Saturday, 27 February 2010

Unison's new campaign "HCA's are Nurses too"

Apparantly Unison has been handing out badges for  health care assistants to wear that say "HCA's are nurses too".

I have now had 2 separate people contact me and inform me of the fact and would like to hear from others who may have seen this.  I need a little more conformation before I really show you why I termed myself a militant.

If it is true it is criminal ,and I cannot believe that an organisation like Unison would be so stupid and reckless.  I already knew that they were absolutely useless and in business to promote themselves rather than workers.  But hearing about this has made me realise that they are actually quite dangerous.

The lack of real nurses on our wards is a public health crisis that maims and kills.  I do not care how nice an HCA is.  I do not care how hard working she is.  I do not care how good she is at doing a bedbath.  The fact is that 1000 HCA's cannot replace one Nurse.  Nor can more nurses make up for a lack of doctors. 

I have well over 5 years of university under my belt and I cannulate.  So where is my "Nurses are Doctors too" badge.  Yeah right. I'd throw something like that in the goddamn bin.  And that is what any conscientious HCA should do with her Unison badge.

I was an HCA once, breaking my back to do bedbaths and getting in a huff about being ordered about by Nurses who seemed every so distant to their patient's basic needs. I drew blood as an HCA.  I performed ECG's.  I was a senior nursing student at the time and the Nurses allowed me to hang drip bags (under direct supervision), suction, and apply 02.  I worked as an HCA to pay my nursing school tuition.   I took observations. I made minor assessments of patient conditions and reported them the Nurse.  99% of the time my observations were wrong because my level of knowledge was not fully developed.  But I tried.  I, too, thought that I was "just like a nurse".

Of course I was not allowed to legally call myself a Nurse until I graduated from University and two months later sat and passed the licensing exam for nurses.  Then I was legally allowed to apply for a job as a Nurse.  And this I did.  It took a week to get a job.  During that week I was still an HCA at my old hospital.  They offered me an RN position but the hospital down the road paid more.

The first thing that struck me when I qualified was just how every different (and more demanding) it was to actually be a Nurse.  It was like getting hit by a lorry. 

It was like my eyes suddenly opened to what was really happening on the ward and why. I suddenly felt bad and ashamed for my previous frustration with the Nurses I worked with as an HCA.  I felt mortified for thinking that handling basic care , taking a few blood pressures, and doing bedbaths on my own for a large group of patients was stressful, or anything like being a Nurse.  My god, there is no similiarity whatsoever. 

We know that a lack of real nurses on the wards is killing patients.,  We know that an increase in care assistants staffing the wards compared to Nurses leads to poor care, tragic outcomes and death.  We know that a lack of Nurses in favour of health care assistants actually leads to increased costs.  We know that hospital chiefs do not want to hire nurses for the wards and that they are not trying to hire real nurses.  We know that I am going to be on my knees as one Nurse to 15 patients and that this is the case whether I have 2 or 10 care assistants on duty with me.  To be honest, 10 care assistants would be worse than 2.  They don't know what they don't know and they interfere and they need to have an eye kept on them.  I pity any doctor who has to cover a large group of patients with only noctors to assist rather than other doctors for this very same reason.

When organisations like Unison run around handing out badges to HCA's that label them as Nurses it completely undermines the claims we make for more real Nurses on the wards.  It adds to the confusion of patients and visitors. Yesterday I was the only RN on the shift with 3 care assistants.  The visitors informed me that they thought I was the "Sister" and the care assistants were my " junior nurses".  I corrected them, but the fact is that public doesn't have a clue.  They didn't really understand what I was telling them about the care assistants not being nurses.  They couldn't understand why the fact that I was in an emergency stopped me from bringing their dad his PRN pain killers at that moment.  "Well matron, if you are tied up in an emergency can't one of your junior nurses bring the morphine to dad?" they said.

Sometimes I will see a group of visitors stare down at a 19 year old care assistant who looks decidedly unprofessional and I hear them say "These new university trained nurses look like slobs".  Ha.  If only the girl you were staring at was actually a Nurse, or had ever been to university I might see your point.  This may sound cheeky but more often than not, the real nurses do look very professional whilst the carers (who have no professional standards)  do not. Enough said about that.

If we are going to fix the problems with Nursing care in our hospitals we need to fight every attempt to undermine RN's and replace them with care assistants.  I love the care assistants I work with, I do.  But depicting them as Nurses is unfair to them, the real Nurses, and the patients.

I can cannulate, interpret ECG's and bloodwork, draw blood and listen to lung and heart sounds.  But I am nothing like a doctor.  I can do certain physical tasks but I cannot pull the whole picture together in the way that a doctor can.  And an HCA cannot pull the whole picture together the way a nurse can.

I am going to look into this further, and then notify the NMC and I hope they deal with it.  I know I would be prosecuted for impersonating a cop or a doctor.  Why should anyone be able to call themselves a Nurse?  It is not legal and this needs to be enforced.

Doctors, I suggest you get on board with this.  Do you really want to see band 5 staff nurses running around  wearing "I can prescribe just like a real doctor" badges?  Didn't think so.  It sounds pretty far fetched but the current efforts to dumb done medicine and nursing appear to know no limits.

It's not going to be long now before we have one real nurse covering every ward in the hospital.  The ward staff will consist of health care assistants who will throw everything back onto the nurse's plate.

110 comments:

Nikita said...

Brilliant!

GrumpyRN said...

Anne, as usual an excellent post pointing out problems. However, I am going to pick you up on a couple of points that effect me directly.

You have written, “The first thing that struck me when I qualified was just how every different (and more demanding) it was to actually be a Nurse,” and “I suddenly felt bad and ashamed for my previous frustration with the Nurses I worked with as an HCA,” You then write, “I pity any doctor who has to cover a large group of patients with only noctors to assist rather than other doctors for this very same reason.”
“But I am nothing like a doctor. I can do certain physical tasks but I cannot pull the whole picture together in the way that a doctor can. And an HCA cannot pull the whole picture together the way a nurse can.”

And a Nurse Practitioner can put together a bigger picture than an RN. You have stated that you are not a Nurse Practitioner but you are quite happy to denigrate us while pointing out your own previous ill will towards RN’s until you understood the role. Is this not a case of pot calling the kettle black?


"Do you really want to see band 5 staff nurses running around wearing "I can prescribe just like a real doctor" badges?”

If I wore a badge, it would say I can prescribe just like a real prescriber, not a doctor. My prescriptions are actually more legal than most doctors (and legible) and are done within the confines of my area of expertise.


"Sometimes I will see a group of visitors stare down at a 19 year old care assistant who looks decidedly unprofessional and I hear them say "These new university trained nurses look like slobs". This may sound cheeky but more often than not, the real nurses do look very professional whilst the carers (who have no professional standards) do not."

