Wednesday, 9 September 2009

Idiot Managers and Commodes.


We have a 20-30 bed ward. There is one toilet/showeroom. At any given time 99% of our patients are COMPLETELY UNABLE to walk there, even with assistance. Wheelchairs are often AWOL. Half the time we cannot even find one. We have 3 commodes for the whole ward.

The male patients are not a problem because they use bottles. The female patients are mostly large, unable to transfer out of bed onto a commode and require two staff to transfer them onto the commode. Either they have urinary frequency or dementia. Either way it won't be more than 5 minutes after they are assisted back to bed before they are again crying for the commode. They refuse bedpans. The damn things hurt, beleive me. With 3 commodes and 15 ladies crying for it all at once,all the time, you can see why we have problems. The dirty room is where the commodes are emptied and cleaned. This room is a long walk away from the patients.

So you are with the patient in bed 25. You have just assisted her back to bed. The lady in bed 24 sees you with the commode and demands it now. But in order to empty and clean it you need to walk all the way back to the dirty room. To get there you have to walk past at least 10 other people who shout for the commode as you walk by.

You clean the commode and head back to bed 24. On your way back the 10 people now inform you that they are pissing/shititng in their beds because you are not bringing that commode to them right now. 10 minutes later you finish assisting the lady in bed 24. She could not be left alone on the commode as she will almost certainly fall. Sometimes she does get left by the care assistants and nurses, because the others are screaming for the commode or you are in the middle of something that you cannot leave in order to do commode duty. For example, if you are caught leaving a deteriorating patient or being late with drugs because you were fucking about with commodes you could be looking at loss of registration and a lot more.

When you finish with the lady in bed 24 you need to push the commode full of piss and shit back down the looong hallway to the dirty room, past those initial 10 people who shouted for you to provide a commode over 10 minutes ago.

This is the setup. And of course it is the Nurse's fault when people are left in their own waste and commodes are not cleaned properly. Yeah right. What a fucking stupid ass set up this all is!!!! What a crock of fucking shit.

Remember that this goes on all day long. They will not allow us to have any more than 3 commodes. If we are lucky we have 3 or 4 or maybe 5 staff and most of them will be up in their eyeballs trying to keep people alive and painfree already.

We have 2 siderooms where MRSA and and CDIFF patients are isolated. Two of our commodes usually end up in there. One in each room. No, we cannot take them out and use them for a patient on the ward. 16 year old unthinking braindead agency untrained care assistants can't seem to grasp this by the way. You will not be able to clean the damn thing properly in the short amount of time you have. This means we are left with one other commode for the whole ward. It is a ward full of patients and visitors who wrongfully assume that if mum or gramps needs the toilet any member of staff walking by will immediately be able to provide one. They get angry when their unrealistic expectations are not met. Um. Ten people are in the que ahead of you dear, and some one is having a heart attack and the other 3 staff are tied up. What the fuck do you want me to do?

We are not allowed to have anymore commodes. They probably don't want to pay for it. If they did allow us to have more, there would be no room to store them anyway.

We have made management aware of what I have told you here. Their response has been silence. It's disturbing.

But what do we get to hear ten times a day from patients and visitors?

"You nurses are disgusting for making people wait for the toilet"

"You nurses are disgusting for only have 3 commodes and one toilet on this ward"

"You nurses are disgusting for the smell in this place" (the dirty room drain is often blocked)

"You nurses are disgusting for causing people to piss in the beds"

"You nurses are disgusting for not coming immediately with the commode"


"If mum or dad or auntie Gladys piss the bed IT IS ENTIRELY YOR FAULT YOU DISGUSTING NURSE"

Honestly, if I had a penny for everytime I heard one of these comments each shift I would be rich. These comments are what I listen to all day long. I listen to it as I am running between the dying and the suffering, when I am trying to talk to people who have just been told they have a death sentence and when I am running to people who are bleeding. I still have to listen to it when I leave those people to try and sort all of those who are desperate for a wee. I never hear "Thanks for leaving that dying patient to find me a commode". Instead I hear "What the hell took you so long to bring me that commode you fucking lazy bitch". Okay, since they probably don't know that I have other patients who are dying I guess I can let them off the hook for their shitty comments.

