Thursday, 30 September 2010

Quote from a Newly Qualified Nurse

Found this quote on the Nursing article linked on the post below.

I am a newly qualified nurse working as an auxiliary on the bank when I am lucky enough to get shifts, there has been so much red tape to stop newly qualified nurses from getting a job in the NHS. It is very disheartening to go through all the studying and work to have nothing in the end. I am now looking to go in a new career direction as I need paid employment and that is not something I can find as a nurse sadly. When will they realise they need frontline staff and this is not something they can cut?

I keep hearing this over and over again from new Nurses.  Over and over again.

How can people blame  university (new) training for Nurses for the hellish conditions on the wards when our new RNs cannot even find jobs?  The vast majority of Registered Nurses practicing in the NHS trained under the old system and they are on their knees due to the lack of RNs.   We need RNs and we need new blood to replace an aging workforce.  What we don't need are more untrained unskilled minimum wage earning ward assistants. But that seems to be all that we are getting.

Monday, 27 September 2010

Pay Freeze or Job Loss?

Reason number 386 that we are all trying to get out of the UK.  The pay. Registered Nurses (Not care assistants) already work a large number of unpaid hours.  Our pay does not increase as our workload triples or becomes more complex during the course of a shift.  We do not get paid for overtime much of the time.  We are on less than RN's in other first world countries.  Child tax credits are gone, child care costs are sky rocketing.  Taxes and cost of living are high.

I have often hesitated to conplain about pay on this blog.  The problems I describe go way beyond "RN's are not paid enough".

But have a look at this:

And look at this quote from the same article:

“If we have a demoralised workforce, performance will suffer, quality will suffer, so it’s up to nurse leadership to make sure that doesn’t happen"
Nurse leadership?  Nurse Leadership? Oh shit.  What are they going to do? They are too busy blowing the chief executives, looking down on floor Nurses (who are much more knowledgeable by then way) and trying to be  corporate suits.  We aren't going to get sweet fuck all from those age 55+ sluts.

Friday, 24 September 2010

Footloose: Nursing School Style

From the Louise Herrington School of Nursing at Baylor University.
For a Baptist school with a strict academic admissions criteria which is really very competitive; their students are pretty funny.

My students are told to make me a video like this or fail the placement. ;)

Another Classic Quote from High Level Nurse

We already had a previous comments post. This new comment wins hands down. 

I cannot tell you if the person who said the following is a Matron, a Clinical Lead, a Nurse Specialist, a non ward based Nurse manager etc etc.  But she is one of the above.

Like most of the silly commentators mentioned in my previous post she is an older nurse, trained under the old system; she hasn't worked on a ward since 1982 and she HATES Nurses who choose to stay at the front lines providing direct patient care.  She sees them as "Nurse Failures".  Thank god that us University educated Nurses don't think like that. We are going to be on the wards providing direct patient care until we retire anyway.  It is where you start out when you graduate Nursing school and these days it is where you stay as there is NO PROMOTION and recruitment freezes.

She has given the frontline staff nurses even more scores to do.  Not content with having them down twice a week she now wants us to do them on all  35 patients every day (irregardless of risk factors) and document the results in 4 different places. Each sheet of paper of course requires the nurse to write the patients name, date of birth, 9000 digit long NHS number on both front and back.  There is the waterlow score for pressure areas, the nutrition score, the fall risk score. Blah blah blah.  If a patient deteriorates and moves from a low waterlow score to a high one then obviously there is higher risk of pressure area damage and certain actions we will then need to implement. As if we wouldn't realise without the score....eye roll.

We told Nurse Ancient that this amount of writing is ridiculous, physically impossible etc etc.  She called on us to ask why her scores were not being done.

When we told her we had too many patients, too many things going on at once and  that doing this insane amount of redundant paperwork was impossible and pointless she called us "whingers".  And then she said:

"You don't really have to score them every day if you are busy.....just copy down what the last person wrote or make it up...guesstimate....just make DAMN SURE THAT THE DOCUMENTATION IS COMPLETED".

Um.  Well what is the point then?  If I am going to write all these names, patient info, scores and numbers on 4 different worksheets back and front for 35 people I need to know that it is actually going to benefit the patients.

Still not going to do it.  She can bite us.  They just had 5 RN's quit simultaneously off the 40 bed even more short staffed hellhole ward below mine.  Let's see if we all get sacked for refusing.

Our younger  RNs are scared of the Queen Bee "Nurse" quoted on this post. There they are running around, trying to get all this stupid paperwork done so that they are seen as "good nurses" by their "superiors". 

Militant Medical Nurse knows that being a good nurse is inversely proportional to being a good employee.  Fuck the non essential paperwork, I have patients to nurse.  I am trying to teach this notion to the youngsters.  Safe patient care first: fucktwittery last...Of course if the hospital gets sued and the paperwork is not 100% complete (including scores) a barrister will use that to nail the trust (and clinicians responsible for patient) to a wall.

will continue

Wednesday, 22 September 2010


It's been an emotionally draining week.