In my department, and hospital, an HCA who did not look professional would be told to smarten up or be disciplined, these thing are in the contract of employment.

An otherwise good post Anne, keep it up and keep letting the truth be told.

Nurse Anne said...

"And a Nurse Practitioner can put together a bigger picture than an RN. You have stated that you are not a Nurse Practitioner but you are quite happy to denigrate us while pointing out your own previous ill will towards RN’s until you understood the role. Is this not a case of pot calling the kettle black? "

No I don't think so.

I know that a nurse practitioner can pull the picture together better than I can. At least I would hope that they can. They are all on masters degrees right? I have a BSc, which is less.

I don't think that nurse practitioners can pull it together better than an experienced doctor can.

But as I have said before, I have never worked with a nurse practitioner so I can only assume...that they are a pita for the docs much of the time.

The Shrink said...

Totally with you on this.

I value HCAs and Support Workers but they're not nurses. Pretending they are is like pretending a nurse is a doctor or a pharmacist is a social worker.

There are legally protected titles, you can't just pretend to be a member of a different profession.

GrumpyRN said...

In my area, which is all I can really discuss with any authority, I work to the same level as an FY2 but with more experience to fall back on. Like them I go to the middle grades and consultants for help and advice when needed. The big difference is that the FY2's can come to me for help and advice and I can tell them to write in their notes 'discussed with ENP' rather than discussed with consultant/reg. What is important to remember is that I do not work AS an FY2, there are a lot of things they do that I can't.

To me, being an ENP has nothing to do with being a doctor or doctor light or (heaven forbid) noctor, it is about being a maxi nurse, about using the skills and knowledge I have to get patients seen and discharged.
I still agree with you that HCA's should NEVER be called nurses. Maybe with the new national uniforms being introduced the public will get the idea of who is who. Although I doubt that it will make that much difference.

As an aside, in our area a few years ago the social workers were desperately trying to take over nursing homes so that they could have all care of the elderly money and do things 'their way'. Turns out the only thing stopping them was to call yourself a nursing home you have to have a nurse somewhere. They tried various SVQ's but bottom line remains, 'nurse' is a protected title under UK law.

Pita......? Surely you don't mean a type of flat bread? Can only assume that is a typo.

Anne said...

As a newish HCA in the NHS I agree with your post and comments. Our ward repeatedly gets extra HCA's when there is a RN shortage but its just not the same - we end up frequentely with two frazzled RN's for 32 patients and too many supposed 'support workers' who don't have a clue and need supervision from us permanent HCA staff, even though they are paid more than us...desperately need more nurses!

And I am happy (at the moment anyway!) just being HCA, just wish there was a proper system of telling visitors & patients that we are not nurses, as it doesn't seem very well communicated and I am fed up of repeating myself that no, I cannot give you your drugs, sorry... I for one would not wear such a badge as think its insulting to the nurses.

Sachin Kumar said...

Delhi/India based manufacturer and supplier of suction pump, suction machine, medical suction, portable suction, suction unit, and surgical suction buy today and get discount on all Suction equipments.

Anonymous said...

With reference to "newish HCA" Anne's comment. Good for you for being truthful and telling patients you are not a qualified nurse. You are clearly conscientious and hard-working. However time and again I heard support staff say contemptuously "we are the real nurses, they just do the paperwork". Let's be frank about this, some support staff actually enjoy the fact that patients and members of the public are confused because it enables them to pretend that they are more important, skilled and knowledgeable than they actually are. Personally I feel that this situation is downright dangerous. All the different titles mean zilch to the public. Perhaps all staff who are not qualified nurses should wear badges stating clearly "non-registered assistant".

Anonymous said...

If you took a poll of the general public and asked them to describe the role of a Nurse.....they would list off the jobs routinely undertaken by band 3 HCA's/Support Workers.
It is true that some HCA's/Support Workers do not understand the boundaries of their role, but some Nurses are blinded by the perception that a Degree actually means you are capable of being an effective Nurse. Having a degree proves that you have what it takes to get a degree.....nothing more.
Maybe we should bring back the title Axillary Nurse for trained level 3 staff, that way it would be clear that they are not registered.....but still perform the jobs that members of the public would call Nursing.
I do not approve of the Unison Badge as it just confuses the public and creates animosity within the Nursing team. A team that should embrace and value well trained support workers.
It is petty to be precious about a job title, unless of course your Status anxiety and Ego are bigger than your desire to do the job.

Anonymous said...

We weren't discussing Degrees though, were we? It isn't a question of being 'petty' or 'precious' about job titles - you are missing the point. And "what the public would call nursing" is nowhere near the full extent of a qualified nurse's duties and obligations, is it? The issue in question is that the public have a right to understand, for example, that this member of staff can give them their medication, the other member of staff is not allowed to. The only way to avoid confusion is to ensure that patients and the public can clearly identify who is a qualified Staff Nurse and who is not. It is impossible to work harmoniously as a proper team if there are some support workers (please note I stress "some") who have a chip on their shoulders due to low self-esteem and resent the fact that other members of staff have Degrees. It was not my intention to criticise support staff in general because I have worked with some brilliant ones. Most support workers do an excellent job however you cannot deny that however competent they are at the basics they do not have the same specialised knowledge and high levels of skill as qualified nurses. As Nurse Anne put it "they do not know what they do not know". Unfortunately on my ward a minority of support workers were obsessed with 'status' and their place in the 'pecking order'. Personally I couldn't have cared less who did or did not have a Degree, I was too occupied rushing about like a BAF to bother about such trivialities. I had hoped that everyone would muck in together as a team. What really made me livid was when these 'status-mad' types were so busy showing off that they neglected the patients' needs. To me that was the ultimate sin. To refuse the clean up a patient because you object to being told what to do by 'someone with a Degree' is childish. We all have to obey instructions at some time or other whether we like it or not. We all have to work alongside people who are less qualified or more qualified than we are - get used to it, it is called life. Degree or no degree, what makes a good nurse is someone who focuses on the patients rather than being all wrapped up in themselves.

Anonymous said...

HCA Work a dam site harder than nurses, and yeah why shouldnt they call them selves nurses, afterall they are the ones that look after the patients while the nurse plays at the nurses station and pen pushes. the term nursing is about giving direct care, caring for patients, HCA are unqualified / unskilled nurses, RGN's are Qualilfied nurse, and if you must no i was a HCA for 9 Years and now a qualified nurse, as a HCA i did the nurses jobs i.e. obs, BMS, Venepuncture all so the nurse could sit and pen push

GrumpyRN said...

