Unsafe working conditions.

[borisbeaver]

Just remember one important thing. You are not alone.

[Night Owl]

Thanks Boris. We have got heavy snow falling now! Just spoken to the ward manager and she will be in contact if she can get to work tomorrow.

[NurseAnne]

I hope it gets better! Please keep us updated.

[Night Owl]

Thanks NurseAnne. Meeting at 14.00hrs. Heavy snow overnight but O/H and daughters all moved their cars.......just!

[Sali]

Night Owl

I think many people who make a stand against what they see as unfair or unjust or plain wrong, get slowly worn down by officialdom and eventually give up. This would be exactly what they want. I can only imagine how frustrating this must be for you. I hope you don't give in. Good luck.

Edited January 13, 2010 by Sali

[Night Owl]

Ok, was just about to update this when all I could hear was.......whats for tea?

 

Tea's in the oven!

 

Ok, update.

Meeting was held today between me, ward manager, Matron, Head of Nursing and RCN rep.

 

Firstly we discussed the issues around my letter and refusing to go to work as I believed that my nursing registration was being put at risk with sub-optimal staffing and being unable to maintain nursing standards, I believed that the ward was unsafe.

They all listened and agreed on what I was saying and made apoligetic noises.

 

We discussed staffing and the fact that it had been agreed for the shifts I was working, and the week up to them, that we were to have extra staff.........this happened but the staff members were taken away shortly after starting the shift. This was unaceptable and ultimately put us in a difficult situation where we struggled. Our concerns were not being heard.

 

We discussed the increased work load and increase dependency of the patient group we care for. In 2009 we had trialed a dependency tool designed by another hospital. It was huge and time consuming to complete for each patient for each shift. We hadn't had any feedback after the trial was completed........I asked. It was agreed that our dependency was considered high at the time of the trial........NO SH*T SHERLOCK...........thats what we were trying to highlight from the start.

 

The RCN rep told us about another dependency tool designed for the specific patient group I care for (sorry if this seems cloak and dager not identifiying more, but I can't).

The dependency tool was being trialled at another hospital before being available for our use. She said she would try and get me a copy.

 

We discussed if it was possible to do a brief dependency tool whilst we were going through this crisis until the other specific tool was available so that we could justify our increase in staffing demands. We all agreed that it would be good and will put something together over the weekend to show management and role out in use.

 

We also discussed previous actions identified by me in 2008 and brought to the managements table at that time. I stated that we are still fighting for staffing and having to justify our reasons..........nothing has changed in a year.

 

They looked at staff shifts and stated that if staff were struggling then we should impose shift time changes back to shorter shifts from 12 hour shifts making more days to work in a week.........not popular with alot of staff.

 

Sorry gotta get tea out back in a mo.

[NurseAnne]

Nightowl I am afraid to say that these people do not understand the situation and are not going to make waves. Hospitals are now hell bent on getting as many patients in and out with as few qualified staff as possible, and it is going to get worse I'm afraid. They are bringing in ideas that utterly destroyed nursing care in america in the 1990's. I can't believe that they think shorter shifts are the answer. Their lack of understanding regarding nurse patient ratios and what nurses do is the problem here. I am still trying to figure out how to get threw to them.

 

But I always hope that I am wrong. I have my fingers crossed for you. Most hospitals really come down on nurses who speak out and refuse assignments so I am glad to hear that they are listening. As always, keep us updated.

[Night Owl]

Thanks NurseAnne. Yep, sadly bad nursing ratios are here to stay and soon certain patients will be cared for by untrained staff doing task orientated care and the public will have to get used to that. Trained staff will "supervise" that care and carry out the extra care such as medication, dressings and extra care required.

 

I think that it's disgusting that we are travelling backwards in the nursing profession, or more like being bullied into it. I started my nursing career doing task orientated care , then in came holistic care for patients.

 

Strangely the public still see well staffed "Casualty and Holby City" TV programmes that show plenty of trained nurses caring for patients which is not realistic to whats happening in the NHS.

 

I can only fight to improve our current situation not the national problem.......that may take longer!!!!

 

By looking at staffing working hours there may be staff that will like the idea of changing their shift hours. Our whole time entitlement of staffing will be increased if we can get some staff to make the change to working earlys, lates and nights.

 

By devising a dependency tool, until we have the one being trialled by another hospital, we can prove our increased patient dependency and our requests for increased staffing to the management and beyond. Legally this will provide the backbone of what we are doing and management will have to accept the results and agree the changes.

