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?

It's sick that those bastards can leave 1 nurse and two assistants on a 35 bed ward that is bursting with post op patients/acute medicals/and care of the elderly. We usually have 16 or 17 that need to be fed. They won't even let us have a ward clerk to answer the phone.

I don't think I ever go more than 10 minutes without having to walk away from what I am doing to take phone calls from the relatives.

What exactly do they think we would be able to tell them? In order to tell them anything worthwhile we would have to actually know the patient/spend time with the patient and properly assess the patient and implement interventions and evaluate. That just isn't going to happen even if you put a gun in my mouth. It's a physical impossibility. This is what I want to do as a Nurse and my registration demands that I do this for all of my patients but it is really a physical impossibility.

How can these bastards staff these places like this when there is no need and how can the public be fucktarded enough to turn around and say that the nurses don't care and don't want to do nursing care.

I really think it is totally sick.

I sent some letters out and the replies that have come back have said "not our problem".

incident forms are the answer. we filled in one for months and months and months every single time we were short staffed and eventually we got our full quota of staff

fill in one every single time something goes wrong. even if you dont have time to fill in the care plans.

i have found my self on a 13hr nightshift with 24 patients and just me

its frighttening

I apologise for the fucktarded comment but I am sick of the ignorance. I really wish the public would wake up. Nurses and Doctors can wage war and demand change until they are blue in the face...but nothing NOTHING will change until the public understand how crucial staff/patient ratios are and demand change.

But instead they just come charging into hospital raging at the staff.

i think they encourgare rels to complain. There are signs everything telling ppl how to complain and if they don't want to do it, someone will help them do it. Rels are not interested in other patients. We got told other day that care plans are not good enough, we have to document every 'fart' these days. When is patient care done. They say you can be reported to NMC for not documenting. Bring it on, sometimes i wish i had gut to leave nursing,

Anne, will you be nursing abroad or giving it up, just being nosey.

This makes me to read.
Where are you thinking of moving to ?
Sending you sympathy and support across the interweb.
(am not nurse but allied medical professional)

i regret ever doing nursing

i really honestly do

i only did it cos it meant i could leave home and have an instant job with somewhere to stay

my mum is a nurse told me not to be a nurse
she was right.
saw GB talking about beating inflation last night with 2% pay rises.gggrrgghh
lets use all public sector workers to do it

its all just one big pile o shite

i fancy going to canada and saying bugger the lot of you

My local trust is also crap atm. They are closing wards , making staff redundant, downgrading 80 odd band 6 nurses to band 5, student nurses have no jobs to go to so are employed on temporary contracts or even employed as HCAs!.Staff morale is at its lowest point, so very different to the way it was 9 years ago when i qualified.
I work in general practice now, its not perfect by any means, but its beats working for the trust.

Nursing takes a certain type of person many people could not do the jobs we do but there has never been any recognition of that fact.

Of course the chief exec and her merry little band of yes men are fine and suffering no financial penalties even though its them who screwed up spectacularly in the first place!

Patients , as others have already said, have no clue as to the pressures of the job and the fact that you actually have no time to do anything properly let alone 'nurse'. The expectations are far too high and everything needs to be done yesterday.

In essence the NHS is fab and i'm a great believer in what it was set up for but the general population now expect maximum output for minimum input. Many compare it to other systems in other countries but neglect to see that the levels they are taxed are far higher than what we pay.

Totally agree about unrealistic expectations.
I work aon a general paediatric ward that caters for sick babies to mentally unstable teenagers.
We have 35 beds that are constantly full,and can be running to theatre one minute then tube feeding a three day old the next. We deal with around 10 specialities,all with assorted consultants,registrars etc.
Fortunately,I only work 10 hrs a week.
God knows how anyone can nurse fulltime.

anne - I've not got time to post properly but it really sounds as though you are working in an appalling place. Have you considered talking to the relatives who are less than happy with the care and explaining to them in much the same way as you have to us and ask them to phone/write to PALS/Chief exec whoever to tell them their experiences? Explain to them that you know things aren't good but you want them to get better for all involved and this action may help to achieve it. good luck.

I regret nursing. If I had a manageable number of patients and could do the job right I would love it.

