Saturday, March 6, 2010

Are They Hiring?

I just had a look at my Trust's current vacancies.

There are jobs for managers and administrators, purchasing officers, and HR.

Lots of them.

No Staff Nurse posts are being advertised.

They are advertising for more "apprentices" and aiming the adverts at teenagers.

It still makes me laugh when people say that the University education of Nursing is what has destroyed Nursing care.

You idiot.

If we actually had university educated nurses staffing the wards I would agree with you.  But the university educated nurses are stacking shelves at Asda while they try to find a job at the bedside.  Even if they only want to do noctoring and managerial stuff they cannot even dream of it, if they do not have years of experience as a bedside nurse first.

The vast majority of staff on the wards at any given time these days are untrained, uneducated but mostly nice if a little dippy carers who have never been to university and do not want to become Nurses.  It is getting to the point where we rarely have more than 1 RN per shift.  The Nurses are an aging workforce.  Most of the time that one nurse per shift is someone who trained back in the "good old days".  The majority of NHS staff who are actually qualified nurses trained pre project 2000.  Carers cannot help with drugs, treatments, orders, information organisation and action etc etc.  The lone nurse carries that on her own.  There are more drugs that need to be prepared and given than you can possibly, physically give.  That's the case even with the threat of getting sacked for a med error and getting struck off as a nurse at the forefront of your thoughts.  Even if your stomach is doing flip flops, due to fear that you are going to kill someone due to medication problesm, you still cannot do it.

In Victoria, Australia and California, USA the hospitals must staff their wards with degree nurses so well that no degree nurse is to have any more than 5 patients at a time. This is law.  The hospitals tried to resist these laws but patients were dying.  The law went into effect around the year 2001.  If one of her 5 patients gets unwell, she gets another real nurse to help out with her other 4. In the UK I start my shift with more patients than I can handle, then I get more and I have so many constant and unrelenting interruptions that I cannot accomplish a thing.  The only way to survive, and ensure my patients survive is to stay focused.  This makes me look hard---as if I am lacking in compassion.
 The  degree RN in California has a small number of patients which allows her to do everything for them.  Care assistants are few and far between. This is what they have over there, rather than untrained kids running around and one real Nurse trying to do it all for 30 patients like we have in the UK.  On a 30 bed ward in California you would have 7 real Nurses  at least (One in Charge), maybe one care assistant who is merely helping out rather than taking charge of the basic care, admin staff to answer the phone, domestics, dietary staff for a shift..   In the UK  you will have one real Nurse and 3 untrained kids on a 30 bed ward per shift and that is all. This is getting to be the norm.

You won't hear of any patients getting starved, neglected, and left in their own filth in Victoria or California.   And their staff nurses are ALL degree nurses. 

You think it costs too much to pay all that well educated staff?  Wrong again, they actually have lowered their costs by improving patient outcomes as a result of having strict, legistlated nurse patient ratios. If hospitals weren't so busy fucking around with government initiatives and interference this stuff would probably be automatic.

http://nurseactioncenter.org/campaign/Staffing_Ratios/explanation

http://www.haponline.org/downloads/HAP_Summary_HB_147_SB_689_Nurse_Staffing_Levels_Sept2009.pdf

The second link is fabulous.  The hospitals would not be able to include care assistants and non direct care providing nurses in their ratio declarations.

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