Once upon a time I got an admission. This lady was technically elderly but was very youthful in looks and manner and as sharp as a knife. She is a nurse and worked on my ward about twenty something years ago as a staff nurse. I think she retired in the 80's. I think she was pretty old then.
"Over there in that side ward we had the cardiac arrest from Hades" "You see that closet over there, they used to have 2 patients in there and once we got stuck behind equipment".
This woman was great. We didn't want her to leave the place. She kept us laughing with her stories about things that happened years ago.
She seemed very concerned about Nurse Anne and her colleagues...
"Why are you not taking meal breaks, they used to prepare meals for the staff"
"Why do they not launder your uniforms or provide changing areas?"
"Where's the staff?"
"Why do they let the visitors interrupt and harass you so? Matron would have dragged them out of here by their shirt collars"
"Who is in charge? You cannot be the only nurse for that many patients and be 'in charge'!"
I couldn't answer her questions. Did they really provide all those things for nurses years ago?
One day she leaned in close to me. "There are 5 of you on duty right now. How many of you are nurses"
Hmm. I decided right then and there to be brutally honest with her. She isn't stupid. I wasn't in the mood to hold back. She was on her way home that afternoon anyway. And I trusted her.
"Two of us are actually nurses. I have been qualified for over a decade but am still technically a junior staff nurse because they won't promote and because of agenda for change re banded me downwards despite a pristine nursing record. I am the most senior nurse on duty so that makes me charge nurse as well as primary nurse for 12+ patients without the pay and official title. Susan is the only other nurse. She has been qualified for 6 months. She is the primary nurse for the other 12 patients. The other two members of staff are health care assistants. The third member of staff is a "kid" with even less training than the care assistants receive." That is all of us, for the whole ward, for 12 hours+.
My Nurse-patient took off her glasses and looked at the ground, rubbing her eyes. "They really are bastards you know. In the mid eighties, they started with this 'health care assistant idea'. We were very against it you know. Patients need trained, qualified staff. We were against all this, but they reassured us that the health care assistants would be used in addition to qualified nurses not instead of qualified nurses."
I would have liked to tell her that we are lucky if we get an experienced health care assistant these days. We are down 5 members of staff in total and if we are LUCKY we get 2 junior staff registered nurses and 2 or 3 untrained 16 year old "kids" for an entire shift. That is if we are lucky. These kids don't seem to hear call bells, nor can they feed patients without the patient aspirating, they don't seem to notice nil by mouth signs, nor do they understand about not sharing commodes between the MRSA patient and the surgical patient. They cannot seem to understand about intake and output charts. They leave side rails down. The next day they are sent to work on a different ward. And I will get a couple more who don't know their way around mine. The medics want the staff nurses to also function as a charge nurse/sister and have us at their beck and call following them on ward rounds for hours. This basically leaves the patients with nothing, NOTHING as far as nursing input.
We cannot watch these kids. They need babysitting and we can barely get the drugs out let alone watch Brittany and Brandon and stop them from fucking up. Tell them off and get stern and they call mummy and cry. It is dangerous. We need direct RN to patient ratios in line with the RCN recommendations that are dependent on adjusted for patient acuity. We need this right now.The retired Nurse assure me that we were doing well considering what we were up against and said "God bless. I don't know how you do it. Thank you so much".
I hope she continues to recover and would like to see her kick Claire " I haven't nursed since Nixon went to China but I am convinced I have a clue" Raynor's behind. Ms. Raynor doesn't really understand what is happening on these wards. She thinks that an RN can go to work and spend all shift focused on basic care without killing someone and getting hung drawn and quartered. It ain't the nurses who made things this way darling. It's not the nurses who wanted this. They have this level of responsibility without being pretend doctors. It's not the nurses who decided that nursing needs to be a well educated profession. So who/what is the culprit? He goes by a few names: progress in medical care, increased knowledge, changes in health care delivery and economics.