For some reason I woke up this morning thinking about something that happened years and years ago.
It was around the time I first went to a medical ward. The nu-labour targets hadn't messed up everything yet. And our staffing was pretty good.
I worked a late shift on a 25 bed ward and there was 4 of us staff nurses and 2 care assistants for the ward.
One of my patients started with maleena and massive amounts of coffee ground vomit. She was only in her 40's or 50's. We swung into action. She was becoming unresponsive. This is a GI bleed and it is life threatening.
Two of us (staff nurses) focused on her. The other two staff nurses managed the rest of the ward and deal with all the other patients. The medic was straight on the job and after he took one look at her the reg was there as well. This happened right before visiting hours. Her family arrived to see her in a hell of a state. I briefly and gently explained to them what was happening. One of the HCAs took the family down to the day room and made them tea,coffee and comfort food and stayed with them.
The doctors were throwing out orders left and right. And the other staff nurse and I dealt with it quickly and efficiently. Diagmostic tests, blood, IV's you name it we sorted it. And we managed to keep her clean and comfortable despite the fact that she had a massive gastrointestinal bleed that was causing bloody shit to poor out of her bottom and bloody puke to come out of her mouth constantly.
She survived. As a matter off fact she walked out of the hospital a week or so later.
I was so proud of the doctors, the nurses and how well everyone dealt with the situation.
I miss those days.
This Angel is pissed off. I'm Nurse Anne and I work on large general medical ward in the NHS. These are the wards with the most issues surrounding nursing care. The problems are mostly down to intentional understaffing by hospital chiefs that result in a lack of real nurses on the wards. "The martyr sacrifices themselves entirely in vain. Or rather not in vain, for they merely make the selfish more selfish, the lazy more lazy and the narrow more narrow"-Florence Nightengale
In an atmosphere if universal deceit telling the truth is a revolutionary act. George Orwell.
Why has Nursing Care Deteriorated
Good nurses are failing every day to provide their patients with a decent standard of care. You want to know what has happened? Read this book and understand that similiar things have happened in the UK. Similiar causes, similiar consequences. And remember this. The failings in care have nothing to do with educated nurses or nurses who don't care. We need more well educated nurses on the wards rather than intentional short staffing by management.
http://www.amazon.co.uk/Nursing-Against-Odds-Stereotypes-Undermine/dp/080147292X/ref=sr_1_1?ie=UTF8&s=books&qid=1263123140&sr=8-1
http://www.amazon.co.uk/Nursing-Against-Odds-Stereotypes-Undermine/dp/080147292X/ref=sr_1_1?ie=UTF8&s=books&qid=1263123140&sr=8-1
About Me
- Nurse Anne
- I am a university educated registered nurse. We had a hell of a lot of hands on practice as well as our academic courses. The only people who say that you don't need a brain or an education to be an RN are the people who do not have any direct experience of nursing in acute care on today's wards. I have yet to meet a nurse who thinks that she is above providing basic care. I work with nurses who are completely unable to provide basic care due to ward conditions. I have lived and worked in 3 countries and have seen more similarities than differences. I have been a qualified nurse for nearly 15 years. I never used to use foul language until working on the wards got to me. It's a mess everywhere, not just the NHS. Hospital management is slashing the numbers of staff on the ward whilst filling us up with more patients than we can handle... patients who are increasingly frail. After an 8-14 hour shift without stopping once we have still barely scratched the surface of being able to do what we need to do for our patients.
My Favourite Posts
Are all those nurses on the ward really nurses? Not by a long shot.
Safe Staffing Testimony videos .
Why do nurses need degrees?
Fighting back against the Media
Why do Patients starve in hospital?
Why do the elderly suffer the most?
Where is Matron?
The Times is full of it
The Times doesn't know anything about Nursing
What happens when people complain?
Staffordshire
Did University training pull student nurses off of the wards? NO.
Things I WOULD LOVE TO TELL PATIENTS AND RELATIVES AND GET A AWAY WITH IT.
Nurse Anne's Information Pamphlet for Hospital patients and Relatives.
Safe Staffing Testimony videos .
Why do nurses need degrees?
Fighting back against the Media
Why do Patients starve in hospital?
Why do the elderly suffer the most?
Where is Matron?
The Times is full of it
The Times doesn't know anything about Nursing
What happens when people complain?
Staffordshire
Did University training pull student nurses off of the wards? NO.
Things I WOULD LOVE TO TELL PATIENTS AND RELATIVES AND GET A AWAY WITH IT.
Nurse Anne's Information Pamphlet for Hospital patients and Relatives.