Hello anonymous of 7th December, your a bit late to this but never mind.
I don't for one second believe you are a qualified nurse because HCA's do not "look after" patients, they do minor tasks delegated by a trained nurse. HCA's do not work harder than nurses, they just think they do.
However, what convinces me you are not a trained nurse despite your claims is;
a) Trained nurses can spell and write grammatically, when you use the pronoun 'I' it is capitilised, not as you have written in lower case, know is spelled as I have written not no.
b) Nurses jobs consist of a fair bit more than obs, venepuncture and BMS (whatever that is) I assume you mean BM's.
c) As a trained nurse, or even if you had just read and understood Annes' story and the comments, you would know that Nurse is a protected title under UK law.

Nurse Anne said...

Anonymous. All of us registered Nurses have been HCA's at one time and we thought just like you.

You have no idea what you are talking about. HCA is physically demanding work but that is all.

"Nurse" is a professional title given to a person who has legal accountability for the patient and actually understands what is going on with the patient.


The term "Nurse" is not a throw around term that describes anyone who cares for patients. In the United States if a care assistant led people to believe that she was a "Nurse" bshe would be fined for impersonating a health care professional. The same thing would happen if I tried to pass myself off as a doctor.

Professional titles are earned and very important.

Internet Services Provider said...

I think this page is very interesting so I really want to get more time to see this . I think if you write more original blogs like this you can improve the website Internet Services Provider

Anonymous said...

To Anonymous of 20th July 2010 - I assume you were referring to Auxiliary Nurses, as they used to be called in the 1960's - axillary means 'underarm'! You might be interested to learn that the rules and regulations of nursing were much stricter in those 'old days'. Staff had to be really quiet when they were working on the wards - communicating by shouting down corridors would never have been tolerated. When Matron visited the ward the nurses had to stand and hold open the ward doors for her when she arrived and when she left. Incidentally, any auxiliary who had the temerity to call a Staff Nurse by her first name instead of by her surname would have been sharply reprimanded by the ward Sister, told not to be so disrespectful and warned in no uncertain terms not to commit this heinous crime again.

Nurse Anne said...

Well most of them have no respect these days.

When I am the only RN on the ward and have a patient who is pre-arrest, another with a BP of 290/140, one with a BP of 40/20, another with a massive GI bleed and another that is unresponsive with hypoglycemia I must try and deal with that on my own. Unfortunately this is all happening at mealtime.

And I will ask the care assistant to please answer the call bells as I am really tied up. Little miss 18 year old care assistant will usually respond with an obscene hand gesture and say "do your dirty work yourself, you are the nurse". They think we are just asking them to answer call bells and take people to the toilet because we don't want to do it ourselves.

Modern matrons won't do a thing about it. They have no respect for the staff nurses either and don't visit the wards. They just want to please their finance overloads by saving money on staffing.

I work with a few older health care assistants and auxilliaries who are so good and even they remark on how the new ones (who are called apprentices) have no respect for the nurses, patients, or anyone.

Anonymous said...

I was going to say whatever are things coming to but I have experienced this sort of behaviour for myself. I used to work with one HCA who argued every time I asked her to perform a task, was impertinent on a daily basis and used to take a perverse delight in doing the exact opposite of what she had been instructed to do. I once told her very clearly to leave a particular patient (who was sitting peacefully in a chair) alone, only to return moments later to see her dragging the(shouting and violently struggling) patient onto a commode, against my express instructions but also against the patient's own wishes.

Miami Office Space said...

I have read articles about of this topic but this is unique is very interesting and it has a lot of good information and it was very useful for me... Well keep doing that good job thanks for all..

florida internet provider said...

very warm greetings to all readers of this blog, regarding this article I would like to add that I found very creative, some time ago I tried to blog and the result was not very good, apart this I believe that the information is also cool. In general, congratulations to all who are related to the creation of this article.

Anonymous said...

I'm inclined to agree with most of your blogs content. However i do, respectfully disagree with some of your statements in regards to HCA's. I'm not a Nurse, in any manner. By appearance(uniform) i could be easily confused as one. I'm not a nurse, But when staff want me to perform certain tasks on their behalf i become, according to their definition: A nurse. I contest (I'm not a nurse) but when i perform CPR, last rights, stem arterial bleeds, assist doctors etc etc. By action,i could be easily confused as being a nurse. I am not a Nurse. I am not paid a nurse salary! In fact Domestics, Receptionists, Caterers, Clerical Staff & Porters all earn more then me. I am not a nurse. I am a HCA, we don't get paid well for what we do at our level. However, that can be said about Trained Nurses also. I say this confidently your WHOLE profession would cease to exist without the standard HCA. You're role is not an independent one. We all need each other! We're all cogs in a overworked, underpaid machine. But essentially, all our roles fundamentally share the same basic principles 'PATIENT CARE' being the most evident. Take the time out to support those who support you. Otherwise, what's going to change? You think the education/courses that are available for your profession are as easily available for mine!? I've had to fight against two levels of management to better myself (educationally. And these resources that're supposedly & free for anyone to undertake. I will be heading back to uni to qualify.


Like i said, initially i was insulted. You sounded like you were taking out the frustrations of your role onto a group that you deemed inferior in position to yourself. But i see now that surely, this isn't what you're trying to communicate. If i was working with you, i'd offer you my up most support. I know the limitations of my role.

Anonymous said...

I'd just like to make a comment in regards to HCA's respecting Nurses. Since this has been a topic highlighted in most of the comments i've read.

Doctors, Police, Firefighters, Soldiers, Nurses etc. All roles that command respect, deservedly of course. There's a reason why society holds these roles in particular reverence. However, let me clarify. It's the ROLE not the INDIVIDUAL that commands respect. Times have changed from the old. Simply donning a uniform doesn't have the social impact that it used to. Now Through Social evolution, It's the person, regardless of position that has to EARN respect. A uniform is not a right of passage nowadays. If you're wearing a nurses uniform/scrubs/whatever... I 'll respect the fact that you're educated at degree level and have dedicated your professional career to care for the well being of others. If you're going to disrespect me and it was unjust, unprovoked or simply from being misunderstood. I'll call you on it! I'll escalate it, if you contest... I will kick and fuss until you will listen. All sounds extreme but i am quick to defend an overworked nurse from a doctors/family members wrath!
I'm a Healthcare Assistant, i respect others in my profession for what they do. You can't deal with the fact that people aren't going to automatically respect you by your appearance? Change professions!

Anonymous said...

I'd just like to make a comment in regards to HCA's respecting Nurses. Since this has been a topic highlighted in most of the comments i've read.

