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I’m not being sarcastic and I’m not wishing to denigrate, but what do nurses actually do ?
Whilst I was in hospital, the nurses;
Took my blood pressure,
Took my temperature,
Changed my surgical stockings,
Changed my Saline drip,
Changed my bedding,
Administered injections,
Dealt with ‘bed-pan’ issues.
I had my medication given to me by specific, possibly senior, nurses.
I had my water-jug and meals brought to me by what appeared to be auxiliary staff or nurses.
Cleaning was by agency staff.
I was supremely grateful to each and every one of them for their kindness and care but it did set me thinking that I often hear about the hours of study, etc. that nurses are obliged to undertake.
However, none of the above activities seem to warrant such ‘study’; with a couple of hours instruction even I could become reasonably competent to perform them.
When it became apparent that there was a problem, the nurses were only able to alert a Doctor who then alerted a Surgeon who then alerted MY Surgeon. There was nothing ‘clinically’ that they could do without authority.
Would the wage-bill to the NHS be reduced if we were to revert back to the model of 50’s/60’s/70’s where nurses were enthusiastic and caring but essentially ‘non-medically trained’ ?
I’m sure that there is a bigger picture I am failing to see..............?
Whilst I was in hospital, the nurses;
Took my blood pressure,
Took my temperature,
Changed my surgical stockings,
Changed my Saline drip,
Changed my bedding,
Administered injections,
Dealt with ‘bed-pan’ issues.
I had my medication given to me by specific, possibly senior, nurses.
I had my water-jug and meals brought to me by what appeared to be auxiliary staff or nurses.
Cleaning was by agency staff.
I was supremely grateful to each and every one of them for their kindness and care but it did set me thinking that I often hear about the hours of study, etc. that nurses are obliged to undertake.
However, none of the above activities seem to warrant such ‘study’; with a couple of hours instruction even I could become reasonably competent to perform them.
When it became apparent that there was a problem, the nurses were only able to alert a Doctor who then alerted a Surgeon who then alerted MY Surgeon. There was nothing ‘clinically’ that they could do without authority.
Would the wage-bill to the NHS be reduced if we were to revert back to the model of 50’s/60’s/70’s where nurses were enthusiastic and caring but essentially ‘non-medically trained’ ?
I’m sure that there is a bigger picture I am failing to see..............?
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Would not have been like that if I was nurse in charge of a shift.... but one thing I will add most of the qualified nurse have to spend a lot of their time completing documents mostly relating to how patients are assessed risk management stuff mostly I left because I burned out but others have left because the art of nursing has been forced out to be replaced by policy driven nursing by numbers which is much closer to the american medical model that evolved to combat the tide of litigation.
I would have helped you eat Jack if no one else was free and remembered to help you wash your hands before...I do miss it sometimes
I would have helped you eat Jack if no one else was free and remembered to help you wash your hands before...I do miss it sometimes
I didn't even get a daily bed bath/wash until Mrs jth visited in the afternoon............
You see, Rowan, that's the sort of thing I mean.
I have no doubt that the NHS is choc-full of committed and caring staff; I also have no doubt that red-tape is also constraining staff.
However, as a 'customer' and lay-person it seems to me that there are many, many chiefs (mainly in admin.) and not enough indians who are prepared to undertake, as craft says, the basics of nursing.
You see, Rowan, that's the sort of thing I mean.
I have no doubt that the NHS is choc-full of committed and caring staff; I also have no doubt that red-tape is also constraining staff.
However, as a 'customer' and lay-person it seems to me that there are many, many chiefs (mainly in admin.) and not enough indians who are prepared to undertake, as craft says, the basics of nursing.
My husband has just had major surgery and I really can't complain at the treatment .Where we would have been without the specialist nurses , district nurses,DVT nurses ,urology nurses etc I really don't know .
However one thing I did notice and it is ongoing is the amount of paperwork they generate between them :)
Sometimes communication along the chain breaks down and I've had to run about with a phone clamped to my ear but on the whole I am eternally grateful to the NHS recently and my husband had really good care .
However one thing I did notice and it is ongoing is the amount of paperwork they generate between them :)
Sometimes communication along the chain breaks down and I've had to run about with a phone clamped to my ear but on the whole I am eternally grateful to the NHS recently and my husband had really good care .
