Saturday, 10 August 2013

Nurses and the Health Service crisis

The Health Service has been much in the news recently; again. And I believe more than ever that many of its ills come down to the state of nursing.

Firstly, I can't stress enough that I know there are many good, caring nurses out there. But I also know that something is terribly wrong. Nurses used virtually to hold the health service together. They were the ongoing link between patient and doctor, between ward and kitchen/cleaning department./ dispensary. I know much of this is now impossible, with the subdivision of all the various responsibilites. But a time was when a good ward sister knew ALL her patients, and the other nurses knew about all patients on their ward. They had to. It was their job. During his recent hospital stay, my husband saw a different nurse every time, and never even met the sister, although he was in for well over a week. I know that part of this is due to the way the wards utilise their staff, but a good part lies in the way nurses are trained. In my last (shamefully long ago) post, I wrote that it would be a start to bring back the SENs, and never has that been more true than it is today. As for nursing degrees, I will never accept that you need a degree to be a good nurse. A good nurse is (in many ways) born, not made. You have to be a certain kind of person to look after the sick, and to do all those less savoury jobs with willingness and a sense of privilege. No amount of clasroom teaching can change the kind of person a nurse is.

But the current training would have it otherwise, and seems to assume that characteristics such as compassion and empathy can be taught. They can't. I've seen it failing to work, as have many unhappy patients.

But to the modern degree training: here is an exerpt from the information about a nursing degree at an English university:

You will be able to design strategies for the collection and analysis of scholarly material relating to nursing care, as well as be able to identify nursing issues from a wide perspective. You will be able to identify and lead changes in practice, improving the quality of delivery of care.

Obviously I have slected a passage that illustrates my argument, but there are many more like it. It costs £20,000 to train a nurse (unlike other undergraduates, they don't have to pay tuition fees), and when student nurses work on the wards, they work with a 'mentor' and are not a regular member of the ward team (in the past, students were seconded to a ward to work as they learnt, and were  paid a salary, albeit a small one). Putting aside patient dissatisfaction, can we really afford this?

Monday, 16 July 2012

A rant about nursing-related issues

A return to this much-neglected blog, prompted by two pieces of news read/heard in the last week:

The first was the appalling death of a young man in hospital, who died from lack of fluids. He was so desperate, that he phoned 999, but when the police arrived, they were turned away. There were underlying problems, of course, and I'm sure there are other sides to this story, but the bare facts are that a young man was desperate for water, and nobody gave him any.

The second is the astonishing revelation that in some hospitals, agency nurses are earning up to £1600 per day. Hospitals are so desperate for staff, they are having to pay out enormous sums for nurses who (through no fault of their own) probably often don't know the patients or their diagnoses, or where the bedpans or dressings are kept. Because of course they are often new to that particular hospital, and haven't had time to familiarise themselves with the ward/dept in question. The next time you are in hospital, one of these nurses may be caring for you.

My point? When, oh when, is someone going to do something about the current state of nursing? And please let's bring back the old bedside SENs, even if we have to continue to have graduate nurses. With good bedside nursing, that young man would almost certainly not have died. And with enough trained bedside nurses, we wouldn't need nearly so many very expensive agency nurses. It seems we are stuck with graduate nurses (expensive to train, and often with inadequate hands-on experience), but the SENs would be a start, and a very good one. Also, bringing back their training would mean that many young people without the desire or the qualifications to be university students could still be nurses. Real nurses. Who look after people.

Oh, and who make sure they have water to drink.

Wednesday, 8 February 2012

So much for degrees in nursing!

My daughter, who did the old non-graduate nurse training, but gave up eleven years ago to have her triplets, is looking into "back to nursing" courses so that she can return to her former career. These courses last for twelve weeks.

This implies that in just twelve weeks, a non-graduate nurse can bring herself up to the same standard as those nurses who have degrees. Hmmmm. Makes you think, doesn't it?