 

The Head of Nursing was not in this current post when I made my last concerns heard in 2008. She was very interested to hear about it and the actions agreed and if the actions had been put into force. I took my file of paperwork with me!

I will be monitoring this on a regular basis and in a years time to see that improvements have been made. If not and the situation remains I will continue to bring this to the attention of the managers and the RCN.

 

After writting my initial letter at the start of all this I completed the "Raising Concerns, Raising Standards" form on the RCN website. I now know that the regional officer from the RCN has made an uninvited visit to the hospital and wants a full report from the RCN rep that came to the meeting and the Head of Nursing.

 

We will make a change to the care our patient group recieve and the staff caring for them...............we have to...........and there are plenty of nurses out there that must make a stand and complain officially and use the unions, and continue to make official complaints, constructive complaints backed up with incident forms and PALS complaints.

[Night Owl]

Feeling so frustrated again.

 

2 days after my meeting and last night a trained member of staff was poached for another ward. They gave us an untrained nurse! We asked for the descision to be documented for the managers that we thought the idea of swapping staff not appropriate for the patient dependency.

 

2 off us (trained staff) spent the first 6 hours doing back to back IV drugs, the bulk of our work load. Then again in the morning, 2 and a half hours doing IV drugs. Hardly any direct patient care apart from to say "I have just come to do your meds!"

 

The ward manager was on shift this morning and showed her anger at the descision made.

[NurseAnne]

Hang on it is going to get worse.

[Night Owl]

Off sick at the mo but am aware that this week the ward manager and band 6 staff have been documenting and quantifying the nursing hours needed per patient...........but they only seem to be doing it for the day shift when we provide 24 hour care!

 

Waiting to see a copy of the AUKUH paediatric dependency tool which has been produced.

[NurseAnne]

Wow. You work in Paeds? I thought it was only adult medicine (and occasionally adult general surgery) where they screw with the staffing numbers so badly.

 

I like this line that I saw today: Registered Nurse staffing levels: It's not a matter of TLC, it's a matter of life and death".

 

People have this silly "angel" image of nursing....the hand holding and stuff. They don't realise that poor RN staffing is actually extremely deadly. They think that as long as they have a "smart" doctor and a "nice" nurse that they are in good shape. Wrong.

 

I have been a nurse for over a decade and believe me. I care more about my nurse being smart and a quick thinker who can analyse a whole lot of information very quickly. If she is nice and caring as well then that is a bonus.

[Night Owl]

Yep, I'm an RSCN. Training was generic adult nursing 30 years ago!!!!! Then specialised in Paeds. 25 years ago!!!! I have always embraced change but will not tolerate poor care.

 

Whilst off sick I heard today that we have officially increased our night shift by 1 untrained and are able to cover 2 trained maternity posts with 1 trained. This has all come from the outcome of the meeting I went to. It's postive progress and that has to be start. I feel that the fight is getting somewhere.

 

It will take a lot to change the publics view of nurses because of all the damage that has been done over the years.

[Sali]

Congratulations Night Owl. A small victory. Let's hope that it is not a temporary measure to quell the staff disquiet. Keep us posted.

[Night Owl]

Please can I ask people for their support on the Royal College of Nursing Campaign - Nursing Counts.

 

Big Thank you.

 

http://www.consumeractiongroup.co.uk/forum/campaign/244650-nursing-counts-please-show.html

[Night Owl]

Bumping my last post.

http://www.consumeractiongroup.co.uk/forum/campaign/244650-nursing-counts-please-show.html

 

Update to this thread now things have settled down.

 

We have beds closed and increased staff, and this has been a stable situation for a while now.

Things have improved at last. Staff moral has increased too.

I hope this can continue (or I will be starting all over again!).

[Sali]

I hope things continue to improve Night Owl. Let us know either way. I have mailed your link to friends who are nurses. I'm sure they will forward on to their colleagues.

[Night Owl]

Many thanks Sali for forwarding the Nursing Counts link.

http://www.consumeractiongroup.co.uk/forum/campaign/244650-nursing-counts-please-show.html

 

Here is the manifesto

http://royalnursing.3cdn.net/7fbe07033d9dc34634_4vm6ipcyv.pdf

 

Friends, family, members of the public can support this, not just nurses.

Anybody who has had dealings with the NHS as it is today can sign it and hopefully we can bombard the Government to sit up and listen and make positive, sustainable changes.