I agree with you Jack, completely. During a lot of visits to hospital over the last couple of years, with both my mother and husband being very ill, I would say there is very little in the way of actual 'caring' duties being carried out, the nurses have taken on many of the roles of doctors and the 'minor' duties (for want of a better word because they are very important) are now not being done to satisfaction. I am not saying that the nurses aren't caring people, most of them are, but the system is all wrong. I would like to go back to the days where nurses cared for patients under the watchful eye of matrons.
My mother certainly didn't get much 'caring' at all, which is why I spent days and nights at the hospital with her. During that time I certainly did see a lot of hanging around at nursing stations and paperwork being filled in. The patients were sadly neglected on the caring front.
Definitely too many chiefs and not enough indians.
My mother certainly didn't get much 'caring' at all, which is why I spent days and nights at the hospital with her. During that time I certainly did see a lot of hanging around at nursing stations and paperwork being filled in. The patients were sadly neglected on the caring front.
Definitely too many chiefs and not enough indians.
Somewhere along the line -probably in the early 70s.- the nursing profession lost it's way. Hospital 'managers' suddenly proliferated and became the sole authority, superseding the exacting matrons of yesteryear.
Coinciding with this major downgrading of nurses came the laughable 'Nursing Process',
where trivia became de rigeur, to be recorded,and regarded as the compulsory way to proceed, regardless of common sense, clinical training or knowledge-base.
Then came 'Aims and Objectives', a hopelessly outdated behaviourist model , which suited the managers, but reduced all nursing activity to 'nursing by numbers'.
Rather rapidly, nurses became deskilled as they sought simplicity, thus avoiding technical complexity, and keeping the bureaucrats satisfied. Any departure from the rigid norms of bureaucracy could quickly result in disciplinary action. It became far safer to abandon all clinical skills lest they invited litigation and an irate management,
which had now established a dominating, and domineering, ethos throughout the hospital service.
Targets (i.e. Aims and Objectives) were set, irrespective of clinical need. Patients and nurses suffered as the overweening managers thrived on inflated salaries and positions at the head of all other hierarchies
Gone was the effective tripartite management of one Matron, one Physician Superintendent and one Hospital Secretary. Now bureaucracy rules, OK ?
The writer speaks as an ex Nurse Tutor, Principal Tutor, Lecturer, and Inspector of Nurse Training Schools. I was glad to retire........
Coinciding with this major downgrading of nurses came the laughable 'Nursing Process',
where trivia became de rigeur, to be recorded,and regarded as the compulsory way to proceed, regardless of common sense, clinical training or knowledge-base.
Then came 'Aims and Objectives', a hopelessly outdated behaviourist model , which suited the managers, but reduced all nursing activity to 'nursing by numbers'.
Rather rapidly, nurses became deskilled as they sought simplicity, thus avoiding technical complexity, and keeping the bureaucrats satisfied. Any departure from the rigid norms of bureaucracy could quickly result in disciplinary action. It became far safer to abandon all clinical skills lest they invited litigation and an irate management,
which had now established a dominating, and domineering, ethos throughout the hospital service.
Targets (i.e. Aims and Objectives) were set, irrespective of clinical need. Patients and nurses suffered as the overweening managers thrived on inflated salaries and positions at the head of all other hierarchies
Gone was the effective tripartite management of one Matron, one Physician Superintendent and one Hospital Secretary. Now bureaucracy rules, OK ?
The writer speaks as an ex Nurse Tutor, Principal Tutor, Lecturer, and Inspector of Nurse Training Schools. I was glad to retire........
Very true about the paperwork .We managed to fit in a blood test whilst waiting for a clinic appt a week or so ago .Scatterbrain (me) handed them the wrong form, so when they phoned me for dosages they said they couldn't give me a dosage that day due to the wrong form in spite of the fact it had DVT stamped all over it .But I said it was all the same blood from the same man .
The answer was a classic .
" Not without the correct form it isn't "
The answer was a classic .
" Not without the correct form it isn't "
Laughable Shaney.
What really upset me when Mum was in hospital, was that before during and after changeover in shifts everybody seems to be busy filling in forms or talking and patients could ring the bell as much as they liked. They were ignored. Obviously priority is getting paperwork correct!