I went to work today from 1PM to 9PM. I got out at 11PM. No break at all that whole time and those 2 extra hours are unpaid. It was hell on up there all shift and the night nurse who took over was to be alone with an HCA and a student.

Four Acute admissions came in during handover and 2 post op patients went down hill at that time. One patient with dementia and an HB of 5.5 was having 3 units of blood....and she kept pulling the venflon out. It looked like a massacre. 17 of them were on IV antibiotics. There was just no way I could get out of there on time safely.

I keep complaining about it and saying that I am done but it is taking ages to sort out visas and sell the house to move abroad. There are no other jobs in our trust at all right now.

What these managers are doing to nurses is disgusting. None of our students can find jobs either.

We have requested multiple meetings with our matrons and managers and they have refused and still are refusing. The press doesn't want to know.

The managers don't have to take any shit off of the relatives (who have every right to be angry IMHO). The constant screw ups because of poor communication etc. and the nurses and doctors being overwhelmed is just dire.

We had a guy pick up a chair and throw it at a staff nurse because he wanted her sat with his wife all shift to make sure she drank and nurse obviously couldn't do it because she had people trying to um.... die on her hello!!! The man was a total nutter.

Management kissed this mans ass and rewarded him and the wife with a nice private room on another ward.

People are actually scared to go to work.

It's bad. Telling the patients and their families that you have too many other patients and are overwhelmed and scared will get you in deep shit fast.

I don't think I had time to document a thing all shift...it is so scary to think that they could and would take your license for that.

Management doesn't care if care was implemented or not...they only care if the documentation was correct.

Can't sleep.

Oh gosh I don't do it full time...the full timers are more nuts than I am at the minute. Our deputy sister..who is the best bedside nurse I ever saw...looks like complete and utter hell right now.

'Telling the patients and their families that you have too many other patients and are overwhelmed and scared will get you in deep shit fast.'

why will it? If you do it in a way which encourages them to complain to try and bring about change?

I am very lucky I work on a well staffed ward with people I love working with and a patient group I find challenging and rewarding, all in a trust which is doing ok.

who is your rcn representative? if you have not got anywhere with her what about her senior? How many of you were on shift yesterday? Does it help to be reminded that these winter months are almost always the worst time of year?

The whole way in which the ward is set up sounds crazy - medical and surgical are so very different and if only recently merged getting used to one or the other type of patient is difficult.

What about your local MP?

Anne - it really seems as though you are having to live on your last nerve, and I am really sorry to hear how things are on your ward, and for you. I guess you suffer from a problem that you share with other good nurses, but not so many of your managers - you care about your patients.

Although it will not address your problem immediately, I echo the suggestion made earlier to contact the Healthcare Commission. This page on the HC's website explains how you can go about whistle blowing. You can 'whistle blow' to your own trust managers - but it is easy to see why many people would be reluctant to do that, despite the protections offered in law.

But you can also raise your concerns with the HC's Helpline on 0845 601 3012. Your piece of information alone might not be enough to prompt an investigation, but the HC receives all sorts of information about how well a trust is doing, including complaints from patients, and they cross-check all this info when deciding what action to take - so if you can provide some detailed information/examples of times when you think the health and safety of patients has been compromised, this might feed into other info the HC already has, and prompt them to look into it further.

The Helpline staff are friendly, and could just talk to you generally about how you can raise your concerns with them/
whether you want to provide more info/what that might mean for you.

Best of luck, whatever you decide.

About telling the relatives...

Management encourages complaints in order to appear as if they care. The only thing they care about is saving money and looking good to their NHS overlords. They KNOW damn well that the wards are dangerous because they short staff it. They know it. They know that the nurses are in a position where the care they provide will be appalling because they are overwhelmed. They know that mistakes are inevitable. They know it and don't care. They wil never get held accountable. The nurse will be held accountable for any mistakes. This is how the law works.

If a nurse makes a mistake and or misses something vital because she is overwhelmed it is all her own responsibility. No one will go after management and say "oh well it is your fault because you short staff the wards". This occurs because people don't actually understand the impact and the fall and the dire consequences that occur when a nurse has too many patients. So people blame the nurse. They actually think that a nurse with 35 patients could be effective if only she tries. It is this moronic kind of thinking that is hurting us.