I have had many many lovely, kind, interesting and funny patients on my assignment recently.  These people are a joy to look after.

And it's amazing to me that they can be so sweet and lovely when they are so sick.  I would be a miserable bitch and then some.

Many of them are way too young to be getting these shit diagnosis and prognosis.  They are young with young children. It is unbearable.  We are talking 30s, 40s and 50s.

I didn't want to be there when the consultant told Mr. and Mrs. Doe that John has cancer everywhere.  The look  of agony and fear on their faces is keeping me awake at night.

Another young patient who likes to prank the Nurses (in a nice way) and has me laughing so hard that I cry is also very very sick.  He suddenly deteriorated on a recent shift of mine.  I was shaking in my boots, thought we were going to lose him then and there.  Thank god my other patients were okay and I was able to stay with him at all times. The team really pulled together well.  The junior doctor was brilliant and so was her senior.  The xray folks and ITU nurse were on the scene right away and very competent. The ICU ward that I rushed this  patient to was fabulous.  I was proud to work in that place after seeing how well the team functioned.  I am surprised that ITU  accepted him but they did.

 I think they saved his life that night even if it only extends his life for a few more days.  But facts are facts and the truth is that this person will not be with is much longer no matter what we do.   He didn't want me to call his partner in because "she'll worry too much and the little ones are in bed and can't be left alone".  He said he will see her during visiting.  I am afraid that he won't be there for the next visiting hours.  But I couldn't tell him that. It isn't my place.  He wouldn't let me call his partner.  He was adamant. The medical team were on their way in to speak to him at that point and were going to be very very direct and they are going to speak to the partner. I think he knows the score anyway but is in denial.

Instead of being pleased at myself and the team for a job well done I feel like crap with a knot in my stomach.

The icing on the cake was my dying elderly patient. This patient has  sprightly elderly parents. The parents had asked that we ring anytime so that they could be with their 70 year old child when he dies. One morning it became very obvious that this was going to be it and I phone them to come in straight away.  The patient died before the family made it back to the hospital.  The arrived on the ward and I didn't want them to go into the side room and find the corpse so I asked them to come with me into the family room first.  When I asked them into the family room they pretty much realised that he had gone and started grabbing onto each other.. When I sat them down and told them that he had indeed passed and that I was so very sorry the mother started screaming and tearing her hair out.  I don't care how old you are or how old your child is......losing your baby is the worst thing in the world.

Later on we received  lovely letter from this family thanking us for our kindness and for caring for this patient so well.  Still feel like complete  shit.

* details have been changed to maintain confidentiality.

Friday, 10 September 2010

The Stupid Things They Say

Here are some authentic quotes from hospital managers and chiefs, family members, doctors etc etc for your entertainment:

1. "Why do you need any more than 2 qualified Nurses on a 35 bedded ward?  Two Nurses and two untrained ward assistants should be plenty".......said by my Chief Nurse who hasn't worked on a ward since John Lennon walked the earth. Is this what she is telling management?  The cow.

2. "I don't want to hear any more whinging from you Nurses about protected mealtimes.  If you get interrupted by doctors during that 15 minute window that you get to feed patients then stop feeding the patients.  If I were a patient I would rather the Nurse attend ward rounds with the doctor and get me discharged rather than hand out meals"..............................Another Nurse leader from my hospital who is older than the hills and last did ward nursing in the 80's. She seems to miss the point that it is wrong to starve one dependent person in order to get healthy patients' discharge paper work in order.  And they say that younger Nurses are the problem.

3. "Audits are basic nursing care in my book. Deal with it"........said by a medical manager when he was told by ward sisters that their are not enough Nurses to care for patients basic needs on general wards....................... let alone fill in time consuming audits for him. Hell, we can't even keep these people alive in the time we have when we ignore the form filing.

4. "Why do you need a second Nurse for your 30 bedded ward when I have already sent you two untrained  16 year old ward assistants who have never been to nursing school to help staff your ward for the shift?  Deal with it and cope.  AND we are sending you 6 admissions and don't give me that shit about not being able to handle the patients you all ready have"..............................................Bed Manager.

5."If the phone is ringing and you are busy don't answer it" ........said by a high level and as old as Moses Clinical Nurse Manager when she was told that we need a ward clerk because a Nurse cannot take time to answer the phone every 30 seconds.  This is especially true when we are the only qualified nurse on duty  and trying to stay on top of doctors orders and keep patients alive. Sounded sensible until:

6. " And if I hear one more complaint for a relative who phones up here to enquire about their family member because the Nurses aren't answering the phone right away there will be a disciplinary"........said by same manager on another occasion when we told her that the only RN on duty cannot spend 55 minutes out of every hour answering the phone without harming patients.  Then it gets worse.

