This week in the Nursing Times we have a couple of articles that caused me to have the usual reactions: "WTF?" and "Sigh".
WTF
The first article lead to my 'WTF' reaction is here. I would like to know how we are going to implement any of this when hospital managers refuse to communicate with frontline nurses, listen to their views or acknowledge their existence. Even our ward sisters are not allowed any say over how they staff their wards. And those people (sisters) are anything but passive. They are outspoken and they are ignored. The fact is that 99% of the deterioration in the public's view of nurses is down to horrific levels of care secondary to short staffing. One of our hospitals main managers (non clinical) turned his back on the Sisters when they formed together to explain the problems with poor RN to patient ratios to him. And he has refused to discuss it or meet with any nursing staff ever since.
He did issue a mandate ordering the registered nurses to stay on top of audits or else. He was told that we don't even have enough qualified nurses to fire fight or manage basic care on any shifts let alone play around filling in audits. His response? "Audits ARE basic nursing care" and "you are not short staffed". I'd love to know what kind of matrix they use to assign appropriate staffing numbers at my trust. Maybe it works on whatever planet he is from but it sure as hell doesn't work here on earth.
Sigh.
Then we have this. Waste of time really. It has always been considered wrong for anyone who is not on the NMC register to call themselves a Nurse. It isn't the HCA's who are calling themselves nurses. They just don't correct the patients who call them nurse because it gets too confusing for the patients. The public are calling the HCA's nurses because they don't really understand what a nurse actually is or what the term nurse means. Joan Public thinks that if she has someone who is kind and washes her hair for her in hospital that she has one hell of a good "nurse".
A large proportion of the activities that an RN undertakes to keep Joan Public and the ward's 30 other patients alive is completely invisible to Joan. So Joan she disregards the RN and promotes the HCA as the good nurse. The reality is that the RN has a higher workload, total cognitive overload, longer hours and more responsibility than the HCA ever will....for only a few £ an hour more. The RN also has the fear of god in her. But to Joan's untrained eye the HCA "cared" for her while the RN ran about "doing paperwork and tablets". Oh Joan, if only it were that simple and easy. The Registered Nurses never would have run away if it were that easy.
Thus the shortage continues because it is just to hard to do this for no recognition. There is too much responsibility and no control. Run from the wards guys, run. Run like hell if you are studying to be a registered nurse and don't look back until they swear on their lives that they will fix it. Run. Australia is very nice.
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