Example. One of my colleagues had 10 insulins due at the same time one morning..she headed straight into the treatment room to get it ready. 30 seconds later an HCA shouted her because someone wasn't breathing. The commenced CPR..put the crash call out...and actually got the guy back because they worked so hard. This was a dire emergency and the man lived because they acted fast and saw it through with him.

As soon as the cardiac arrest was over and the man went to ICU my colleague called his family and headed straight back to get those 10 insulins ready and administered. They were now an hour late. There was no other nurse on duty to give the insulins while she was dealing with the emergency. The patients and their relatives complained about the insulin being given way to late. They accused my colleague of:

1. Being to stupid to understand that insulin needs to be given on time

1. Not caring enough to give the insulin on time

They made official complaints about THE NURSE rather than the fact that she should have never been alone down there. No one told them them that if she had just merrily continued along giving the insulins that other man would have died. Management apologized to the complainers and disciplined the nurse for getting the insulin out late. These are the same managers who short staff the place in the first place.

If I tell the relatives what is going on and to ask the managers why they intentionally short staff the place to dangerous levels this is what will happen:

The managers will tell them some total bullshit. Who are they going to believe? The stupid good for nothing nurses or the guy in a suit?

I make my bosses look bad and I get in trouble.

oh Anne . i cant think what to say to make you feel better

this happened to me a while back;

someone came back from theatre during a nightshift and was settled, but a few hours later woke in pain and i tried tramadol, paracetamol etc but it got to the stage where i wanted to give the pt a controlled drug for the pain. i had to phone another ward to get a nurse to come and check the drug with me, when i did i was told that nurse couldnt leave the ward as she was alone too, the next ward along one nurse was on her break so that left a lone nurse in that ward too, i bleeped the nurse in charge for the hospital and asked her to come and check it, she did so but took an hr and a half to do so. meantime the pt was getting aggressive demanding pain relief.

pt told his relative in the morning and the relative complained about me to my manager. it was horrible

We have that problem too. WE need two nurses to check a controlled drug out and legally give it but often only have one nurse on duty at a time. We have post op surgical patients..palliative care patients...medical patients...one freaking nurse and 2 HCA's....

The patients rings for pain relief every 5 minutes..nurse ignores the other patients to ring around the damn hospital trying to get another nurse so that the pain relief can be given. No one will come.

Same thing happened to me and I got a midwife to come and bless her she did. That was probably not a good idea though because of cross contamination. But it took a long time. The poor patient was dying of ovarian ca and really really needed her pain meds.

But the patient blames you and tells everyone that the horrible bitch nurse denied him pain relief. The managers kiss the patient's ass and say oh sorry we will deal with her.

Even when have two nurses on at a time we struggle so much to get us both in the same place at the same time. For the amount of patients we have on controlled drugs we need like 10 nurses.

I am going to be making some phone calls today. Some of my colleagues are helping...we are trying to coordinate something here.

sorry that isn't normal. On my ward we hAve 23 beds. And usually at least 4 trained on and atleast one hca. only time this tends to vary is occaisionally early evening. Often we mIss breaks too. We are a surgical ward and we have high dependancy beds And often palliative patients. I can't imagine how with the staffing you describe you ever get a break.

I might be being very unproffesional but I would have told the relatives that a patient on the ward had neArly died, not how etc, but surely if they were there they couldn't have missed the hectiness and panic of an arrest?

We have 6 bays and it is quite a large ward so they probably missed it. But you know how older people are...they aren't always aware of what is going on around them.

Staff nurses do not get breaks. Management tells us we half to but it really isn't possible. That is why I stopped doing long days and went back to 8 hour shifts. It was too much to go that long without food.

You have 4 nurses and an HCA for 23????? Is your hospital hiring?

My general medical ward was closed down and we were combined with a surgical ward. We get everything...20 of our beds are care of the elderly with dementia at any given time...we also have gynae, general surgery, orthopedics and palliative care.

It was 36 beds but they turned our day room, staff room, and treatment room into patient rooms. No 02 of course.

Handover takes over an hour and a half. Management, chief nurse, etc are still refusing to meet with us to discuss this.