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I wasn't for a second suggesting that bad practice should be taught. All I was trying to suggest was that what is taught should be really relevant to the practice of nursing,- not some fashionable waffle that will never aid a nurses practice. ( If you want to see a student nurses eyes roll, just try mentioning "models of nursing" or "the nursing process" ). As we all know, until ward based practice is improved(in all the ways you have very clearly elucidated ), patients will not receive the care they deserve and student nurses will contiue to experience extreme cognative dissonance between the classroom and the wards. Clarinda made a very good point regarding University involvement in clinical areas. We are told that practice should be based on evidence. Every time student nurses "report back to" ( or what ever term is current ) their university after some completely nightmarish placement their reports will add to what must surely be an already vast amount of evidence regarding the very poor standards of care they have experienced. It has long been taught that nursing must function according to professional, legal and philosophical priciples. If these principles are to have any meaning, is the university therefore not duty bound to attempt to influence the quality of care in the clinical areas? If a large part of the profession (ie. those preparing the registered nurses of the future) are indeed well aware of the problems we're discussing,why aren't they trying to do something about it? Is it not tragic that the "victims" of the current situation are the very patients our profession is meant to serve?bampotnoreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-79480848704807184362010-01-13T16:07:32.552-08:002010-01-13T16:07:32.552-08:00What Bampot, Are you suggesting that nursing educa...What Bampot, Are you suggesting that nursing education should teach the students how to take shortcuts and do everything in the 5 seconds you have between interruptions....or how to break every rule of nursing just to get your drug round done in less than 10 hours?<br /><br />Because it is so bad on the wards that is what you would have to teach them to prepare them for reality. In order for the universities to really tach "reality" they would have to teach the students some very bad things indeed. Things that are big no no's. <br /><br />People (university students included) become nurses because they want to care for patients not because they want to run around like a headless chicken barely accomplishing anything for 10 hours. Management is concerned about "productivity" they want the nurse to see 30 patients a second. That is what they see as efficient and cost effective.<br /><br />It's quite the opposite really.Nurse Annehttps://www.blogger.com/profile/05400048448105519082noreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-36308591915748792942010-01-13T15:55:25.920-08:002010-01-13T15:55:25.920-08:00Oh believe me anonymous I know that a junior doc&#...Oh believe me anonymous I know that a junior doc's life is chaotic hell. Bleep going off every 3 seconds for stupid shit that we have to call you for and all that.<br /><br />Bampot, I work with older nurses who trained when you did that don't know one end of the patient from another. It's not just new nurses. The new nurses I meet seem pretty on the ball, as much as anyone can be working in these hellish chaotic conditions.Nurse Annehttps://www.blogger.com/profile/05400048448105519082noreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-60976261816031267732010-01-13T13:34:27.882-08:002010-01-13T13:34:27.882-08:00One of the main issues you mention throughout your...One of the main issues you mention throughout your blog explains some of the issues between medical and nursing staff. That is staffing. Doctors, certainly in the junior grades would like to spend more time of the ward, would like to manage patients and would like to have a good nurse who knows the patient with them. Unfortunately, with the many patients we have we spend a great deal of time on "clerical" tasks be they making endless phone calls (usually engaged or not answered), writing TTOs and filling out endless blood request forms. This limits the time we can spend getting to know what's going on with a patient. Add this to the fact that on call we have to cover wards and patients who may have been in hospital for weeks with many developments but who we have never met and who the nurse knows exist, but even with the best will in the world cannot keep up with and you have conflict. And I can't believe I'm saying this, but spare a thought for the Consultants. While they're moaning and whinging at juniors and the nursing team a lot of the time it is because some mysterious office person has their balls in a vice (those balls have been too crushed to stand up for us btw). Being still relatively junior I started work just before European Work Time, but I do have (providing it is sensibly regulated) some fantasy that nurses would be able to call "their" doctors and doctors would be able to rely on "their" nurses. <br /><br />I've been an a***hole to some nurses before and I'd say the majority of times it has been because both of us are rushed off our feet and damn frustrated that neither of us can do our job as well as we would like. Working (for a short time) in a non ward branch of medicine has led me too be so much nicer to people. Unfortunately, the work on the medical ward it what really excites me.