Wednesday, 18 January 2012

A New Start

Hello!

Well I have been in the States for months now and still haven't bought a PC.  Blogging from a crappy tiny laptop notebook thing would probably cause me to loose my hair.  So I am finally going to buy a real desktop computer.

Is anyone even still interested in this Blog?  Should I let it die because I am no longer in the UK? Or do you want to hear some stories from the NHS frontlines that I never dared to post while I was actually physically present in England?

To be honest I was going to let it go.  But then David Cameron's comments about Nurse's doing hourly rounds nearly caused me to choke to death on my own vomit.

He doesn't seem to grasp that one qualified nurse to 15+ patients is not going to be able to get around to everyone she is responsible for in a 12 hour shift.   The only things she is going to be physically capable of handling are the most high priority doctors orders and tasks and emergencies.  Those things are not going to go away at any point in her shift so that she can round.

What Cameron won't admit is that the government has had hiring freezes on qualified nurses for years, decades even, and that the trusts are refusing to pay for more than one or two qualified nurses to staff  40 bedded wards for a 12 hour shift.   The acute medical wards have the sickest most complicated patients outside of critical care and also have the lowest staffing levels of qualified nurses in the hospital.  In addition to that acute medical wards are also bombarded with elderly patients who need one to one care in order to survive and be treated with dignity.  Bombarded is an understatement.  The system simply cannot cope with the growing population of dependment, medically complicated elderly.  It is the same here in the USA.

When qualified Nurses such as myself would call management crying and asking for help because patients were suffering we were told "tough" "not managements problem"  "not within budget" "you aren't getting any help, deal with it" "grow up" "put on your big girl knickers" etc etc etc.

When we would tell management that forcing qualified nurses to fill in hundreds of forms in order to obtain emergency transfusions, medications, labwork, diagnostics, and equipment stopped us from getting near our patients, we were told "tough".  If I had refused to fill in the forms in order to do a Cameron round on my patients I would have been held 100% responsible for any deaths that occured due to missed transfusions, medications, labwork, diagnostics and lack of equipment.  David Cameron knows that this is the situation.  He is not going to admit that government is NEVER going to finance the hospitals properly or force local managers to staff wards with enough qualified Nurses.  So he is trying to pass on the blame for neglect of patients and save his own skin by depicting Nurses as people who just don't care.    I would hope that the public isn't dumb enough to drink that Kool aid but comments I see in the papers make me despair.

In the early 90's hospitals had the bright idea of trying to control costs by reducing the number of qualified Nurses at the bedside.  The managers who control staffing and budgets are people with backgrounds in finance.  They are not people with a background in health care.  They do not understand how crucial qualified Nurses at the bedside are to patient outcomes.  These people also do not hold a license to practice in the way that a doctor or a qualified nurse does.  Therefore they cannot get held responsible for the lapses in care that are caused by their refusal to staff hospitals with enough qualified people.  They make a lot of money from forcing doctors and nurses to take on uncontrollable workloads and by replacing qualified staff with unqualified people.  And they are not the ones who get labelled as uncaring and incompetent by the papers, even though they have total and sole control. They even make it so bad that as a qualified nurse I cannot even control how long I spend with each patient, except to keep the time to less than a minute.  Junior doctors have it a lot worse when they are carrying the bleep for medicine.  

We do care.  But patients sure aren't going to see that side of us when we are prioritizing, overwhelmed, full of anxiety, hungry, exhausted, panicked and scared shitless. And angry.  We ARE ANGRY.  We are not angels, or superhumans or demons or anything else.  We are just plain people trying to do our best. Granted that health care professionals can handle a lot more than most people.  But we are by no means magical, perfect or superman.

When these finance cunts are told that patients are suffering and dying their response to the health care professionals is often "tough" "deal with it" and "sucks to be you, nursey".


Now who is uncaring?  The Nurses and the Doctors?  Don't think so. 

Caring with no control over the situation equals no care at all.  Your doctors and nurses care.  But they are simply cut off from time, resources, control and support from budget driven cunts with MBAs.

By the way, if you walk onto a ward and see support workers and secretaries sitting at the Nurse's station gossiping and cackling .......it is no indication of how busy the Nurses and Doctors are at that moment.  Unqualified staff cannot help us with most tasks. Just an FYI.

So yeah I was pretty sick over David Cameron's comments, enough to want to start blogging again.

My readers have probably all grown old and died by now ;).  But if anyone out there has looked at this, thanks for reading!

Anne

29 comments:

Doctor Zorro said...

Welcome back

ophine said...

Hi Nurse Anna!
Jo here from Manila, a newly registered nurse aspiring to work soonest in a hospital. Although it's tough to find one, I'm aiming for the best! Welcome back and keep blogging! =)

Anonymous said...

I'm so glad to see you're back, hope it's all going well for you in USA. I'm a nurse educator & before that was a community nurse, so many people leave the wards because it us intolerable & added to that is guilt for leaving people to their fate. Cameron disgusts me, my students are caring and idealistic but it beaks my heart to think how they will be ground down by the system. Good t hear you speaking out again .