Thursday, 26 January 2012

Caring and common sense

In order to boost my argument (that things aren't what they were in the nursing profession), and also to keep this blog from dying away altogether, I thought I'd give an example of what I mean.

Quite recently, one of my sons, T, was admitted to hospital. He was in dreadful pain, and since his wife couldn't leave her toddler to be with him while he waited for surgery, I tore up (as you do) to do my mummy bit and sit with him. So far so good.

When I reached the hospital, he was in an A & E holding area; ie everyone on trolleys, but with curtains between them. Fair enough. But while it had taken me two hours to get there, my son was lying on his trolley fully clothed (he hadn't even manged to take his shoes off as he was in so much pain), uncovered, with no pillow. I asked a nurse (who was hanging around doing nothing) if he could please have a pillow, and he (the nurse) looked at me as though I were mad, but found one for me (there was a trolley laden with pillows). T was on that trolley for several hours, and in that time, not one single person so much as looked round the curtains to see how he was.

Yes, nurses are busy, but nurses have always been busy. In this case, they didn't seem to have anything much to do at all. A nurse shouldn't have to be trained to have the common sense to make someone comfortable; any fool can see that someone lying on a trolley needs something behind their head (and trolleys are hard. Believe me; I know). No amount of training is going to instil that kind of common sense (never mind compassion).

This is a small example. Nobody died, and T made a good recovery. I have heard many far worse stories. But it shows that at least some nurses shouldn't be doing the job at all. Nursing is, quite simply, attracting some of the wrong people, while putting off many who would make competent, caring nurses.

Any more exmaples (good or bad!)?

Sunday, 22 January 2012

"Named" nurses

Nowadays, as anyone visiting (or being a patient in) a hospital will know, most patients now have a "named nurse". This is great, in theory, because (in theory again) your nurse knows you, and you know him/her. You are able to form a relationship.

The problem with this is that nurses, like everyone else, have coffee breaks, days off and even need to go to the loo. I was talking to someone last week about her sick brother. My friend had phoned the ward for a progress report, but the named nurse wasn't there, so no-one could tell her anything about him. Isn't that wonderful? When I was a nurse on a hospital ward, from my student nurse days up until my time as a ward sister, I had to know ALL about EVERY patient, even after several nights off, and I did. We all did. Because that was our job.

A few years ago, I was in hospital with a broken elbow. A delightful young man introduced himself, and told me he was my named nurse for the duration of my stay.

I never saw him again.

Thursday, 19 January 2012

Bring back the SENs

I guess things may have now gone too far for a return to the old hands-on style of nurse training for Registered General Nurses (or SRNs), but what about the SENs (State Enrolled Nurses)?

These - for those who don't know - were nurses who were very much trained on the job to be practical, informed nurses. Often, they were people who didn't have much in the way of academic qualifications, but who really wanted to look after people, and they wer invaluable. They had enough theoretical knowlege to be able to spot, say, an incipient deep vein thrombosis, but didn't wante to go up the career ladder and be ward sisters. As students (they were known as puils), they trained on the wards. Every ward had its quota of SENs. But now, they are no longer recognised. Such a shame, and such a dreadful waste. For they, almost above all, would be the staff who would make sure that a patient was fed, watered, kept clean and comfortable; all the basic care which is being gradually eroded, for whatever reason.

Wednesday, 18 January 2012

A long time coming

This blog grew out of a campaign I started a few years ago (with a great deal of support) to increase awareness of the parlous state of the nursing profession. While I would be the first to agree that there are many excellent nurses, there are also some lamentably bad ones. Only last week, David Cameron said that every
hospital patient should be seen by a nurse or doctor at least once an hour. Once an hour? There was a time when it would have been unthinkable for any ward sister to have to be told to do this; it would have happened automatically.

Please feel free to comment, to disagree, to add your own ideas or experiences, or to volunteer to contribute a guest post.