Doctors, Police, Firefighters, Soldiers, Nurses etc. All roles that command respect, deservedly of course. There's a reason why society holds these roles in particular reverence. However, let me clarify. It's the ROLE not the INDIVIDUAL that commands respect. Times have changed from the old. Simply donning a uniform doesn't have the social impact that it used to. Now Through Social evolution, It's the person, regardless of position that has to EARN respect. A uniform is not a right of passage nowadays. If you're wearing a nurses uniform/scrubs/whatever... I 'll respect the fact that you're educated at degree level and have dedicated your professional career to care for the well being of others. If you're going to disrespect me and it was unjust, unprovoked or simply from being misunderstood. I'll call you on it! I'll escalate it, if you contest... I will kick and fuss until you will listen. All sounds extreme but i am quick to defend an overworked nurse from a doctors/family members wrath!
I'm a Healthcare Assistant, i respect others in my profession for what they do. You can't deal with the fact that people aren't going to automatically respect you by your appearance? Change professions!

Anonymous said...

Respect is a two-way street. It is absolutely true that an individual cannot 'command' respect simply by wearing a uniform (or, incidentally, by means of attempting to instil fear via bullying). What is the dictionary definition of "respect"? Words such as reputable, honourable, decent, considerate, fair, civil and polite. If the nurse who is in charge possesses all of the aforementioned qualities then most of the time reasonable HCAs, who are in the majority, respond positively. Sadly however there will sometimes be a few immature individuals who get a warped sense of pleasure from acting as a troublemakers, pushing the boundaries and refusing to work as part of a team. In an ideal world such people should never be let loose on the wards in the first place but sometimes they slip through the vetting net. They do their colleagues no favours whatsoever by behaviours such as refusing to follow instructions etcetera, which, in extreme circumstances, could even potentially endanger patients. If they truly had the patients' welfare at heart they would not act in such a way.

Indian Surgical Industries said...

Hello, I love reading through your blog, I wanted to leave a little comment to support you and wish you a good continuation. Wish you best of luck for all your best efforts. medical suction machine, suction machine.

Anonymous said...

Sadly, your argument is blown apart by one rather simple observation:

'Nurse' is not a legally protected term. The term 'Nurse' actually encompasses the whole spectrum, from HCA up to Matron and beyond. However, 'Registered Nurse' is indeed protected to those who have completed the required level of education and passed registration exams.

HCAs do as much back-breaking work as RNs. Yes, you're right, the patient is ultimately the RN's responsibility, but don't belittle HCAs just because you're in a grump. You're not the only one running around for 12.5hrs, missing lunch breaks and going home long after your shift ends - they do too. They may not have to fill out the legal forms, they may not have to administer drugs, but their mistakes can be as fatal as yours - and they can catch mistakes you will miss.

And, of course, the HCAs are probably having a more miserable time than you. Of the five HCAs on my ward, two of them are nurses in their home countries, one is a GP, and one was a care manager for a rather well-run home - so imagine all the work they're not allowed to do, but they know they can do? While the nurse worries about getting the drugs running and that the ventilator is on the right settings, the HCAs are the ones who spend a half-hour cleaning up the lovely effects of C. Diff or Norovirus, or holding the bariatric patient on his side for two hours so that the dressings can be changed, or have half an hour to complete two deep cleans in time to receive our latest post-arrest admissions from ED. They may not have the responsibilities of the RN, but they still have their vital role in the chain, doing the menial, unskilled jobs that allow the RN to go and do the more technical jobs they are trained to do. So before you complain too loudly about your workload, consider what else you'd have to do if you didn't have them around.

Oh, and remember a HCA makes nearly half as much as an RN - ~£14k compared to ~£22k. So they get to spend 12.5hrs a day cleaning up other people's diarrhea, vomit, sputum, blood, sweat and tears for half your wage or less.

And don't get too arrogant about a nurse's diagnosing abilities - a BSc doesn't always mean you know better. I had the singular experience of watching a HCA with no acute hospital experience correctly diagnosing hypothermia while two junior sisters and the senior sister puzzled over the symptoms. Having come from a primary-care setting I often catch the 'simple' problems long before my straight-up nursing colleagues - 'simple,' but life-threatening, like shock or an arrest.

As stated earlier, we're all on the same team; doctors, nurses, paramedics, HCAs, radiographers, physiotherapists, et al. Perhaps you should afford everyone a bit more respect? Maybe hang up your outfit for a month, put on a HCA namebadge, and do their job for a while and learn what it means to be under-appreciated.

Maybe I'm just old and jaded. Or maybe it's because in ICU we all wear scrubs regardless of role, so we feel that little bit more like a team. But thus far everyone in my Trusts, from the Chief Nurse down to the Band 5s, call the HCAs 'nurses.' We introduce them to patients as 'nurses.' The visitors respect them as 'nurses.' And I personally do not feel insulted knowing that someone with nothing more than an eight-day induction program under their scrubs is grouped in the same category as the Matron who has worked for twenty years and more to get to where she is. She calls them 'nurses,' without a hint of irony or disrespect.

Or maybe I'm just lucky and I work in a tolerant ward. But if this is the attitude displayed in other Trusts, I hope I never leave my little corner of paradise.

Anonymous said...

Sadly, your argument is blown apart by one rather simple observation:

'Nurse' is not a legally protected term. The term 'Nurse' actually encompasses the whole spectrum, from HCA up to Matron and beyond. However, 'Registered Nurse' is indeed protected to those who have completed the required level of education and passed registration exams.

HCAs do as much back-breaking work as RNs. Yes, you're right, the patient is ultimately the RN's responsibility, but don't belittle HCAs just because you're in a grump. You're not the only one running around for 12.5hrs, missing lunch breaks and going home long after your shift ends - they do too. They may not have to fill out the legal forms, they may not have to administer drugs, but their mistakes can be as fatal as yours - and they can catch mistakes you will miss.

And, of course, the HCAs are probably having a more miserable time than you. Of the five HCAs on my ward, two of them are nurses in their home countries, one is a GP, and one was a care manager for a rather well-run home - so imagine all the work they're not allowed to do, but they know they can do? While the nurse worries about getting the drugs running and that the ventilator is on the right settings, the HCAs are the ones who spend a half-hour cleaning up the lovely effects of C. Diff or Norovirus, or holding the bariatric patient on his side for two hours so that the dressings can be changed, or have half an hour to complete two deep cleans in time to receive our latest post-arrest admissions from ED. They may not have the responsibilities of the RN, but they still have their vital role in the chain, doing the menial, unskilled jobs that allow the RN to go and do the more technical jobs they are trained to do. So before you complain too loudly about your workload, consider what else you'd have to do if you didn't have them around.

Oh, and remember a HCA makes nearly half as much as an RN - ~£14k compared to ~£22k. So they get to spend 12.5hrs a day cleaning up other people's diarrhea, vomit, sputum, blood, sweat and tears for half your wage or less.

And don't get too arrogant about a nurse's diagnosing abilities - a BSc doesn't always mean you know better. I had the singular experience of watching a HCA with no acute hospital experience correctly diagnosing hypothermia while two junior sisters and the senior sister puzzled over the symptoms. Having come from a primary-care setting I often catch the 'simple' problems long before my straight-up nursing colleagues - 'simple,' but life-threatening, like shock or an arrest.

