Nurses
A barrage of stories linked to the RCN conference at Harrogate:
The Government is “blackmailing” nurses over whether they will take industrial action according to Dr. Peter Carter.
The former NHS trust chief executive, who took up the post in January, said: “Training budgets are being raided and public health programmes are being targeted.
“We’ve got workloads gong through the roof as jobs are lost and vacancies frozen.”
The most likely industrial action nurses would take would be “work to rule“, which would see nurses working their contracted hours and no more.
That step if adopted will be enough to scupper the most recalcitrant govt.
Nurses voted to pass a motion calling for new legislation to ensure appropriate staffing levels.
Ratios would vary depending the type of care a patient was receiving but could mean in some specialities (did not specify which one) one-to-one care would be guaranteed.
But Howard Catton, head of policy at the RCN, said: “The problem with minimum ratios is that they becomes maximums and that takes away from professional judgement. And if minimums can’t be met, wards are closed.”
I agree but levels are below even the minimum at the moment in some places compromising patient safety. At others, minimum levels have been used to draw up staffing plans or years. I am not sure that there are many units that are optimally staffed.
A survey for the Royal College of Nursing (RCN) found that almost half of students had been placed in sole charge of patients without warning. Of these, nearly one in seven reported witnessing adverse events while unattended, such as patients falling over or suffering a rapid deterioration in condition.
The RCN said patient care was suffering drastically as a result, adding that students felt under pressure not to raise the matter with superiors because they did not want to appear to be out of their depth.
The survey showed 44% of student nurses had been left unattended without warning and without a doctor or qualified nurse present.
Eight in 10 of those said it had happened on at least three occasions.
Of the 553 first-year students questioned, 42% said they had been left on their own.
And 15% said they had witnessed adverse events while left unattended.
But 84% said they did not report that they were left unsupervised.
And this is the wrong time to be cutting bed numbers.
Another RCN survey of 173 wards in 84 hospitals across the UK found 60% of qualified nurses said patient care was “compromised” at least once or twice a week by poor staffing levels, with 31% saying standards were compromised on every shift. Nurses on more than half the wards said they had more than 100% bed occupancy, meaning that during a normal day they had more patients than beds.
In my hospital days I filled out more “yellow forms” (incident reports) than any of my colleagues. Not much came out of them. Platitudes do not cut it.
Speaking of overcrowding, there is more news from the RCN about the occupancy levels.
The survey suggests the average occupancy rate earlier this year was 97 per cent, and that more than half of wards were running at 100 per cent to meet increased patient demand and hit waiting time targets.
Howard Catton, the head of policy, said: “Our report shows we have a system running very hot, with very high bed occupancy and the average length of stay down from 12 days to only nine. The number of nurses on these wards is 14 per cent lower than it should be.”
The survey of 173 general medical and general surgical wards in 84 hospitals across the UK found that 54 per cent were running at maximum capacity in February.
Recent figures show that in 2005, a total of 3,807 people died after contracting C difficile, an increase of 69 per cent in 12 months, and a further 1,629 died after contracting MRSA - a rise of 39 per cent in a single year.
And Norovirus is on the loose in Hampshire.
Nursing Standard (April 10) reports that palm-readers are being piloted to clock nurses in and out of work at two hospitals in Birmingham.
And in similar vein, St George’s Healthcare NHS Trust in London is installing hand-readers that will be used to open ward doors. The move is intended to stop agency nurses and other staff claiming more hours than they have worked. All ward staff will check in at the beginning and end of each shift by putting their hand into a reader that will match the shape of their hand to a pin number and record the time.
Sounds like the HR departments & the boards have gone off the rails.
Continuing yesterday’s report on the shortfalls in neonatal care,
In a report prepared for the charity Bliss by two researchers at the National Perinatal Epidemiology Unit, it finds that units are understaffed, often have to close to new admissions, and that babies often need to be driven hundreds of miles to the nearest empty intensive care cot.
The new report, Special Delivery or Second Class, was based on data provided by almost 80 per cent of the 224 units in hospitals for the care of newborn babies.
The report shows that, on average, baby units are understaffed by a third and suitably qualified nurses are in particularly short supply. Two thirds of units, not wishing to turn babies away, admitted more than they could care for properly. Many babies needing the highest levels of intensive care had to be treated in units capable of providing only lower levels.
Ideally, said Bliss, there should be one nurse for every baby in intensive care, a staffing figure agreed by ministers. The research for its report shows that if this target were achieved infant deaths could be reduced by 48 per cent. At present less than 4 per cent of units achieve this staffing ratio.
At least 2,500 extra nurses are needed, at a cost of £75 million, to ensure that NHS cots are staffed adequately. The high number of babies born sick and premature - 80,000 a year - has been put down to the rise in older women having babies, an increased reliance on IVF, and a high rate of teenage pregnancies.
And finally a couple of comments collected in the Times that I can wholeheartedly agree with:
“Government policies will result in patients finding it as hard to get a GP as an NHS dentist.†Dr Charlotte Jones, a Gwent GP, says that dentistry reforms 20 years ago sparked a shortage because pay hasn’t kept pace with workload, in Doctor (April 10)
“At the moment, we’re providing care on the cheap, and the reality in which we operate is an illusion of protection that we can’t offer.†Gary Fitzgerald, of Action on Elder Abuse, says that the approach to adult protection is minimalistic, in Caring Business (April)