Any nurses out there? How are things in your trust?

[AnneMayesR]

My trust is a mess to be honest. I work on a general medical ward that has been combined with a general surgical ward and we also take HDU and care of elderly. Bad bad combination but the managers are closing wards and restructuring and making a mess of everything.

We have no staff, no beds, no resources and there is a recruitment freeze so they will not hire. There are no jobs anywhere so we are stuck where we are. Managers have been overheard saying that the staff will just have to suck it all up because there are no jobs in the country or anywhere else to go.

They want to make thousands of redundancies but the community spoke out against this. But the managers still want rid of nursing staff so they are making our lives as hellish as possible. People are leaving in droves and they are not being replaced.

Staffing is so bad and the patients are so acute that it is very easy to work a 12-14 hour shift with no break and nothing to eat and barely scrape by. The patients and their families get very abusive because they have unreasonable expectations and expect one to one care. They really need a reality check.

One of my colleagues came on duty and was going to be on her own with 30 highly dependent and acutely ill post op surgical patients as well as confused and deteriorating general medical patients. She called the matron begging for help and was told "tough shit". Six of her patients fell that shift because they were confused and there was no one to help them. One crashed and went to ITU. One dropped her urine output to zero and it wasn't caught for about 5 hours which isn't surprising considering everything else that was happening.

Then the relatives and patients are bitching about the nurses "not doing this and not doing that". They have no idea, no idea whatsoever. It is very easy for the managers to intentionally short staff the wards because the public will blame the nurses when all hell breaks loose. It's like they think we all have magical powers and can astro project and be everywhere at once.

I come home after a 14 hour day rushed off my feet and I can't eat or sleep for days. I lie awake worrying that I made a mistake that might kill someone. I can't deal with my kids. I just kind of zone out. If everyone is still breathing at the end of the day you have worked your ass off.

The managers know very well the dangers of short staffing and that if something happens the nurse will take the fall and lose her registration, possibly get charged with manslaughter. The nurse will be the recipient of the wrath from the public. The managers get no comeback whatsoever. They staff our ward with 1 or 2 nurses when there are 20 patients who need to be fed and 10 patients who are actively trying to die on us and then people say "nurses can't be bothered to feed people".

Why aren't unison, the RCN, or the NMC saying a damn thing about it. Where the hell are they? They definitely know what goes on.

How are things in your trust?

Hi, that is horrific. Our trust sounds a lot better. I am never think I am going to have it bad again. We are well staffed. Trust is in surplus amazingly. We are quite well staffed. I work on an elderly rehab ward with 24 patients, always have two qualified on plus 2 hca in afternoon and 4 in morning. My main complaint is rels. Dont mind if it is justified complaining but i feel sometimes it is just a case of complaining for no reason. Think it is all these posters on display in ward saying 'want to complain' and then tells you how. Nurses get all the sh*t anyway. We are always the messenger and have to break news if dr cannot come or social worker is too busy or if something else has been cancelled. We have had some massive complaints this year, more than usual. Your ward sounds very dangerous with mix of ill/not so ill patients.
I only work 2 days a week, if I was full time I wouldn't cope. Sometimes I wish I could go back to my shop job where decisions and actions are not life and death. It is the sort of environment where one little drugs error can end careers and lives. Heard one such story recently

Management do not care. The fat cats at the RCN do not care. The NMC also do not care.

Everytime you miss a meal break do a IR1 (incident form). Keep on doing them. They are your protection if anything goes wrong.

I also get very angry when I read stupid reports in the Daily Mail and Times about nurses who are too lazy to feed patients, or keep the wards clean (yes, nurses are cleaners)!!!!

I feel the government has orchestrated the mass media against nurses so they can give us a crap pay deal again this year.

Your ward does sound dangerous. Please start filling out those incident forms.

That is just hideous

Makes me feel glad that I work in primary care - ok there is constant penny-pinching and endless bloody targets to meet, but at least I can cope with my workload.

Can you tell us where you work?

God - sounds awful. Definately start writing those incident forms - for dangerous staffing, no meal breaks, all falls and other clinical incidents. Yes, I know you've probably not got the time, but if anything should happen, they are your witness. Can you write to your line manager/matron with your concerns and ask for a meeting?

I'm on mat leave, due back in the new year but my job has 'gone' due to 'workforce change' (ie massivley in debt so lets get rid of non-ward based nurses) so heaven only knows what cr@p I'll be doing!

that sounds really scary. I know mw have on call supervisors they can contact what ever shift they are on if there is a situation like you are describing or is it worth contacting the RCN for advice?
I have had shifts where I have been the only midwife with a health care assistant (thankfully the ones I worked with were fantastic) caring for 22 mothers because the other midwife has had to go to delivery suite when they are short staffed I would have high risk antenatals, inductions and babies I always work nights, it was hard work and I used to worry myself sick that I had missed something.

