Think hospital and usually the first thing that comes to mind is an NHS hospital with a poor nurse to patient ratio, extreme stress and pressure and a patient population almost entirely over the age of 70
Of course this is not the case for all hospitals or wards but from my experience it is what epitomises hospital care in the 21st century NHS. So to be placed on a mixed medical/surgical ward in a private hospital challenged my view.
How does it contrast with the NHS?
The first surprise was the nurse to patient ratio - one nurse to three or four patients. This means the workload is more manageable, although the number of healthcare assistants is much lower - one at the most. This means that nurses are much more hands-on. From a student perspective it allows for much closer working with mentors and allows time to develop practical skills without being used as a healthcare assistant.
“It allows for much closer working with mentors and allows time to develop practical skills without being used as a healthcare assistant”
Secondly, the patient population is on average much lower (around early 40s) and most patients are self-caring day cases. Again from a workload perspective this is much better and helps reduce stress and pressure on nurses. This does however have an impact on the development of student assessment skills of more complex patients but as a student at the beginning of my training this was a nice way to gently ease into it. There were opportunities, such as patients admitted for stroke rehabilitation and investigations for autonomic conditions, which allowed these skills to be improved with the added bonus of much greater time.
“Each patient has a single, en-suite room, catering services that provide meals at any time the patient wishes, and ample pillows and blankets”
There are other advantages to private care, especially with regards to the ward environment. Each patient has a single, en-suite room, catering services that provide meals at any time the patient wishes, and ample pillows and blankets. Furthermore there is good turnaround on TTAs and scans and fast access to other professionals and medical staff.
There are negatives, of course. Perhaps the biggest issue with private care is the need for insurance or finance to be agreed prior to referring to say, speech and language therapy. And if the finance is no longer possible the patient is transferred back to the NHS. Innovation is not quite as noticeable in private care either - the use of technology such as electronic documentation for one. From a student perspective there are less opportunities to experience nurse-led roles because there are high numbers of doctors which has seen these advanced roles develop less. Additionally, because of the greater financial stake that patients have in their care, patients and families seem to be more demanding of the nursing care they receive. Of course this is both a positive and a negative, however from a health promotion perspective this does present a challenge.
“It is very informing to see how a different model of delivering healthcare works in practice”
Would I recommend a placement in private care? Absolutely. From a student perspective there is excellent opportunity for practicing skills as well as working closely with mentors and a diverse patient population. Furthermore it is very informing to see how a different model of delivering healthcare works in practice and I believe this helps to become a flexible practitioner. I value my NHS experience, but it is great to see a different approach.
James H Lee is currently studying for a PgDip in adult nursing at KCL.