As stated earlier, we're all on the same team; doctors, nurses, paramedics, HCAs, radiographers, physiotherapists, et al. Perhaps you should afford everyone a bit more respect? Maybe hang up your outfit for a month, put on a HCA namebadge, and do their job for a while and learn what it means to be under-appreciated.

Maybe I'm just old and jaded. Or maybe it's because in ICU we all wear scrubs regardless of role, so we feel that little bit more like a team. But thus far everyone in my Trusts, from the Chief Nurse down to the Band 5s, call the HCAs 'nurses.' We introduce them to patients as 'nurses.' The visitors respect them as 'nurses.' And I personally do not feel insulted knowing that someone with nothing more than an eight-day induction program under their scrubs is grouped in the same category as the Matron who has worked for twenty years and more to get to where she is. She calls them 'nurses,' without a hint of irony or disrespect.

Or maybe I'm just lucky and I work in a tolerant ward. But if this is the attitude displayed in other Trusts, I hope I never leave my little corner of paradise.

Anonymous said...

PS - When were you last a HCA? I only ask because it says you've been qualified for quite some years now, and I assume you haven't worked as a HCA since then? The roles and regulations for all UAPs have changed in the years since, so things may have changed since you were last 'just an assistant.'

Nurse Anne said...

Was last a CNA in 1998, in the United states. That's a certified Nurse's assistant and I did that job for 4 years while I was in university. I was usually the only CNA for 30 patients and did all the basic care,turns, toileting and blood draws and everything else. This was on a 30 bed med-surg oncology ward.

It was backbreaking work but still easier than being an RN with 6 patients. The amount of things that you have to think about and accomplish as an RN is completely beyond the understanding of the HCA. I would find it easier to clean up 20 shitty beds than deal with one doctor and his crap as RNs do.

You are not a nurse. Nurses act on doctors orders, use the nursing process, assess patients, and medicate. Wiping a butt and noticing a venlon hanging halfway out and being kind enough to notify the Nurse so she can deal with it is not the same thing as being a Nurse.

It's a protected title in the United States and should be in Britain.

If patients think that HCAs are "nurses" they will also think that you are post project 2000 university grads. Its confusing for them.

Nurse Anne said...

Was last a CNA in 1998, in the United states. That's a certified Nurse's assistant and I did that job for 4 years while I was in university. I was usually the only CNA for 30 patients and did all the basic care,turns, toileting and blood draws and everything else. This was on a 30 bed med-surg oncology ward.

It was backbreaking work but still easier than being an RN with 6 patients. The amount of things that you have to think about and accomplish as an RN is completely beyond the understanding of the HCA. I would find it easier to clean up 20 shitty beds than deal with one doctor and his crap as RNs do.

You are not a nurse. Nurses act on doctors orders, use the nursing process, assess patients, and medicate. Wiping a butt and noticing a venlon hanging halfway out and being kind enough to notify the Nurse so she can deal with it is not the same thing as being a Nurse.

It's a protected title in the United States and should be in Britain.

If patients think that HCAs are "nurses" they will also think that you are post project 2000 university grads. Its confusing for them.

Nurse Anne said...

By the way should scroll up to Grumpy's post and read that.

Nurse Anne said...

Just to add a little story.

Once I was the only RN on the ward with 4 health care assistants.

I had to leave the drug round because a patient had a low BP in the 60's systolic. I notified the doctor and he ordered a bolus of IV fluids.

The other patients were mad because they weren't getting their meds. They were pointing out the HCAs and saying "those young nurses won't bother to bring us our medication. You can tell by their youth that they are degree nurses who won't care about us"

I wanted to scream and say "OMG they aren't nurses at all, they can't bring you your meds, I am the only nurse and I am tied up with an emergency!!!!!!!!!!!!!!"

Anonymous said...

I don't believe I said I was a HCA; I clearly indicated that I am an RN as well. However, I am proud to say that I started as a HCA, and that I am proud of those who work in that capacity when you consider their alternatives.

When I was a HCA, I was sitting there with a Masters degree on top of my teaching diploma, as well as several years front-line care under my scrubs, so I feel that it is retrospectively a little insulting to say that what the RNs were doing was 'beyond my understanding.' Certainly for our current HCAs some of them are actually more experienced and competent nurses than the RNs are - one of them has 20yrs of Nursing under his scrubs back in NZ, so to say he knows less than the 24yr old freshly-registered nurses we have on the ward is again insulting. Not all HCAs are these spotty, bratty 19yr olds you talk of - to be fair most of the HCAs I see in my trust are older than half the nursing staff, and have been doing the job three or four times as long as the RNs.

Frankly, for all of your complaining you do sound like you are part of the problem, not the solution, with that superior attitude that you ironically condemn others for. The kind of brow-beating you are undertaking here would create so much discord that you would do more harm than good on a ward, and to be honest I'd rather have a slightly incompetent HCA than an embittered RN who won't give anyone without that deified BSc the time of day. Be thankful for the assistance you have, and try to give them at least some credit for what they're doing. Yes, when you have the arrogant SOB who sits around doing nothing, boasting of being a nurse but not doing so much as getting the patient a sip of water, go ahead and chew them out for being bad at their job - in the same way that anyone, from consultant to cleaner, who is not doing their job should be chewed out. But the next time that HCA comes off the 12hr night shift with you, having just cleaned those 20 dirty beds, wrapped three dead bodies - one of which they attempted to resuscitate along side you - and like you had to skip both lunch and tea breaks to get it all done, don't come down on them for saying they're part of the nursing team. Say thank you, and actually mean it. Coz if they were not there you would be in hell that night.

Again, perhaps it's my experiences that give me this attitude - Intensive Care does mean we have the luxury of one-to-one nursing. We'll only have 2 HCAs on our 15-bed ward but I'll tell you for free, when they're not on you notice it. It becomes impossible to finish washes before your morning break. It's impossible to clean down a bedspace in any appreciable time limit. It's impossible to find anything in the stores because they're the ones who keep the stock levels up. Don't even bother trying to get someone out into their chair if the HCAs aren't there, because no RN can afford half an hour to help a colleague, much less find two or three of them to spare. So maybe it's because I'm in an environment where the HCA is actually as important a team member as the rest of us, and I've had the pleasure of always have ones with their heads screwed on. It's why I feel no shame introducing them as nurses alongside me.

We all came into nursing for the same reason; a desire to help and do good. HCAs are paid less than shelf-stackers and only marginally more than toilet-cleaners, so if they wanted an easy life they would just go work in Tesco instead. They are there to try and be decent people, and the horrific attitude you're displaying here is frankly inexcusable. You talk about how difficult your work is, yet if you then make the rest of your staff's workload a misery with that attitude then you're setting yourself a rougher path.