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-30100717720434317652010-01-13T08:18:17.822-08:002010-01-13T08:18:17.822-08:00Clarinda makes many accurate and pertinent points....Clarinda makes many accurate and pertinent points.I would suggest that the split (or should that be vast chasm?) that we now have between the universities and practice areas is not condusive to the provision of high quality nurse education. Unless there is a high degree of congruence between what is taught in the classroom and what they may experience in reality, then we are failing our student nurses. As Clarinda put it,"preparing students for slaughter at the workface". I have known many students who, after three years of training and through no fault of their own could tell you all you'd ever want to know about the menstrual habits of yak breeders in the Hindu Kush and yet hardly know one end of a patient from the otherbampotnoreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-7198751881446967482010-01-13T04:38:10.575-08:002010-01-13T04:38:10.575-08:00I'm with Clarinda. My nursing career began in ...I'm with Clarinda. My nursing career began in 1970 (Nursing Auxiliary). I became a Student Nurse in 1971, and qualified in 1974. At no time in my clinical nursing career did I see anything but mutual respect between doctors and nurses (incidents happened but in general that was true). I will never forget the evening when a consultant arrived on the ward to see a patient, found me (2nd year student, all alone on the ward, the staff nurse had gone to supper), behind the screens, washing an incontinent patient and changing his bed, and helped me to finish my patient before he went on to see his patient. I remember junior doctors as being responsive to requests for help and equally responsive to suggestions. As for now, well I expect appropriate behaviour from everyone I work with and I suppose I benefit from "age-related" authority!Brianhttps://www.blogger.com/profile/05139453606214695764noreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-78629586658302215982010-01-12T13:14:24.239-08:002010-01-12T13:14:24.239-08:00Hi Anne
I agree that at the moment all that peop...Hi Anne <br /><br />I agree that at the moment all that people care about is how to take the next 5% out of my budget. I have managed oncology, womens health and palliative care wards and what was needed on all of them was the correct skill mix not the cheapest. There are many efficiencies still to be made but non filling of vacancies is a crude and dangerous tool. Why is it that all the wrong people leave? <br />Good luckJohn the Managerhttps://www.blogger.com/profile/11200132172472555184noreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-76727773739340918092010-01-12T12:43:00.308-08:002010-01-12T12:43:00.308-08:00John,
That is a good point. All I know about pat...John,<br /><br />That is a good point. All I know about path lab is that they have long hours and multiple science degrees. <br /><br />I took micro at uni and we did some labwork--like staining and testing bacteria to see what it was....that was a long time ago and all I remember was that it was difficult!! Point is that I am indeed ignorant about path lab. I wouldn't want to work down there and make a mistake!!Nurse Annehttps://www.blogger.com/profile/05400048448105519082noreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-77921893756417030912010-01-12T12:39:04.933-08:002010-01-12T12:39:04.933-08:00That's an interesting perspective. You are o...That's an interesting perspective. You are one of the first older nurses to tell me that doctors were more respectful of nurses. What I have been hearing from relatives and friends who were nurses (and journalists who write about this stuff) is that the doctors were not respectful and could often be abusive towards the nurses. My godmother was a nurse in the 60's and 70's and she often tells story of physical violence she saw directed at nurses from doctors.<br /><br />But then again, you were there and I was not so I am MORE than interested in what you have to say.<br /><br />I have ragged on the medics on this blog just for kicks but I have insane amounts of respect for physicians. They have an extraordinarily difficult job and decisions to make. I'd hate medicine.Nurse Annehttps://www.blogger.com/profile/05400048448105519082noreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-2923199979975155102010-01-12T12:28:00.556-08:002010-01-12T12:28:00.556-08:00Hi Anne you should be so lucky try working in a Pa...Hi Anne you should be so lucky try working in a Path Lab nobody knows what we do, the only recognition in the media is 'get me a full blood count, U&Es and 6 units stat'John the Managerhttps://www.blogger.com/profile/11200132172472555184noreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-16748383759800612732010-01-12T12:17:26.439-08:002010-01-12T12:17:26.439-08:00Nurse Anne - I was in direct active clincal work f...Nurse Anne - I was in direct active clincal work from mid-60's until 2003 - and I therefore have the direct perspective of being subjected to a myriad of change, reform, 'modernisation' and too many other ravages of politico-managerialism that has obliterated the previous complimentary intra-professional working relationships of nurses, doctors and PAMS. You are, I'm afraid, incorrect in stating that doctors and nurses did not have a mutual respect for each other - I was there!