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AIBU?

To think that David Cameron is out of touch with the realities of the NHS?

71 replies

Lougle · 05/12/2012 12:39

I've been listening to Prime Minister's Questions.

David Cameron wants to introduce 'hourly roundings'. That is, that each patient under a nurse's care should have a 'nurse by the bedside, at least once an hour, checking that they have had water, that they're not uncomfortable, that they don't have bedsores....'

Let's think about this. One nurse can have up to 15 patients on a normal ward now. In 2003 as a Newly Qualified (ie. 3 weeks qualified) RN, had 12 patients in the morning, then 18 in the evening.

So, working with 15 patients. Each hour, the nurse must visit each of them. That means that the nurse has 4 minutes per patient, per hour.

What happens when patients need washes, morphine (requires two nurses to sign out, check, administer), theatre prep, admission?

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impty · 05/12/2012 12:50

I suspect the sentence could have just been- AIBU that David Cameron is out of touch.

And the answer is yes to both.

I think the NHS is one of the greatest things in this country. I am terrified that it is being slowly dismantled. For this reason we have opted in for private medical cover. Which I realise plays into the hands of the politicians.

My hope is that if we ever need to use it then that may save money for the NHS to treat someone else quicker.

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VicarInaTutuDrankSantasSherry · 05/12/2012 12:55

he is out of touch - full stop. YANBU.

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belindarose · 05/12/2012 13:07

I'm in hospital with baby DS now. I didn't know the realities and my DH is a hospital doctor. There are scores of people involved in DS's care - and he's not even particularly ill. Not one of them has the capacity for more work. This is an amazing experience - not one I'd wish on anyone or want to be repeated, obviously.

DC should have seen the realities when his own son was so poorly. Sadly, he seems to have a short memory.

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rogersmellyonthetelly · 05/12/2012 13:46

DC has his head up his arse. There aren't enough doctors, nurses or hcas to cope with the current demand. This is causing inadequate care, mistakes, staff burnout/stress. The answer to this is not to give more targets, as all that happens is that someone has to implement them, monitor them, have meetings and form committees to deal with them, and eventually, find a way of reporting that shows the targets are being met, when in fact they aren't being met, the figures are being fudged.
My younger sister works on a ward where a number of patients is incontinent, and they run out of nappies/pads regularly because due to budget issues they have to leave ordering until the last minute. Crazy situation. I have volunteered on the postnatal ward at my local hospital as a bf supporter and I've seen a full ward of 30 women and 15 antenatal women being dealt with by just 2 midwives because someone has called
in sick and they don't have anyone available to cover, and can't pay for bank staff.

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CogitOCrapNotMoreSprouts · 05/12/2012 13:50

YABU. I've personally experienced an absence of basic care by NHS staff on several occasions. One nurse memorably preferred to start her night shift by dishing out sleeping tablets to all patients whether they needed them or not. That way she could spend the next few hours uninterrupted by pesky requests for attention .... Hmm. Another time staff only seemed galvanised into action when a doctor was about to do their rounds - invisible otherwise. Whether Cameron's specific suggestion is right or not is debatable but the problems with basic care in the NHS should not be underestimated and should concern us all.

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OutragedAtThePriceOfFreddos · 05/12/2012 13:56

I think he knows that what he is suggesting is never going to happen, but by saying it, enough people will believe he cares about the NHS that it's worth saying whether or not it happens.

The future of the NHS is terrifying.

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OnwardBound · 05/12/2012 14:01

I don't imagine that DC ever saw the real situation when his DS was unwell...

Although he was in the NHS, he would have had a VIP experience.

So it would have seemed as if there were plenty of smiling happy nurses to attend them and a polite and pleasant consultant [not a junior Dr!] who popped in regularly to advise and explain.

I am sure it was still a stressful and upsetting experience for DC to see his child so ill but I am sure he was shielded from the realities of staffing and budget cuts, dire hospital fare, etc.

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FannyFifer · 05/12/2012 14:11

The patronising nurses are angels, don't call me a feckin angel, just make if possible for me to do my job properly.
Care of the elderly wards are usually working with the bare minimum numbers of staff as non acute, people who are unable to dress, eat, drink, move, toilet without full assistance, it's utterly heartbreaking.

So much so that I no longer work in general hospitals as I don't feel able to do my job. I was ill, staying hours after shifts completing paperwork, sitting with dying patients, going home fretting that I had forgotten, missed something.

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Lougle · 05/12/2012 14:12

"YABU. I've personally experienced an absence of basic care by NHS staff on several occasions."

Cogit...that isn't going to change by giving nurses an hourly checklist. There is already too much to fit into each hour. Nurses are already being told off if they spend too much time dealing with patients and not enough time documenting care.

What is needed is more staffing of permanent staff, who can devote time to patients as they need it. What currently happens, is regular budgets are restricted, so 'natural wastage' implemented to cut costs. Then, agencies used to plug gaps at huge cost, but it's ok because it's from a different part of the budget!

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Electricblanket · 05/12/2012 14:29

I Realy don't know!

6 years ago a member of my immediate family was in hospital for 5 weeks, We too experienced first hand a basic lack of care.

We wern't as mentioned v I p's!

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MustTidyPlayroom · 05/12/2012 14:41

It's a mess - no staff, no money, low staff moral and quite rightly high patient expectations.

Staff across all area of the NHS are drowning in paperwork - time the could be spent on patient care. No one is listening. All politicians are interested in saying what the public wants to hear, they have no clue how they are going to deliver it.

