Too many untrained staff.

I lost my mojo with writing a wee bit.  But I thought I would update you on any new developments.

Awhile ago I explained that my trust was replacing real nurses with care assistants.  And then they started replacing care assistants with untrained 17 year on "nursing cadets" who I like to refer to as "kids".  Most of these kids have no interest in nursing.  They take the job because it pays a little more than McDonald's and because they like to play around in the nurse uniforms.  The few that do have an interest in nursing would be wondeful to have in addition to a well staffed ward.  But instead they are all we have instead of a well staffed ward.

6 years ago we had 4 or 5 registered nurses and 3 or 4 healthcare assistants on a day shift for a large ward.

4 years ago it went down to 3 staff nurses and 3 care assistants.

Now we have 2 staff nurses and two cadets per shift on a good day.  That means that they only people who can handle most of what is going on are the staff nurses.  The cadets can do very little outside of bed pans.  And many are not willing to even do that.

The health care assistants are leaving.  The qualified nurses are leaving and they are all being replaced with untrained cadets.  Being untrained (and young) means that even though they are counted in the staffing numbers, there is very little that they can do or understand about what is happening on the ward.


The cadets call off sick constantly.  We are talking at least twice a week..  Weekend call offs are a given because teenagers like to get drunk. 

They walk up and down the ward with mobiles.  They talk to the patients like idiots.  Some try  to copy the staff nurses in their interactions with patients but they don't really know what they are on about.  I once stood outside of a room eavesdropping on a patient telling a cadet that she thought she had a UTI as it burned when she passed urine.  The patient probably assumed that the cadet was a nurse.  "Is your pain radiating anywhere?  Like to your left arm?" asks the cadet.  At that point I went into the room, trying to keep a straight face.  When I get student nurses on the wards I need to use them to babysit the cadets rather than teach them how to be a nurse. 

We have to remember that the patients assume that these kids are some kind of Nurse.  Most are not even wannabee nurses.  They have had NO training.  The few in number qualified nurses are so on their knees that we cannot watch these kids or avoid delegating the basic care to them.  It gives me nightmares.  I have not a minute free to teach them.  This is why the cadets are only great in addition to real staff, not instead of real staff.   The qualified nurses are unable to find jobs.  But we are getting batch after batch of cadets.  And the trust tells the world "oh yes indeed we are increasing our nursing numbers".  There should be some kind of law that says that an NHS trust is only allowed to use the term nurse when they are actually talking about qualified nurses.  That would bring stats down.

It is getting pretty obvious that these kids are not being vetted properly.  We have had kids caught red-handed stealing drugs after asking for the keys to  "get some sudocrem".  We have had kids who have been found out to have a criminal record when they were once again arrested for assault.  We have kids who are coming to work hungover.  All sorts of alleged social problems stop these kids showing up for work much of the time.    One kid's boyfriend showed up on the ward and got into a physical altercation with her.  We have 16 year old pregnant kids who refuse to lift-the only thing that they are allowed to do anyway.

Thank god for the one or two cadets who are planning on nursing or medical school.  They are there for the right reasons and take pride in their work.  The rest of them are crap.

We have 4 decent health care assistants left.  Three of them handed in their notice along with a qualified nurse who has had enough.  In their place, we care getting 4 of these cadets.  The experienced health care assistant that is left has told the managers in no uncertain terms that she has had enough of the cadets and is refusing to work with them from now on.  The qualified nurses feel the same.

One of our qualified nurses was the sole RN for 30 beds with 2 cadets on a monday morning.  It was hell on and she was ringing and ringing and begging for more help.  They kept sending her more cadets and acting like the nurse would be fine as long as she had a "few more sets of hands".  This is how badly management devalues nurses.  They think that untrained chavs can do the job and help the nurses.  The qualified nurse broke down completely and resigned. And she is getting replaced with a cadet.  And the public thinks that these cadets are their new "modern nurses" who have been "ruined by university".   Wrong.  Most of these cadets probably never even finished high school.  And they are of no help to us when we are low on qualified nurses. The real new and modern nurses are stocking shelves as Asda because they cannot find a job.