<br />- as student nurses our Nemesis was more often the occasional Ward Sister whose charisma had been excised at birth.<br /><br />I note your RN career started in 1995?- I must inform you that the decline of nursing authority and leadership began in the mid-70's reaching terminal velocity in the mid-80s. It was utterly frustrating and demoralising to see nursing leadership and control handed to layers of non-clinical managers with our professional bodies stupefied in silent acceptance.<br /><br />I agree with you that it is totally unacceptable that to be a good nurse today depends more on determination, commitment and luck rather than design! I still maintain that university education in nursing ought to be more influential in the clinical area - it is hypocritical to prepare students for slaughter at the workface and relinquish responsibility on their graduation. In Scotland we have had nursing degree education for many years and although there will always be some disparity between pre and post registration education and employment, the patient is too important to be left in the tenuous hands of chance.Clarindahttps://www.blogger.com/profile/08189996558442989039noreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-70968603076388884772010-01-12T07:44:50.630-08:002010-01-12T07:44:50.630-08:00anne that is nice of you.........but i cant spell ...anne that is nice of you.........but i cant spell or use grammer and anyhow i am drunk a lot of the time so would be a liability. <br />i like you posts though i am just tired due to a stretch of long days. <br />will read it on nights (if i can get some zopiclone prescribed for the patients).capgrassnoreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-22915233946744402662010-01-12T04:22:45.010-08:002010-01-12T04:22:45.010-08:00Capgrass, I mean this in the nicest way: Why don&...Capgrass, I mean this in the nicest way: Why don't you do a guest post for this blog. Show me how it should be done! ;)Nurse Annehttps://www.blogger.com/profile/05400048448105519082noreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-57532270503826738952010-01-12T04:15:04.075-08:002010-01-12T04:15:04.075-08:00Yes I am definitely long winded.
Have I not menti...Yes I am definitely long winded.<br /><br />Have I not mentioned Filipino nurses before? I have only ever worked with two of them but they were fantastic.Nurse Annehttps://www.blogger.com/profile/05400048448105519082noreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-67288367511650148592010-01-12T04:07:15.841-08:002010-01-12T04:07:15.841-08:00sorry but i am not even going to read the above po...sorry but i am not even going to read the above post. Its just too long!<br />Anne you have an important message to blog about. However you got to get the art of saying it is about 120 words. like India Knight on Twitter.<br />big long speils are just too off putting to anyone who works at the coal face like i do also why you never ever mention the quiet hard working "you say jump i say how high" Filapino nurses. who are obedient to the point of cruelty sometimes. (got the inappropriate use of non-invasive ventilation (cpap and bipap) is a terrible way to die for many medical patients with copd on poorly staffed wards.capgrassnoreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-34563476010745592292010-01-12T00:22:07.297-08:002010-01-12T00:22:07.297-08:00Most of the nurses I work with are pre-project 200...Most of the nurses I work with are pre-project 2000. And they can't cope with the current environment either.Nurse Annehttps://www.blogger.com/profile/05400048448105519082noreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-23284104195807139922010-01-12T00:07:01.544-08:002010-01-12T00:07:01.544-08:00Project 2000 has nothing to do with anything. Uni...Project 2000 has nothing to do with anything. Universities do not turn out bad nurses. Quite the opposite actually.<br /> If they have attitude it's because of the hellish working conditions that exist these days rather than some attitude they developed from university.<br /><br />So Clarinda, I completely disagree with you. I don't think a nurse who hasn't practiced since the 70's could cope on the wards now. It's a lot different.<br /><br />Nurses need to be trained in universities. But I do agree that their programs have too much in the way of soft sciences. However they have lots and lots of time on clinical placements too now. They do shift after shift on the ward but the quality of those placements are terrible because of the chaotic environment.<br /><br />No the doctors did not respect you back in the day. <br /><br />And I work with many many new grad nurses who are excellent.Nurse Annehttps://www.blogger.com/profile/05400048448105519082noreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-80242410994064261742010-01-11T23:12:49.447-08:002010-01-11T23:12:49.447-08:00To some extent the nursing profession have brought...To some extent the nursing profession have brought this upon themselves, one teaching hospital I worked on the nursing staff wouldn't even reply to my cheery "good morning". Then came project 2000 and this type of attitude spilled over to the local DGH.