that they would not be paid for working past 5pm. They have more recently been informed that they must do a ward round at 8 am every day. Nowadays, consultants do not have their own wards - their patients are scattered all over the hospital. It can take a whole day to do a ward round. Quite how the clinics, operations, teaching the students etc is going to be fitted in is a mystery.

There are no longer enough qualified nurses to accompany the ward round, so communication is compromised.

Junior doctors work far shorter hours then their predecessors. The consultants who are qualifying now have around half the experience of DH's generation.

As has already been said, consultants have very little say in what goes on in terms of patient care. Things will only get worse. NHS Trusts are in so much debt just with the PFI initiative, that there is little chance of more money for nursing staff.

[merlottits]

Interesting thread.

I've been qualified 20 years and am now a senior manager having been student nurse, staff nurse and a specialist nurse.

The state of our hospitals and especially nursing is shocking.

Just in the last 3 months my father and I have both been patients and the nursing care has been pretty awful.

My father admitted to a surgical ward with renal colic (kidney stones) one of the most painful things there is. I practically had to sleep by his bed for 4 days until he had surgery as the nurses just would NOT give him the painkillers he needed. They wanted him to manage on paracetamol but he needed stronger stuff. The sheer annoyance and irritation at his complaints of pain. "Mr ...... you really should give the paracetamol a chance" to my father curled up in the foetal position barely able to speak from acute pain.

Myself admitted for cellulitis (arm infection) needed IV antibiotics. Nine doses of IV antibiotics and not ONCE did the nurse return to take down my drip. Each time I had to ring my bell or call out after an hour or so after it finished to be met with eye rolling, tutting and sighing. Not one nurse flushed the cannula after taking the drip down (correct procedure). I felt an utter nuisance.

I despair that someone I know and love will need nursing care.

There are too many managers, too much paperwork/audits/meetings, too much cost-cutting.

[LineRunner]

I've been very surprised in various hospitals at just how rude some nurses are allowed to be to patients, for no reason, snapping 'Oh grow up' to patients asking for news on their discharge arrangements, for example.

When I had pre-eclampsia just before having my DD, I was in a maternity ward for three days with a 15 year old girl who was terrified and cried a lot of the time, and not a single member of staff ever came to comfort or support her. Obs and tests frequently went undone.

These events were all over 16 years ago. How can it have got worse?!

[Nishky]

I had a recent stay in NHS hospital and it was bloody fantastic. I had a severe asthma attack and for the first 12 hours was absolutely terrified. I then spent two further days on the ward and all the staff were amazing. So kind and caring

I sent an email to the hospital as I am sure they get plenty of dissatisfied ones!!

[SucksToBeMe]

This is a great thread.

[AtoZandBackAgain]

Thanks Goat. That was interesting to know. No hope of change in the future then

[TakeMyEyesButNotTheGoat]

Just read that last post again. I could have shorted it to say that basically, the power and control of staffing levels lies with whoever holds the purse strings.

Not the Consultants, Ward Managers or Nurses.

[TakeMyEyesButNotTheGoat]

Consultants don't have the power they used to. Certainly not on my ward anyway.

The power and the decisions no longer rest with the Ward Manager, who are skilled nurses btw. Some people don't realise they are ward sisters but have the title of manager.

The power and decision making lies with Senior Nurses or Directorate Managers who have to answer to the Chief Executive.

Senior Nurses/Directorate Managers are clinically trained but have not worked on a ward in years. Our Senior Nurse is supportive though, Directorate Manager- not so much. They are the ones that work with the budgets.

One thing I will say, hopefully without outing myself, two weeks ago we were so short staffed - 2 Q and 2 HCA's. The wardmanager asked for permission to go to agency for one Q staff. Guess what she was told? Be imaginative with your staff because we are not paying for agency!

That's 4 members of staff for 30 elderly, confused and wandering patients.

The people making these decisions have no idea what it is like to work on a ward these days.

[AtoZandBackAgain]

So where do the hospital Consultants feature in all this?

