Sunday, 31 January 2010

RCN Nursing Counts. Does the RCN believe in Nurses?

Look at what the RCN has come up with recently.

I would really like to see them do even more to get across to the public what it is that bedside registered nurses actually do.  But encouraging nurses to be politically active is a good place to start.

Many of the problems that we currently have with nursing care is that bedside nurses are not valued. They are abused, overwhelmed, exhausted and frustrated over not being able to even remotely do their jobs well.  They run away from hospitals and managment loves it because they don't want to pay them to be there.   People think that an airhead with a good heart can be a good nurse.  They don't understand why a bedside nurse needs a good education on top of vocational training.  It's well known amongst nurses that a nursing student is going to have to hit the books a lot more than many other university students.  It is also well known that when they qualify that they are going to have a level of responsibility that most people cannot even fathom. But people think that nurses hand out tablets and hold hands and clean up.  That statement on it's is such a sick oversimplification of what we do that it is actually quite distressing.  The Media is at fault for this and the main culprit is TV.

I would like to see the RCN really push a campaign to show the public what BEDSIDE nurses actually do, how complex their job is, how much life and death responsibility they have and how analytical they need to be to not kill anyone.  Then show how hellish it gets when they are trying to do all this for too many people.  I have some ideas about how to get this across.  No time to post it all today though.

I guess that maybe  Nursing Counts  is a very good start.

Check it out and let me know what you think.

If anyone reading this is from the RCN let me tell you something.  Your photo of the nursing helping a patient to stand up with her zimmer sucks.  Show a nurse standing over the bed of someone with multiple drips calculating IV rates and assessing for heart failure or something...then you should have little information boxes nearby explaining just what it is she is doing.  From head to toe, show everything that the nurse needs to keep on top of for that patient.  Everything from changes in mental status and associated causes to pressure care, IV rationales, hydration etc etc.  Oh wait, you muppets have been away from the bedside for so long that you don't even know.  Not only does the public need education about the value of a bedside RN but so does the RCN apparantly. Stop it with the hand holding "my only job is to wheel patients around and give them pills" fucking shit in your photos.  It is damaging.  This is better:

That pic is not of a doctor or a nurse specialist.  It is a picture of a bedside nurse. She is supposed to handle all those drips and a million other things for multiple multiple  patients.  She cannot restrict the number of patients that she has. She is expected to always hold their hands as well and clean the ward without making mistakes with those IV drugs.  Drugs such as that need constant checking and supervision. Mistakes with those drips kill, and she'll have charges brought against her if she makes a boo boo.

But instead of nurses being depicted by pictures like the one above, we get this fucking shit below:

No wonder people think that a moron with a good heart could be a good nurse.  No wonder they think that untrained teenagers staffing the wards are nurses. These kinds of images depict one small aspect of nursing while disparaging all of the other things that real bedside nurses do to keep their patients alive.

Stop saying that nurses are better these days because they can do all these things that doctors used to do.  Forget that rubbish.  Promote bedside nurses.  I once had an office job as a nurse years and years ago.  It is easier than bedside nursing mentally and physically but we had more respect than bedside nurses.  Most things are easier than bedside nursing but attract more respect.  We need to respect nurses at the bedside, not pretend that leaving the bedside is advancement.  It may get you more money to leave the bedside.  But the work is easier away from the bedside and the cognitive strain is less .  Why people who leave the bedside to sit in an office and  create rubbish like productive ward are deamed cream of the crop nurses is beyond me.

The strong, knowledgable and smart nurses are at the bedside getting shat upon from a great height.  The specialist nurses, the discharge  bed magnet specialist bullshit nurse etc can't handle the bedside.  And that has nothing to do with being too smart and educated to handle shit and piss.  It has everything to do with the fact that they cannot mentally handle all that information overload and quick thinking that one needs to have as a professional nurse on the ward.  That is why they leave.  They are not better nurses or super nurses.  Bedside nurses need more in the way of education and brains than a discharge planning specialist pen pusher nurse sat in an office does. The infection control special nurses have memorised a lot of misinformation that they have been spoon fed and they know how to regurgitate it and bully any dissenters who actually think..  But other than that, they are as dumb as a bag of rocks.  They have no ability for independent thought whatsover. They aren't bright enough or tough enough to handle ward nursing.  That's why they have an office job. 

Here's a pic of the chief nursing officer. 