<br /><br />Cardiac Arrest was very "raw" as commented in the post above, but from a junior doctor's perspective, it was spot on. Written by a junior doctor about true stories, yes those things all actually happened, albeit his medical career was short lived.<br /><br />In GP land we work very closely with our Practice Nurses who are invaluable and very respected part of the team, shame there isn't more teamwork in hospitals.Doc Dochttps://www.blogger.com/profile/10301757544726737234noreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-29635989901337381872010-01-11T16:47:03.179-08:002010-01-11T16:47:03.179-08:00In my day the bad nurse stood out now it's the...In my day the bad nurse stood out now it's the good nurse who does?<br /><br />Sadly what there are more of than anything today is the indifferent nurse whether by nature or nurture. <br />The standard of many university nursing degree programmes is pretty poor (far too much emphasis on the soft 'sciences' and 'management' styles etc. rather than more concentration from able teachers with an understanding of the necessary and sufficient experience to enable and inspire their students to learn and apply their life sciences knowledge base)- with too many students struggling to string a sentence together or understand fundamental life science processes to the point where they can integrate the theory with the clinical nursing needs of the patient. <br /><br />My training and education in the late 60s in Scotland would put many so called degree programmes today to shame - I should know as I was a Senior Charge Nurse in Critical Care, a Clinical Tutor in Critical Care before becoming a university lecturer and academic programme leader for post registration nursing degrees in a career lasting over some 40 years.<br /><br />In that time the excellent relationship between the medics and nurses was destroyed by a load of codswallop from the new nursing hierarchy of frigid feminists determined to split nursing away into becoming an autonomous profession. This had the unfortunate side-effect (one of many) of demoting nursing in the eyes of the brave new world of management - where before nursing held sway with their medical colleagues in the board-rooms! The previous power, authority, goodwill and respect that nursing had to promote and assure maximal attention to the criteria to sustain patient nursing care was laughed out of the thickly carpeted NHS managerial suites.<br /><br />Matron did not act alone - she (always!) had a robust coterie of Deputies, Assistants, the redoubtable Ward Sisters and Senior Staff Nurses (no letters of the alphabet then!)that acted as a co-ordinated nursing ethos and examplar throughout the hospital.<br />This power-base along with the medical power-base has been systematically razed by politico-managerialism. So in fact it was the new breed of nursing leaders who have caused most of the damage to nursing and it's little wonder that medics are regarded too frequently as the opposition rather than our professional partners.<br /><br />For your information research (I could find the reference with more time)demonstrates that when you presume medics spent very little time in direct face to face contact with patients on the ward - nursing contact on an individual basis is frequntly even less - don't mix shift hours with contact time. <br /><br />I must say I've only just found your blog but I will be reading it from now on as I agree - as a "dinosaur" with many of your points. Do remember dinosaurs could give many modern beasts today a good run for their money!<br /><br />I agree with DocDoc that although the series Cardiac Arrest was pretty close to the actual bone - it was perhaps a little too raw for public viewing where it might have been taken too easily out of context and therefore did little to distinguish the nursing profession when it was also being attacked from within its own senior ranks.Clarindahttps://www.blogger.com/profile/08189996558442989039noreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-29900622357380617682010-01-11T12:29:14.470-08:002010-01-11T12:29:14.470-08:00On the whole you are right that doctors don't ...On the whole you are right that doctors don't appreciate nurses, which is a big shame. I'd like to think that the negative attitude will disapear towards nurses, most of my fellow medical students seem to appreciate and respect the work done by nurses. <br /><br />The media like to portray nurses as evil scumbag, who cant be bothered to talk properly to patients or relatives, or who leave patients with food going cold. They never consider that the poor nurse would love to spend more time with patients (often the reason they went into nursing to start with), but they cant as there simply are'nt enough of them<br /><br />Unfortunately a nurses job is only going to get harder, HCAs are going to be pushed more and more as they are cheaper and an ageing population means multiple drug regimes etc etc.Fuddled Medichttps://www.blogger.com/profile/01745789223098027251noreply@blogger.comtag:blogger.com,1999:blog-6277229251527832949.post-751808622607062012010-01-11T10:46:31.247-08:002010-01-11T10:46:31.247-08:00Bloody hell I can't type for shit. I need a p...Bloody hell I can't type for shit. I need a proofreader.Nurse Annehttps://www.blogger.com/profile/05400048448105519082noreply@blogger.com