Everyone expects an immediate response from a nurse who is already in the middle of something that she cannot walk away from, even though there are ten other patients making the same demand, for the same piece of equipment all the time.

But of course the biggest problem is the filthy state of the commodes. The cleaners utterly refuse to touch the damn things. It is the job of the two nurses and two assistants for the entire ward to clean them. There is not enough time to clean them properly. They are in constant demand from impatient, needy people who need our help and their dignity maintained. There are not enough of us, there is a hell of a lot going on, and there are certainly not enough commodes and facilities.

One day we were left with two RN's and two untrained children to care for the whole ward. On that day a gaggle of overpaid worthless jobsworth infection control peeps showed up, and swabbed the commodes for germs. Now we are getting lectured about dirty commodes.

Why don't they staff the ward with nursing staff?

Why don't they staff it with cleaners who clean?

Why do nurses in these hospitals have so little in the way of domestic/housekeeping support?

Why do we have no say in any of this while having to always shoulder the blame, apologise, and listen to the verbal abuse.? Oh right. Management doesn't want to admit liability.

Why not deal with that? Why send overpaid worthless tits around with expensive swab kits to tell us what we all ready know?

So there you have it. Management cannot even fucking sort out the toileting facilities. They'll happily sit in their offices and let the frontline staff shoulder the blame however.

And what they hell can we do about these idiots who are running around with swab kits, who then lecture the hurried staff about "taking pride in their work".

Look, if any of you reading this are infection control or managers let me tell you something: Expecting nurses who are working with ratios that wouldn't even be legal in the shittiest part of Haiti to clean commodes properly is begging for failure. The idea of a nurse with 6 patients taking on cleaning duties is insane. IT WILL ALMOST CERTAINLY COMPROMISE PATIENT CARE. Nursing staff are so shafted these days that there is no way we can clean anything properly. We often have more than 12 patients per nurse here in the UK (a total abomination right on it's own). If you want to hit the nurses with these kinds of fucked up ratios, and then demand that they take on housekeeping duties as well you are a crazy fuck. You are smoking crack and even worse than that, you are not sharing it with the staff..

1.Increase the amount of cleaners/domestics on the ward.

2. Allow the cleaners to clean the commodes. Currently they are not supposed to.

3.Have domestics on the ward for more than 2 hours in the morning and 2 hours in the evening.

4.Allow us to have decent toileting facilities.

5.Have separate domestics for cleaning and food service. Duh.

Either do this exactly as I have directed here or shut the fuck up and go away for eternity. Those are your options. Make it so.

Rant over. The end.


Nikita said...

Hello There!,
Welcome back! I was just about to say the same to your entry last week, when todays popped up. I work in a different environment, so although I cannot personally relate to your experience, I am grateful that you have made me aware of it. I view 'things' differently now.
Hang on in there!

Stneotser said...

Welcome back Anne!

Does the Guardian now link to this page? I hope so.

The whole concept of "cleaners" irritate me even here in the USA.

Had a "housekeeper" come and interrupt me in the middle of my med pass to tell me that a patient had peed all over the floor in the visitors toilet and left the incontinence brief in the trash can. I was told by the "housekeeper" that I needed to clean it up ASAP as it was not her job.

Right, so because it was not her job it was the job of the person who had the most critical job to do and the most responsibility on the whole damned unit????? But say that and you'll get "Oh, theses nurses have such big ideas of themselves they won't even pick up a dirty brief!"

Anonymous said...

Welcome back, Anne! The NHS needs to clean house first before you can get decent housekeeping in your facility. As in, they need to FIRE the administration that won't spring for a bedside commode in every room. I say this because C diff is rampant and so is MRSA! They also need to get rid of the idiots who are calling for 10% reduction in staff! THEY need to reduce the amount of top heavy administration and increase direct care staff. You don't need to have more that 6 patients per nurse. That's unsafe in this day and age. AND you need qualified HCAs to help. And WHY is the UK mixing housekeeping duties and food handling duties? That is utter lunacy. Bless you, Anne. I think I'd flip burgers rather than work in your hospital. You guys need health care reform just as badly as the States need it. It's time for the nurses in the UK to start reminding their parliament and Prime Minister that they vote, too! And then lobby to vote out the idiots who are screwing the health care staff!

Happy1 said...

