Practice team blog
All posts from: December 2011
Mary is a sister on a surgical ward. She was told a few months ago that theatres no longer have staff to escort patients back to the ward after 5pm, so ward nurses now have to collect them. Mary only has four staff on a late shift and queried how they will manage, but the business manager said there is no alternative. On the first evening of the new system two nurses went off on escort, buzzers started ringing and a patient complained about having to wait 15 minutes for a bedpan. A problem solved in theatre created a new one on the ward.
Does this sound familiar? We work in silos, one directorate competing with another for resources. Solving a problem in one area often means it is just pushed onto another service - and all too often nurses are expected to absorb change and get on with it. These artificial boundaries create systems that may work well for the organisation but are not always best for patients.
Like Mary, many nurses have no part in decision-making processes that directly impact on patient care and I wonder if anyone ever measures the ripple effect of change on other wards, departments and services.
We talk a lot about patient stories informing care. I would argue that nurses’ experiences are powerful too. You are at the front line and witnessing day to day the positive and negative effects of changes in services.
So my New Year wish it is that nurses’ stories become part of the quality agenda. I am not talking about staff satisfaction surveys but the actual words you use to describe what happens to you and your patients. Your voices must be listened to because ultimately you see and know what matters to and works for patients. Your voices coupled with patient voices are a powerful force and should be used to shape services for the better.
The debate about whether the country can afford to pay public sector pensions will, I’m sure, continue to rage long after the current dispute is resolved. And I doubt some sections of the media will ever stop referring to them as ‘gold-plated’.
But I’d like to take a step back from the politics, and look at the practicalities. So let’s try to disregard the fact that people are being asked to work longer and pay more in order to receive less (go on - I know it’s hard, but do try).
There are some basic issues that make the ever-rising retirement age simply unworkable for a huge proportion of public sector workers – and nurses in particular.
As they work on into their mid and late sixties, how are nurses expected to keep up with the demands of the job? They can have access to hoists, sliding boards and other equipment to move patients, but even so, many other aspects of the job make it hard physical work.
Will there be a division of labour so younger nurses take on the heavy work and older ones are given light duties? I can see that playing out well on the wards.
And while ageing doesn’t have to equate with ill health, I’m only too aware myself that it is associated with a certain amount of unavoidable physical decline. A lot of it is manageable if irritating if you’re deskbound – the aching knee means you don’t bother going out at lunchtime, and I sometimes think a reduction in my hearing ability wouldn’t be all bad when a colleague bellows across the office while I’m trying to proofread.
But I’m lucky, my job doesn’t require me to walk miles a day, and hearing loss would mean I’d only miss out on an unwanted opinion rather than a plea for help from a frail patient. Working until 68 is unlikely to cause me much physical damage – although I’d probably benefit from having someone responsible for finding my glasses every time I leave them on a printer or someone else’s desk.
I suspect the working conditions of those who make decisions about how long people can be expected to continue nursing are more like mine than they are like yours.
Maybe Mr Osborne should spend a week working as a healthcare assistant. After all, you’re expected to ensure patients can make informed decisions, so surely politicians should be enabled to do so too?