Poor nursing care.
4-Jul-2011 4:09 pm
Has anyone given any thought as to why patients (mainly the elderly), can come in to hospital and deteriorate due to poor nursing care, in some cases becoming dehydrated and malnourished and dying as a result. We live in the 21st century for Christ sake and I honestly believe things are getting worse. Where are the managers making sure that standards are maintained? Let me tell you. They are in their offices filling in bloody forms or gossiping. I have had personal experience of this. They leave the Band 5's or HCA's to do all the work. Some of these nurses are very inexperienced indeed or think that basic nursing care is beneath them because they have a degree and cannot wait to get to Band 6 so they can spend more time in the office. Or they feel that relatives should do most of the day to day nursing care. We now rely on staff from the Third World to keep our First World (!!!) health service afloat. Many of these are excellent but they are used to keep wages down in this country because the only way to increase recruitment from the indigenous population is to improve wages. If you have nurses desperate to escape their own miserable country for a better life in the UK, you can keep wages low because you will always be able to recruit. Nursing managers who should know better, have been responsible for the implementation of this policy. Role on privatisation. Maybe standards will improve if you can sack people more easily.
Sort: Newest first | Oldest first
30-Jul-2011 1:40 am
"Some of these nurses are very inexperienced indeed or think that basic nursing care is beneath them because they have a degree and cannot wait to get to Band 6 so they can spend more time in the office. Or they feel that relatives should do most of the day to day nursing care. "
Absolute load of crap. There is a point about inexperienced Nurses not being given the support they need, but many ARE experienced too. Often the 'day to day' tasks are not done due to lack of time and staff, not due to a lack of will. And those who cannot wait to get to band 6 and sit in an office are in the minority. The vast, vast majority of Nurses are struggling to provide the care they want to give, BECAUSE THERE IS NOT ENOUGH STAFF!!!!!!!! That 'too posh to wash' argument is as pathetic as it is erroneous.
"We now rely on staff from the Third World to keep our First World (!!!) health service afloat."
Again, a load of crap. It is true that foreign labour is probably over represented within our profession, but they are hardly keeping the NHS afloat. There is a vast number of indigenous born and trained Nurses who cannot get jobs due to job freezes and cuts. It is a joke. So it is a myth that foreign labour are the backbone of the NHS, because there are more than enough Nurses to fill the gap if they were not there. Saying that however, I believe Nursing is one of the few professions that should ALWAYS be open to immigrant workers, BUT the posts should be available to indigenous workers as well.
I HOPE you are not a Nurse, because you really do not have a clue, and your attitude needs a lot of rethinking.
30-Jul-2011 2:42 pm
on an acute medical ward with elderly admissions as well at any time of the day if we were on the shift alone or short of pairs of hands and had an emergency such as a resus. which took up all our time but afterwards were feeling guilty because a dependent patient hadn't had a wash we were told by our superiors that a a dirty patient is better than a dead one! a wash can always wait until later, or at worst until the next day, whereas a life threatening crisis cannot!
I do wonder though, why some nurses decided to take their job when they prefer to sit all day in the office?
31-Jul-2011 2:05 am
Anonymous I agree entirely, but as for the Nurses who want a career in an office, I do believe these are in the minority, and that career path is there for them, but there are the rest of us who want and choose to stay clinical, for better or worse. We should not all be lumped into the same pot.
31-Jul-2011 10:56 am
Apologies to Mark Simmons if my comment is not entirely relevant but I just wanted to respond to Mike above to clarify I point I made which is also related directly and indirectly to poor care.
Actually Mike, I didn't make my sarcastic comment clear. I was referring to nurses on the ward who spend most of their day in the office rather than providing hands on care! as you know this puts considerable extra stress and strain on the team. these taskmasters always manage to come up with a good pretext which can be difficult to dispute even though it is wrong and they are good at putting others down. they don't seem to want to spend time with the patients or to nurse at all and i just wonder why they have chosen this career. because they spend so much time in the office they are usually the first point of contact on the ward with anybody who comes on the ward (giving the impression to some that they are in charge), including our superiors with whom they then have more contact than the rest of the team working harder on the ward. they act as our spokespersons and develop good relationships with them which enables them to jump up the ladder to an official office job where they can continue to bully their juniors!
i have met a handful of these types on several of the wards where i have worked. Perhaps their behaviour is a blessing for the patients as they may be more suited to work behind the scenes than being involved in direct patient care. In fact some may be hiding behind a mask, to disguise their own insecurities, in the office where they can give the impression of being busy and bustling with efficiency whereas they are often the one's whose 'care' patients complain about!
when I started a new job there were two nurses who regularly went off the ward for a smoke at the same time each morning before we got our coffee break, smugly saying that they had already finished all their work but leaving one nurse to prepare the drugs, answer phone, colleagues queries and buzzers (often for some work they had not completed) all at the same time. obviously as the new girl I did not answer back but found it highly stressful coming to grips with their very complicated medication system which required all my concentration and needed more time than normal. support for the other tasks to avoid constant interruptions would have been greatly appreciated to relieve the pressure on me. however, I had to stay until my tasks were completed.
we were not allowed to go and have a coffee break when our body clocks dictated a need for a shot of caffeine even though we might be on our knees by the time our break came. so why are tobacco breaks prn but not caffeine breaks? when they both take about same length of time!
