Monday, 2 August 2010

They have sunk even lower.

Can't believe I am having to tell you guys this.

We are losing our cadets/apprentices whom we have been trying to get up to speed for the last year or so.  Most of them are still crap as they have not had nurse training and don't understand the patients.  But if the trust refuses to staff the wards with real Nurses then the best we can do is try and help these kids succeed.

The apprentices have been doing NVQ things since they started in order to get them qualified as a Health Care Assistant.

All of them but one have passed their competencies and can now be health care assistants.  As they are turning 18, they will also be paid more than £3.00 an hour.

The trust has told them that they have to re-interview for HCA jobs now that they are no longer apprentices or whatnot.  Their contract as cadets is up.  Only one out of the seven is getting employed on the ward.  The rest are getting told where the door is.  Lots of tears.  A few of these kids were showing promise and were thinking of Nursing school someday.

And we are getting a new batch of 16 year old untrained inexperienced kids on £3 an hour to "bring up our staffing numbers".

The people who are the most pissed off at this situation are the two excellent experienced Health Care Assistants we have left on the duty roster.  Both of these women have been health care assistants for 15+years. They have been through hell in back trying to show these little snots the ropes. They have been through hell and back trying to carry all of the basic care while the lone Nurse was tied up with rounds, drugs, emergencies, and the cadets were chilling at the nurse's station.  It is easier for a proper health care assistant to get a job somewhere else than it is for an RN.  So these two are talking of leaving.

Man oh man we are so fucked.  No change there then.

The wards are going to be staffed with one or two RN's and 2 or 3 apprentices who don't listen no matter how many times you tell them that if a patient only has 50mls of urine in their catheter over the last 12 hours YOU NEED TO TELL SOMEONE.  The RN's have way too many patients and interruptions. It is physically impossible for the RNs to keep an eye on these things themselves.  Regulating the real health care assistants won't do squat for us as we don't actually have any health care assistants.

If you want to read more about the untrained assistants who are replacing Nurses on the wards as a result of management directives look at these links:


Frustrated Fairy said...

Ergh, the more I read the less and less I want to star my nursing course :S

Nurse Anne said...

Once you qualify go to a big city like Leeds or something and avoid general medical and AAU type places. You'll be fine. I once worked on a short stay surgical and ENT ward and I LOVED IT. It was great. Too bad they shut that unit down and moved it to another trust.

Frustrated Fairy said...

Thanks :) I'm in a big city and I'm hoping to do perioperative nursing eventually. I'm gonna be terrified of doing my general medical placements though. Still at least I'll go prepared for the worst lol!

murse said...

If it is any consolation, we're even getting fucked over in ICU at the mo ;-)

Nurse Anne said...

Oh please don't tell me you are getting apprentices in the ICU instead of Nurses!!!

One of them decided to disconnect an drip without telling me because she wanted to change a patient gown. It was dextrose she disconnect but she didn't disconnect the actrapid insulin syringe so that kept infusing.

When I told her that she cannot do that and explained why she just shrugged her shoulders and rolled her eyes at me.

Two minutes later a patient shouted "Nurse" and the same girl responded to the patient. I wanted to scream out "that is not a nurse goddammit".

I'll bet money that the trust will turn around and say "we are increasing our nursing numbers" because of the apprentices.

Lisa said...

Surely it would have been easier to thread the bag through even with the pump attached!!

Nurse Anne said...

Yeah but they just stop the drip, pull the tubing out of the pump and then leave it hanging there when they are done.

Dino-nurse said...

Sounds like a nightmare...unfortunately "coming to a theatre near you" is no longer a jest. I have alot of friends from my training that are still nursing and still in ED/ICU roles. Many work in central London and their horror stories of staffing levels you just couldn't make up. As for our pit of an admissions unit, we now get daily requests to transer ICU staff to them. Even though they are in a different directorate. The latest rumour is that not only will the CPAP story become a reality (I shudder to think where this is going) if no-one volunteers to take responsibility for the new unit then staff will be forcibly moved whether they like it or not...once again two other local trusts are hiring for ICU so we can see where this will be going. Crap....

Nurse Anne said...

That's one thing we don't have i.e another local trust.

Management was overheard to have said "well where will our staff go if they don't like it ha ha ha".

The other thing about legislated Nurse patient ratios is that it retains Nurses at the bedside and prevents nursing shortages.

Anonymous said...

How come they passed their competencies when according to your posts they are so bad?

Nurse Anne said...

Passing their competencies involves things like getting signed off for doing a blood pressure, or taking a patient for a test.

They get signed off and can do some skills but they don't have the knowledge behind what they are doing.

They have improved somewhat over the last 18 months but that doesn't mean that they can replace nurses.

Anonymous said...

Who actually assesses the apprentices? Are they assessed against NVQ standards? If so, what level?

Nurse Anne said...

There are staff on the ward who are nvq assessors. They dont get paid for it or anything. THese kids are getting assessed regarding whether or not they can remove a venflon etc etc. Something a monkey could learn how to do. Doesn't mean that they are safe workers in general.

the a&e charge nurse said...

I read this and immediately thought of you;
"Despite her history of poor attendance and successive failure of her nursing examinations, she was taken on a temporary six-month contract at the chronically understaffed Grantham and Kesteven Hospital in Lincolnshire in 1991, where she began work in Children’s Ward 4. When she started, there were only two trained nurses on the dayshift and one for nights, which might explain how her violent attention-seeking behaviour went undetected for as long as it did.;jsessionid=252A8ECEDDE51C89506EE2D215E84622

Under staffed and under trained - I fear some things will never change?

Nurse Anne said...

Um. You read something about a child murderer and it made you think of me?


the a&e charge nurse said...

Bad things are more likely to happen when there are too few suitably trained staff around - it was certainly a contributory factor in the Allitt case.

Yet 20 years down the line it is all too apparent that lessons have not been learnt - it may not be children who are suffering nowadays but plenty of other patients do.

Anonymous said...

If Nurses need somewhere to go, well, here in Australia we're always looking for good staff. The parity in training means no extensive testing/re-training and the weather's better.

Anonymous said...

In a nutshell. Nurses are encouraged to use a logical approach to nursing. Simple maths problem 1: If it takes 2 men 2 hours to dig a hole, how long does it take 1 man to dig a hole of the same size on his own? Logic dictates that the Correct Answer is 4 hours – twice as long. Simple maths problem 2: If it ordinarily takes a Nurse and a HCA 2 hours to bed-bath a group of patients, how long does it take the Nurse to bed-bath the same group, on her own, the following day? (Because, due to short-staffing, the HCA is commandeered to help out elsewhere). Logic dictates that the Correct Answer is 4 hours – twice as long. Unfortunately however management are unable to comprehend logic. They chide her for being “behind schedule”. She is sternly rebuked for taking “too long” over the task. Finally they produce their trump card, the ‘stock response’ in such situations – she is told “you need to improve your prioritisation”. “Simples”? (Or just simply nuts?)

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