Monday, 27 April 2009

The Matron who actually worked a shift

I can barely type this or drink my coffee because I am laughing so hard. I did hear this secondhand. I have seen similar situations first hand and I have no doubt that the following occurred.

Let's set the scene. Not my hospital but I wish it was. Really I do. I would have had fun with this. A certain very large very acute medical ward at a hospital nearby with 30 beds was short one RN for the shift. This left one RN for 30 patients. She kicked off and their highly paid and god knows what she actually does Matron got roped in to work an 8 hour evening shift.

So Matron was to have 15 patients and the other RN was to have 15. It takes forever to do a drug round for 15 patients, let alone 30. So each nurse takes a side in order to maximise the chances of patients getting their medications on time and reducing the amount of errors. Once you finish your drug round (after about 2 hours)you are pretty much locked into being the primary nurse for that side only and you really are not up to date about the other side. That is why nurses have "sides".

Now keep in mind that highly paid modern Matrons never come near the wards. Ever. This is the case even when we are in way over our ears and we actually beg. If a mistake occurs they rip you get this mock trial thing where they all sit around you and destroy your character like high level judges in a kangaroo court. And you are guilty until proven innocent. If you really are innocent and just outspoken they will make something up to punish you for rocking the medical shitboat. I am surprised that they don't give them wigs, robes, gavels and iron maidens.

How this matron got roped in I don't know but she agreed to work a late shift.

When she arrived on the ward she informed the ward registered nurse that was going to be on duty with her that: "I will be working as an HCA because I have been away from nursing too long". Remember that today's matrons may be qualified nurses from a long time ago but really they are an extension of management rather than nursing staff. They are focused on management aims and goals.

The ward nurse wasn't having this. The matron has something like double the ward nurse's salary. She knew that it is impossible to be a primary nurse and do all drugs, interventions, and assessments for 30 acute medical patients. Matron had to take a side.

Andy by 9PM when night staff came in Matron was at the nurse's station in tears. "This is impossible, this is impossible" "This is ridiculous". "There's not enough time". "The interruptions are constant and unending" Blubber blubber blubber.

Really, Matron. No shit. Why don't you get your ass down to the ward a bit more often?

She gave a fractured and weak handover to the night staff and left. She really had no idea what was going on with her patients. Night staff said that there were so many unsigned for/ not given drugs on her side that it wasn't even funny. Nothing got done. It was like she just gave up.

The nurse who worked with her said that at mealtime she brought a diabetic patient some chocolate cake and nearly gave a confused who was on clear free fluids and plate of chips. She just couldn't keep up with it all. The drugs that got given were given late. A few warfarins and IV antibiotics were missed totally. It took nightshift the first few hours of their shift to sort out all the problems.

No wonder Matrons don't come near the wards. This one never came back to do a shift. They are not completely stupid you know.


Anonymous said...

Any decent manager occasionally works a real shift on the shop floor, not in 'fiddled' circumstances (no mysterious extra staff), just so they really know what is happening.

Doubtless this is why Matrons, Head Teachers, Senior Police Officers etc. don't do it.

Anonymous said...

LMAO! Maybe she will have a little more compassion with the real nurses! And maybe tell admin how difficult her night was. Hope it happens to more of these matrons! Kudos to the nurse who put her foot down about not taking 30 patients. Good for her!

The Shrink said...

Doesn't the NMC Code have something to say about such nonsense practice? I wouldn't have thought the NMC would like such a matron to leave her ivory tower and pretend to cut is as a proper nurse, for a while, and compromise patient care in the process . . .

Nurse Anne said...

Well the matrons are qualified nurses with active registration.

I don't know if I would have let one of ours do a shift on the ward. These older trained nurses who haven't been on a ward since 1981 scare me. They are dangerous in today's ward environment without any further education.

The Shrink said...

Nurse Anne, exactly. The matrons obviously are registered nurses but invariably earn their 8a salary for management malarky not direct patient care.

Thus, are they competent? Are they working within the NMC Code of Conduct if undertaking such clinical duties that they're woefully shabby at?
* You must have the knowledge and skills for safe and effective practice when working without direct supervision
* You must recognise and work within the limits of your competence
* You must take part in appropriate learning and practice activities that maintain and develop your competence and performance

Happy1 said...

This reminds me of an experience I had during one of my first shifts as a new A&E nurse. Due to being short staffed I'd been left alone in resus with a patient (stable but post-ictal).

I was getting a bit anxious because the doctor was prescribing IV meds which i needed to calculate and draw up with another RN for checking/safety purposes - and there was only me.

Imagine my relief when i glanced through the open resus doors to see Matron walking past...and...she was in uniform!

(This was rare in itself - the nurses used to joke that she only wore her uniform for the X amount of "clinical" days required by the NMC to maintain registration)

Anyway, I called to her to ask her to check the IV dose/calulation/preparation with me. Well she clearly nearly died, she was flustered and agitated, and openly admitted that she hadn't got a clue, that it had been so long, and that she would just take my word for it and trust me.

She signed her signature to the infusion without even going through it with me, and left.

Great stuff eh....inspiring.

I grabbed another colleage (staff nurse) to check with me.

Nurse Anne said...

Typical Happy1 Typical.

And yet everyone thinks that they need to bring the matrons back to whip up into shape.

They are back. They suck. They do nothing.

Anonymous said...

Wow! In the USA I believe you have to spend so many hours on the floor per year to keep your registration current. Is this not the case in the UK also? I know certain management RNs that never actually do go on the floor but seem to keep their registration current. It's great that you started up your blog again Anne, I stopped reading sometime last year when you stopped posting - Thanks.

Diane (Brit in the USA)

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