Saturday, 24 March 2012

Evil Nurses, Care of The Elderly - or Lack of It.

Unless of course we are called to higher office sooner, as sure as eggs is eggs we will, well, all end up old, some of us very old and well past our sell by date, we may succumb to the old arthuritus (sic) and/or diabetes and/or heart disease - perhaps multiple comorbidities and our little grey cells may thin at the same rate as our greying hair.

It is well known that unless a relative of yours, old people are a burden on the state and indeed society itself and are not worthy of the title of human being, okay they might be human but their being here is, well, bothersome.

Never mind, the hope is that they will end up a hospital patient and then – God bless’m – the nurses can finish them off!  What more satisfying than leaving someone’s gran or granddad lying in their own excreta, starving to death or dying of thirst while you read Hello at the nurses station and discuss last nights date in sordid details!   And then there is always the LCP if all else fails!

But of course it is not that easy for when learning of this despicable care via that stalwart of the media The Daily Mail, suddenly the entire world and his brother are up in arms stating that nurses don’t care any more and “They were Angels when I was a lad!”  Suddenly everyone cares about the elderly while they ignore Mrs Miggins next door who is so damn lonely the only friends she has is her GP and that nice nurse who visits weekly to dress her wounds.  (Mrs Miggins sometimes accidentally on purpose pulls off the dressing so that nice nurse calls more often.)

Interesting then that this recent  RCN survey shows that these unfeeling nurses (caring for the elderly) report that due to unsafe staffing levels “that activity was left undone, or was done inadequately on their last shift due to lack of time.”  These activities include comforting/talking to patients (78%), falls prevention (45%), helping patients with food and/or drink (34%), helping the patients use the toilet or manage incontinence (33%), pain management (19%) and care of the dying (17%).  Please read the full list, the full survey yourself.

Read the whole thing and learn that although older people “who often have the most complex and intense needs…  …have a more dilute skill mix than other types of wards.”

Staff (nurse) ratios are thus: 

·        9.1 to 10.3 patients per RN on older people’s wards.

·        6.7 patients per RN on adult general/medical/surgical wards

·        4.2 patients per RN on children’s wards.

This survey mirrors findings of the RN4CAST survey which found:

·        High nurse BURNOUT and job dissatisfaction were common among nurses in Europe and the US.

·        On average, only 60% of patients were satisfied with their hospital care.

·        Those nurses reporting high levels of burnout (notably in Greece and England) also reported an intention to leave their current employment.

·        Each additional patient added to a nurse’s workload increased the odds of a nurse reporting poor or fair quality of care.

·        Patients were less satisfied with their hospital stay in those hospitals that had higher percentages of burn out ore dissatisfied nurses.

Dean Royles, director of NHS Employers, said: "Mandatory staffing levels can not guarantee safe care.
"We do not believe that imposing a crude system of staffing ratios is the right way to tackle poor care."

Well there you go – bloody typical – things will stay as they are!

It is a fact that these unfeeling nurses – alongside completing only tasks they can do such as meds, admissions, discharges, etc, - spend their time completing reams and reams of required (tick box) paperwork that is deemed more important than the tasks they are tick boxing.

It is also a fact that working under these conditions, these unsafe conditions, they are in breach of their Code of Conduct.  However there is always the safety net of the Nursing and Midwifery Council (NMC) who stand up for their subjects and demand change (not)!

“There are now almost 3,500 fewer nurses working in the NHS than in 2010 and the number of managers has also dropped, the NHS workforce census has shown.” ( Daily Telegraph).   So much for Cammers promise of protecting front line staff then folks!  Things will only get worse for granny now the HSCB is soon to be enshrined in law – you were warned!  (See Jobbing Doctor). 

I don’t deny that crappy nurses exist as do crappy doctors, plumbers, electricians and whole (coalition) governments for that matter – but if we continue with this scapegoat (the nurse) crap – nothing will change and granny and granddad will continue to be left to stew in it.

Stand up and be counted – do something – complain about staffing ratios when you see poor care – please do something!  The odds are YOU will be old one day!

What say you?

Anna :o]

Urm - the cutting and pasting shows - didn't before I posted!


Hilary Melton-Butcher said...

Hi Anna - the country seems to only be able to fill and tick spaces in forms ... they do here at the Nursing Centre.