Nurse Anne said...

Did I not make it clear in numerous other posts that my trust got rid of experienced older HCAs and replaced them with bratty spotty 17 year olds (under 18 means cheaper)? I did. You just don't read before you respond.

And hon, I am the last person to be sitting around at work.

By the way, tell me what an HCA can do when 15 people are waiting for pain meds and there is one nurse on the ward tied up in an emergency?

Even if we did have high numbers of really good HCAs I am still screwed if I am the only RN for too many patients. Why is it so hard for you to grasp this?

Nurse Anne said...

The problem is that you don't get the situation is med-surg. 99% of the tasks that need to be done are RN only tasks. That puts a lot of pressure on the RN. There are 5 hcas to deal with the other 1% of tasks.

The hospitals need to have hcas in addition to RN's instead of RNs.

But they are too cheap to pay for that.

Nurse Anne said...

And you have to also remember that this blog is based on a general ward with one nurse to 15-30 patients.

Someday you might be a patient on one of this wards in absolute agony waiting 6 hours for pain meds, or dehydrated and unable to drink and waiting for IV fluids to get started.

Or you might have a trach that needs to be suctioned and you may be feeling very short of breath and panicked. The RN is not going to be able to be there for you if she has 25 other patients.

You'll wish then that there was a higher proportion of RNs to HCAs on the ward.

And thats all I want. I want to see more RNs on the wards. And I want to people to understand the limitations of even the best HCAs.

Nurse Anne said...

I have an idea anonymous.

For one week get out of the nicely resourced ITU and go to work on a general medical ward. You will be one RN to 30 patients (most of whom should probably be in HDU).

The hospital has gotten rid of the experienced hcas. Your only help is going to be 5 inexperienced 17 year old kids.

Do that for about a week and then come back here and tell me that I should not continue to push for safe RN staffing on general wards because it is "insulting to hcas"

I would rather clean up 30 shitty beds with my tongue and lift all the bariatric patients by myself for 14 hours straight unpaid then EVER have to go through the one RN to 30 complicated patients thing ever again.

hotel indianapolis said...

Simply marvelous!!! This atrcile keeps it real, no doubt. Thank you so much.

Indian Surgical Industries said...

Hello, I love reading through your blog, I wanted to leave a little comment to support you and wish you a good continuation. Wish you best of luck for all your best efforts. medical suction machine, suction machine.

Indian Surgical Industries said...

Hello, I love reading through your blog, I wanted to leave a little comment to support you and wish you a good continuation. Wish you best of luck for all your best efforts. medical suction machine, suction machine.

Anonymous said...

A HCA is a valuable member of the nursing team, however they are not NURSES, period. I am a male staff nurse in oncology and our roles are clearly defined by uniforms, badges and a ward sister that would not tolerate a HCA being valled a nurse. The word nurse is earned by a 3 year training now at university. If a HCA as i was once wants to a nurse then get off your butt as i did and train instead od walking around with a chip on your shoulder. lastly i see in all the comments nurses and HCA's are referred to as She, a bit sexist don't you think these days!! Robert. London. UK

Anonymous said...

Well well well...To say I'm shocked/disgusted by the way the HCA is described here is an understatement! I am a hard working HCA in an Acute Medical Ward & I'm telling you lot, it is damn hard going. We have Nurses who don't answer buzzers, do toileting or get their hands wet! We can have 4, 5 or more buzzers going at same time.....& yes! Nurses are ignoring them! I clearly do not have more than 2 hands/feet, but they sit with a folder & decide to have selective hearing...NOW my issue is, one or more of those Patients could be in real bother & this is when their duty of care comes into it.....I was actually washing a Patient in a side room, & heard buzzers going & noone answering, so I pop my head out the door to find a Nurse sitting reading a folder, while the buzzer in next side room was going for at least 5 mins....right in front of where she was!...Now, as it was a side room she could not see the Patient, but chose to ignore this! I was livid! & pointed up to the buzzer light on door, just to highlight that it needed answering - now! On the same shift, the same Nurse walked into the Bay where I was assisting a Patient onto Commode, she called me to say there's s**t on the floor...clean it! & swiftly pranced out of the Bay! This behaviour is unacceptable & believe me the Nurse in question is getting reported! This is what goes on with the Title of being a Nurse & is disgusting care!

Anonymous said...

Professional image......yeah right. Have you ever seen how some staff nurses and doctors look when they are at work. Like the have just dragged themselves out of bed. Enough said on that because you know where it is going.

Anonymous said...

Basically, when working in healthcare you choose your own level of involvement. You want more respect and responsibilities... Go to uni! I felt like a right bum as a HCA, even though I respected the role, I wasn't happy with my lack of real involvement in patient care and related clinical decisions. I urge any HCA who wants to better themselves to consider higher education. It's a great introductory role, if you're happy within the role, then good for you! Hope that you take into consideration that a registered nurses role differs greatly from your own


I researched all the trained roles with healthcare, now I'm training to be a ODP ( much better than theatre nurse lol) and I love it. But seriously, there's no need for either side to be threatened by each others role. You'll never replace a RN with a HCA and vice versa.

Anonymous said...

buy cheap viagra online viagra online without prescription+25 mg - buy mexican viagra online

Jonathanqowx said...

In February of 1948, the orchestra held its opening live performance, conducted by Maestro Seong-Tae Kim. In October of the identical year, the Seoul Philharmonic Society was established to provide support towards the orchestra. The Johann Strauss Orchestra, with Andre at the helm, have given acclaimed performances all over the globe, including Europe, the Americas, and as far away as Australia. He speaks, at least, seven languages, including Dutch, German, English, French, Italian and Spanish. His recordings and DVDs have also been received, with enthusiasm, by his world-wide family of faithful fans. You would never want to miss that concert in which you will obtain rock music of your own choice. Moreover, when you will get to know that you are going to have Trans-Siberian Orchestra tickets, you will never want to miss the opportunity to see this band onstage. Basically, this band deals in heavy metal music which is very hard and which make you crazy to jump off your seats and go along with each and every beat. This band has done sparkling job to make their fans crazy about them. This is the reason, whenever this band comes on the stage; people want to scream out loud by moving their exciting bodies. [90]Shirley Mullins, -Just Do It Again!,- The American String Teacher 47 (Spring 1997): 27.

Anonymous said...

My experience of nurses' university education was sitting in too-long lectures which are intended more for medical students and of which very little - or no knowledge - is retained by nursing students, the majoriy of whom are simply not as bright! Also, sitting in 'group-therapy' like sessions talking about a load of rubbish! The only skills and proper learning takes place on the wards - as with health care assistants! So where does this mystical, magical - "A health care assistant can never be like a nurse" rubbish come from? It is experience only which makes a good nurse - not sitting in a classroom! Good health care assistants with several years of training and experience should be qualified as nurses - they would be much better than what comes on the wards now straight from university! What pathetic one-man-upmanship! It is time someone told the truth about this 'profession'!