As I patient I have always been placed under the care of a Consultant while in hospital.

Why are they not raising merry hell? Or are they? I would have thought they had a vested interest in ensuring their patients were properly cared for. After all, it looks bad on their statistics if patients die through neglect or get HAIs.

Why do they never see their patients lying in blood-stained sheets or in their own urine, or comment that obs have not been taken at the correct times (as the nurses were too busy with an unrealistic workload) etc etc

Genuinely interested.

[fridayfreedom]

been reading this with interest after a really crap day at work.
Am working in Community Care mainly with people with dementia and their carers.
It's shit in the community too. Services are being cut back and roles which a few years ago were deemed too specialised for lower bands and HC support workers are now being given out to these roles. I actually work with superb HCSW, but it is still a worry as we are told to supervise this work and no doubt will be held accountable if it goes wrong.
As said before, we need more staff at all levels, but managers , who may not have seen a real life patient because they don't have them where they came from eg Sainsburys!!, are making decisions about how and what services should provide.
Twice I have been told to "lower my standards"!!
Yes there are bad health care workers as in any job but please , there are many more of us trying to do our best and suffering ourselves as a result.
Ask any GP which is the main group of workers on anti-depressants?

[Erebus]

Indeed, lazeybones

[lazeybones]

I was a HCA working in acute wards until very recently.

I am educated in health care, as were many of my colleagues.

I have been asked a few times recently if I miss my old job. I miss the times I got it right, when you knew you had made a patient more comfortable, when patients thanked you, when you felt like you had made a difference, however small.

I don't miss the sense of dread I got during handover. When every single patient, out of 30, needed all cares and I knew that it was just me and the other HCA who had to do it all because the patients were so unwell the qualified would be busy all night with meds, obs etc. I don't miss finally getting to someone at midnight who had been waiting since 7pm because I had not had a minute until then to help them. I don't miss coming on to a ward at 8pm and having to pick up and clean every single cup that was out on the ward before I can even offer people a cup of tea because the catering staff finish at 5pm and the day staff had have no time to do it. I don't miss announcing 2 hour waits at the outpatient clinic because the doctors didn't turn up on time for clinic. I don't miss running out of clean sheets, towels, soap, gloves, pillow cases and having to beg other wards for spares. And all the while I am doing this I know that patients are waiting for me. I don't miss the times that three buzzers were going off and the staff nurses were busy and I had to decide which person to take to toilet first, and then dealing with the aftermath. I don't miss mopping up dirty bathrooms at 3am because the cleaner forgot to do them, and as I do it I know people are waiting for my care. I don't miss being sworn at, spat on, assaulted at work. I don't miss checking patients and realising that the person before me didn't change their dirty (dried on) sheets. I don't miss arguing with colleagues about how someone really doesn't need to get up at 7am, we can make them toast when they wake up! I don't miss not sitting down all shift and going home feeling guilty because I didn't have time to do everything that needed doing.


This is controversial, but nursing seems to be one of the few professions that seems to think that people cannot both care and be well educated. Nobody judges teachers, occupational therapists, physiotherapists for being too educated to care or make a difference, but they all have degrees.

The answer is more staff, more qualified, more unqualifieds.

[ditavonteesed]

About to start work as a HCA, I am keen, caring, well educated, have common sense and am told I am going to be trained very well to carry out basic care need, this is the role of a HCA, I am a little upset to read how badly thought of they are, if nurses dont go into it for the money then surely that can be said even more so for the HCA's. I am going into this job becasue I want to care for people and free up nurszes to do their role.

[Erebus]

I just want to add my support to what badnurse said.

I really couldn't agree more with her description of a day on an average ward. She has summed it up brilliantly.

I should add, I am not a nurse, but I am HCP, but I see exactly, precisely what today's nurses are up against. I think the point of abandoning 'the drugs trolley' in favour of 'basic care' was very well made. There simply isn't time to do both well, and the simple fact remains, whilst a patient left lying in their own dirt for far longer than is 'acceptable' is bad, that has considerably fewer 'long term consequences' than giving the wrong drug, the wrong dose or even none at all to that patient.

