Comment on: Staff and patient views on intentional rounding
The intention of checking on each patient, hourly or two hourly for toilet needs, drinks, comfort is good.
Under normal circumstances, that is what a team of nurses would aim to do. We are trained to care.
By having to write every intervention down( I presume in scaredom of litigation), it limits how much time is spent meaningfully with either that patient or then next one.
Much of what is on the 'rounding' can be done by eye, and it is right that the patient is not aware of it. Check the call bell is in reach, a drink is able to be accessed by that particular patient. Tissues etc.
It is a tool and I have had patients swear at new staff who have gone every hour with the bit of paper and read out the questions.
I would really like to see trained nurses starting to be trusted.
If they say, there is not enough staff to ensure all these things are done for each patient, then we need to be listened to, that is exactly what didn't at Staffordshire, and it has not changed.
I would suggest a round was never completed because, once a patient expressed a need, the nurse then would sort out the issue, therefore the round stopped, as there would not be anyone else available to carry it on. And so things get left. No brainer.
I am not judging Gill, as having nursed elderly people during most of my nursing career, I often find myself voicing the opinion, 'Is this where we will be in x number of years'.
However, I am surprised that someone who is apparently healthy can do this, and why not just commit suicide, be it with the knowledge of those around you.
I thought the clinics were for those who were unable to do it for themselves.
It then brings us to ask what old age is. We devalue our elderly.
We push all the cures for all the problems they have, without reasoned choice,and then publicly berate them for being a burden, as in, we are an ageing population and cannot afford to continue looking after them.
It seems that only recommendations of the Frances report that suit the government are forcibly put into action. And yet the main findings of; management not listening to the frontline staff, and poor staffing numbers are being pushed aside and watered down.
Recommendations are not enough, the RCN are full of published reports ending in recommendation.
When I have place these under the noses of my senior nurses, all they say back to me. 'Well of course it is only a recommendation'.
Meanwhile, we work shifts where there are 12 sick patients to one trained nurse, or now to balance the figures, 24 patients to 3 trained nurses,but have lowered the numbers of HCA's accordingly.
So at the beginning of a shift, we just decide which trained nurse is to be the health care assistant for most of the time.
You cannot expect one person to wash and dress 14 dependant patients on their own.
This is all juggling figures to stop facing up to the reality that you need more nurses per shift.
Thank you NICE for not giving in to the pressure. The whole reason you were chosen by Lord Frances is because you are independant of the NHS. Well done.
Conservatives want market forces to dictate the price paid for work.
eg, bankers need to be paid very high wages, and have bonus' otherwise they will go abroad or into other financial sectors and not run the countries banks. It is what balances things out.
BUT it has always been said that if you pay nurses a high wage, you will get people in the job that are there only for the money.
These are two opposing arguments, and I defy anyone who will tolerate taking stool samples or clearing up faecal vomit to do it purely because the pay is good ( some hopes)
Does anyone other than another nurse know what nurses really do?
Safe staffing numbers are individual to each section of nursing and needs of patients at any one time.
Therefore, trust the well trained staff to risk assess each day/ week.
Any blanket decision will alway present overstaffing in some places and grossly unsafe staffing in others.
Registered nurses are not trusted to make valued judgements,
Is it our training that is not trusted,? is it our calibre?, are we aiming at being as lazy as possible, so will risk assess to our advantage?. What have we done that our professional judgement has been so downgraded?
Give each ward/area of nursing a well worked out risk assessment tool, have a standard evaluation of maximum and minimum staffing within that section, and give the nurses working there the ability to vary the level of staffing as the need arises.
There will always be situations where the planned level of staffing becomes inadequate due to a unforeseen patient need or change in circumstances, or staff sickness, but it should be able to be covered by the next shift, and so not be a day in day out occurrence