Anonymous said...

viagra online without prescription generic viagra united kingdom - cheapest place to buy viagra online

Anonymous said...

generic viagra legal order viagra online us - order viagra online canadian pharmacy

Anonymous said...

buy tramadol online tramadol withdrawal after 2 weeks - tramadol online no prescription usa

Anonymous said...

buy soma online where to buy sytropin spray - soma quality recordings

Anonymous said...

buy soma discount shopping soma san francisco - soma for sale

Anonymous said...

buy soma online soma.drugs - buy soma online cheap

Anonymous said...

buy soma online who makes generic soma - soma generic dosage

Anonymous said...

buy soma information on soma pills - generic form soma

Anonymous said...

buy soma online buy soma online usa - buy generic soma no prescription

Anonymous said...

soma online soma in brave new world - taking 2 350 mg soma

Anonymous said...

buy tramadol online tramadol with no prescription needed - buy tramadol online no prescription usa

Anonymous said...

cheap tramadol online order tramadol online no prescription - buy tramadol online visa

Anonymous said...

buy tramadol online tramadol hcl solubility - buy tramadol online in usa

Anonymous said...

buy xanax online cheap no prescription overdose xanax 0.25 - what do generic xanax pills look like

Anonymous said...

Brokersring.com - Learn how to turn $500 into $5,000 in a month!

[url=http://www.brokersring.com/]Make Money Online[/url] - The Secret Reveled with Binary Option

Binary Options is the way to [url=http://www.brokersring.com/]make money[/url] securely online

Anonymous said...

generic xanax xanax 2mg erowid - xanax klonopin drug class

Anonymous said...

xanax online xanax wiki drug - xanax withdrawal time

Anonymous said...

buy tramadol tramadol half life - tramadol dosage pain

Anonymous said...

xanax online generic xanax 0.5mg - xanax online legitimate

Anonymous said...

buy tramadol online without a prescription safe place buy tramadol online - tramadol hcl online

Anonymous said...

carisoprodol 350 mg carisoprodol 350 mg tablets used - what is soma carisoprodol

Anonymous said...

buy tramadol tramadol withdrawal emily - tramadol klonopin

Anonymous said...

generic xanax xanax overdose children - xanax online overnight

Anonymous said...

buy carisoprodol cod carisoprodol 350 mg bluelight - carisoprodol schedule

Anonymous said...

carisoprodol 350 mg carisoprodol price - soma carisoprodol wikipedia

Anonymous said...

buy xanax bars xanax with alcohol high - xanax bars 555

Anonymous said...

buy tramadol online cod tramadol online ireland - tramadol 800mg ibuprofen

Anonymous said...

buy tramadol tramadol 50 mg price - buy tramadol 50mg net

Anonymous said...

buy cialis in usa generic cialis walmart - best place to buy cialis online forum

Anonymous said...

buy tramadol cyclobenzaprine and tramadol high - tramadol 50 mg get high

Anonymous said...

buy tramadol tramadol purchase cheap - tramadol hcl 50 mg high

Anonymous said...

buy klonopin online klonopin 2 mg erowid - purepac generic klonopin

Anonymous said...

buy tramadol tramadol for dogs uses - tramadol for dogs by weight

Anonymous said...

http://buytramadolonlinecool.com/#96430 tramadol hcl for cats - tramadol schedule

Anonymous said...

http://landvoicelearning.com/#51438 tramadol dosage rabbits - tramadol with suboxone

Anonymous said...

http://www.integrativeonc.org/adminsio/buyklonopinonline/#cheap klonopin withdrawal fever - klonopin green mg

Anonymous said...

http://landvoicelearning.com/#62431 cheaptramadolonline - rimadyl or tramadol for dogs

Anonymous said...

http://www.integrativeonc.org/adminsio/buyklonopinonline/#buy klonopin 2mg overdose - where can i buy klonopin online

Anonymous said...

http://buytramadolonlinecool.com/#91646 tramadol generic ultram 50 mg 180 pills - tramadol high grasscity

Anonymous said...

cheap carisoprodol carisoprodol how long does it stay in your system - generic name of carisoprodol

Anonymous said...

carisoprodol 350 mg carisoprodol recreational drug - carisoprodol 350 mg efectos secundarios

Anonymous said...

http://southcarolinaaccidentattorney.com/#31694 carisoprodol high - carisoprodol 350mg tablets price

Anonymous said...

carisoprodol 350 mg maximum safe dosage carisoprodol - carisoprodol overdose dosage

Konstantina Zafeiropoulou said...

Someone to slap her please..

Konstantina Zafeiropoulou said...

Someone to slap her please...With all the respect Nurse.

Anonymous said...

Hello there! Would you mind if I share your blog with my facebook
group? There's a lot of folks that I think would really appreciate your content. Please let me know. Thank you

My web-site ... http://www.viafarajw.net/

Anonymous said...

Hey there I am so happy I found your blog, I really found you by mistake,
while I was looking on Google for something
else, Anyhow I am here now and would just like to say thanks
a lot for a marvelous post and a all round thrilling
blog (I also love the theme/design), I don't have time to read it all at the minute but I have book-marked it and also added in your RSS feeds, so when I have time I will be back to read much more, Please do keep up the awesome job.

Feel free to surf to my blog; http://Dentistsoralpq5.Bloghi.com/2013/01

Anonymous said...

This printer does not have a voltage choose change.
It is sold as a 110 volt model or a 220 volt version.
To transform the printer from one version to the
other, you would certainly have to replace both the electric supply and the
fuser. At least it just didn't power up. If you had actually relocated the printer in the contrary direction, it would probably have gone bang and/or tripped out the whole office.

Here is my site ... galilee.ezpt.kr

Anonymous said...

Youг сurrеnt post fеatures verіfieԁ nеcesѕary tο me pегsonаlly.
It’ѕ veгy іnformative and you really are naturаlly quite
knoωleԁgeable of this typе. You havе got opened up
my own еye to various views on thiѕ paгticulаr tоpiс togеthеr with inteгeѕting and reliable
content material.

Alsο viѕit my blog pοst ... tramadol online

Anonymous said...

I have a degree from UCL and work as an HCA. I agree with you that HCA's should not be called nurses. The reason being is that it creates too much expectation of us from the patients. Patients naturally assume that because we are on the ward and wear uniforms that we are nurses. I have to constantly explain that I have no medical knowledge so cannot answer most of their questions but will ask the nurse to do so.

When I give obs readings to the nurses I am aware that they are the ones that can interpret them as I do not have the training to do so.

