Hello Dawn
You make an interesting comment re SENs. It appears that we have gone full
circle - the role of the HCA overlaps to some extent with that of the EN
with one significant difference - they are not currently required to be
registered/enrolled with the NMC.
I have to say that I have experienced better care given by a number of HCAs
than by some RNs. But I won't start on that discussion - I could write an
essay if not a book on that one!
One of the most caring of my teaching colleagues started as an EN, worked
her way up through the nursing ranks and now is the course director for a
foundation degree at LSBU accessed by HCAs. She is a brilliant role model.
Anne
On 17/07/2011 13:14, "Dawn" <[log in to unmask]> wrote:
> Dear All,
>
> I want to balance my previous reply.
>
> Since my Mum died in May my son developed appendicitis as well. At 17 it was
> borderline whether he was going to a childrens ward but as he was in college
> he did. Thank goodness! TV was free( Wimbledon was on so he was happy..),
> staff their to organise distractions for the children and activities and
> obviously more staff. This led to better care all round and I have no
> complaints ( it was our local hospital and not the same as my Mums).
>
> When I wrote to complain about Mums care I expressed my thanks to those who
> had helped as I am all for giving positive as well as negative feedback. The
> OT was amazing and worked with me and not against me. She was ringing me at
> home at 8pm when she has finished at 5.30pm. It was dedication. Also a lovely
> HCA went beyond her remit to help Mum when I wanted to give her a shower as
> she had not had a bath or shower for 3 weeks since coming into hospital.
>
> Yes there are very good nurses I agree but the RGN who shouted and then
> because my Mum could not move up the bed (too weak and ill, oh we dont lift
> anymore do we?)) ran her finger nail down my Mums foot 'to encourage her' was
> not. The outcome of this was via the trust she had ' reflected' and
> 'aplogised' via them and was being sent on a 'communication course'.
>
> In my own opinion as an old SEN who then became Dip N and is now doing my
> Degree in OH.I feel the theory does not meet the practice. Nurses feel they
> should document everything but either do so at the risk of not actually doing
> what they say or do what the say and leave a gap for litigation as they dont
> document.
> When I started we had crown immunity and a big part of time spent on wards now
> is covering themselves. With barely enough nurses to do the work this means
> the care suffers.
>
> I also agree that it was madness to take away the SEN role. You don't need a
> degree to give basic nursing care. Those non academic but caring people who
> would be SEN's can't become Nurses. We have lost the most important element of
> care. Maslows bottom line is missing and if thats not in place it wont matter
> what you give above. Heal from
> within...rest...food...fluids...hygienne...warmth( not lying in a wet bed).
> You can't underestimate these.
>
> The reason its the elderly who suffer most is they are the most
> vulnerable...no-one to protect them if they have no family or visitors ( quite
> often in some cases). Look at the asian community and they take it as part of
> their resposnsibility to be with a family member to feed them, wash them. I
> wonder if we compared the recovery of this aspect of our community to others
> if it would prove the basics really do matter?
>
> I still await the results of the ongoing inquest. I want the hospital to
> change but have not best decided how to fight thme with Mums case to acheive
> it. The fact they had a similar case in 2007 as quoted by the Ombudsman in the
> Feb report this year makes me feel that another approach is needed.
>
> I have been thinking about it a lot on my drives to work and back and feel to
> get them to set up a pilot ( with my input) at their cost as a possible way.
> Win for them as shows they are trying to improve and Mum gets to rest in peace
> knowing she did not die in vain. Still working on idea of what and how but I
> feel it must focus on basic care....with two similar wards one with the pilot
> the other to remain as it is and then consider the data of the wards in
> respect to recovery etc....still not there with it yet.
>
> I would love to think as OH's we could give up a day and go in but they would
> resent us. I collaborate with my local hospital to improve communication in
> chronic health and just to get on the site was a beaurocratic nightmare.
>
> Also not sure if you are aware but if any of us wanted to go and do some basic
> shifts on NHS professional we would not be accepted as unless you have 3
> months practice in a NHS setting in the last 2 years we are not up to it.
> Thats the truth honest. They wont accept Nurses who have worked in Nursing
> Homes etc either. You must have 3 months in the last two years in NHS. But a
> student just about to pass can....ironic or what!
>
> What we do have as a voice is that we are free to talk. I have noticed that
> many NHS nurses are actually frightened to stand up and actually report poor
> practice for fear of it affecting them moving forward in their careers. I have
> witnessed this alot over the last 10 years. They will moan to each other but
> not actucally report.
