Monday, 30 March 2009
Here come the kids. God help us.
Yeah it just gets worse and worse and worse. The photo above pretty much depicts the only new staff members we have had over the last few years.
Once a upon a time there was some dickhead worthless manager with a large salary and too much time on his hands He had a determination to justify his existence and job title. So he came up with a plan to staff the wards in a cost effective way.
It is anything but cost effective. Costly and begging for a million pound lawsuit is a better way to describe this crap.
They actually started hiring ward staff at one point before now. But these people were not nurses or health care assistants (who at least have of a bit of a clue). What we got was something called cadets and trainees. Once upon a time I was bitching about health care assistants. Now I want my experienced health care assistants back.
On paper it looks good. Replace all the leaving HCA's and nurses with cadets and trainees. In some places they are called apprentices. They are on minimum wage and do not get shift differentials to work unsocial hours. The 16 year old kids are on less than minimum wage. They will be an extra set of hands on the wards. They will learn about nursing. The trust can get away with paying them less for a myriad of reasons. They are on less than a healthcare assistant. But it is an extra set of hands on the ward in a nurse's uniform. Hopefully someday they will want to go to nursing school.
The idea is supposed to be that (in the beginning of their career as nhs employees) these kids work along side knowledgeable staff and learn and help out. I am just going to refer to these people (apprentices, cadets, juniors, trainees) as kids since most of them are barely out of high school. They are completely untrained and have no prior experience in healthcare.
Occasionally we get a good one. You know what I mean. The ones who are aiming for medical school and nursing school and want to learn all they can are great. But even so they are still dangerous. This is not their fault. I'll explain why in a minute.
Others have no interest in nursing and just want a paycheck. Macdonalds would be much easier love. Some figure this out after about 2 weeks and leave.
Others cannot even spell their names, have no chance of getting into nursing school BUT think that they are already nurses simply because they have a job on the ward caring for patients.
Their confusion is understandable. First of all, their uniform is identical to a nurse's uniform except for one tiny little detail. They have a dark green stripe on the sleeve. Nurses have a light green stripe. The patients and relatives think that every woman in uniform on a ward caring for patients is a nurse and addresses all of them this way. God, does that piss me off. "Nurse" is my hard earned title. Most staff on the ward are nothing like a nurse and this includes healthcare assistants. Sob. I miss the healthcare assistants. I just want someone who knows what they are doing around. Now I have "kids" instead.
And not one of these "kids" has any idea of just what they are walking into. Not one. This job is a little different than selling ice cream cones like they did last summer.
The first few weeks that these untrained kids with no nursing knowledge and no understanding of consequences came onto the ward they were not supposed to be counted in with the staffing numbers. Instead they were supposed to shadow the existing staff and learn how to do the few things that they are actually allowed to do. They cannot even take observations or do blood sugars at this point. They certainly cannot fill in a fluid balance chart. If they know how to do it they certainly hide it well because they never fucking do it. Ever.
What happened on the very first day we had "the kids" starting on our ward (the very beginning of their orientation period)? That shift we had 2 nurses and 3 health care assistants. When the site manager saw that we had 2 new cadets on for that shift in addition to the 5 of us they immediately floated our 3 health care assistants somewhere else. That left only 2 registered nurses and two purple haired, tattooed brand new cadets.
They do this every fucking time we have someone new start. From the first day on the job when new staff are supposed to be on orientation and supernumerary the staff that is supposed to be training them is floated off the ward to cover extreme short staffing on another ward. They do this to new graduate nurses their first week on the job. They do this when we have student nurses on the wards. They float away some of the regular staff to cover dangerously short other wards because we have an extra set of hands in the form of nursing students. The nursing students spend all day running after call bells and never fucking learn anything.
When yours truly started as a brand new nhs staff nurse, having never worked in an NHS hospital before because I lived with my dad for awhile and trained abroad; I had 2 days being supernumerary and then on the 3rd day I was left in charge of the ward whilst my mentor was sent to cover sickness on the ward downstairs. New nurses should be on a 6 month preceptorship as new nurses. And please, none of this BS about how this is due to academic nurse training not preparing people. That has nothing to do with this.
The university trained nurses are getting plenty of time on the wards as student nurses. PLENTY. It is the quality of that time that is the problem. THE FUCKING QUALITY.
Almost immediately after the kids started we were finding that the experienced staff were outnumbered by the kids on most shifts. But they are still being paid as "apprentices". They were never trained properly to do the few things that they are allowed to do because they were never there in addition to a well staffed ward. If we had 2 staff nurses and 3 kids we were grateful. A fucking supercuts salon has more goddamn trained staff than that. And they only have to deal with one person at a time.
I said earlier that it was the idea that these kids would gain vocational experience and go on to nursing school later. Ha ha ha ha. They see the nurses getting screamed at, blamed for everything, working like dogs 14 hour shifts with no breaks while the kids themselves have multiple tea breaks and hide in the toilets on their mobiles. If I say anything to them management will get real upset with me for upsetting the cheap labour.
None of them want to be nurses anymore. If anything they have been talked out of it. Right now they get to prance around in nurse's uniforms, get addressed as "nurse" by the patients and visitors, all the while taking lots of breaks and not being accountable for any of their actions. They don't have a registration. Everything they do is on my registration. They are happy right where they are.
Our HCA's are becoming a thing of the past. The ones that are leaving are not being replaced by anything except kids. I feel like I am spending 99% of my time babysitting these new dangerous brats. At least the HCA's were goddamn trained to do their goddamn jobs.
That's cruel of me. There are a few of them who work hard and at one time wanted to continue into nursing. Many of them are doing way better than I would have done thrown into a ward like this at age 16.
But it is still a really fucked up situation. And all this time qualified nurses with years of experience who moved into the area are getting told "sorry, no jobs". That hopefully will change now that the Staffordshire story broke. We are holding our breath, desperate for a miracle and some trained staff.
I need to run now but I will do a blog post all about cadet horror stories and explain just how much this situation screws with patient care.