When wards are busy, nurses have to cut corners. Persistent lack of staff and heavy workloads mean nurses have to make difficult decisions every day about what they do and don’t do.
When staffing shortages become chronic the numbers of cut corners can lead to ingrained poor practice that puts patients at risk. We learnt all these lessons from the Francis report four years ago but last week a leading nurse staffing expert Peter Griffiths, warned that the “lessons of Francis” are starting to be “forgotten” as the focus again shifts to finances over safe nurse staffing levels.
It is vital that nurses monitor the effect this is having on patient care and remind themselves of importance of essential skills such as mouth, skin and continence care and what the gold standards should be.
“This week’s archive issue looks at essential care skills and focuses on hygiene”
This week’s archive issue looks at essential care skills and focuses on hygiene which is often delegated to unregistered staff. Our first article on how to provide effective oral care reminds us that oral care is a fundamental part of nursing and is a skill that requires practice. If you would like to explore the topic in more detail a Health Education England programme called Mouth Care Matters has produced a comprehensive guide.
Our second article looks at foot care and older people and highlights that poor foot care can have a profound effect on mobility and lead to social isolation. It explains how to care for people’s feet and describes how the routine activity of washing feet can be transformed into a pleasurable experience for both the patient and their nurse.
Our final article looks at the complex problem of caring for patients whose hands have tightened by spasticity after stroke, brain injury or other neurological conditions. Good hand hygiene is essential for this group of patients to prevent skin soreness, breakdown and infection but patients often experience pain and are reluctant for their hands to be handled. The authors describe how to overcome these problems and ensure patient safety is maintained. As with anything described as ’a basic nursing task‘ it is clear that considerable skill is required to provide this care effectively every day.
“As with anything described as ’a basic nursing task‘ it is clear that considerable skill is required”
What is clear from these three articles is that essential nursing care is highly skilled and nurses need to consider the assessment skills and practical training of unregistered staff before delegating care to them. Omissions of care, such as failing to attend to patients’ feet, is poor practice and failing to provide care because of lack of time should be documented and reported.
It is important that those who make decisions about staffing appreciate fully the impact that poor staffing levels have on all aspects of patient care and what needs to be cut when workload exceeds pairs of hands.’