>
> Control has been lost by outsourcing hospital food,cleaning,transport and a
> lack of communication. Team work does not exist and Sisters have no power over
> their wards.Sisters need to be removed from the rest of staff and
> respected...hard when some Sisters go out with juniors and get
> plastered.Sisters never did that in the 70's and 80's where I worked. The
> Sister was an enigma feared and respected in equal measures with no
> favourites.
>
> In essence many Nurses are good but worn out or down by trying to remain
> professional and deliver the care they want to due to staff shortages as a
> major factor and too much bearocrasy. Its a multi faceted problem and actually
> in some cases nurses are the scapegoat at the bottom.
>
> We also think our care is better than the rest of the world combined and
> forget the Raj and Empire is gone. The NHS has fantastic potential with ground
> breaking ideas but it's inconsitant in availability and delivery and is
> russian roulette for the patient based on where you are, how old you are, how
> vulnerable you are and what family can support you.
>
>
> Right thats off my chest now.....and yes it makes me sad as I came into
> Nursing from school and have two daughters who I would never encourage to be a
> Nurse now.
>
> Happy Sunday....Dawn
>
>
>
> -----Original Message-----
> From: [log in to unmask] [mailto:[log in to unmask]]On
> Behalf Of Tracy Turner
> Sent: 17 July 2011 09:04
> To: [log in to unmask]
> Subject: Re: [OCC-HEALTH] Please listen to this :
> http://www.bbc.co.uk/iplayer/episode/b010mrzt/Four_Thought_Series_2_Care
> _to_be_a_nurse/
>
>
> Hi everyone
>
> I quaified in 81 and had a ten year gap from nursing until returning
> the day of 9/11. In the 'old days' pre project 2000 we all lived in
> hosptial accomodation and formed great friendships with each other. We
> respected the nurses senior to us and new who was in charge. The
> nurses, admin, cleaners, cooks, porters all came under the same charge.
> We were a team and supported each other, On my return I was confused at
> how many sisters were working on one ward all with different ideas of
> leadership. The back biting between admin and nurses, nurses and
> doctors, porters etc. The staff did not like to be at work and welcomed
> the 12 hour shifts as this meant that they would only have to spend 3
> days a week in the environment. Sole responsibility had made nurses
> isolated when things unfortunately went wrong, no one else wanting to
> admit or share responsibility. Unions their only means of support.
>
> I have often wandered what had gone wrong in a profession I had always
> wanted to be a part of since a very small child when I had whitnessed
> the nurses caring attitude first hand. But after time I also began to
> look at society as a whole and how that had changed. A locum GP advised
> me that he uses to have no problem getting up in the middle of the
> night to see one of his patients who had called but over the years he
> had become afraid, not knowing who his patients were and what he may be
> getting involved with - would a drug aditct be behind the door wanting
> more or worse - or would it be a prank and his sleep was disrupted for
> no useful cause.
>
> I worked in A&E and left when I was asaulted, but not after I had
> recieved an enormous amount of abuse from countless members of the
> public 'knowing ther rights'. When dealing with these people or some
> that we thought could turn violent we were shaddowed by security and
> then due to costs it was decided that the security we relied upon was
> being reduced due to costs. My family was amazed to know that I had to
> stitch up potentially violent people with security watching' just in
> case'.
>
> I witnessed people who were in custidy shouting, spitting and
> threatening the police who brought them in. The police remained calm,
> how did they do this day after day - ?
>
> Society has changed beyond all recognition. People had respect not only
> for nurses but society in general. Technology has moved on. Where
> patients used to be in hospital for a week - 10 days following a hernia
> they are now home the same day. Wards were full of patients but the
> care requried varied. Those who were nearly better helped to lay the
> tables for lunch speak to other patients. Nurses were only required to
> do a few bed baths. Now adays the wards are full with very ill people
> and soon as they start to improve they are sent home. Nurses were not
> required to monitor epidurals, give IV drugs or all the other extended
> roles a general nurse is expected to do now. The nurses work has
> increased and the staff levels have reduced. They are tired as are so
> many other professions these days. the difference is if an office
> worker does not want to speak to anyone that day due to home pressures
> - he does not have to. A security guard may catch a few winks during
> his/her shift. A nurse however has to be alert at all times, they cant
> switch off for the lst 5 minutes of their sift as they may miss
> something crutial. They have to been seen to smile all the time no
> matter what pressures they are under. If they are seen discussing ward
> issues it is seen as chatting. How many people are nursed each day and
> how many complaints hit the news? How many lives have they actually
> enhanced but dont get the recognition for? There are good nurses but
> they arent spoken about enough.