Quotes of Interest. Education of Nurses.
Hospitals with higher proportions of baccalaureate-prepared nurses tended to have lower 30-day mortality rates. Our findings indicated that a 10% increase in the proportion of baccalaureate prepared nurses was associated with 9 fewer deaths for every 1,000 discharged patients."...Journal of advanced nursing 2007
THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES
Dr. Linda Aiken and her colleagues at the University of Pennsylvania identified a clear link between higher levels of nursing education and better patient outcomes. This extensive study found that surgical patients have a "substantial survival advantage" if treated in hospitals with higher proportions of nurses educated at the baccalaureate or higher degree level.
THIS MEANS WE NEED WELL EDUCATED NURSES AT THE BEDSIDE NOT IN ADVANCED ROLES
Dr. Linda Aiken and her colleagues at the University of Pennsylvania's Center for Health Outcomes and Policy Research found that patients experienced significantly lower mortality and failure to rescue rates in hospitals where more highly educated nurses are providing direct patient care.
Evidence shows that nursing education level is a factor in patient safety and quality of care. As cited in the report When Care Becomes a Burden released by the Milbank Memorial Fund in 2001, two separate studies conducted in 1996 - one by the state of New York and one by the state of Texas - clearly show that significantly higher levels of medication errors and procedural violations are committed by nurses prepared at the associate degree and diploma levels as compared with the baccalaureate level.
Registered Nurse Staffing Ratios
International Council of Nurses Fact Sheet:
In a given unit the optimal workload for a registered nurse was four patients. Increasing the workload to 6 resulted in patients being 14% more likely to die within 30 days of admission.
A workload of 8 patients versus 4 was associated with a 31% increase in mortality. (In the NHS RN's each have anywhere from 10-35 patients per RN. It doesn't need to be this way..Anne)
Higher registered nurse staffing levels resulted in reduced numbers of urinary tract infections, pneumonia, upper gastrointestinal bleeding and shock in medical patients and lower rates of "failure to rescue" and urinary tract infections in major surgery patients.
Thirteen separate studies on nursing care in the late 1980s and early 1990s analyzed by Patricia Prescott,
RN, Ph.D. in late 1993 documented a direct correlation between safe staffing levels and lower mortality
rates and other related patient outcomes.......
Registered Nurses in NHS hospitals usually have between 10 and 30+ patients each on general wards.
Earlier in the year, the New England Journal of Medicine published results from another study of similar genre reported by a different group of nurse researchers. In that paper, Needleman et al3 examined whether different levels of nurse staffing are related to a patient’s risk of developing complications or of dying. Data from more than 5 million medical patient discharges and more than 1.1 million surgical patient discharges from 799 hospitals in 11 different states revealed that patients receiving more care from RNs (compared to licensed practical nurses and nurses’ aides) and those receiving the most hours of care per day from RNs experienced fewer complications and lower mortality rates than those who received more of their care from licensed practical nurses and/or aides. Specifically for medical patients, those who received more hours per day of care from an RN and/or those who had a greater proportions of their care provided by RNs experienced statistically significant shorter length of stay and lower complication rates (urinary tract infections, gastrointestinal bleeding, pneumonia, cardiac arrest, or shock), as well as fewer deaths from these and other (sepsis, deep vein thrombosis) complications
In a given unit the optimal workload for a registered nurse was four patients. Increasing the workload to 6 resulted in patients being 14% more likely to die within 30 days of admission.
A workload of 8 patients versus 4 was associated with a 31% increase in mortality. (In the NHS RN's each have anywhere from 10-35 patients per RN. It doesn't need to be this way..Anne)
Higher registered nurse staffing levels resulted in reduced numbers of urinary tract infections, pneumonia, upper gastrointestinal bleeding and shock in medical patients and lower rates of "failure to rescue" and urinary tract infections in major surgery patients.
Thirteen separate studies on nursing care in the late 1980s and early 1990s analyzed by Patricia Prescott,
RN, Ph.D. in late 1993 documented a direct correlation between safe staffing levels and lower mortality
rates and other related patient outcomes.......
Registered Nurses in NHS hospitals usually have between 10 and 30+ patients each on general wards.
