Comment on: 'Why are qualified nurses trying to put me off?'
I'm one of the ones who will be gone in less than ten years and my advice is that if you love it stay. If its tough at times - those times will pass. Nursing can be hard work but its also incredibly rewarding. This is a great time to be a nurse. Nursing has changed beyond all measure since I first put on that uncomfortable uniform with the starched collar and my little paper hat. Nurses now do things were once unthinkable, we have nurse specialists doing an amazing job in diagnosing and treating patients. We have nurse led clinics. At the heart of everything we do are our patients. We see them at their worst, ill, frightened and distressed and we need to offer them kindness and compassion. We also need to be kind to each other. Good luck in your career and remember to nurture students and junior nurses.
This is an excellent paper and I personally shall refer to it in relation to treating frail older people. It is so important to realise that one size does not fit all and that the aims of treatment differ at different points in the life course. We need to learn to balance risks and benefits and keep the patient at the centre of all we do. As our population ages it is more important that we combine the art and the science of nursing and medicine. Clinical guidelines need to take account of the needs and aspirations of older people especially those who are frail so that they experience the best possible quality of life. Here's the link to the paper
I support the campaign as a nurse and as a recent inpatient. As a nurse who has cared for older people for decades I can say that encouraging and enabling people to retain and regain mobility doesn't need more staff. Having more able patients actually reduces nursing workload. Its all about culture.
The PJ paralysis is also about culture change. I recently had surgery and as soon as I came round and drank enough to convince the nurses to discontinue my IV fluids I got up. My nurse accompanied me to the toilet, having checked my blood pressure first, as I was feeling a bit wobbly. I then changed into my nightclothes. In the morning I got up and dressed and went for a walk on the ward. I felt so much better up and dressed but I was the only one on the ward who was dressed. In getting dressed I put yesterday and the surgery and the problems I'd had behind me and started my recovery. We need to change the culture on wards so that people who are recovering don't lie around getting deconditioned .
My grandmother and my great aunts told me what it was like to live in the UK before the advent of the NHS. They told me how people feared getting ill, saved money so that they could afford to see a doctor and how they delayed seeking help for medical problems. Data from the OECD and EU show that the NHS spends 7.7% of Gross domestic product on publicly funded healthcare. That's less than Germany (9.4, Sweden .3, France 8.6. I'll try to add in a graph at the end. We provide universal healthcare free at the point of delivery. The US spends 16.97% of its GDP on healthcare whilst excluding many of its most vulnerable citizens.
OECD/EU (2016). Health at a Glance: Europe 2016: State of Health in the EU Cycle.
Health expenditure in relation to GDP.
The easiest ways to prevent catheter associated urinary tract infection (CAUTI) are:
1. To minimise the use of indwelling urinary catheters, the NHS inserts a million annually and an estimated 25% could be avoided
2. To offer those with retention the option of an intermittent catheter when ever possible.
3. To remove urinary catheters as soon as possible when there is no longer a clinical indication.
I fail to see how an different design of catheter will cut CAUTI rates. When a person has an indwelling urinary catheter for a certain time, typically two weeks in acute settings and four weeks in community the bladder becomes colonised with bacteria. Unfortunately medical and nursing staff are frequently frequently unable to differentiate between CAUTI and asymptomatic bacteriuria so people with indwelling urinary catheters are frequently inappropriately treated with antibiotics leading to the development of antimicrobial resistance.
As professionals we need to think very carefully before inserting a urinary catheter as they can increase infection risks. The person with the catheter may suffer bladder spasm and this can cause pain and discomfort. Bladder capacity is reduced if catheter valves are not used and not everyone is suitable for a catheter valve. So catheterising a person necessarily can affect the person's health and well-being long term.
Catheters have their place and can be a boon to patients when used appropriately and a bane when used inappropriately.
I don't understand how this new design will improve matters