Anonymous said...

Yes please do keep on writing!

Nurse Anne said...

I give your students 6 months on the job (if they get a job) before the suicidal ideations start.

My colleagues (the very few of us who were qualified nurses) used to play this game where we all drove to work without seatbelts on hoping that a car accident would kill or maim us enough to provide an escape from the hell. When we would all make it into work alive we would say "dammit, none of us lucked out today"

You think I am kidding? We literally were going crazy.

Nurse Anne said...

So lucky I was able to immigrate. Things are better here but all that is going to change real soon.

Also lucky for me is that my dad is established in the US and is grooming me to take over the family owned business and, get this, IT HAS NOTHING TO DO WITH HEALTH CARE!!!

I made an escape from the NHS and now the plan is to escape from health care all together before the babyboomers become elderly and overwhelm and destroy the system.


I need

Julie said...

Yay!! Militant Medical Nurse is back.We've missed you, Nurse Anna..

Anonymous said...

Please write all those NHS stories you couldn't before.
Thinking about going into nursing in order to emigrate!
Did you note the announcement yesterday on London training for nurses - focussing on empathy and compassion in recruiting trainees by cutting the numbers.
Poppy.

pj said...

More more!

You want to see the state of the mental health wards. Without even starting on the chronic lack of any dual trained nurses (which makes the junior doctors have to act as 'physical health' gimps because they are literally the only people on the ward with any knowledge of physical illness) the mental health nurses are in such short supply (being replaced by HCAs and 'mental health practitioners' whatever they are) that they have to spend all their time doling out the meds.

dr phil said...

Welcome back! One of my favourites was your post on matrons, two barrels between the eyes of all that is wrong with the addition of political meddling to healthcare.

Dr Phil

Nurse Anne said...

Link, Poppy, Link!!!

PJ, I can believe it about mental health nurses. The government gets away with it because the public is so ignorant about what a nurse is. Joe public things that if the ward employs a nice young lady with empathy who brings him cups of tea it means that he has "good nursing care". What does Joe understand about meds, doctors orders and nurse assessments for changes in condition? Nothing. Anyway I am sorry to hear that things are so shit in the mental health sector.

To the rest of you a big thanks. Now lets kick some ass.

Prisoner of Hope said...

I too am pleased that you may return to reflecting on you NHS experiences and look forward to you sharing thoughts that - even you - found difficult to share while still working in the UK. Welcome Back

Anonymous said...

Please post the stories you were afraid to post before. Please don't disappear yet.

GrumpyRN said...

Agree with above Ann, keep the posts coming.

Northern Doc said...

Welcome back and we are waiting with baited breath for more of your tales from the tombs in the NHS. Must be nice to be back in first world medicine ;).

HyperCRYPTICal said...

Yay you're back! 2012 is indeed a good year!

Can't wait for you to kick ass!

Anna :o]

Nurse Anne said...

USA first world medicine? HA HA HA HA HA HA HA.

Nah, it's a total clusterfuck. The ER sent me a patient who stopped breathing the second he hit my floor yesterday and someone else went to IR with a high INR because some lab results got switched.

Better staffing ratios but much sicker patients. And they don't let anyone die here. We have 103 year olds with dementia on the wards with cardizem drips and telemetry, central lines, and everything else. When the government pays (as they do with old people) the hospital milks the system for all they can get.

Its a clusterfuck, just a different kind of one.

tippy said...

I've thought of you often over the past few months, as nurses are being singled out to take the blame for our health system - and missed you! Welcome back, and please stay

Dr Aust said...

Welcome back.

Since you went off-line I've been wondering where to send my 1st yr B.Nursing students (sic) blog-wise so they can get an idea of what will be in store for them once they qualify...

Anyway, looking forward to more posts.

Conundrum said...

Followed you on Google Reader for quite some time, its good to see you pop up again. If you write it, I will read it.

Anonymous said...

So glad you are back, just clicked on my old "favourite" on the off chance and here you are. Looking forward to more tales of UK and US. Others on here in the UK might be interested to see More4 tonight a documentary promising to show what nurses really think . . . could be interesting.
Nurse Armadillo

Sue, UK said...

I'm glad you posted, hope all is well! Please keep posting.

Poster above- I watched that documentary and I'm not sure what to think yet. I need to watch the next couple in the series I think before I make up my mind if it's true to life or not. You can bet the hospitals chose the "best" wards for them to film in.

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Anonymous said...

Nurse Ann, don't leave us!

Please blog those posts you felt inhibited to whilst still working in the NHS....I think so many can relate to *wanting* to whistleblow but being too terrified about the potential consequences.

No-one wants to know. No-one.

Ben S said...

To echo the chorus - YES PLEASE TELL ALL!

I hope things are working out for you over there, and I hope you get time to write more - everytime a relative or friend would bitch about the NHS this is where i would send them, so the more the better. Must be good to be loved! (In fact Jobbing Doctor lamented the cessation of your blog just the other day...)

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