OPINION

Time to care must not be jeopardised by NHS job cuts

16 November 2010 | By Jenni Middleton

Understandably, the inquiry on Mid Staffs has been a major part of virtually every conversation I’ve had with healthcare professionals since it started a few days ago.

Regardless of their discipline, or whether the person I’ve been talking to has been in an acute or primary situation, they have all raised concerns that our current financial backdrop and the news that nearly 27,000 jobs could go from the NHS, will mean that another Mid Staffs is “inevitable”. A chilling remark considering that as we go to press, news emerged of another tragic case at the same trust. It could, of course, be totally coincidental, but with the trust in the spotlight, it’s unsurprising that people will make a connection even if there isn’t one.

The Royal College of Nursing says care will suffer as a result of the job losses, despite the government’s diktat that the cuts must not jeopardise these standards. Even trusts with the keenest management skills, which manage to hang onto their nurses, midwives and other healthcare workers, will find it hard to lose this number of staff without stretching nurses beyond their traditional roles. Those nurses who retain their jobs may well have to absorb the to-do lists of their administrative peers to keep their trusts running. Maybe soon we’ll see nurses with one hand on the calculator and another on the cardiac monitor.

Productive Ward programmes were developed to release time to care. We must make sure this time is used for exactly that purpose - and not for taking up the slack of fulfilling the duties left in the wake of clerical colleagues.

Elsewhere last week, the RCN was presented with the Rolls of Honour, featuring the names of more than 2,000 nurses who lost their lives in the two world wars.

At the eve of Remembrance Day ceremony, I met 92 year old Betty Barker, who was a nurse in Cardiff during the Second World War. She told me how the soldiers refused to leave their beds when the air-raid warnings started, and she would have to stay and tend to them as the bombs dropped. Proof indeed of the tremendous effort made by nurses in the toughest of times.

Readers' comments (20)

Anna Lincoln | 18-Nov-2010 10:59 am
Pharmacy demands that Nurses do their jobs for them. When a 34 bed ward is staffed with two RN's and two care assistants pharmacy demands that we run back and forth all over the hospital to get the drugs we need for each drug round. This is what the ward staff must do while 13 pharmacy staff hang around in their department. If the Nurse doesn't do it, the patient doesn't get their drugs. And the Nurse gets held responsible.

Equipment library expects the Nurses on a 34 bed ward staffed with 2 Nurses and 2 healthcare assistants to clean beds ( a 100 step process to make the equipment library staffs's job easier) clean and repack air mattresses etc etc, and run back and forth between the ward and their department all the time. Meanwhile equipment library has more staff on duty and they are all getting lunchbreaks. When we don't clean and re-pack the airmattress up for them just so, they go nuts and make laminated posters showing us how it needs to be done. They don't seem to get that when a ward nurse with 18 patients has 4 critically ill patients as well she cannot fuck about with equipment. This is especially the case when she is already having to run back and forth to pharmacy and all over the hospital to get drugs when pharmacy doesn't bother.

The domestics go mental when they come into work on a morning and the 2 staff nurses and 1 HCA that were on duty by themselves for a 34 bed ward at night haven't collected, cleaned and handed out jugs and cutlery for breakfast. It is too stressful for the domestics to do this themselves you see.

The porters are "too busy" to bring graseby pumps, provide assistance with portering duties etc. So it falls to the ward staff again. As if the NMC registered staff Nurses don't have enough problems already.

The ward clerk expects the Nurses to help her answer the phones and manage administrative things because she is so stressed out. Never mind the fact that the Nurse is cruising for a bruising by the NMC because of failure to rescue, late meds, missed orders, and general neglect because she cannot get to her patients fast enough.

The bed managers have a whole list of jobs for the ward staff (4 of us to 34 beds) to do to make their jobs easier.

What the hell happened to British hospitals? Why do the Nurses (who have the most responsibility, liability, and accountability as well as higher workloads) seem to work for all the supporting departments?

You want the Nurses to have "time to care"? Don't tell us. Admin clerks, Pharmacy, housekeeping, portering etc need to understand that the Nurses have a job to do with real risks and consequences if it doesn't get done. And this is happening at a much higher level than anything a pharmacy tech or a porter is dealing with.

And you are telling me that the situation is going to deteriorate even further?

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Anonymous | 19-Nov-2010 11:29 am
I hope you're filling in the incident forms for every shift then Anna cos you're going to rely on them to cover your actions and accountability when the hooey hits the fan there.
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Anna Lincoln | 19-Nov-2010 7:14 pm
Oh hell yes. The staff Nurses at my hospital are the incident form queens. And we photocopy every single one and save them.

Have a meeting with the matron this week. The last time I tried to tell them they responded with "well what do you want us to do about it?"