7..  "The idea of a 30 bed ward needing a ward clerk to answer the phone for the Nurse is ridiculous.  The Nurses can do that.  We are not paying for a ward clerk" ...said by same manager after a patient nearly died of a major  error because a Nurse was on duty alone and trying to answer a phone that never stopped ringing rather than concentrating on her job.  We (with the support of a medical consultant) were begging for a ward clerk. Again.

*update, they gave us two part time clerks dressed in scrubs who sit in front of the nurse's station painting their nails and telling dirty stories. They only work 4 hours a day. Part timers from the job centre.  They don't answer the phone either.
8. "I don't know anything about a staffing problem with Nurses. "............said by our Chief executive publicly one year and 147 short staffing incident forms after I started this blog and 1 day after the press picked up on what is going on here.  It was a few months after the recruitment freeze on Nurses and the hiring drive for untrained ward assistants on minimum wage instead.

9. " Untrained Care assistants are Nurses too and as long as they are there you are not short staffed"............said by Chief Nurse (ancient trained) after I complained about being the only trained nurse for 20 patients with no one to help but a 17 year old child ward assistant who has never even thought about attending nursing school or any kind of training.  That shift was so bad.  Half of those patients didn't have life saving orders given by doctors implemented that shift because I was overwhelmed.  And I ran my ass off for 12 hours non stop.  Not one cup of tea, not one pee break. Got screamed at by consultants for stuff not being done too.  Thanks for your support and understanding, asshole.

10. "The Nurses aren't taking care of my gran" and "The Nurses don't bother to answer the phone"....said by an idiot relative who likes to call the ward 5 times an hour and get her entire sibling set to do the same.  All 9 of them.  I can either take your idiotic phone calls all the time OR I can see to the patients.  Doing both is physically impossible.

11. "Nurse I need you to stay with me uninterrupted for 10 minutes while I do this procedure. NOW."....said a by a registrar to me, after he showed up on the ward without warning to do a procedure.  This was his greeting. The procedure was routine and non urgent.

12"And just how the fuck do you want me to do that?  I am the only Nurse for 19 patients, 10 of them have family members up my ass and hostile over stupid shit. My patient in 4 has blood shooting out of his mouth and rectum and no IV access, two of my dementia patients are on the floor and one is spreading shit up the wall causing other patients to scream, the detoxer is trying to beat the care assistant with a drip stand, the phone is ringing off the hook.  I have people on 4 hourly IV antibiotics that have been missing doses all day, I have patients who are on IV fluids whose bags have been dry for hours with urinary outputs dropping off and AAU are sending me three admissions.  Oh and there are 3 other doctors here wanting the same thing from me for their patients.  Fuck off out of my way NOW...............said by me to the Registrar in number 10 as I pushed past him and ran to the bleeder.  That was my greeting.

13. We are the real nurses here because we do bed baths.....said by a ward assistant.  The fuck you are.   I have been running my ass off for hours managing hundreds of meds, drips, problems, etc etc while you did a few bedbaths between playing on your mobile and having fag breaks.  Since you are not a nurse you cannot help me with the 6 IV meds due in the next 15 minutes, the phone calls, the orders, the treatments, the assessments, the admits and discharges etc.  Seriously.  Just bite me. 

14. "Tough shit, I only care about my father, your problems are your problems you slag".............said by a visitor after I told her that I could not come right now and fix her dad's blanket because I have a critically ill patient going south with a page and a half of doctor's orders that are complicated and needed to be implemented immediately as in 5 minutes ago.  She had grabbed my arm to ask me to fix her dad's blanket while I was running to the treatment room to get 02 masks and IV fluids.

15. "The treatment of my mother in this place is appalling.  You Nurses are pigs"...............................said by another happy visitor after I told her 24 stone mother that I could not lift her on my own and that I could not get her chocolate from the shop when she has a BM of 22 after insulin and is waiting to see if her legs need chopping off as a result of non compliance with her diabetes care.

16. "My taxes pay your wages"..............and what do my taxes pay for...the fucking boogeyman?  To be honest I don't think your taxes pay for shit. That is why I am working so many unpaid hours and being forced to take on more patients than I can handle while being denied resources.  It is why my workload triples just as I am getting a payfreeze.  We all pay taxes, you are not special. That is why I won't kill one patient to come and deal with your dad's non urgent need right now. Hell, even if your taxes did cover the cost of this shit (and they don't sunshine), I still wouldn't kill one person in order to deal with another's non urgent need.   You see love, missing a doctors order for a fast IV bolus of fluids because I am fluffing daddy's pillow could get a crashing patient killed and me in a whole lot of legal trouble.   You need to sit down and try to behave like a grownup.