It’s time to start looking after nurses to boost care
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After all, if they did understand the implications of diabetes insipidus they should have been able to give Kane the care he needed. If not, they had a responsibility to get the information they needed to ensure his care was safe and effective.
When a student, I was told never to give a drug unless I knew the indication, contra-indications, side effects and normal dose; the same went for understanding a patient’s diagnosis and treatment. Indeed, if you don’t truly understand what is wrong with your patient - the underlying anatomy, physiology and pathophysiology, then how can you look after them? Without this knowledge, nursing is nothing more than tasks - and tasks without understanding are dangerous things.
Which brings me to skill mix. Recent data from national nursing research unit suggests the average proportion of registered nursing staff - compared to unregistered healthcare assistants - on day shifts is 56%. This places the onus on the registered nurse to ensure that HCAs carrying out day to day care, such as fluid management, understand the significance of patient diagnosis. This is probably easy when staffing is stable and patients are on appropriate wards, but what happens to patients who have multiple and complex conditions?
It is often claimed in the media that anyone can give someone a drink but it’s not “simple” for someone with diabetes insipidus. Anyone can wash someone but it takes a bit more thought if a patient has a fractured neck of femur. Anyone can help someone to eat but not if they have dysphagia. Nothing in nursing is really simple which is why delegation has to be managed carefully and nurses given time to ensure those giving care, who often are not nurses themselves, understand the significance of what they are being asked to do.
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Readers' comments (49)
Anonymous | 6-Aug-2012 10:39 am
tinkerbell | 5-Aug-2012 5:52 pm
I agree with your little group. It is very important that people should not be afraid to ask, question and comment.
I'm not so sure about these animals all being lovely - I've an idea (too dim to be sure, so far) that Tiger called me a slightly mentally-challenged beautician somewhere recently. I object to that - slightly mentally-challenged, is an under statement !
Anonymous | 6-Aug-2012 9:26 am
'The concept of nursing is simple and one of the problems in hopsitals these days is that people try to over complicate things.'
'They need to follow protocols and policies which are there to protect the patient, protect the nurse and protect the establishment.'
The 'rocket science' bit, is working out when to not follow protocols and policies that don't actually fit an unusual situation, and therefore would harm rather than protect the patient if you did follow them.
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Juggling Dog | 6-Aug-2012 11:51 am
tinkerbell | 5-Aug-2012 5:52 pm
Re your she/he - I'm a bitch.
Perhaps animals, being less socially-aware than you humans, just say what they think ? Is that confidence, or something else - you humans can get into the philosophy of that one !
I've always wondered - are you a real fairy, or not ?
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Anonymous | 6-Aug-2012 2:47 pm
I'm a bit dim but ... | 6-Aug-2012 10:39 am
"The 'rocket science' bit, is working out when to not follow protocols and policies that don't actually fit an unusual situation, and therefore would harm rather than protect the patient if you did follow them."
That's not rocket science, that's common sense.
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Anonymous | 6-Aug-2012 2:53 pm
Anonymous | 6-Aug-2012 2:47 pm
'That's not rocket science, that's common sense.'
It ideally would be common sense - but common sense is not all that common, and not necessarily always in evidence.
If common sense were the answer, why do all those protocols, etc, exist ?
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Anonymous | 6-Aug-2012 5:28 pm
what is rocket science? what is common sense? do they really exist and are they of any use?
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tinkerbell | 6-Aug-2012 7:21 pm
Juggling Dog | 6-Aug-2012 11:51 am
Of course i am not a real fairy, don't be daft, i am a real pixie:)
I remember you mentioning you did not extend your liberalism to cats, well my cat loves dogs and has spent many a playful hour with them when we use to have 2 german shepherds (all trained attack dogs in the dog section) and a labrador (drug sniffer dog). He assigned honorary cat membership on them all as he had 3 dogs to contend with when they retired from service and they appeared to accept him as some kind of fluffy miniature dog with a strange bark that should be treated with kid gloves. I would, therefore, ask you to reconsider whether dogs can extend liberalism towards cats.
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tinkerbell | 6-Aug-2012 10:27 pm
I'm a bit dim but ... | 6-Aug-2012 10:39 am
I was called a 'loud mouthed fluff ball' on here once and like yourself thought i'd got off quite lightly.
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Juggling Dog | 7-Aug-2012 11:45 am
tinkerbell | 6-Aug-2012 10:27 pm
I don't have a problem with getting along with cats - it is just that I consider them to be very self-centred and not very co-operative in their approach to life, and it is paying too much attention to their views that I'm not very liberal about.
I didn't think fairies or pixies were all that fluffy, so 'loud mouthed fluff ball' is an interesting comment. Perhaps someone misread tinkerbell for tennisball ?
I think Agent probably holds the record for abuse received - didn't he once re-post a very abusive post that had been removed by the site, on the grounds that despite it being rubbish he defends free speech ? I think NT took it down again.
And Tiger Girl poses a problem for me - as a chimera, I'm not sure where she sits on the cat-to-human scale (loud mouthed fluff ball might work better for TG - a higher class of insult on this site, would better fit a supposedly professional group, I think).
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Juggling Dog | 7-Aug-2012 11:54 am
Anonymous | 6-Aug-2012 5:28 pm
Sense presumably means 'pretty clearly right' but it is the common part where the problem rests.
