Friday, 29 January 2010

Latest from the Daily Mail and more insanity on my ward.

Here's the latest from the Daily Fail.

Shock.  They actually mentioned the staff shortages.  They actually came close to recognising that one RN to 18 critically ill patients who need one to one monitoring may not actually be able to bed bath a patient without killing someone.

But their readers are still fucktwits.  Look at the comments sections.  "Nurses won't bedbath these days" "Can't be bothered".  Whatever.

Let me tell you what happened to me yesterday or  sometime thereabouts.  I was one RN to  WELL over 10 patients.  I had a student on his first placement, second day.  He worked as a retail manager before attending nursing school and holds a degree in English lit.  He is bloody marvelous for someone who is such a novice.  I had him on shift with me and a teenage carer.  It was her 2nd day on the job..  She has no training.  This was her induction. That was the ward staff.

Let me start by saying that degree students  ARE NOT FUCKING SUPERNUMERY.   Not really. They can't be.  This guy jumped straight in and did a hell of a job.  He had about 2 minutes to pick up how to do obs, blood sugars, and basic care. And he did it like a champ with a few minor fuck ups along the way.

My plans for the shift was to bring him around with me, show him a bed bath, let him watch me give meds etc.  The usual first placement stuff.

But of course reality got in the way of that. Details have been changed.  The following are not real patients.

I was running around like a headless chicken and the student had to work off his own initiative.  I had to do all the meds, interventions and treatments and orders for all those people.  The phone was constantly ringing.  Early in the shift they sent me a critically ill patient.  The ward he was on "couldn't handle" him.  There were no beds in ITU.  I had to take him.  I really kicked off with the "But it is so unsafe and I can't handle him either".  I had no choice in the matter, just total responsibility for any bad outcomes. After my shift ended I reported the manager who forced this transfer on me.  I'm in the process of complaining to high heaven.  This bullshit was not fair on the critically ill patient. the other patients, the student, or the carer.

This new patient was in a bad way. He needed one to one monitoring, and my arse parked at his bedside to survive the shift.  He needed multiple infusions, cardiac monitoring, suctioning, etc.  He was  going badly into CCF as they transferred him to me.  His 02 sats were in the shit long before that because of pnuemonia and COPD.  His observations  were a mess. I had to send the kids running around the hospital searching for those elusive IV pumps so we could deliver his medication to him.  The junior doctor on duty was having a pyshcotic episode/nervous breakdown  weepy moment in our staff room.   Had I not been so busy I would have hooked the doc up with some coffee and chocolate.  Some retarded specialist nurse had laid into doctor for no reason and was trying to dump a lot of rubbish onto the doc.  The poor doc was on his/her knees already because he/she was carrying that fucking bleep, trying to prioritize 1000 jobs..  Told doc not to worry about that cuntface who yelled at her because we all hate her. She yells a lot and is always barking up the wrong tree.

Our new patient was very elderly.  Very elderly.  Still for resus if he crashed and died however.

Guess who took care of all the other patients on their own with no supervision while I was up to my eyeballs in this?  Newbie one and Newbie 2 did.  I use the phrase "took care of my other patients" very loosely.  They are incapable of having anything to do with medication, IV's, NG's, catheters, noticing any real changes in condition etc.  They cannot answer questions from family. They couldn't even manage to change the bed linen for a large bedbound and incontinant patient because they didn't know who to react when she started biting, screaming and hitting and they couldn't move her around the bed.  Most of my patients are like that woman.  

The student was surprisingly on the ball and helpful and gracious even though he was thrust into a situation from hell when he is supposed to be learning.  He reported crappy vital signs, blood sugars etc.  He figured out that one patient was uncomfortable because she was in retention (I hadn't even laid eyes on that poor patient).  He must have done his homework because he picked up on stuff that I would have never picked up on during my very first placement.   I wanted him with me so that he could have some really good learning experiences.  He told me he had never even down a bedbath.   I was going to show him the right way to do one and how we assess patients and tie that information into their situation. I want to mentor people properly, not use them as free labour.  Not until they know what they are doing anyway. But he had to help me out by being my eyes and ears.  He certainly didn't think that he was above getting his hands dirty.  He ran right over to the little old lady who was wandering to the bathroom and pooing on the floor as she went.  He cleaned her, cleaned the floor and made her a drink.

