Tuesday 31 August 2010

Um. What does this tell you?


The number of nursing vacancies has fallen by nearly 40 per cent in the last year, according to data gathered by Nursing Times.

The figures, together with new data from the NHS Information Centre, have fuelled fears that NHS trusts are freezing vacancies, are not replacing nurses and are converting posts to lower grades in order to tighten budgets.

Shock horror. Yawn.


Eleven nurses and 21 healthcare assistants have been forced to retire by an East Midlands primary care trust despite the government’s plans to scrap the default age for retirement from October next year.

RCN Scotland has said policies such as freezing posts and not replacing people who leave mean newly qualified nurses and midwives are struggling to find jobs in the NHS. The union has warned “unsustainable tactics” are being used by health chiefs struggling to cut costs, and called for more to be done to protect frontline services. It added the decisions could have “devastating consequences” for patient care in the future.
Remember this my dear reader: This has gone nationwide.  And it has been going on for a hell of a long time.My trust still hasn't hired any nurses.  But they have been advertising for management posts with stupid names and "champions" on salaries around £130,000 a year.

Wednesday 4 August 2010

Dame Christine Beasley

So who thinks that she would grant this site an exclusive interview?

Anyone?  You can place your bets in the comments section.

I am going to try both Chrissy and Peter Carter.

I have some nice questions in mind.  Add your questions below.


Tuesday 3 August 2010

Charlotte Gets Yelled at For Feeding a Patient.

Charlotte is a colleague of mine who is excellent at her job.  She completed her training at University about 6 years ago. She is a wonderful bedside registered nurse.  She really stays on top of things and will work a 14 hour day without a break to do her best to ensure that the patients all receive their treatments and orders.

Like the rest of the RN's on the duty roster Charlotte often finds herself as the lone RN for 19 patients when she is on shift.  She may have one or two apprentices to help.

Just mixing preparing and administering all of the drugs due at 8AM takes until way past lunch time when you are the lone Nurse for 19 patients.

 Not only is medication administration complicated and time consuming but the lone RN will be constantly interrupted by doctors, relatives, patients, pharmacy, social services, path lab etc etc during her attempts to get her patients their first lot of drugs for the day along with a basic nursing assessment.   There is no break, no let up from these interruptions.

 The apprentices can neither continue with the drugs or deal with the interruptions.  Many medics will show up during this time and demand that the Nurse abandon her patients to follow them around on a doctors round for an hour.  The doctors don't care if patients don't get their ordered treatments or get cared for by an RN.  They just like to monopolise the Nurse's time for the sheer fun of it.  It takes until lunchtime for Charlotte to see each patient once and administer the drugs due at 8AM.  And that is if you keep it to two minutes with each patient and then run off.

On Tuesday morning Charlotte was receiving handover from the Night Nurse.  11 out of 19 of Charlotte's patient's that day were going to be unable to feed themselves.  Charlotte hauled ass that morning.  She took short cuts with the drugs and ignored the phone calls from families.  This was the only way she would get to a point where she could obtain the ability to feed all of her patients at lunchtime. 

Noon rolls around.  Both apprentices are off the ward escorting patients to diagnostic tests leaving Charlotte trying to feed 11 people by herself simultanously while handling everything else that is going on for those 19 people.  She was grateful that no one was really poorly at that time and that the high priority things (blood transfusions, life saving drips that need to be put together and administered) were under control by noon. 

She happily commenced a serious and whole hearted attempt to feed her 11 patients.  She started with the first two patients who were next to eachother and tried to feed them at the same time while telling the patient across the bay that she would be there to help as soon as she could.

Enter Doctor Hellboy.  He has been told repeatedly not to show up at lunch time to do his rounds so that the Nurses can feed the patients.  When a doctor arrives to do rounds he pulls the Nurse away from whatever she is doing for a good hour and a half. But Doctor Penisbreath has a lot of patients to see and not a lot of time and it is very convienant for him to show up for rounds at lunch.

But he shows up at lunchtime anyway.  He doesn't care if patients get malnourished as long as they are not his patients.  He walked up to Charlotte as she was feeding her first two patients, snapped his fingers at her and announced " I am here for my rounds, come on now" and he walked away expecting Charlotte to follow him.   She did not.  She continued feeding her patients.  He went nuts on her. Absolutely nuts.

"How dare you refuse my ward round blah blah blah how can you know what the plan is with the patients if you don't attend the ward round blah blah blah".

Charlotte held her ground and was able to get most of her patients fed.

The funny thing about this particular consultant is that he has been overheard telling the complaining family of a malnourished patient "These Nurses today cannot be bothered feeding patients, they went to university you know".

What a cock eh?

Same guy declined to give his support to our ward sister when she made a case for getting extra RN's employed so we had enough to feed the patients and attend ward rounds.  Therefore we could know the "plan" with the patients and get them fed as well.  My ward sister was not only shot down on that request but the medical manager, chief nurse etc laughed in her face and told her she was "exagerrating the ward conditions".  None of these people have been on a ward in over 20 years.

I wouldn't bother posting this if it was a one off but the consultants are pretty much on my shit list this week for these same kinds of things.  And the next few posts will reflect that.

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:



Sunday 1 August 2010

Dear Mental Nurses, Doctors...anyone really

What the fuck is going on?  I need you to shed some light on something for me.

Why are GP's sending self harmers and anorexics who steadfastly refuse ALL TREATMENT as direct admissions onto medical wards?

These people have no medical issues. This is happening a lot lately.  I can understand an overdose needing IV parvolex but when they are purely mental health issues we cannot manage them.   We don't know what to do with them.  Psychiatry is refusing to take them over until we "force feed" these patients.  This is something medical doctors and nurses ARE NOT ALLOWED TO DO UNDER ANY CIRCUMSTANCES IN A DISTRICT GENERAL HOSPITAL AND WE DON'T MAKE THE LAWS.  We can't section them apparantly as they need to go to their previous psyche facilities for that.  News to me. We have resorted to begging these patients to eat, on our hands and knees.  This includes the chief exec visiting these patients and doing some begging.  The psyches won't take these patients over but will be taking the hospital to court if we don't "make" these people eat, stop threatening suicide etc etc etc.

Why the hell are the medical consultants getting this dumped on them?

The GP's are even sending people to AAU with "anxiety" and no other problems at all.  Even if we can get the psyches into see them (mission impossible on a good day), it could take over a week.  And medical patients die due to lack of beds, and getting discharged to early to free up more beds.

We have no RMN's on staff so basically we are up shit's creek.  The local psychiatric hospitals won't "get involved".

What am I missing here.  These patients definitely do NOT have medical issues.  No electrolyte imbalances yet.....or confusion related to infection.  Nothing like that. 

What is going on?

Will probably have to delete this.