We are just expected (by all) to get on with quietly attempting to do the impossible, whilst taking the abuse and critisism, knowing that the patients & relatives will never know the reality of the shitty situation.

This is why I love your blog Anne, and i hope and pray that members of the general public read it. And i'm glad you took the opportunity to write a piece in the Guardian. On behalf of all overwhelmed and demoralised NHS nurses >>> THANK YOU Nurse Anne.

Anonymous said...

I was a HCA for all of 3 months and it was awful. We had a ward of 21, and quite often there were 2 RNs and 1 HCA to sort it all. The RNs didn't have time to sort commodes/feed people/change soiled bedding because they were busy with paperwork/meds/stopping people from being dead.

We had a shed load of commodes (about 10), but with only one person to dish them out, it was ridiculous. Of course, it wasn't just commodes - it was obs, reporting stuff, feeding, comforting, running round to steal things from other wards, going down to pharmacy, escorting patients places, welcoming new patients etc. There just WASN'T ENOUGH TIME.

Some people understood that everyone was doing their very best, and that it wasn't our fault that things were so far from perfect. Some people did not, and I got lots of abuse from patients and relatives.

It stressed me out no end, and I decided it wasn't worth the band 2 salary.

Anonymous said...

Aboudt ten years ago, after a op for rectocele/cystosele I told the night nurse IO had not quite made it to the toilet and had peed on the floor. Thouhght no more of this until the following morning and my pee was still on the floor. I cleaned it up myself with toilrt paper. They did not seem busy.

Nurse Anne said...

She probably forgot. We are all useless simpletons on night shift. You wouldn't believe some of the stupid shit I have done after beign awake with my kid all day and then going in for a 12 hour night shift.

dharmesh said...

Normally I wouldn’t comment on posts but I felt that I had to as your writing style is really good. You have broken down a difficult area so that it easy to understand.

Anonymous said...

Hello! Would you mind if I share your blog with my facebook group?

There's a lot of people that I think would really appreciate your
content. Please let me know. Many thanks|

Here is my web-site; pity 2014 program

Jasa seo jakarta said...

what i think, facepalm is respon that right :D

Anonymous said...

Hey there! This is my first visit to your
blog! We are a group of volunteers and starting a new project in a
community in the same niche. Your blog provided us valuable information to work on. You have done a
outstanding job!

Also visit my weblog ... New Piyo Workout

Anonymous said...

Link exchange is nothing else however it is just placing the other person's website link on your page at appropriate
place and other person will also do same in favor of you.

Here is my webpage ... cleanse plus diets (Http://

Anonymous said...

If you want to find hotel rooms or any affordable accommodation, you can now
see the exact location and the surrounding area in 360-degree view via Google Street View.
The hotel Hilton Quebec now features an Executive Lounge on the top floor.
Caution: Before inserting or removing the SIM card,
you must disconnect the router from the power adapter.

My weblog :: free wifi

Anonymous said...

If some one needs to be updated with newest
technologies therefore he must be pay a quick visit
this site and be up to date daily.

Also visit my site ... Monkey king Online hack

Anonymous said...

My brother suggested I may like this blog. He was entirely right.
This submit actually made my day. You can not consider just how much time I had spent for this information!
Thank you!

Also visit my page; first time bhyer ()

Anonymous said...

Hi! I could have sworn I've visited this site before but after looking
at some of the posts I realized it's new to me. Regardless, I'm definitely happy I discovered it and I'll be book-marking it
and checking back frequently!

Look into my page; jungle heat diamondhack

John son said...

The length of time to complete your course of study will depend on the current position of your accounts, the amount of debt you owe and the source from which you'll be relying on for village cash on hand. Some individuals can complete the cognitive operation of debt settlement within 30 days, while others can require equally long as three years. Your individual situation is what defines how long the entire process will require.
Debt settlement lawyers in Massachusetts

Metamorfosis said...