Don't let anyone tell you that students are supernumery.  Don't let anyone tell you that they don't want to get their hands dirty.  In my opinion, that is not the case at all except for the rare bad apple.  I must be lucky because I have yet to get a bad apple student.

I'll tell you what I did accomplish during that shift.  I tore the cleaning schedule that identified all the things we were to dismantle and clean during that shift and I shoved it into the shit eating machine.  Had the infection control tickboxing lardo specialist nurse been around I would have shoved it up her bottom.


Dino-nurse said...

Nice to see The Press getting it right (not). I really dispair about the future of the NHS at the moment. The cynic in me thinks that all politicians realise that the only way out is to bring in private insurance- so they are doing it by the back door. Deliberatley running the system down so that eventually enough people will vote with their feet and take out PPP or BUPA. We have students on the ICU who are all saying that they will never work on a general ward due to the staffing levels. Frankly, I can't blame them. Whenever I have to set foot on MAU/SAU/CDU my heart sinks- nothing I can do to make a difference and all complaints fall on deaf ears. Our latest crop of new starters (medics and nurses alike) look like rabbits in the headlights most of the time. As for the patients- where do I start? Wish to God that DOH peeps would come and spend a day with me without warning so that they could see what the NHS has been turned into by their incompentence.

Nurse Anne said...

Hi Dino,

We did have an unexpected visit from the DoH. They are evil as well as stupid. I blogged about it. Will post the link later.

Was just reading some further daily fail comments. Looks like there are still fucktards out there who think that student nurses are no longer educated on the wards and that we need more matrons. How could people be so ignorant as to what is going on in their hospitals.

Glamorganist said...
This comment has been removed by the author.
S to the G said...

Gosh, reading all this reminds my why I emigrated! I work in Victoria, Australia where in public hospitals they have implemented the 4:1 ratio (I'm sure you already know that, sorry if I'm teaching you to suck eggs), and even then you have days when you are so mental that you can't get anything done. I remember when I first started working (bank, in care of the elderly) in the UK, and it was tha most horrible experience of my life. Little or no supervision, massive patient load with REALLY heavy patients and 12 hour shifts! Its insane! If I ever move back home I'd never work as a nurse. I really admire NHS nurses for sticking at it. If I'd stayed I'd have had a nevous breakdown by now.

capgrass said...

i would have prioritised: by keeping the man alive with pumps ect.......he might live another 2/3 days. I`d have let him die and concentrated on the patients that might live. but then its easier for me, we always had to do this in zambia

Anonymous said...

This is the first time i've read your blog, are you stalking me?? I think you must work on my ward!! I love it thanks

Nurse Anne said...

Thanks anonymous. i work on a lot of people's wards apparantly. I have been accused by people who are 100% sure that I work in:


The Dobbing Doctor said...

Maybe you work in all these places! It sounds just like my ward.

Also, all infection control nurses I have met are lardos. Is that in the job description? It only means more flesh to cover in alco-gel.

Dino-nurse said...

ratio of 4:1 sounds like heaven! Even having 8:1 on the admissions wards would double our staffing levels (so is not about to happen). Am cuurently staring at yet anothe pointless audit that our beloved leaders want completed...oh yes, its about infection control. Have already scanned to see if there is anywhere I can mark the Trust down because of staffing levels but no! its all about plastic mats and tabards. Also have a pile of IR1s to do with staffing levels for me to answer...seems so pointless, We have no staff becuase we have no money to pay them and our permanent staff are all off sick due to being run into the ground doing extra shifts. This is what I will write but no one will care.