>
> I do not feel that Project 2000 is entirely to blame but transfering
> the teaching to a University did not help the situation. I am amazed
> that students only require 40% to pass their exams and be a nurse. How
> then can they be expected to deliver more than 40% care or mentor
> students to deliver above this?.
>
> There is constant drive for nurses to undertake further qualifications,
> but it should be remebered that not all nurses want this and perhaps
> this is where we are getting it wrong. If the SEN was to make a come
> back I am sure things would improve as it bridges the gap between care
> assisstants who may not have any interest in study and some SRN's who
> would prefer to conitnually study (deg and masters).
>
> This topic could be cotinued for years and isn't that what the NHS
> does best - all talk and no significant action which is why I left 6
> years ago!
>
>
>
>
>
>
>
> -----Original Message-----
> From: Sarah Witwicka <[log in to unmask]>
> To: OCC-HEALTH <[log in to unmask]>
> Sent: Sun, 17 Jul 2011 3:34
> Subject: Re: [OCC-HEALTH] Please listen to this :
> http://www.bbc.co.uk/iplayer/episode/b010mrzt/Four_Thought_Series_2_Care_to_be
> _a_nurse/
>
>
>
> Hi everyone.
>
> Please don't think I'm trying to belittle anyone's dreadful
> experience... but does
> *anyone* have anything *good* to say about the nursing profession...???
>
> Late last year I went onto the wards looking for staff to give flu jabs
> to. Aiming to leave no stone unturned, I went to the far end of one
> ward; a bay of about 4 beds all with little old ladies in. "Nurse", one
> of them called out to me. How did she know when I was in mufti?!?! I
> went up to her and she asked me if I could take off her glasses so she
> could go to sleep. I did as she requested. Seconds later a uniformed
> nurse came in and called to the little old lady. "(Name)", she called
> out politely, "You'll need your glasses on because I brought your lunch
> for you. Let me help you with this and then you can get some sleep"?
>
> The hospital I work at is far from faultless; the staff aren't all
> flawless either. Staff I see who are being performance reviewed or
> disciplined or investigated are predominantly nurses. Hopefully it's
> those processes that help facilitate a positive change in care
> standards.
>
> Many moons ago I said to a Dr, "Drs are a nurses' worst enemy". "No",
> he said, "Nurses are nurses' worst enemy". I thought about what he'd
> said. Whilst Drs close ranks when one may be in trouble, I've seen
> nurses scatter away from who might be a scapegoat.
>
> Thank God, I have never been performance reviewed, disciplined, under
> investigation, had a compliant made against me or witnessed such poor
> standards of care. That may be a lot to do with the fact that it's been
> well over a decade since I worked on a ward. Maybe I wouldn't be able
> to say that if I was working at "the coal face" currently...
>
> So whichever nurses pass through your department in the above
> circumstances, please can we support them? They may have done something
> very bad and be uncaring, but that hopefully comes out through the wash
> of the formal investigation service. In the meantime they may
> appreciate a friendly face. It may be that they haven't done a bad job
> and that they'll take the memory of one nurse being friendly and
> non-judgemental of another.
>
> Most people notice a bad job, but no one tends to acknowledge a good
> job. To be recognised for the positive things we've done, it has to be
> a GREAT job.
>
> Have a great Sunday everyone.
>
> S :-)
>
>
>
> Sent from my Windows Phone
>
> -----Original Message-----
> From: [log in to unmask]
> Sent: 16 July 2011 20:43
> To: [log in to unmask]
> Subject: Re: [OCC-HEALTH] Please listen to this :
> http://www.bbc.co.uk/iplayer/episode/b010mrzt/Four_Thought_Series_2_Care_to_be
> _a_nurse/
>
>
>
> Dear Dawn
>
> I can empathise with your experience as I have had a similar
> experience. My mother had been very fit and well until she sustained a
> very severe CVA in 2007 resulting in a massive cerebral infarct. Prior
> to that event she lived alone in her own property and did lots of
> voluntary work with Age Concern and assisted me on the AIDS project I
> set up in S Africa. The care given to her by RNs was appalling and
> left me embarrassed to be a nurse. The CVA left her with a dense right
> sided hemi-paresis and total aphasia. I was informed of her admission
> to hospital near Manchester probably 12 hours after the event - I live
> in London and therefore could not get up to the hospital that night. I
> was initially telephoned by a neighbour who had found her collapsed on
> the floor. I pieced together what had happened and summised from the
> history they gave me that she had either had a CVA or a massive fit. I
> eventually spoke to doctor responsible for her care who returned my
> call but would tell me nothing due to medical confidentiality telling
> me that my motherıs condition was stable but she couldnıt discuss her
> condition with me incase I was a ³nosey neighbor². Highly unlikely as
> she rang a London number and my name and contact details were in the
> hospital notes as the next of kin. When I asked if I could talk to her
> she told me I couldnıt, it was like 20 questions trying to work out if
> that was because of her being one or more of the following:
> unconscious, too sick to talk to me, or having aphasia resulting from
> the CVA.