Thanks for highlighting the challenge - I think organisations have lost common sense - and everyone gets lumbered into categories. Since when did humans lose their individuality ..

All the best Hilary

MorningAJ said...

Having had a lot of hospital stays (in an adult unit) as a child, and a stay a few years ago, I'd say that the old idea of 'Angels' was wrong.

My latest experience was a much happier one (in spite of its seriousness) than any I had as a kid.

Nurses today work hard in very tough circumstances and I was very impressed with the way they cared for me. (The old Derby Royal Hospital.)

Dr Erhumu said...

I don't have the ratios of my part of the world, but i can say its very high. Sometimes you see nurses handling the diverse pressures very well, other times they just flip out . Personally, i would run away if given half the amount of work they are given.

Frances Garrood said...

I have posted about this before, but why can't we bring back the good old SENs? Bedside nurses, with excellent training, who really cared for their patients. They didn't want or need degrees. Just a good basic training. Much cheaper and better than the thousands of agency nurses who have to be called on every week.

Anonymous said...

Frightening. Sad. Difficult. k.

Jenny Woolf said...

As a layman I am never sure if all that paperwork is necessary. I have a feeling it can't be but haven't the knowledge to be sure.

Not sure nurses ever were angels, at least not to my recollection, but the bottom line in this as in so many other fields, seems to be that trying to write people and their skills out of the equation as much as possible, is actually not a way to make things better.

Anonymous said...

While visiting an elderly relative in hospital not long ago, I listened to other relatives moaning about nurses standing around gossiping and eating at the nursing station.

A few questions elicited the following info - the nurses standing around had finished their shift and were waiting around for the chance to do a proper handover when the incoming nurses had finished running around after relatives. All were working a minimum of 1 hr unpaid overtime after every shift.

The nurses munching sarnies were on lunch but couldn't take a break because there weren't any other nurses to cover, so they worked through and just snatched a snack.

But that wasn't what it looked like to aggrieved relatives. I disabused as many as possible.

Dave King said...

Thanks for this, a problem we have experienced twice recently - with our children's in-laws, but possibly coming more directly our way any day now.

Muhammad Israr said...

that is the problem with our society in general... we always trying to find scapegoats and always finding faults with others... we wouldnt care for our grands in our homes but we start crying that nurses are bad and not caring... sad...

hyperCRYPTICal said...

Thank you for your kind comments folks and apologies for not responding sooner as ‘things’ got in the way…

Hilary ~ a recent stay in hospital highlighted (to me) the insane tick box mentality where nurses were rushed off their feet while they completed their task on all day/day+ patients entering for surgery. In this case the forms indeed needed to be filled – but there was not sufficient nurses to do this within the given time scale – hence surgery timetable up the swanny.

Before surgery three different disciplines had to tick their boxes – all standing in front of me asking the same questions – but the requirement was they asked them singly – hence more delay.

Despite the above – I cannot fault the care provided.

AJ ~ I had many hospital admissions as a child and too would state that nurses were not a flock of angels – just a cross section of society as are we all. But safe staffing gave the nurse’s time – time to care.

Dr Erhumu ~ I am glad that ratios are safe in Nigeria and I thank you for “Personally, I would run away if given half the amount of work they are given” as I believe that many (including docs) do not realise or appreciate the workload of nurses.

Frances ~ I totally agree with you in the need for suitably qualified SENs and cannot understand the logic of their demise.

Manicdaily ~ frightening indeed.

Jenny ~ there is of course a need for record keeping but the tick box mentality has eroded care and is completed often at the expense of care.

As said, nurses never had to be angels as a prerequisite – but they did have time to care. To me, those without the skills needed of those they manage understand not the ramifications of this tick box mentality…

Anonymous ~ very wise comment – if only others would try and see the whole picture...

Dave ~ sad to hear of your recent experiences and yes you might experiencing it more directly in the future… …worrying isn’t it?

Israr ~ excellent observation – we all have double standards (I think)…

Anna :o]

ananursinguk said...

Thanks for this, a botheration we accept accomplished alert afresh - with our children's in-laws, but possibly advancing added anon our way any day now.

Respite Care London

Adam Gill said...

Thanks for sharing such a real concept which should be made important for the people who don't care for their parents.

Home Nursing Care

Theodore Wong said...

Some people are afraid of growing old, but I think most of us are scared to grow old alone. I sometimes lose sleep over this particular issue.