Pelatihan SDM is network marketing and training information or training an employee who has worked with many consulting firms and training institutions.
pelatihan hrd,
pelatihan pengembangan diri,
pendidikan dan pelatihan sdm,
pelatihan akuntansi keuangan,
pelatihan sales marketing,
pelatihan kehumasan,
pelatihan sdm jogja,
lembaga pelatihan sdm,
pelatihan manajemen bisnis,
pelatihan administrasi perkantoran,
lembaga training motivasi,
pelatihan sekretaris,
pelatihan karyawan,
lembaga training di jogja,
pelatihan in house training,
pelatihan public training,
jasa konsultan,
pelatihan pengembangan sdm,
pelatihan manajemen sdm,
program training karyawan,
diklat sdm,
program training sdm,
pelatihan sdm rumah sakit,
id card murah,
harga id card,
cetak kartu santri,
produksi id card,
bikin id card,
cetak id card jogja,
id card murah jogja,
cetak id card,
percetakan id card,
pabrik id card,
cetak member card,
cetak kartu pelajar,
cetak kartu siswa,

oakleyses said...

oakley sunglasses, michael kors outlet, nike free, oakley sunglasses cheap, christian louboutin shoes, michael kors outlet, louis vuitton outlet, nike shoes, air max, kate spade outlet, polo ralph lauren outlet, true religion jeans, longchamp handbags, burberry outlet, louboutin outlet, gucci outlet, air max, michael kors outlet, longchamp outlet, louis vuitton outlet stores, oakley sunglasses, tory burch outlet, louboutin, longchamp handbags, coach purses, coach factory outlet, kate spade handbags, ray ban sunglasses, jordan shoes, louis vuitton, coach outlet, louis vuitton outlet, michael kors outlet, louboutin, ray ban sunglasses, michael kors outlet, chanel handbags, coach outlet store online, tiffany and co, burberry outlet, michael kors outlet, prada handbags, polo ralph lauren outlet, louis vuitton handbags, tiffany and co, prada outlet, true religion jeans

oakleyses said...

timberland, nike blazer, sac louis vuitton, sac louis vuitton, ray ban pas cher, hollister, louis vuitton, north face, new balance pas cher, sac guess, louis vuitton uk, louboutin, michael kors pas cher, vans pas cher, abercrombie and fitch, mulberry, ray ban sunglasses, longchamp, air max, converse pas cher, hollister, polo lacoste, true religion outlet, ralph lauren, michael kors, true religion outlet, nike roshe run, nike free, air max, michael kors, hogan outlet, polo ralph lauren, air jordan, air force, air max pas cher, sac burberry, nike tn, nike free pas cher, north face, oakley pas cher, sac longchamp, vanessa bruno, lululemon, nike air max, sac hermes

oakleyses said...

barbour, ugg pas cher, vans shoes, instyler, nfl jerseys, herve leger, wedding dresses, ugg boots, celine handbags, longchamp, marc jacobs, ghd, new balance shoes, lululemon outlet, soccer jerseys, beats by dre, ugg australia, chi flat iron, ferragamo shoes, ugg boots, mcm handbags, canada goose, birkin bag, bottega veneta, north face outlet, insanity workout, nike huarache, p90x, nike trainers, asics running shoes, canada goose outlet, mont blanc, uggs outlet, valentino shoes, nike roshe, giuseppe zanotti, canada goose jackets, abercrombie and fitch, north face jackets, nike roshe run, reebok outlet, rolex watches, mac cosmetics, jimmy choo outlet, babyliss pro, soccer shoes, hollister, ugg

oakleyses said...

converse, canada goose, hollister, rolex watches, ray ban, moncler, swarovski, air max, moncler outlet, moncler, gucci, pandora jewelry, pandora charms, moncler, thomas sabo, pandora charms, juicy couture outlet, karen millen, canada goose, wedding dresses, hollister clothing store, ugg, toms shoes, links of london, canada goose, louis vuitton, swarovski crystal, supra shoes, canada goose, parajumpers, moncler, montre homme, canada goose uk, lancel, vans, juicy couture outlet, moncler, oakley, iphone 6 cases, moncler, baseball bats, ralph lauren, hollister, converse shoes, timberland boots, louboutin, air max, coach outlet store online, ugg

Anonymous said...

I like your stuff, classic right, Now... everything with digital, perdita di peso thanks for remind me for this memories

45645646546565 said...


Fghkfhk Dfgaert said...

nike air max 2015
tory burch outlet
coach outlet
converse shoes
coach outlet
oakley sunglasses
polo outlet
birkenstock sandals
michael kors outlet