But we have a new matron now and she seems really nice and interested so keep you fingers crossed.
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Anonymous | 19-Nov-2010 7:39 pm
its true. nurses seem to expect others to take responsibilty for all their difficulties instead of using a little initiative and coming up with suggestions for solutions themselves and then blame everybody else when things go wrong.
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Anna Lincoln | 19-Nov-2010 11:47 pm
The bottom line is that the patients would get better care if Nurses were left alone to Nurse. Unfortunately this doesn't happen because other departments think that the Nurses work for them. I am aiming to put a stop to this garbage at my hospital.
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Anna Lincoln | 19-Nov-2010 11:49 pm
By the way anonymous 7:39 your comment sucks. You have no idea about what you are talking about. Nurses are always reporting this stuff and making suggestions. We (front line ward nurses) have developed excellent and cost effective solutions to these problems. The main problem is that people have archaic 19th century views of Nurses and therefore do not want to listen to the profession.
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P. Damien | 22-Nov-2010 1:29 pm
Well said Anna.

I think it's about time nurses realised that by tolerating such working conditions/and abuse they are in fact contributing to the problem!

A lack of action by nurses is just making this worse.

I understand that our unions are usless on this matter. I wonder what would happen if just ten nurses from every hopital in the country wrote to their local MP's and voiced concerns.
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Anonymous | 22-Nov-2010 3:36 pm
I repeat what I said above but it is not just suggestions for solutions that are needed but also action as well instead of so much complacency and complaining, and some commentors should watch their insulting language from others who also have experience in the matter!
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Anonymous | 22-Nov-2010 3:43 pm
what happened to the professionals and angels who used to make up the nursing workforce? they looked after patients instead of spending their time making derisory comments.
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Anonymous | 23-Nov-2010 12:00 pm
3:43-these angels you speak of did not do all the tasks that are expected of a modern nurse. As healthcare advances the demands on nurses increase, but the roles of many others in the hospital do not increase, nor do the numbers of nurses.
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Anna Lincoln | 23-Nov-2010 7:09 pm
We can be angles and look after patients when we are at work and make offensive comments to the ignorant and the backward while we are home and online. I see no problem with that.

Anonymous 12:00 talks sense.
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Anonymous | 23-Nov-2010 7:58 pm
Anna Lincoln | 23-Nov-2010 7:09 pm

The above comment has been reported to the Moderator with the follow note:

I wonder if you take any notice of reported comments. I find this one below irrelevant to the article, inappropriate for a professional journal and offensive to other commentators.
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Anna Lincoln | 23-Nov-2010 8:19 pm
I spelled angels as angles. Too funny.

Don't really care about the moderator thing.
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Anonymous | 23-Nov-2010 8:20 pm
Anna Lincoln | 23-Nov-2010 7:09 pm

We can be angles and look after patients when we are at work and make offensive comments to the ignorant and the backward while we are home and online. I see no problem with that.

Anonymous 12:00 talks sense

DOUBLE STANDARDS
Does this mean that we look after patients at work but treat our colleagues, especially outside work, and whoever else makes comments, how we wish and without respect? Does it mean that those who make comments which are contrary to your views ignorant and backward?

Please can we stick to commenting on the article instead of insulting other commentators. If the comments cannot lead to rational argument and debate they are not worth bothering to read at all as too much time lot can be wasted sifting through the irrelevant ones to find the valid and useful thread of the discussion and nurses are busy people or have better things to do with their time.

For those simply trying to give vent to their personal worries by taking them out on others, there are other blogs more suited to this purpose.
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Anonymous | 23-Nov-2010 8:50 pm

Don't really care about the moderator thing.

Please may we have some respect on this site. The Moderator is a person with a role and not a thing or an object.

Nurses once had a reputation of being caring people and such a careless attitude towards others reflects on one's work in caring for patients and their visitors too and other staff involved in their care.
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Anna Lincoln | 23-Nov-2010 8:58 pm
"thing" referred to the issue with the moderator rather than the moderator himself.

The last part of your comment is BS. The Nurses are on the receiving end of the uncaring attitudes. Not vice versa.
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Anonymous | 23-Nov-2010 9:13 pm
Are you always so rude to everyone Ms Lincoln. I think if you would like to be treated caringly it works both ways!
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Anna Lincoln | 23-Nov-2010 9:30 pm
Am I always rude? Nah. My patients think I am sweet as sugar. But when I get angry online I suppose I get a but rude. Sorry.

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Anna Lincoln | 23-Nov-2010 9:38 pm
Anyway don't take it personally. You should see how I talk on the militant medical nurse blog.
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Anonymous | 23-Nov-2010 9:45 pm
I'm sorry too but I don't think we should be taking it out on each other.

I am very lucky in my career and don't have so many of these difficulties. Everybody has mutual respect for each other and with excellent communications we usually manage to sort out any problems and oersonal differences and often have a good laugh too despite the stress of our work in acute medicine, difficult hours, periodic staff shortages, excessive and uneccessary paperwork which keeps us away from our patients, and working lots of hours entirely on our own with 20 beds plus the more than occasional extra five squeezed in between other beds and in the corridors, especially in the winter.

I'm glad your patients think you are as sweet as sugar and if we were all like that to everybody, not only patients, we would all get on much better. My patients and colleagues label me as very diplomatic!
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