Can you believe this shit. How can this be news to these people? Bear with me. I have just complete two shifts from hell so I am in a bad mood. I started at 0700 and by 10 AM I hadn't even set eyes on half my patients. The healthcare assistants were missing the fact that people were obviously going into septic shock, they forgot to check the blood sugar on the lady that goes hypo. I was up to my ears in meds etc. I couldn't go 5 minutes without consultants showing up and interrupting me. Every time they did so it pushed me back from carrying out an initial assessment on my patients by another 15 minutes. It got so bad that by 10AM I hadn't even seen half of them and was afraid of walking into a room and finding a corpse.
If a trained nursed has the recommended ratio of 6 patients she can get to all of them and see all of them and get to grips with their situation within the first hour of her shift. But with 21? No way. By 10AM I had no idea what was happening with half of these people and the 4 care assistants that were with me were no help to any of this whatsoever. A registered nurse does not walk onto a ward of 20 people and suddenly "know" everything about the patients by some kind of psychic phenomenon or information osmosis. We get a brief report on 20 people...that takes 45 minutes and then we don't know much until we assess the patient, look at their observations, fluid balances, their doctors notes, talk to the patient, look at the nursing notes etc. It takes about 20 minutes per each patient to do this kind of assessment so I that know what is happening with them. The written info is kept in about 4 different places throughout the ward.
Anyway back to the Nursing Time Article.
This has already been going on for years. This is why nursing care these days is shit. Everyone knows (except the fucktwits who run hospitals) that the decreasing the number of registered nurses and replacing them with untrained kids is a big fat fail. The reasons that RN's cannot function is because we are spread to thin among to many patients and forced to delegate to care assistants who don't know what they don't know and don't care either.
I told you that it was management moving nurses away from the bedside not an over academic nursing profession. Nurses need to be highly educated, they need to be at the bedside, and they are not too posh to wash. University educated nurses are taught that they need to provide basic care in order to assess their patients properly. Assessment is the first step of the nursing process.
These hospitals are saying that there is a shortage of band 5's (registered nurses). This is bullshit. They are not advertising to hire them on the wards. They are only posting ward jobs for care assistants and many newly qualified nurses are on the scrapheap, unable to find jobs.
I told you that this shortage of RN's working at the bedside is down to economics rather than arrogant nurses who supposedly think that they are above caring.
I told you that the "shortage of trained nurses" is/was manufactured by greedy hospital chiefs.
In every post on this goddamn blog I explain how care fails when an RN runs between too many patients and is so swamped handling drugs, assessments, and orders by herself that the care assistants are doing all the actual care, and totally fucking it up. They cannot assess patients, electronic monitoring does not help. The care assistants go through the motions of providing care like it is factory work. Too much gets done incorrectly and or completely missed until it is too late. This is called failure to rescue. The few actual nurses are to swamped to actually assess and plan and implement care. Our hospital patients are getting nothing in the way of nursing input.
It's a total fucking fail and it will kill more people and cost more money if it continues.
I said it here.
I explained it here and in pretty much every other post.
How dare they devalue proper ward nursing and say that someone who isn't trained and registered can take over?
IF this is a good idea then why does research show that a smaller proportion of qualified nurses in the ward skill mix causes higher mortality rates and increased costs?
IF this is a good idea then why do patients of hospitals that employ a higher number if highly educated RN's to work at the bedside have much lower mortality rates.
When they say that they are not creating band 4 protocol based posts to save money....THEY ARE LYING.
And yes RN's do report that we have to do many things that are "beneath our level of training". We have to wash mattresses when we have 3 patients crashing because the care assistants cannot be bothered and we are getting an admission in 5 minutes. You don't look at that and think "Okay, then let's have less real nurses and more irresponsible untrained people who don't have a registration to maintain and don't care on the ward then". You are supposed to look at this and you hire domestics to avoid a multi million pound damages payout when a patient dies because his nurse is washing mattresses.
I am heading into another shift from hell today. Bear with me.
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