The Onus is on the Nursing Staff

45 minutes to dismantle, clean and rebuild a bed.

This is the trust's latest trick in fighting infection control. 

They continue to ignore the issues of safe staffing while scoffing at any suggestions made by the professional nursing staff regarding this matter.  They are unable to address the issue of high bed occupancy as a result of being forced to meet targets.  In a nutshell, this means that the ward is always to full to clean properly.  We continue to get slammed with admissions we cannot handle at mealtimes, during rounds, change of shift, and when we are struggling to care for the patients we already have.   We don't have enough domestics.  We have no right to have an uninterrupted block of time at any point in our shifts to do our jobs.  We are doing so many things at once that nothing, NOTHING gets done well.

None of this gets addressed.  Ever.

But the trust behaves as if it is  quaking in their boots at the thought of getting busted over poor hygiene, super bugs and poor care.  They cannot deal with the real issues that lead to these problems so they are covering their assess and putting the onus on the Nursing Staff.

I attended a study update the other day to learn about the trusts requirements for the cleaning of all 30 beds on the ward.  The process that we were instructed upon is to be implemented daily and between every discharge and admission.  They want each bed completely dismanted and every part cleaned in a certain way, every single day and between each patient.  It is heavy work that requires at least 2 members of staff.  It takes at least 45 minutes to do one bed.

There are 30 beds. We have between 5 and 15 discharges and admissions per day.  There are 2 nurses and 2 assistants for a 12 hour shift during the day who cannot even attend to all the Nursing care that needs to be accomplished. 

Do the Math.

We cannot even get around to everyone fast enough to prevent pressure sores, dehydration, notice changes in condition quickly enough or medicate properly.  Here's a newsflash for the doctors:  you know those IV antibiotics that you prescribe to be given 4 times a day?  They are getting given two times a day max because the nurse has so damn many of them to mix and give that it takes hours.  Yeah, doses get missed regulary.

Now you need to take into account that in addition to this we must clean and dismantle 30 beds that take 45 minutes each to clean every day.  And in addition to that we have to dismantle and clean them between each patient.

They won't bring more staff on board.  They don't want the domestics doing the beds and there are not enough of them anyway.

During the course of the study update we did explain that we will be unable to follow this bed policy due to a lack of time and staff.

This statement was met with ridicule of the Nursing Staff in the form of eye rolling and the inferred notion that Nurses are too thick and lazy to do their job properly.

And I quote:  " The trust is implementing this policy to prevent the spread of infection.  There will be spot checks to ensure that these actions are being carried out.  If they are not, the blame is on the professional Nursing staff."

Did I tell you that they want us to spend 11 minutes exactly in a cramped room cleaning and dismantling commodes and documenting it between each patient use.  Four commodes are being used over 15 times an hour on some days. They are swabbing them to ensure that this is done.  The swabs are never clear.  And infection control is up our asses over it.  They have devised even more cleaning checklists and paperwork.  Same with pressure sore audits etc.

And they want to know why we have so many pressure ulcers, and drug errors as well.  And they have demanded that the RN on duty drop what she is doing as soon as the consultants arrive (we don't know when they are coming and cannot plan for it) and attend every ward round, following the medical teams around the ward for hours while they see their patients.

And if my patient suffers harm because I am off on a ward round or dismantling a bed I must take full responsibility.  It's tough shit really.

Fuck them.  I am going to Nurse my patients starting with the high priority actions and working my way down.  I will turn the patient and if that doesn't leave time to document that I have turned them it is too bad.  The trust wants documentation that it is done more than they want it to actually get done.