in fact coffee could be brewed in the ward kitchen at any time so, unlike smoking, one did not even need to leave the ward.
as a footnote, I was actually employed to take charge of this ward who last person in charge had left one whole year previously unbeknown to me when i took over. By mutual agreement i worked without being in charge for the first three months to learn the ropes but there were so many difficulties within the team and I was forced by the Director of Nursing to hand in my resignation following an incident where I told another nurse off for being extremely rude, offensive and insulting to a new patient in the corridor who had just arrived who she was admitting. To sack me she had to prove professional negligence but the team psychologist who knew the Director well said that if I did not resign she would make my life hell with the risk of me making an error out of pure stress and thus a blemish on my cv. i sought union advice and apparently there had 20 files of similar cases and five of these had gone to the tribunal but I declined to follow this route and handed in my resignation.
In such circumstances, a bad reference is not given and mine emphasised one or two of my strong points but there are gaps which can leave prospective employers wondering and this is a well known strategy they employ not to condemn the person but also not to help them in getting further employment.
This last scenario took place in a medical, surgical and mental health rehabilitation clinic in Europe outside the EU where employment laws are different but the difficulties and attitudes may be the same wherever one works and the office scenario described at the beginning refers to periods during my training and time in a London teaching hospital and a university hospital abroad.
23-Aug-2011 10:59 am
to be frank the fact that so many elderly white patients are in terrrible shape is the majority of the problem. they will quite contently sit at home, declining and declining, unable to wipe their behinds because they have grown SO fat. they eat a disgusting diet and live in squalor.
They can't all have been like that to beginwith.
nor can they pretend they didn't know they needed to drink water, exercise, eat well, diet if they become massive.
when they come into hospital you get them at the end of the journey. those pressure sores were always goig to happen because they LEt their precious bodies (and minds) to rot away at home.
Trust policy rapes them of any decision making power or even the need to do things for themselves.
These poeple ask me t wash their god damn facesfor christ sake. that is abuse. they leave problems with incontinence, blood pressure, pain and mobility to continue on forever whilst the british style of abandoning your parents to an isolated lonely lifestyle is all the rage.
Elderly people are abused by nurses, they are abandoned and neglected by their children. Considering how much Britain sashayed it's way into supposedly inferior cultures and took the good things they didn't quite take the respect for elders culture with time.
They day the adult child of an elderly patient shows up on admission day one i'll eat my hat. When they volunteer to clear years of urine soaked carpets and filthy fridges out instead of preferring toal strangers to do it i'll also eat my hat.
Sorry but the elderly rarely have anyone else to blame for thie poor health but themselves and no amount of apologies from the profession will change the fact that these peolpe let the only real resource they have wither away and die.
They often obstruct their own recovery and even in the acute phase are unwilling to make an effort to journey the whole 0.5m to an armchair. these people can't even move up a bed!!! my fault or theirs?
There is no such thing as poor nursing care that doesn't relate to crappy management, resource restriction and unrealistic workloads (patient and paper).
In my hospital they think a TURP takes 48 hours. It actually takes up to 7 days! not th patients fault in this case but bad planning and unrealistic surgeon led judgemnts.
We're ordered to make sure patients brush tier teeth and wash their hands before meals. Obviously neither of these things are British. toothbrushing is unheard of in the elderly but they of course pretend they wanted to do that. but i can't just leave those easy to use implements in front of them, no no. i have to nag and nag to get them to invest 2 minutes 3o seconds in themselves. of course their teeth were previously unbrushed for decaded but can they really pretend they 'didn't know'they should brush their teeth? i don't think so.
I routinely remind my patients that it's their life - not mine and that alot of their recovery is actually dependent on whether their body can take what's being thrown at them. that's honesty. pretending that theirentire beingis dependent on me working like a dog so that they can just lie there is a falsehood. It's not a hotel or a spa.
if they don't want to invest in their ownrecovery fine. but son't expect me to care more about you that you should care about yourself.
Even if i was struck off, at leasti wouldn'tbe guilty of willfull self neglect far worse a crime if you were a drug addict or alcoholic
30-Aug-2011 6:54 pm
Thanks for the comments so far. Yes Mike I am a nurse and I mean what I said and I think you should be a bit provocative in order to stimulate debate. I agree with you that staffing is an issue but I have had experience of a well staffed ward where Band 6 staff would go to one of their homes in order to have a meeting leaving the ward (paediatric) without senior cover. I can bet you they did not discuss work issues for most of the time. Absolutely taking the piss in my opinion. I do conceed though that this does not go on everywhere and I have nothing but admiration for staff who cope in very difficult circumstances.
13-Jul-2012 1:20 pm
poor nursing care could be seen as inevitable at the present time.
The prevailing conditions in our trust is the saving of money -first and foremost,and preserving the lavish lifestyles of the highly paid.
We have recently had a rejig of some management posts-the savings negligable.
The highly paid are offered redundancy the lowered paid MAS.
Staffing on the wards is well below the level where quality care can be given.But the number of trained nurses in office settings, on off ward secondments and in jobs doing goodness knows what are multiplying.
Quality and Safety matrons are a contradiction in terms-how are we supposed to deliver safe ,high quality care when the staffing numbers don't add up?
Could some of these people not be demoted and sent to roll their sleeves up on the wards?Instead of auditing (fault finding) other nurses efforts?