Earlier in the year, the New England Journal of Medicine published results from another study of similar genre reported by a different group of nurse researchers. In that paper, Needleman et al3 examined whether different levels of nurse staffing are related to a patient’s risk of developing complications or of dying. Data from more than 5 million medical patient discharges and more than 1.1 million surgical patient discharges from 799 hospitals in 11 different states revealed that patients receiving more care from RNs (compared to licensed practical nurses and nurses’ aides) and those receiving the most hours of care per day from RNs experienced fewer complications and lower mortality rates than those who received more of their care from licensed practical nurses and/or aides. Specifically for medical patients, those who received more hours per day of care from an RN and/or those who had a greater proportions of their care provided by RNs experienced statistically significant shorter length of stay and lower complication rates (urinary tract infections, gastrointestinal bleeding, pneumonia, cardiac arrest, or shock), as well as fewer deaths from these and other (sepsis, deep vein thrombosis) complications
RN's spend less time on the basics these days. Why?
They can't help it.
Patients today have much higher acuity, yet the skill levels of staff have declined as hospitals insist on replacing trained nurses with unlicensed assistive personnel. The registered nurse still is responsible for everything. He just covers a much larger, and sicker group of patients than his colleagues of yesteryear.
•Lower levels of hospital registered nurse staffing are associated with more adverse outcomes such as Pneumonia, pressure sores and death.
•Patients have higher acuity, yet the skill levels of the nursing staff have declined as hospitals replace RN's with untrained carers.
•Higher acuity patients and the added responsibilities that come with them increase the registered nurse workload.
•Avoidable adverse outcomes such as pneumonia can raise treatment costs by up to $28,000.
•Hiring more RNs does not decrease profits. (Hospital bosses don't understand this. They think that they will save money by shedding real nurses in favour of carers and assistants. The damage done to the patients as a result of this costs more moneyi.e expensive deaths, complications,and lawsuits, and complaints....Anne)
Patients today have much higher acuity, yet the skill levels of staff have declined as hospitals insist on replacing trained nurses with unlicensed assistive personnel. The registered nurse still is responsible for everything. He just covers a much larger, and sicker group of patients than his colleagues of yesteryear.
•Lower levels of hospital registered nurse staffing are associated with more adverse outcomes such as Pneumonia, pressure sores and death.
•Patients have higher acuity, yet the skill levels of the nursing staff have declined as hospitals replace RN's with untrained carers.
•Higher acuity patients and the added responsibilities that come with them increase the registered nurse workload.
•Avoidable adverse outcomes such as pneumonia can raise treatment costs by up to $28,000.
•Hiring more RNs does not decrease profits. (Hospital bosses don't understand this. They think that they will save money by shedding real nurses in favour of carers and assistants. The damage done to the patients as a result of this costs more moneyi.e expensive deaths, complications,and lawsuits, and complaints....Anne)
Contact Me
Posts
Followers
Very Cool Blogs:
Blog Archive
-
▼
2011
(24)
-
▼
January
(16)
- What it is like.
- Had a Blast on the Surgical Ward. part 2
- Had a Blast on the Surgical Ward.
- Judith Potts is at it again
- Managers who support the pay freeze:
- Ward Nurse Suspended...
- Another article on Hospital care.
- Hold me Back
- Housekeeper hell
- No unsocial hours pay.
- Wow Peter.....
- Memories
- Conversation with a Moron
- Poor Child.
- Great Post over at Mental Nurse...
- How Sweet
-
▼
January
(16)
Disclaimer
I know I swear too much. I am truly very sorry if you are offended. Please do not visit my blog if foul language upsets you. I want to help people. That is why I started this blog and that is why I became a Nurse. I won't run away from Nursing just yet. I want to stick around and make things better. I don't want the nurses caring for me when I am sick working in the same conditions that I am.
Of course this is all just a figmant of my imagination anyway and I am not even in this reality. Or am I?
Any opinions expressed in my posts are mine and mine alone and do not represent the viewpoint of the NHS, the RCN, God, or anyone else.
Patient confidentiality will not be breached in this blog.
Of course this is all just a figmant of my imagination anyway and I am not even in this reality. Or am I?
Any opinions expressed in my posts are mine and mine alone and do not represent the viewpoint of the NHS, the RCN, God, or anyone else.
Patient confidentiality will not be breached in this blog.
Are YOU CRYING?
There is no crying. THERE IS NO GODDAMN CRYING IN NURSING .
13 comments:
Imagine if that happened today...and the 2 RNs did the same...worked as a team to ensure this lady survived.
Who would have looked after ALL of the other patients?!
No-one! So, one RN would have managed the emergency alone impossible if IVs and blood transfusion required)...and one RN would have looked after the other 28 patients (also impossible due to simple logistics!)
So, all in all, impossible all round!
One sick patient and everyone is in trouble!
ps I challenged your Anon moron to answer a few questions over at NT...
You are correct UKnurse.
The one Nurse might of busted her ass to save the critical patient's life but she sure would have had a lot of apologising to do to the other patients. LOL.