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reikizen · 05/12/2012 14:52

He's a fucking idiot. No-one in the NHS is an angel, we are human beings trying to do a job which gets harder and more paperwork intensive every day. He is trying to make NHS staff look like we don't give a shit to make it easier to sack us and reinstate bare minimum numbers on worse pay and conditions with the support of the public who are being led to believe we all go to work cackling and devising plans for snoozing in a spare bed somewhere. I work without a break on 95% of my shifts, particularly nights. And that means they get between 30-60 minutes work for free off me every shift.

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LRDtheFeministDude · 05/12/2012 15:00

I think outraged has it right - he imagines he's going to look caring and righteously angry about keeping the NHS up to scratch if he says this.

Instead he just looks like an idiot who didn't do his research and/or didn't believe his listeners would know any better.

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AllYoursJingleBellbooshka · 05/12/2012 15:11

DC could not be more out touch if he was living on Pluto in an air-tight bubble.

Actually that sounds like bliss, let's start a little collection to get him there. Xmas Smile

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TakeMyEyesButNotTheGoat · 05/12/2012 15:26

Stupid idiot.

I've just finished an early shift, 1 Q & 2 HCA's looking after 12 elderly, acute medical patients. 10 also have dementia.
We already have 4 checklists. Falls, skin, catheter and environmental.

All our patients need assistance to wash, most need 2 members of staff. You cannot transfer a patient from bed to chair without 1-2 staff. 3 needed feeding while the rest need prompting or food cutting up etc.

This as well as all medical needs met, IV's, controlled drugs (2 Q staff)

One patient has been trying to climb out of her bed all morning, too high risk to sit her in a chair. One patient wanders and is high risk of falls.

Hygiene needs are priority, nutrition and hydration is a priority, prevention of falls and absconding of the ward, medications, paperwork. It goes on and on and on.

Everything is a priority. Making sure everything is documented has become a priority over everything else it seems.

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Lougle · 05/12/2012 15:28

'So, Mrs Ramsbottom, how was your stay in hospital following the introduction of 'hourly roundings'?'

'Oh well, they were very caring. Every hour, it seemed, I had someone checking that I had water and didn't have bedsores. Unfortunately, because the nurses were so busy doing their hourly roundings, they didn't have time to give me my morphine....'

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Viviennemary · 05/12/2012 15:29

Less time spent at those so called nursing stations might be a help. Since when did a desk need nursing. I think David Cameron is on the right tracks.

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Latonia · 05/12/2012 15:33

Well maybe it would have helped the man in hospital who was slumped over with his face in a plate of food when I was visiting my Father. I pointed it out to a nurse, but he was still in the same position some time later. Had another word with a nurse who then did go to him.

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sashh · 05/12/2012 15:37

David Cameron wants to introduce 'hourly roundings'. That is, that each patient under a nurse's care should have a 'nurse by the bedside, at least once an hour, checking that they have had water, that they're not uncomfortable, that they don't have bedsores

So they can die of sleep deprivation? And what is the point of HCAs if nurses are doing this?

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FreddieMercuryforQueen · 05/12/2012 15:40

Most of the time spent at the nursing stations is doing the paperwork. If it ain't written down then it never happened. So we have the choice of being with patient or being with paperwork. If we're with patient we have to write it all up anyway. I know some people do sadly have bad experiences within the NHS but if we had less paperwork and more staff I'm sure they'd reduce. All we ask for is enough time to perform our necessary tasks and to care for our patients in a way that everyone comes away satisfied by the experience. Hourly rounds are not the way to achieve this.

I can just imagine the 7 women with breastfeeding problems, 2 of whom have twins who are of a low birthweight would be really happy with the 2 or 3 minutes I'd be able to allocate to them during my hourly rounds.

Do you know we are no longer allowed to have a cup of tea or water on the nurses station any more as members of the public assume we're sitting around doing nothing when actually we're more likely to be working through our break doing paperwork and grabbing the only chance we might get in 13 hours to rehydrate ourselves.

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Viviennemary · 05/12/2012 15:44

I certainly agree with less paperwork and more staff. What's the point of paperwork if patients are dying of neglect.

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threesocksfullofchocs · 05/12/2012 15:45

yabu for thinking he might have the faintest idea.
yes he had a child that will have been in hospital. but he was not the carer. so he would not have spent a lot of time there.
he will have a rosy veiw of it all.

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agedknees · 05/12/2012 15:47

Neglect by government not ensuring the correct amount of nursing staff on a ward.

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chris481 · 05/12/2012 15:47

I think good basic care is an absolute requirement, not a question of priorities. So if hourly checkups are required to ensure it happens, then they must happen. Tax rates will just have to go up to whatever is necessary to pay for the staff increase.

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TakeMyEyesButNotTheGoat · 05/12/2012 15:50

The nurses station is there for the nurses to use. Where are they supposed to write their notes, make referrals, sort out discharges etc? The toilet??

It's not always nurses sat there anyway, sometimes its physio's, OT's or clinical nurse specialists visiting the ward's.

I bet that most of the time when a visitor has come in and found a nurse sat at the nurses station, there is paperwork on the desk.

Also, we do have something called specialling. Where a nurse/HCA have to sit in the middle of a ward or outside a patient's room and stay there to make sure no one falls or tries to abscond.

There is a bigger picture than most of the public realise.

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