However what does upset me is when I relay a request from a patient - a pressing one, not a superficial one - and it is not acted upon. For example when a patient repeatedly requests for their leg bandages to be changed and it is not done for several shifts or a patient has a colostomy bag that is unsuitable and no one deals with it (resulting in the site becoming sore). Or when I see a nurse very roughly turning a patient. On these occasions one does not need medical knowledge to know that it is not right.

Being an HCA is a very very physically demanding job - nurses walk the wards with their drugs trolleys but HCA's are doing a lot of heavy lifting. When the ward is not staffed properly it is exhausting on the body. So when a nurse asks me to take a commode to someone when i have worked very hard all day due to the ward being understaffed and then see her sit down for an hour, I find it mean spirited and demeaning. Yes its my job to do those things but on the when there is a shortage of HCA's and a ward full of patients with poor mobility, nurses should support HCA's if they are free.

Anonymous said...

A healthcare assistant comments that "Good health care assistants with several years of training and experience should be qualified as nurses". Irrespective of how much practical 'experience' healthcare assistants have they are not and indeed cannot be qualified unless they gain essential knowledge about drugs and their administration, learn how to carry out various complicated treatments and practical procedures, understand physiology, learn how to recognise the different types of shock, the action of hormones, how to manage pain, etcetera. The truth is that those healthcare assistants who really want to be qualified nurses do apply to train and then they find out what hard work it is. The remainder fall into two camps i.e. those who admit honestly that they are not sufficiently motivated to train and prefer to stay as they are, and those who whinge, are full of resentment and complaints but don't have the guts to apply.

Anonymous said...

I like to all a touch of color when taking care of Christmas card "envelopes".
Is it difficult to add a small "clip craft" candy cane
or Christmas Bells or Minature Christmas tree when utilizing tags?
Believe I will begin making use of labels this year.
Thanks!

Ellen.

My page luisramirezjoubert.wordpress.com

Rick Crouch said...

Hi, I am a male RN and agree about the hca's who deliberately mislead patients into thinking they are qualified should have large disciplinary action taken against them. But, about 6 years ago I was working as a Physio and continually patients thought I was a doctor. Once I was pulled up on it as they made a complaint (this doctor didn't prescribe blah blah) obviously I didn't agree or mislead and was wearing my white PT polo top so I can see when it is by accident it could ruin innocent people's livelihood. Nursing jobs, physio jobs, hca jobs, they are not harder or easier or than each other just different. And hard working people in these roles should be respected for their roles. If you are a hca and feel like you need more responsibility. Go to UNi! But what I ferverently do agree on is that people under 21 with little or no life experience should not be allowed on a wrd!!!!! Ha ranting!!

Anonymous said...

Yes, you can do this IF your Christmas card list is in data
source style AND you know ways to partner with Mail Merge in your
word processing program. Or else, this is the thrust for my tip.
Yes, it takes some time up front the first year, yet after that it is cake.


Stop by my site xerox phaser 8560 ink

Anonymous said...

I feel very appalled at some of the comments on here in reference to new Health Care Assistants or young nurses. I am 22 years old have studied hard for 3 years to become a registered nurse, however I have been working on the nurse bank as a Healthcare Assistant for the NHS(until my NMC pin comes through). The attitudes I get off permanent members of staff in particular (health care assistants) who are old enough to be my mother, they are so disrespecting and degrading to bank workers and that is even before they know I have completed my training. I think all you permanent staff should think what it was like when you first started and not judge new staff or complain when they are there to help. I go in with a smile everyday and give great patient care, I may take my time with patients but I still get the job done. I am fed up of full time hca's thinking they run the ward and like to stand about doing nothing whilst others work hard. I always have patients ask me are you a bank nurse and ill say yeah I'm a bank hca and I will ask how can you tell, which they then reply to yeah the bank staff who come in are always so lovely unlike some of the staff. So goes to show we are actually doing our job right and don't need to be monitored. For every time I make a patient smile or go the extra mile for them makes my job so much easier and rewarding.

philip michigan said...

The vein is a very delicate tube connecting organs in the body. As the name suggests, venipuncture is a process of obtaining samples and doing the process in “within the vein.”
http://www.phlebotomytraininginmichiganhq.com/

Anonymous said...

im an experienced male carer, but have only worked as a nhs hca for 9 months.the problem is people not uniform colours or job titles. if im with the right nurse or hca we can look after two bays easy, with others its a nightmare.ive only had somebody show me how to do obs in passing and im pressured to do them because if i dont they wont get done, not trained to do B.M,s borrow a bar code is the answer,nobody on the ward with a bar code, oh borrow one off another ward, crazy stuff indeed. i was once told by a good nurse that i need to get the nurse in my bay to pull her weight a bit more . constantly doing illegal handling moves (rare in private care)because the other hca has dissappeared again for a fag. yesterday me and the next bay nurse worked more together than the one i was supposed to be with. certain nurses only go in the bay to give drugs, they dont wash change or body map (they rely on my limited info, because im not trained) i googled blanching btw. i really thought the nhs would be at the top of the care tree but its been a big dissapointment. the non medical standards are way below private care, so back to private i will go. oh yeah whats with treating agency staff like second class citizens thing about ??? i used to wonder why we got on so well ,then i realised i was the only one who spoke to them ! if your the kind of person who thinks a consultant is more important than a porter perhaps its time for a job change

eng sara said...

شركة تسليك مجاري بالدمام
شركة مكافحة حشرات بالدمام
شركة تنظيف منازل بالدمام

شركة تنظيف فلل بالدمام
شركة تسليك مجاري بالدمام
شركات نقل عفش بالمدينة
شركة تسليك مجاري بالرياض
شركة تنظيف فلل بالخبر
شركة تنظيف موكيت بالدمام
افضل شركه لتسليك المجاري
شركة تنظيف موكيت بالخبر

here
here
here
here
here

















eng sara said...

تخزين اثاث
شركة تنظيف بيارات بالرياض
شركة عزل اسطح بالرياض
شركة تنظيف خزانات بالرياض
شركة رش مبيدات بالرياض
شركة مكافحة حشرات بالرياض

eng sara said...

شركة تنظيف فلل بالرياض
شركة نظافة بالرياض
شركة عزل خزانات بالرياض
شركة عزل اسطح بالرياض
شركة تنظيف شقق بالرياض
شركة تنظيف موكيت بالرياض
شركة تنظيف كنب بالرياض
شركة تنظيف بالرياض
شركة رش مبيدات بالرياض
شركة تنظيف موكيت بالرياض
شركة تنظيف شقق بالرياض
شركة تسليك مجارى بالرياض
شركة تخزين اثاث بالرياض
شركة تنظيف منازل بالرياض
شركة جلي بلاط بالرياض
شركة تنظيف خزانات بالرياض
شركة تخزين عفش بالرياض

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