I'm dissapointed that I won't qualify and be able to work in environments like this. It's heartbreaking, actually. I'm dissapointed as well that patients don't get this kind of care anymore, through no fault of the nurses or medics.
Anne, I'm gonna to derail your memories to say I've just seen this:
http://www2.skynews.com.au/health/article.aspx?id=559921&vId=
And that is awesome. Why can't our unions do something productive like that?
Great link.
As far as I am concerned the public of this country can do one of two things:
They can support Nurse to Patient ratio legislation.
OR
They can SHUT THE FUCK UP about waiting 3 hours for pain killers and not being able to use nurses as maidservants to fetch them snacks, etc.
If your nurse has too many patients she is barely going to be able to catch serious changes in condition and action doctors orders for all of you. She will make drug errors because she is rushing around.
You may think that she damn well better get you a cup of coffee if you ask for it because "your taxes are paying her wages".
But you can bet your ass that there is a coronor just around the corner waiting to shop her and criminalise her for not prioritizing properly when she didn't catch onto blood results promptly because she was fluffing someone's pillow.
Support safe ratios or die. Literally. Support safe ratios or stopping bitching about the Nurses.
That would be my RCN bulletin to the public.
Hey Anne, any time you feel like you might be willing to defect to the US and get away from NHS, just let me know. Hell, I'd probably sponsor you myself if we could get you on my floor. We don't generally have mandated staff ratios, but they're never that bad. At least no where I've ever worked. Fancy working cardiac?
Thank you so much JG.
I might actually have a job lined up over there. The visas and sponsership are no problem. The problem we are having is the real estate market. People giving offers on the house and then pulling out at last minute etc. Buyers unable to get a mortgage etc.
I decided not to tell you all I am going going gone until I am over there and working. We have just met too many obstacles along the way (real estate). So many times I have said "okay I am out of here" only to be stopped in my tracks.
Hope things turn out ok this time Anne. We are also leaving the UK due to my husbands job (Canada). I've started applying for nursing exams etc but to be honest I'm not that bothered anymore. Sad to say the UK has nearly finished me off.
ICU has always had better nurse to patient raios but we still have situations arise because we all have a patient (or 2 if its HDU) and no one is free to be the runner. I also remember when medical wards had adequate staffing. Problem is that medical wards are black holes, literally sucking life and money. Surgery can make a profit so most foundation trusts are staffing surgery at medicines expense. The young and fit rarely have any reason to visit a hospital, it's only the chronically sick and the old that end up on medical wards and who cares about them? I've emailed my MP and the so-called chief nursing officer about ratios and to date have not received a reply...big fat suprise!
They replied to my emails by saying that I need to tell this to my line manager!! Duh, we have aleady done that 10000 times.
uknurse is so right!!! our services and efficiency are greatly affected by the lack of staff!
This can't really have effect, I think like this.
oakley sunglasses, michael kors outlet, nike free, oakley sunglasses cheap, christian louboutin shoes, michael kors outlet, louis vuitton outlet, nike shoes, air max, kate spade outlet, polo ralph lauren outlet, true religion jeans, longchamp handbags, burberry outlet, louboutin outlet, gucci outlet, air max, michael kors outlet, longchamp outlet, louis vuitton outlet stores, oakley sunglasses, tory burch outlet, louboutin, longchamp handbags, coach purses, coach factory outlet, kate spade handbags, ray ban sunglasses, jordan shoes, louis vuitton, coach outlet, louis vuitton outlet, michael kors outlet, louboutin, ray ban sunglasses, michael kors outlet, chanel handbags, coach outlet store online, tiffany and co, burberry outlet, michael kors outlet, prada handbags, polo ralph lauren outlet, louis vuitton handbags, tiffany and co, prada outlet, true religion jeans
barbour, ugg pas cher, vans shoes, instyler, nfl jerseys, herve leger, wedding dresses, ugg boots, celine handbags, longchamp, marc jacobs, ghd, new balance shoes, lululemon outlet, soccer jerseys, beats by dre, ugg australia, chi flat iron, ferragamo shoes, ugg boots, mcm handbags, canada goose, birkin bag, bottega veneta, north face outlet, insanity workout, nike huarache, p90x, nike trainers, asics running shoes, canada goose outlet, mont blanc, uggs outlet, valentino shoes, nike roshe, giuseppe zanotti, canada goose jackets, abercrombie and fitch, north face jackets, nike roshe run, reebok outlet, rolex watches, mac cosmetics, jimmy choo outlet, babyliss pro, soccer shoes, hollister, ugg
Post a Comment