Friday, 7 December 2012

Care for the Elderly

I am currently watching the Politics Show and Ann Clwyd MP is reciting the story concerning the death of her husband.  It is a tragic episode and a scandal which taints the NHS. Firstly I have to respect the views of Grumpy RN and other medical professionals who inhabit the blogosphere but we cannot ignore the torrent of complaints that are in the main justified.

I have seen with my own eyes nurses only doing the very minimum which often includes dispensing medication and routine checks on blood pressure and heart rate.  After that they do not go near the patients and care involves mental as well as physical care.

Communication is minimal.  They don't even inform the nearest relative if they if the relative moves wards or even hospitals!  I find it difficult to get someone to give me a progress report. Something must change.  It may be staffing levels and it may be time but it is also attitude.  I do wonder if the number of nurses obtaining degrees affects attitude.  Is it now beneath them to attend to the needs of the patient. Whatever it is something has changed the attitude of nursing staff, not all of them of course but...far too many!

Perhaps a leaving proforma would be the answer but only if it is not ignored.  If the family or the patient is concerned about their experience whilst in hospital then we should be able to name and shame.  It would also highlight the nursing staff who are doing a good job which is just as important.


NewsboyCap said...


I feel for you and your mother, as you well know We are in a similar situation.
It is not the fault of the Nurses/Doctors. They are overrun with patients/targets to meet.
The fault lies with us, we expect, nay demand, a service that is not possible to achieve with the Nurse, Doctor/ Patient ratio. We pay for a service that is unobtainable within the NHS. Too many pen pushers, too many 'managers', everything reported in Triplicate, too many targets to hit. I feel for the front line operators as much as I feel for you, they are on a hiding to nothing. Please don't blame them solely.
This and past GOVTS.Promise the Earth, ringfence the NHS, cradle to the grave, world class health care, yet behind the smiles and photo ops.- "the OLD folk don't contribute enough"- so Fuck 'em, " they deserve a 2nd rate service" always been that way always will....Bastards

GrumpyRN said...

Hi Bryan, hope your mother continues well. I was going to answer you on the last post but this will do.

"She had been moved but all her personal belongings (little items like orange squash, maltesers etc) were still in a plastic carrier bag which had not been unpacked!"

Actually I would normally expect patients to unpack their own stuff, only if it became obvious that they could not would I do it for them. Many patients - especially female ones for some reason - become completely helpless in hospital and won't do things they are perfectly capable of doing. A common complaint about patients is that they come in for whatever reason and their hands stop working. I know your mum is in her 90's and I would expect a much lower threshold for helping.

"I have seen with my own eyes nurses only doing the very minimum which often includes dispensing medication and routine checks on blood pressure and heart rate. After that they do not go near the patients and care involves mental as well as physical care."

As I stated in my last comments, time with patients is at a premium, if you can get the basics done you are doing well. What else are they doing that you are not seeing? People tell me our department is very quiet as there is no one in the waiting room and very little happening in the department - they are not seeing the full resus room with almost all staff involved in dealing with the sick patients. Trained nurses are in very short supply on the wards compared to when I was a student.
When the report into Mid Staffordshire comes out next year I am positive that they will find that the biggest contributing factor was shortage of nursing staff. We are expensive and are the first to go when cut backs take place. You can then blame the 'lazy' nurses for not caring for your relatives even though they are overwhelmed.

Attitude, unfortunately we are a profession that has a high number of young people and attitudes have changed over the years - I am quite sure my seniors were horrified by the attitudes shown by my classmates.

Degrees...? There have been degree nurses in Scotland since the 1970's so it is not new and Scotland is now a completely degree training. Does this affect anything? Yes, it makes nurses more confident, we now are able to challenge medical staff when required. I can assure you that nowhere in the training that I have seen is the idea that care is beneath anyone being taught or instilled.

Perhaps I am lucky, I work in a good hospital but we still have complaints and yes sometimes they are justified - sometimes we just plain screw up. I can only talk about my hospital but all complaints are taken seriously and all have to be answered Some of them go to the ombudsman and we have had our knuckles rapped.

NewsboyCap, thank you for your understanding, you are correct we mostly try but are finding it harder and harder. Targets get put in place by government with much publicity and all it really means is that we have another bit of paper to complete for every patient.

At the moment the government are nurse bashing but for over 20 years they have cut the budgets, over the past 2 years we have had a pay freeze - effectively a pay cut and we have been told that the pensions we will get are too large so they will be cut as well, and we get to pay more into them and for longer for the privilege. We are getting slagged off by press and parliament for things that happen naturally by people who have no medical training or knowledge. So yes we are a bit pissed off at present.

I work in an A&E department as a nurse practitioner, under no circumstances would I (or indeed could I) go back onto a ward. The level of work required would at my age either kill me or force me into early retirement.

As NewsboyCap points out the nurse/patient ratio we have is asking for trouble. We need a proper ratio set in law. Some states in Australia and America manage this - why can't we?

GrumpyRN said...

Further to my last comments, too many characters again.

None of what I wrote is meant in any way as a criticism towards yourself or your mother. You can only tell it as you see it. What I am hoping to achieve is perhaps an understanding of what nurses do on a daily basis that people do not see. People think that all that is required is a "good heart" to be a nurse. This is wrong and dangerous. We deal with much sicker patients than we used to and it all takes time to do it, time that we would like to be seeing other patients.

I am not making excuses for poor care as I know it exists and sometimes a culture can build up in hospitals that is wrong. But if I can get people to see why there may be a problem rather than just trying to fix the symptoms we can treat the causes.

My best to you and your mother.

bryboy said...

Many thanks to you both for your comments. GRN you must know that anything that I post is not personal but just a perception. To be honest I consider myself privileged that both of you come back to me time after time.

I just wish that I could find a medium to air your personal experiences GRN. I realise that there are major pressures on the NHS. Our politicians are,in my opinion by and large 'scum'!

Having said that I cannot divorce myself with the lack of communication on the wards of Leicester Royal.

In 2000 I was seriously ill and in intensive care for a week. I had a great relationship with the staff because I could communicate.

My fears are that the elderly who I have seen who cannot ask for help are being ignored. I saw it yesterday when a poor old lady wanted my help because she was asking anyone for help. Now I realise that just perhaps she routinely asks anyone for help but it is still difficult for me to understand how a plethora of nursing staff can congregate around reception giggling and laughing when this poor old gal was distressed.

I also asked for information on the progress of my mother. I was informed that my request would be put to the male nurse in charge of her. He never materialised and I still do not know what is happening. They all ignore the family! We never know who is in charge. We never know who to approach, who is responsible or who we can approach for information.

GRN I appreciate your problems but the gulf between the nursing staff and the family in England is ridiculous!