 

We have the opportunity here to do something positive, lets not waste it please.

[citizenB]

Please can I ask people for their support on the Royal College of Nursing Campaign - Nursing Counts.

 

Big Thank you.

 

http://www.consumeractiongroup.co.uk/forum/campaign/244650-nursing-counts-please-show.html

 

 

Well done for you victory.. Have passed your link on to friends who are in the nursing profession.

 

Lets hope things continue to improve for you.

[Sali]

NightOwl

 

If I wanted specifically to know who was on duty on any particular shift during one year how would I word a Freedom of Information request? I want to know what the trained nurse to patient ratio was - I do not want HCAs, matrons or any other members of staff included in the statistics.

 

For how long would you think such records would be kept?

 

Also are you actively encouraged to raise incident forms when you are understaffed or is there another method that allows you to raise your concerns in a formal way that is recorded?

 

Many thanks.

[Night Owl]

Hi Sali,

 

on our unit we have off duty records that list all the staff on duty, or off sick, for every shift in the 24 hour period. Not sure how long they are kept for but we keep a folder in the ward managers office.

 

We have also just started a computerised off duty programme planning called Roster Pro. Staff can input their off duty requests and the rota for each shift is worked out from this.

 

We keep a daily work book which lists the patients and the staff caring for each patient.

 

The nurse to patient ratio is set by management and sadly is always the minimum number. It is based on the patient dependency per specific unit/ward. It would include the percentage of trained and untrained staff required, or the minimum the management can get away with before the sub-optimal staffing incident forms start flooding in!

 

All paitient care given is signed for either in the medical notes or nursing care plans that, on discharge of the patient, are filled in the medical notes.

 

Yes we are actively encouraged to raise incident forms for sub-optimal staffing but again it is up to each staff member to do it. We have just had a new computor programme installed for us to complete the forms on the computor. There is a paper trail for each incident form as they are processed by management, most staff members still believe that they just go straight to the shredder for all the actual change the make. Each ward should receive feedback for each incident form completed, if not it can be requested.

 

Sorry not sure how you would request specific information under the Freedom of Information Act.

 

Hope this helps you Sali.

Good luck.

[Sali]

Yes, thank you Night Owl, it does help.

 

I think it is wrong that the management should decide on the minimum number of trained nurses to patient ratio. I'm presuming that this can change from Trust to Trust.

 

Rather than the pledge of allegiance for nurses that has been tabled, (you have to wonder at the dullards that came up with this idea), I would like to see a legal obligation on the trained nurse to patient ratio (and this I would like to be proposed by the existing trained nurses) across the NHS, with management held accountable if it fell below.

[lady-in-red]

i have been reading all your posts nightowl and i can where they went wrong in my sons care and safety, they were short staffed, and couldnt turn him from prone to supine it took 8 people and there wasnt enough people in at that time so he was in prone for 20 hours thats how he got the mark on his head, i can understand the saftey issue for the staff but my son suffered badly because of this, who is to blame then really it cant be the nurses they did what they could do, we need more people like you nightowl to make a stand and tell the managers you want more staff or even wrote to david caeron someone has to listen because patients are at risk more now than have ever been when a hospital makes a mistake and nearly causes a death they should speak up and tell the truth not hide it thanyou nightowl for all you have done to try and make your work place safer for patients and staffxx

[Night Owl]

Hi Glitterlady,

 

fancy seeing you over here.

 

Has my thread made interesting reading? It's a bit long now!

It was a battle but the battle was won. Not saying that things will probably slip again at sometime but the management listened as they should.

 

I'm passionate about my job and those I care for. Please don't think of me as a jobs worth. I just love what I do. I will not witness poor care without speaking out and really wish others would.

 

Leaving a patient in one position for 20 hours is not acceptable and is against every Hospital Policy on Pressure Area Care. This is a High Risk Incident and should have been dealt as such.

 

Short staffing is down to those on each shift to make a noise to get something changed. Nurses should not be made to put up and shut up. Incident forms are there to complete especially if you can prove that sub-optimal staffing is leading to sub-optimal nursing care. Back it up with facts......increase in pressure areas, increase in medication errors.

 

Really must stop ranting!!!!

 

Well, back to work tonight............it's gonna be hot too!!!

 

Take care Glitterlady,

Night Owl x

[Allwood]

Night Owl, I have just seen this thread and you are doing a wonderful job, in Speaning Out is essential part of the caring profession. Hope it went OK for you last night.