Caring for her mother during a hospital stay made Nadia Dossa realise that nurses do not have the time to provide fundamental care to patients. She expresses her concern over lack of staff leading to poor standards of care
I am a nurse, a senior lecturer but also a daughter. When my mother was admitted to hospital last year, she was very dependent – I would say equivalent to the care of five patients – but so were other patients on the ward. The nurses were extremely short-staffed, tired and frequently had no breaks. It took almost one nurse just to do intravenous medications on a shift. The 11pm drug round went on until 1am as each patient needed help and the nurse was called away many times. The newly qualified staff nurse needed guidance but he did not seem to be mentored.
There was no time to do what nurses should do – care.
Mum should have been on a pressure-relieving mattress from day one; she did not receive this until day seven. She developed a Grade 3 pressure ulcer on her sacrum and a Grade 1 ulcer on her heel.
Mrs H, the woman next to Mum, needed help too. When she had been left on a commode for 40 minutes, I asked her if I could help; she agreed. The nurses were none the wiser. Mum was very unwell and the nurses kindly let me stay the night. Mrs K, across from my mum, called out to me during the night, expressing how scared she was. I held her hand and eventually she fell asleep.
The nurses were kind, considerate, but totally overworked. They could not manage the activities of daily living for the patients as there were too few staff.
As a lecturer, I felt sad and disappointed. Are we preparing our students for nursing the rising number of patients with complex comorbidities? Are we correctly preparing them to not forget the basic fundamentals of care when trained with higher skills?
Training our nurses to care for carers was also a concern. Mrs H’s daughter also had a husband with a long-term condition to look after at home. She told me how unsupported she felt. A nurse who maybe could have sat with her, or just listened to her concerns, may have helped enormously at this difficult time. Basic nursing care is a right for patients so, as a nurse, healthcare assistant or student nurse, if we cannot meet basic standards of care, help must be sought.
My mum went into hospital with a fractured hip; she did not leave and eventually died. I do not hold anyone accountable, but standards of care are of great concern. I worked with the nurses to care for my beloved mum, washed her, fed her and saw her to what was hopefully a peaceful death – but not every patient is lucky enough to have a daughter, or indeed a daughter with my skills and expertise. Fundamental care cannot be properly provided to increasingly complex patients without an adequate number of staff who are properly supported.
The rationing of health resources is a persistent and worrying issue. With fewer nurses being trained, hospital closures and pay freezes, adding to cuts in funding while more and more people are living longer with more complex conditions is a combination for disaster – we must do something now.
Nadia Dossa is senior lecturer, University of West London.