I just finished my “third” day of placement. Placement is… lightly put, free labour. At the same time, it’s also free invaluable training that I just cannot highlight enough that we all need a lot more of (at times, I just feel it’s not enough). Yet, being unpaid make this difficult for many people.
Today, too, we shed a few tears for the ones who passed suddenly, for those who were terribly ill yet sought to comfort us, the caregivers.
And then, I came home to this shit:
We need to talk about nursing
Tony Delamothe, deputy editor, BMJ
Bad nursing stories have been outnumbering good nursing stories of late, and thanks to the BBC they’ve been given wide exposure. The current run began in April on BBC’s QuestionTime (http://bbc.in/iWGf3B). In an emotional contribution, Telegraph journalist Cristina Odone reflected angrily on the insensitive nursing care received by her elderly mother during her three emergency admissions.
A few weeks later in a BBC radio programme, Independent journalist Christina Patterson discussed the lessons she’d learnt from her six operations in three hospitals over the past eight years (http://bbc.in/kUaarJ). She’d learnt that “the nurses who seemed to have time to stand around talking to each other, and didn’t seem to like their jobs very much, didn’t like to be disturbed and if you wanted to keep them happy the best thing to do was not to ask them for anything and never, ever to press your buzzer.” She couldn’t understand how nurses “could see people who were suffering and frightened and maybe even dying and seem to think they were a nuisance.”
Last week, the BBC dropped an even bigger bombshell on the Today radio programme (http://bbc.in/mgJ9D8). A woman was describing what had contributed to her mother’s death in hospital. “This rash had been caused by the way Ipswich Hospital dealt with toileting for the elderly. It wasn’t just my mother that was swathed in nappies to make life easier for the nurses—they said they didn’t have time to put elderly people on commodes—it was the general rule.”
The plural of anecdote is not data, but data of sorts are now accumulating on the sorry state of nursing in some hospitals. The Today programme coincided with the first 12 reports into care of older people by the Care Quality Commission. It makes chilling reading (doi:10.1136/bmj.d3346) and suggests that something of a pattern is emerging. The CQC’s messages are broadly in line with February’s report from the Health Service Ombudsman (BMJ 2011;342:d1064) and last year’s report into Mid Staffordshire NHS Foundation Trust (BMJ 2010;340:c1137). Richmond House, or whoever’s in charge these days, we have a problem.
The problem is not just heartless nurses or “resources,” although they’re a part of it. As Desmond O’Neill says in his book review, it is clear “that many healthcare workers have a troubling moral and professional blindness to the humanity and complex needs of older people.” The unanswered question remains “how the education, altruism, and professionalism of large groups of healthcare workers have been subverted to such a dismissive attitude to those in greatest need” (doi:10.1136/bmj.d3395).
Together, all the accounts of substandard patient care beg searching questions about the sort of NHS that’s worth saving. We can all agree it’s not the bad sort, but what are the levers that could guarantee the good sort, given that basic humanity seems to be failing?
Nigel Hawkes reports on last week’s attempt by deputy prime minister Nick Clegg to assume the mantle of saviour of the NHS, the latest in a long line (doi:10.1136/bmj.d3368). If he gets his way, the changes to the NHS and Social Care Bill will be so substantial that it will have to be sent back to MPs to be considered again. By the time that’s done, we may have lost a health secretary, and, who knows, the coalition government.
Cite this as:BMJ 2011;342:d3416
Just last week, I found myself discussing this very same issue on doc2doc forums. I am appalled that there was only 1 doctor who tried to defend the nurses while the doctors kept piling it on – “make florence nightingale proud”, “use an iPhone to remind you then”…
Here’s something I will admit to: there are many nurses out there now who will behave like doing any form of personal care is below them, I was at the beck and call of two very such nurses. TWO! However, this has nothing to do with the fact that they have a degree – it doesn’t matter if they have had a degree or not. People who behaves like that, much the same as doctors who behave like that, have got insufferable personalities. Do not fault the ownership of a degree for turning people into smuts – there are many others who have degrees who behave perfectly well thank you very much.
There are nurses who have turned jaded over the years of being abused by both ends of the stick; by the deaths that inevitably comes; by the things they have to deal with with the changes that has happened to nursing over the years; let’s not forget how understaffed and overworked everyone is in the industry, that’s enough to turn anyone disappointed. This doesn’t mean they don’t care, it means they learn to prioritise things in life. The more you flake over someone who died, someone else could be neglected while one fuss and grieve, let’s get real about this.
Sadly, some of the most disconnected from the patients are actually the doctors themselves, i.e. those bagging out the nurses in the forums. They are the ones who have to come and ask us if they have gotten a change of clothes – what’s wrong with talking to the patients themselves? The buzzers are going for various reasons: Mr So-and-so is emotionally dependent on the buzzer – the poor abandoned soul treats the nurses like his loved ones and the buzzer is the only way to get them. It’s like Munchausen, without the illness.
Miss X wants to voice her opinion about how shit the TV is. Mr K needs his soft toy, Mr V thinks the buzzer is a chew toy, Miss Y has just shat her pants and is quite capable of cleaning up, but Mrs O has wandered in and in all her wonderful dementia decided she’s a nurse and wants to help her…
It’s not that nurses don’t care. We know, roughly, what each buzzer is about. It’s the unexpected buzzers that we dash for. We are not crooning over the doctors at the table, or trying to be a wannabe doctor. We have got a genuine job that sometimes is baffling. Sometimes, everything goes out the window, and like everyone else, we forget things amidst the turmoil, the “phone” can be ignored (AS YOU ALL DO IGNORE ALL PAGES) when a patient, a colleague, a patient’s family, allied health needs a hand.
It is that nurses care too much. The ones who do their 24 hours so they can LEARN to do more in their care, whilst working at the same time, WHILE ALSO juggling family life. There’s no respite you know, there’s no bloody discount coupon that goes “Nurse: free kids that looks after themselves” or “husband/wives who picks up after their shit”. Or… those who forgot to get a life + family after being a nurse.
For every one of the doctors who always “ignore” their pages, we will find that one nose who genuinely “ignore” their buzzers. Don’t be reading too much news and actually start interacting with your nurses. Ask them why someone is in pads, is it because they are high falls risk? Ask them why a buzzer isn’t answered, is it because so-and-so is “needy”? It’s called… communication.
Then maybe, you can help us find a solution.
