Wednesday, 3 March 2010

The Department Of Stealth

Yes the good old DoH.  What the hell is their malfunction?
I read this today and I nearly choked on my coffee.

Nurses must be better trained and take more responsibility in ensuring patients are not malnourished, a hard-hitting report has warned.The Nutrition Action Plan Delivery Board report, commissioned by the Department of Health, found not enough attention is being paid by organisations or healthcare professionals to prevent patients from becoming malnourished
The DoH thinks that if only Nurses have more training then patients will stop starving to death in hospital.  Oh happy happy joy joy.  If only we understood that frail patients require assistance with their meals.  If only we were smart enough to realise who needs help!  ( We do know exactly who needs help, we just cannot get to them all before the domestic dumps their tray out of reach and then collects it in 5 minutes later).

What do nurses who work on large wards with frail elderly patients have to say about this?

No amount of training is going to help me feed 10 people simultaneously in 20 minutes while managing critically ill patients, getting interrupted by family members, doctors, path lab, pharmacy and answering every phone call that comes into the ward during that time.Management won't pay for a ward clerk but will formally discipline the nurse for not answering the phone promptly. We (nurses) asked the domestics if they could please not collect the trays back in until we could help everyone to eat.
e can't do it in 20 minutes, primarily due to interruptionsa and numbers.  We were told that it isn't their problem and the domestics will not be held up because the nurses want to feed patients.  Doctors ignore the protected meal times and show up to do their ward rounds almost the minute the trays are being handed out. These consultants demand that the lone nurse on duty immediately stops what she is doing to follow them around on the ward round regardless of the staffing levels. When the nurse refuses, because she wants to feed patients or administer much needed drugs (no other nurse around to do it) she is reported by the consultants.  And the DoH thinks that it is the nurses who need training about this?

I am a nurse working on an acute admission ward for elderly patients.

I know that from the experience on our ward, it's not a question of whether staff need more training to meet the nutritional needs of our patients but a the age old question of staffing and manpower.

That need to be addressed first and the care and attention our patients need will be met. As always, the crisis level of staffing goes on and managers sit proudly in their seats and say there is no more funding.

This isn't the first time the Department of Stealth has irritated me beyond belief.  They pulled a shitty little stunt during an unannounced visit onto my ward some time ago and I blogged about it.

The Nurse responded to her comments by talking about the things that I talk about on this blog. Nurse patient ratios that are unsafe (triple what is recommended by the International council of nurses, the RCN, and AMA etc) constant interruptions, poor facilities, untrained support staff, lack of management etc. The DoH visitor  responded with "It's not really about lack of staff and facilities is it? It's about dirty nurses not wanting to take pride in their work". She cocked her head in a funny manner as she said it, and actually smirked. She said it with a mock syrupy sweet voice. It was sick. One of our care assistants is a hell of a mimic and she repeated it perfectly for me, when I came in for the night shift that night. The very proud hands on nurse was just weeping at this point, as she handed over to me.

Does anyone want to speculate on just what it is the Department if Stealth is up too?  Are they just thick? Do they get a fabulous high off of wasting money on worthless reports?  Are they scapegoating nurses for things the DoH  cannot control?  Are they big government loving politically correct tits collecting a ginormous salary for doing sweet fuck all nothing except coming up with more and more stupid fucking shit to justify their own existance?  Discuss.  I would love to know how much they spend on producing these "reports" and coming out with this kind of rubbish.

The report warns that messages around nutrition are not getting through to frontline staff, possibly because national campaigns have focussed on obesity rather than the dangers of being underweight.

Yeah, the outnumbered Nurses are unable to each feed 10 patients singlehandedly in a strict 10 minute window because we think they will get fat if we do.  We are starving frail and already underweight 96 year old patients  because we are worried about obesity. Go DoH.  Where would we be without your wisdom and knowledge oh great ones. Yeah. If you want to spend money on something worthwhile, why don't you teach your staff to have some manners and decency when they step onto hospital wards.


Paul said...


Slightly off topic but there's an article up about medical ward nurse staffing at my place with reference to this excellent blog, and it's being cross posted later at the much better read

Dino-nurse said...

Its obvious Anne. Healthcare is becoming too expensive as people are living longer. As no one is about to opt for the Logans Run initiative or Soylent Green there is only one way to keep costs down. Force us into an insurance based system. Just look at the wording on the BUPA commercials- all targeted at the worried well types. If enough jump ship then the NHS can be further broken up into acute versus non-acute. Acute hospitals will house ICUs and not much else. Without insurance you will not get into the ICU. NHS will run the non-acute which will basically be staffed by care assistants and GPs. Much like nursing homes at present.

My Thoughts My Country said...

I am so angry at after reading your blog.

Nurses are the most hard working, caring and professional people i have ever had the pleasure of meeting. Yes there are a couple of bad eggs, but isn't that the case in every profession.

I have been in hospital as a patient and visitor and i have nothing but praise for the nurses.

Nurses don't need to be retrained to make sure patients are fed properly.

Like you say just put more nurses, not care assistants, on the wards.

Gordon Brown said a future fair for all. Is that fair for all, but nurses.

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