>
> When I got to the stroke unit the following day I calculated that she
> had probably had nothing by mouth (NBM) for nearly two days and she
> would remain so until her swallow reflex had been checked by the SALT
> team nobody was available at that time. Despite an IV regime having
> been prescribed and an IV being sited in A&E there was no IV running,
> the venflon had clotted and her named nurse did not realise she needed
> IV fluids. Over the period of her admission there were something like
> 23 drug errors and those are only the ones I know about. The most
> life-threatening being when an RN was about to administer an insulin
> injection prescribed for the patient in the adjacent bed. Had I not
> been at the bedside to stop it that injection would have killed her.
> There were a catalogue of shortfalls in her care, alarms on I.V.s
> being ignored, drug charts left on top of the clinical waste bins and a
> health care assistant feeding my mother a breakfast of cereals and
> toast despite being NBM due to an ineffective swallow reflex. The next
> most serious shortfall being when I got a phone call to tell me that my
> mother was waiting in the discharge lounge for me to collect her. That
> call was totally unexpected as she needed 24 hour nursing care and
> obviously she could not go back to her own home and there was nowhere
> else for her to go to. I hotfooted it to Oldham and discovered her
> sobbing her heart out in a double room in the discharge lounge. I wonıt
> go into all the details suffice it to say I made a formal complaint to
> the Chief Executive. Initially he tried to fob me off but my
> persistance resulted in an internal enquiry and eventually received
> 13³personal and unreserved apologies² regarding the shortfalls in care
> she received.
>
> That Trust featured in a Dispatches TV programe earlier this year the
> nursing and other care seems to still be as bad as it had been back in
> 2007 and the Chief Executive is still in post. I despair.
>
> Anne
>
>
> On 16/07/2011 18:26, "Dawn" <[log in to unmask]> wrote:
>
> Dear All,
>
> I am an ONA having trained in both the old and new system. I am
> absolutely devastated at the lack of basic care. I have experienced it
> a few times over the last 3 years whilst supporting a friend and then
> this year my independent 74year old self caring Mum fell and fractured
> her ankle. I live 200miles away and she had been with me for 10days
> prior to the fall. I kept in touch with my stepfather and the hospital
> daily and had decided that as it was 'only a fractures ankle' I would
> come up for a week on her discharge as after all she was safe in
> hospital!
>
> She died 2 months after admission due to the poor care ( dehydration,
> malnutrition) and I am in process of a complaint with the hospital. As
> the coroner who performed a post mortem could not find a direct cause
> of death ( well he wouldn't would he? ) it is now going to inquest. The
> same hospital was in the ombudsman report in Feb 2011 for a case
> similar to my Mums in 2007 but he was lucky and survived. Mum didn't....
>
> Mum weighed approx 60kgs prior to admission and 44kgs at post mortem.
> She was left as she was old vulnerable and didnt moan... she had very
> mild dementai but was also diabetic ( well controlled until admission)
> and then develpoed a massive UTI that was left untreated for weeks by
> which time it had tracted up to her kidneys. So she entered a cycle of
> too weak to eat or drink and ignored and went down hill. I rang daily
> and was up 50% with her thanks to a great workplace allowing me to
> shift my work around. But as visiting was only 4 hoursof her day I
> could not protect her the rest.But they took no notice of me and kept
> saying 'shes fit for discharge!'
>
> Dawn
>
> -----Original Message-----
> From: [log in to unmask] [mailto:[log in to unmask]]On
> Behalf Of Chloe Nightingale
> Sent: 15 July 2011 21:29
> To: [log in to unmask]
> Subject: [OCC-HEALTH] Please listen to this :
> http://www.bbc.co.uk/iplayer/episode/b010mrzt/Four_Thought_Series_2_Care
> _to_be_a_nurse/
>
> Dear list
> this was on Radio 4 today..
> http://www.bbc.co.uk/iplayer/episode/b010mrzt/Four_Thought_Series_2_Care_to_be
> _a_nurse/.
> As a nurse from the "old days" it makes me very sad and very cross to
> think this is how nursing has become and that someone should have
> experienced the care this reporter did. I know as occ health nurses,
> we are removed from the hospital aspect of care (in most cases) but
> hopefully we can still make our voices heard with regard to best
> nursing practice.
>
> If you are on Facebook, you can share the link on your wall.
>
> Chloe
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