Different groups of people - nurses, doctors, cleaners, managers, firefighters, lorry drivers, police, judges, etc, etc) - all tend towards some sort of 'norm' for what common sense would be within their particular group, but what might be 'obvious common sense' to a nurse, might not seem like common sense to a police officer. Etc.
Go and ask a cat, if it is common sense to jump on a mouse - then ask the owner of the pet mouse, if the cat is right. Perspective - complicates almost everything in the real world !
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Anonymous | 7-Aug-2012 1:53 pm
I don't think it is possible to have a sensible discussion about common sense with someone who says:
"Go and ask a cat"
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Anonymous | 7-Aug-2012 1:54 pm
Owr dogy kant jugle I asked my dady and he sad no dogs can jugle he sad the pikture was fotoshoped Ewryone knows tinkabel is a faires name not a pixes name Abert aged 4 and 3/4
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tinkerbell | 7-Aug-2012 2:14 pm
Anonymous | 7-Aug-2012 1:54 pm
Glad to see we're all entering into the spirit of a bit of good old british sense of humour despite the struggles we're going through in nursing.
S/he who laughs lasts!
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Anonymous | 7-Aug-2012 2:23 pm
I never heard of a fairy who turned into a pixie or a pixie who gives him/herself a fairy name - something very queer about that.
are all pixies boys and all fairies girls, not sure about that? Oberon was King of the Fairies what does that make him?
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DH Agent - as if ! | 7-Aug-2012 3:07 pm
Juggling Dog | 7-Aug-2012 11:54 am
Although I have doubts about the authenticity of Dog's claim to be able to juggle (is that possible for anatomical reasons ?), I think the Dog explained the problem with common sense quite well.
'Perspective - complicates almost everything in the real world !'
Oh yes !!!
Anonymous | 7-Aug-2012 2:23 pm
Is there the slightest hint of political incorrectness in there - that would never do, these days ! Oberon sounds a bit like a French name, so it probably makes him a moaner about how les rosbifs have got about twice as many medals as Le Francais !
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Anonymous | 7-Aug-2012 4:27 pm
Oberon - King of the Fairies in 'Midsummer Night's Dream'. I never hear of Shakespeare being called un-PC.
was he French?
I have been dying to write a comment about Hollande's remark to Cameron at the beginning of the Olympics about the French having the more medals than the UK but was unable to find a place for it. Enough said! Long live the Rosbifs, and as for the Frogs, well......?
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tinkerbell | 7-Aug-2012 4:47 pm
Pixies can be male or female. And contrary to what most believe, they are different from fairies, sprites and elves. Each have their own qualities
Read more: http://wiki.answers.com/Q/Are_Pixies_Male_or_Female#ixzz22sJkiKAc
Also Tinker Bell was originally a pixie but changed to fairy in Disney.
Regardless don't take my masculinity away from me as i've had some big battles to fight, up against some male chauvinists over the years who still think that as a female i should not be able to say what i think as this is only reserved for males and should be busying myself with the cleaning. So in a way i guess i have become something sexless as far as the workplace is concerned.
When our consultant was asked if he wanted a cup of tea and then one of us went off to make it he then asked 'does someone have to make it?'. We did laugh, bless him.
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Anonymous | 7-Aug-2012 6:02 pm
phew, tinkerbell, alias Tinker Bell, I am glad we have cleared that up!
I hope your consultant washed his cup up after him, as he would at home!
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Anonymous | 8-Aug-2012 9:26 am
Dear Albert,
You have made some important comments.
It was very clever of you, to realise that dogs cannot juggle. And I’m sure you will realise, that dogs can’t type very well either, because their paws are the wrong shape for typing.
So the photo of the juggling dog must be a fake – but it probably isn’t the dog’s fault. I think a person has taken a photo of the dog, added the ball by Photoshopping it, and is pretending to be a dog when he or she writes about things. Naughty person !
Your other point, that a pixie is calling herself tinkerbell, is more worrying, because as I’m sure you know, the Chief Elf has forbidden pixies from calling themselves tinkerbell, since The Great Scandal of 1847. But as we both know, pixies are very naughty by their nature. However, I will be contacting the Elf Complaints Service, to raise your concern about this naughty pixie who is impersonating a fairy. The Elf Complaints Service is modelled on something called the NMC, so that naughty pixie will be taken to task sometime around 2040.
With warmest wishes, Yours Reginald U Latah
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Anonymous | 8-Aug-2012 9:30 am
tinkerbell | 7-Aug-2012 4:47 pm
'Regardless don't take my masculinity away from me as i've had some big battles to fight, up against some male chauvinists over the years who still think that as a female i should not be able to say what i think as this is only reserved for males and should be busying myself with the cleaning. So in a way i guess i have become something sexless as far as the workplace is concerned.'
Probably deserves an NT piece to itself - I think it might attract some posts.
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Anonymous | 8-Aug-2012 10:02 am
good one Reginald, but shh please!
please be careful what you say about tinkerbell. she is great as she is but if she gets upset she will go and change her name again to something far less suitable such as Cassandra or even go underground as yet another 'Anonymous' and we already have enough of those here who seem to be causing a lot of trouble and confusion for some!
best wishes, Anonymously
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