We stay past the end of our shifts to do incident forms. We have been doing it for years and nothing happens. We had 3 staff to 35 beds (acute medical/surgical and care of the elderly). Half of our patients were wanderers with dementia. Half of them were feeds. This was yesterday. We had 3 post op bleeders as well. And the relatives of the dependent patients accuse us of ignoring their loved ones and being stupid to understand that they need help with meals.

We have begged for meetings with the managers etc and they have refused to reply.

Don't know what to do as there is a recruitment freeze.

that was supposed to say "they accuse us of ignoring their loved ones and being TOO stupid to understand that they need help.

These relatives/visitors need a reality check...they are so abusive and have so many unrealistic expectations.

The Union blows us off. The NMC blows us off. The government blows us off. Our managers won't speak to us. It is a proven fact that bad staffing hurts patients even with the best nurses in the world. Recent studies have shown that anything more than one nurse to 5 patients on a general medical ward is begging for mistakes.

Yet if anything happens...if even one thing gets missed the nurse loses everything and will hang...not the bastards who short staff the place.

There is no reason for it. 80% of the new grad nurses cannot find jobs.

Bastard managers. I can't sleep at night because I am afraid that I will make a mistake that kills because I am so overwhelmed.

Anne, sounds like you really need to blow the whistle. Have a look at the Public Concern at Work website - can't recall URL but google will find.

Otherwise, how about making an anonymous call to the Healthcare Commission?

i know this does not help but could you not leave and go and work elsewhere, maybe in private sector. Bupa always seem to be recruiting in our area. I could not work in thise conditions and would have to leave. it is ruining your whole life.

Actually is was the chief nurse who said "tough shit". She actually said it wasn't her problem and she was sick of the whining. Our matrons won't come anywhere near the wards. All the nurses are so

We have no private hospitals around here...really really cut off and the next nearest hospital is an hour away and they all have recruitment freezes. We are trying to relocate abroad but are having problems selling the house.

Thanks for the tips edam. I will contact them. It is so dangerous...our patients are suffering so bad that they might as well be in a medieval dungeon...and that is with the few staff nurses and HCA's working their tits off.

I have been around the net a bit and am hearing the same exact story from nurses on general wards throughout the country. But it seems as if my trust is especially bad.

Have you thought about moving into practice nursing?

It's booming round here as traditionally practice nurses are much older and so are now retiring.

If I were you I would send your CV and covering letter to all local practices and see if you can find something.

that is one thing you can guarantee if you are lacking qualified nurses on a shift, modern matrons suddenly get amnesia about their qualified nurse status and never appear. Mind you the minute you fill an incident form in about something happening to a relative/visitor or complaint, they break their neck to get onto ward to see what is happening.

We are lacking on every shift anymore...it just gets worse and worse and worse. Our ward had a SCBU nurse sent up...she had not worked adult nursing in years and she was given 18 patients. They told her they would send help and none materialized. I came on the next shift and had a hell of a mess to sort out.

Once I am settled in my new job and new country abroad I am going to bust their asses publically.

We try so hard and are so dedicated to our patients and we get nothing but abuse and accused of neglect and stupidity.

sorry that was meant to be publicly

it sounds like a similar situation to how we were working last year... our recruitment freeze is now over and it's all starting to get better! now all we need are a few more experienced nurses to help out all these new staff!!

if you can't deal with the long days can you do short shifts instead? i only do one long day a week now and 2 short shifts, has improved my home life greatly! i find the long day so physically and mentally straining that the day after i'm useless for anything! please don't forget we work to live not to live to work...

have you discussed this with your ward manager?? do they know your struggling like this?

you have my sympathy.

Clause 8 of your Code of Conduct states that it is your duty to raise your concerns. If you have reported concerns to your Chief Nurse and received that response you should contact the NMC for further advice.

Not everywhere is like your Trust, I work for an Acute Trust on an orthopaedic ward which is well-staffed. It didn't used to be but as the Ward Manager I wrote a business case as to why it should be better staffed and it was.

Hope you are successful in whistle-blowing or that you find a way out!
Good luck.

The ward manager is on our side but seems to be powerless. I hope our hospital starts hiring. We are losing a lot of good experience nurses. People are getting application forms for tescos. Better tescos than the loss of your registration.

Have you registered with NHS jobs?

Nah I am done. I am going abroad.

When I have had crap support from managers I ahve always written their name and contact details out and given them willingly to complaining relatives.You win on all accounts as the rellies feel that they are being taken seriously and before you know it you'll have a meeting with you nursing managers.I have been a nurse for nearly 20 years adn i am also about to move abroad. The NHS is in trouble as all the experiences staff have had enough, mind you we should have striked 15 years ago when we had the chance, things could ahve been so much better.

My sister is a hairdresser and they have 8 chairs in her salon. They never have less than 3 or 4 staff.

3 to 4 staff is the highest number I get for my 35+ bed ward.

How can people say that nursing care is going down the tubes because nurses don't do their jobs?

We get so much crap from the relatives. They just have no idea what is going on up there. There is no way we can know all the details of their loved ones and do everything that needs to be done. The managers who short staff the place practically reward these people for slamming the nurses.

It's sick. I'm out of here.