She couldn't handle the stuff that the bedside nurse in the first picture above is handling.  If I am wrong I apologise but I would imagine that she has been away from proper bedside nursing for years.  Yet she is considered the higher level nurse?  WTF?  I have seen nurse specialists, nurse managers, and matrons come to the bedside.  It ain't pretty.  They'll make like 50 drug errors in 30 seconds.  The trust told them they had to do shifts at the bedside.  They did it once, ran away screaming, and never came to the bedside again. That was 5 years ago.  Why they are the nurses who get respect is beyond me.  Why they are held up as an example as to why nurses need an education is beyond me.

If you listened to the RCN bleat on about nurse education you would actually believe that a nurse needs an education only to leave the wards and "advance".   The RCN is making out that we need smart nurses merely for these advanced roles. That is wrong. They need an education to work on the wards, and tend to stop thinking or needing their brains when they move off of the wards into these silly posts. The wards are where you will fry your brain.  We just have a hard time demonstrating our knowledge because we have to take short cuts and move fast.  Specialist nurses don't have that problem.  They can take all the time they want to perform a task.

These devalutation of bedside nursing is what has led to things like Staffordshire.  Society tells nurses that they only way that people are going to appreciate your brains is to get off the wards. The only way you deserve to be paid for the hours you work is to get off the ward.  Then managment refuses to even considering hiring registered nurses to work on the wards and replaces them with untrained non nurses on minimum wage.  The few nurses left on the wards are trying to do everything, since the untrained non nurses can do very little.  They burn out and they leave and managment loves it.  One of their favourite tricks is to lose bedside RN's through "natural wastage" i.e. retirement and burnout.  Then they bring in untrained carers leaving the nurses with even more patients to nurse.

This country is clinging to backward ideas about bedside nursing and it's killing the profession.  I hope that the RCN completely wakes up.  Right now they seem to be somewhere between fast asleep and the period you enter just before you wake up.  I hope that someone throws a glass of water over their heads and gets them completely awake before it is too late.


Nikki said...

Couple of thoughts on matrons. The matron for my ward cannot handle working on the ward. She holds a bleep and is expected to answer PAR calls (emergency calls triggered by obs going down the pan).
But if she's the first on the scene she doesn't know what to do and goes to look to see if the DR's are coming. I often see her dawdling and avoiding going to t he calls so that she isn't first and everything is started by the time she arrives.

Another matron for a nearby ward has my absolute respect. Saw her on Saturday doing a band 5 bank shift. She actually knows what it is like to work on the ward, as she still does it. I wish she was our matron.

Nurse Anne said...

We had a matron that worked on the wards and was a hell of a nurse.

They got rid of her.

The Shrink said...

You're absolutely on the money, as usual.

The massive problem in our acute Trust is a string of SUIs and IR1's arising from ward teams being under resourced. Too few staff to be fit for purpose.

Of course, our no blame cluture investigated the events and promptly blamed the wards for not being fit for purpose. The outcome was to generate a new tier of management to manage the "governance risk" this posed. Of course, no new money existed for this, so front line staffing was eroded.

So it goes.

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StudentODP said...

That actually had has some relation to the blog, you are either a very advenced spambot or someone actually does that for a job :(

..and you probably have better conditions than a band 5 nurse!

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Oh so true! I long ago gave up with the RCN (although I still pay the fee in case I ever need legal assistance). Wish they would bring cameras onto our ICU and show the public what we do...just how mad the place gets at times - that it remains safe because MOST of the time our staffing levels are spot on. Then follow me to The Pit that is our admissions unit and see the difference that CRAP staffing levels make to a place. Close-ups on weeping relatives, patients falling out of beds, doctors hiding in the sluice crying ( happens on a weekly basis) nurses imploding under the strain. Good crash tv. As for matrons- we have a few who are excellent (ED and ICU) but most are indeed a waste of space- they rely on the senior sisters who are still ward based ( as in NOT ward managers) to hold the place together. I was offered a matrons post a few years back for medicine when the current post holder left due to stress. Thought about it for about 2 seconds and said no. Already had a lonnngggg converstion with the soon to be no-more matron so knew that she had no power to change anything and felt like a glorified pen-pusher. Not sure how the ED and ICU ones managed to stay hands-on for so long (ICU one is ace and stands her ground when even the consultants want to run).

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