We simply cannot afford the Florence Nightingale 'image' of nursing we all treasure in our folk memory; far more people are living into an until very recently unimaginable old age; many live alone; the NHS cannot legally (and wouldn't morally) practice 'age discrimination' (which, as an aside, leads to the situation I witness on a daily basis where very elderly, bed bound, utterly confused and frightened (if they're conscious at all) Alzheimer-suffering people are as kindly and carefully as possible, manhandled into the xray department, onto the CT scanners, into the MRI scanners having scans (some of which involve injections that really can compromise failing kidneys yet further) all to rule out that possible cancer that just might be a causative factor of that elderley patient's condition. No one's going to 'treat' it in such a frail and elderly person (often with co-morbidities, ie other more immediately 'threatening' illnesses that really will kill them); they're not fit for anaesthetic thus won't be operated on- all it does is add a sentence to the post-mortem report... why? because if we don't, we stand a risk of being sued for age-discrimination for choosing not to put that person through that pointless, maybe humiliating, often frightening ordeal.)

DH was in an ENT ward in a large DGH for 2 nights and 3 days last week on IV antibiotics. He was in a 6 bedder. Of the other 5, one was a young thug recovering from a pub beating; one was a middle aged self-caring man with a sinus infection, the other 3 were very old and bed bound, requiring all their needs to be met for them. One of them was bed-blocking (awaiting a social services report). Now, this was an ENT ward, not a geriatric or medical ward, yet 50% of the patients were in need of a far higher input of care than the one nurse there could possibly provide. So even ENT is now moving towards a branch of 'elderly care'- but the staffing model just hasn't kept up because it can't afford to.

If we want to carry on with our current 'model', we either need to accept we have to pay far more into our National Insurance, or we have to ration 'free' health care, or we have to pay for it through private schemes. Or we need to put limits on compensation payouts, accepting that honest mistakes happen, and that to scan 50,000 people so as to ensure we don't miss that condition in one isn't cost effective. I think you would be stunned by a) how many 'just in case/cover my arse' examinations and tests are done within the NHS these days, and how much money is spent either defending actions or just paying them out prior to court as Trusts can't afford the possibility of losing.

What we don't need to do is bash those poor people struggling at the coalface of our stressed, creaking system as it currently stands. Or limps.

[SucksToBeMe]

Good post bad nurse. Interesting to read about a 'normal' day for a nurse. Evens out the argument.

[AtoZandBackAgain]

I've been an in-patient in 3 separate hospitals within the same city over the past 3 years. On each occasion I have not had friends or family with me to help/visit.

1. Major NHS hospital. Gall bladder removal. Operation that had been postponed from the previous week when I had been fully prepared for theatre but op had then been cancelled as they had run out of operating instruments. I was left in severe pain. Nurse removed cannula incorrectly so my blood spurted on the sheets. I was left to sleep in these bloodied sheets. Actually, I couldn't sleep for the pain and the fact that there were only 2 nurses on night duty for a ward of about 20 people and one nurse spent the whole night trying to deal with a dementia patient who insisted on walking around, screaming and disturbing the rest of the ward. No follow-up appointment. Discharged to GP care.
   
   
2. Private hospital. GA for orthapaedic operation. Own room, TV, newspapers, psyiotherapy consultation immediately prior to operation, meal ready for me when I came round. No pain. Left hospital with a set of follow-up appointments.
   
   
3. Major NHS hospital. Biopsy. Superb treatment with care and compassion from real nursing professionals who took time to listen, put me at ease, took obs every 30 minutes and shared their own tea and biscuits with me after my procedure. They were wonderful. I felt they took extra care with me because I was alone.
   
   Now facing an imminent and major 4th operation in yet another hospital within the same city and am terrified.

[SusanneLinder]

Even worse-there are many newly qualified nurses who cant get sodding jobs!

[agedknees]

Meddie, I think we are singing from the same song sheet. Agree with every word you have written.