I have to say that the Cardiac Unit where my husband was a patient was actually very well run and nurses had time to actually sit and talk to the patients and be 'caring' possibly due to the fact that each nurse only had a couple of cardiac patients each under their care.
It also amazed me that different wards in the same hospital were run along completely different lines under different ward managers!!
What really upset me when Mum was in hospital, was that before during and after changeover in shifts everybody seems to be busy filling in forms or talking and patients could ring the bell as much as they liked. They were ignored. Obviously priority is getting paperwork correct!
I have to say that the Cardiac Unit where my husband was a patient was actually very well run and nurses had time to actually sit and talk to the patients and be 'caring' possibly due to the fact that each nurse only had a couple of cardiac patients each under their care.
It also amazed me that different wards in the same hospital were run along completely different lines under different ward managers!!
I have a certain amount of sympathy for the comments made by JTH and I have indeed comments re. nurses in the NHS but will resist and confine myself to describing nurising in Spain, lest I am accused, yet again of criticising the NHS "the Envy of the World"
In Spanish wards, the parents of the next of kin do what we would describe as the "menial tasks"......washing of the patient, taking him/ her to the bathroom and in certain cases bringing in food and feeding their relative or loved one. This enables less nurses to be employed and giving the nurses more time to do the more qualified tasks.
In Spanish wards, the parents of the next of kin do what we would describe as the "menial tasks"......washing of the patient, taking him/ her to the bathroom and in certain cases bringing in food and feeding their relative or loved one. This enables less nurses to be employed and giving the nurses more time to do the more qualified tasks.
I still believe the NHS to be a triumph, sqad.
As an 'outsider' I believe that there has been too much blurring of the roles expected in some areas of health-care.
The simple basic tasks of nursing seem to be either over-looked or are considered to be beneath the dignity of over-qualified nurses, which is understandable, I suppose.
The Spanish model seems sensible-enough, but are hospitals hidebound with visiting-time rules and regulations as they are here ?
As an 'outsider' I believe that there has been too much blurring of the roles expected in some areas of health-care.
The simple basic tasks of nursing seem to be either over-looked or are considered to be beneath the dignity of over-qualified nurses, which is understandable, I suppose.
The Spanish model seems sensible-enough, but are hospitals hidebound with visiting-time rules and regulations as they are here ?
jack.....I agree....the NHS is good.........but to herald it as the "Envy of the World" as was some decade ago is ridiculous and pompous to the extreme. I was brainwashed in thinking that my training and competence as a doctor superseded those from other parts of the world and it was only when one met other doctors and saw their hospitals that you realised that this was not true. The NHS has standards of the best in the world (not better) and standards that are totally unacceptable and this nonsense about the NHS and exPats "running back to the NHS like a rat up a drainpipe" is laughable. The NHS has never been copied by any other country and other countries have equally as good and in certain situations, better than the NHS.
Hi Jack, like Rowan I can only speak from the PCT perspective and I remember the issues around the urgent recruitment of community matrons and the urgency for getting them skilled up for the new job, as many of them were previously district nurses.
I've no experience of hospital staffing, but in primary care all the tasks you describe in your OP would now be delegated to health care assistants and assistant practitioners, who are not registered nurses - often it's difficult to tell the difference unless you're familiar with the uniforms. The HCAs are well trained and very keen to learn, tasks suitable for them (to free up the nurses) are being delegated all the time.
I agree that the situation in hospitals may be different - your story about food being out of reach is sadly not the first time I've heard this.
The current NHS savings may reductions in services in certain areas, my own employer has to save many millions of pounds before the next financial year starts in April.
I've no experience of hospital staffing, but in primary care all the tasks you describe in your OP would now be delegated to health care assistants and assistant practitioners, who are not registered nurses - often it's difficult to tell the difference unless you're familiar with the uniforms. The HCAs are well trained and very keen to learn, tasks suitable for them (to free up the nurses) are being delegated all the time.
I agree that the situation in hospitals may be different - your story about food being out of reach is sadly not the first time I've heard this.
The current NHS savings may reductions in services in certain areas, my own employer has to save many millions of pounds before the next financial year starts in April.
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