On the glory of state supplied services

A study of pensioners who suffered appalling treatment at the hands of doctors and nurses says that half were not given enough to eat or drink. One family member said the maltreatment amounted to “euthanasia”.

The damning report warns that extra money will not help the NHS meet required standards of care and that more problems are likely as the population ages.

Some were left unwashed or in soiled clothes, while others were forgotten after being sent home or given the wrong medication.

In several cases considered by the Health Service Ombudsman, patients died without loved ones by their sides because of the “casual indifference” of staff and their “bewildering disregard” for people’s needs.

Note that line. It\’s not about money or resources.

It\’s about the actions and incentives of those already being paid for by the system.

Some of this sounds like a failure of basic nursing care: thank God they\’re all graduates now, eh?

18 comments on “On the glory of state supplied services

  1. Tim, I couldn’t disagree with you more regarding the blame on the front line staff – they never get such staff to provide serious input into the reports and as such are the only scapegoats.

    The real issue is the amount of paperwork and other non-core jobs that they are required to do which doesn’t give them time to do nurse – it’s absolutely crazy! For example, Mrs FAV has just been told she has to identify and source local items to help save money – a group of about 5 nurses has been set up to do this in just her department. Since when was sitting behind a computer researching the costs of pens or visiting suppliers or negotiating prices the part of a nurse’s job? Especially when they have an overstaffed procurement department!

    Such initiatives (and there are many more) and the failure to provide enough nurses means that they are stretched so thin that when they do a ward round (drugs and checks) they do not have the time to spend with the patients to understand their needs and give them the proper care, especially as by the time they have finished this super fast round, it’s time to start the next one! And that’s without any emergency admissions etc.

    Front line nurses are the easy target. What’s needed is REAL reform that allows the nurses to do the job that most of them love and that patients need – providing proper and attentive care.

    Cheers
    FAV
    P.S. My wife is hoping that my trial job in Hong Kong is successful as she’s reached the point where she wants to jack it all in as she’s tired of not being able to care for patients properly.

    P.P.S. I hope all the above makes sense, it’s hard to type and read in this small comments box.

  2. The worse thing they ever did was make nursing graduate only. Instead of being a vocation (as it was when my mother trained at St Thomas’s in the 50s) it became a career.

  3. Some vindication for the late lamented NHS Blog Doctor, then?

    And ‘foundavoice’, while that may have been YOUR experience, I have to say that mine hasn’t been an inability to pry the nurses away from their crippling paperwork. It’s been an inability to

    a) pry them away from their oh-so-interesting gossip over last night’s tv, or this morning’s ‘Heat’ magazine, or

    b) make myself understood in plain English, due to them being unable (or possibly unwilling) to speak or understand it.

  4. One of the biggest issues are nurses stood around, gossiping and sharing holiday photos around the nursing station. I can count on the fingers of one hand the number of excellent nurses who looked after me in six months of hospital ‘care’. The nurses who did a really good job were: a male night nurse from Kerala, a male nurse from Jordan, an Trinidadian female nurse who only worked one day a week, and an Australian female nurse who seemed to have boundless energy.

    The worst nurses were Nigerians who seemed incapable of communicating in intelligible English and routinely dished out the wrong drugs to the wrong patients. Often I would ring my buzzer and would wait up to half an hour to get help. The nurse would turn up pretty sharpish to turn the buzzer off and then would disappear with a promise to come back later.

    As far as personal care goes, in six months of stays in hospital I had my hair washed four times. I was told to wash myself even though I couldn’t move. Now, I’m a stroppy middle-aged journalist able to stand up for myself. I was unfailingly polite to all the staff who ‘cared’ for me but if I’d been elderly or so sick I couldn’t speak, I would have died.

    I don’t know what will solve the NHS but the envy of the world it ain’t.

  5. Nurses standing at the nursing station, talking: in my experience in one local hospital, the talk was idle gossip; in another, the talk was “shop”. You can’t tell from a distance – you have to approach and overhear the chat.

    In one ward at a local hospital, a few years ago, the nursing was rubbish until for one shift there arrived a wee Scots ball-of-fire Sister. Once she’d gone, the standards slumped again.

  6. There is a weird taboo in this country on public criticism of the NHS. It isn’t just a Leftist wall of noise, even sensible people seem unable to think rationally about it.

  7. The problem is politicians still say things like “the NHS is the envy of the world” and no-one laughs at them.

  8. You can tell it’s idle gossip when they’re shrieking with laughter. Even when I’m on morphine I can hear the difference between someone talking shop and someone gossiping. Besides, nurses should not be discussing patients in voices loud enough for anyone else to hear.

  9. JuliaM, yes, I understand that it’s my experience, or rather, my wife’s. But there’s no more validation in your experience than mine /hers and it comes back to my central point: there needs to be real reform of the NHS (I’d like to see it broken up and privatised) to allow nurses to start nursing again.

    Cheers
    FAV

    PS. Look, maybe my wife’s been unlucky at the last 3 hospitals she works at (in terms of staffing levels). I do know that despite working her butt off on 12 hour shifts (plus the extra hour or so to catch up on the remaining paperwork), she hasn’t had time for a lunch break in 2011!

  10. “But there’s no more validation in your experience than mine…”

    Except mine gels with that of MikeS above, and to some extent, dearieme’s.

    Also, the experience of many of my friends, colleagues and relatives.

    As Rob points out, it’s some wierd taboo that the NHS is (politically) above critiscism from ministers and the left-wing media, but ask people who have had experience of it and you’ll find plenty.

  11. JuliaM,

    As Rob points out, it’s some wierd taboo that the NHS is (politically) above critiscism from ministers and the left-wing media, but ask people who have had experience of it and you’ll find plenty.

    It’s because any criticism about how the NHS works is instantly twisted by it’s supporters into “you hate the NHS because it stops poor children from dying”.

    Also, one could point at which groups the BBC think are important in the debate (no, trade unions aren’t).

  12. The worst nurses were Nigerians who seemed incapable of communicating in intelligible English and routinely dished out the wrong drugs to the wrong patients.

    If it’s any consolation, this could describe Nigerians doing pretty much any job within a major oil company.

  13. JuliaM
    “Except mine gels with that of MikeS above, and to some extent, dearieme’s. Also, the experience of many of my friends, colleagues and relatives.”

    Hang on, first you pull me up for anecdotal evidence, which I fairly concede and just as fairly point out yours is the same. Then you rebut that yours is the same by providing, er anecdotal evidence. Bit strange that, would you not say?

    “As Rob points out, it’s some wierd taboo that the NHS is (politically) above critiscism from ministers and the left-wing media, but ask people who have had experience of it and you’ll find plenty”.

    I agree. As I also said, my preference would be to privatise it. In fact, I’ve been trying to get the wife to start blogging about the internal sh!t that they have to deal with and then how that affects them doing the very job we all want and they all want to do.

    But those who think it is because matron was removed or because (shock horror) we have nurses who graduate are ignorant to the reality. Start with the militant nurse website and go from there. http://militantmedicalnurse.blogspot.com/

  14. After the election I wrote to the new Health Minister suggesting that clerical staff (of whom there are legion in the NHS) should be sent to wards at meal-times to assist old and ill people to eat.

    I had a letter back from a bureaucrat telling me in no uncertain terms that these staff were doing very important work and therefore my idea was effectively crap.

    Yuo, keep shuffling those papers, much too important to leave to help actual patients.

    Alan Douglas

  15. Oh, there are certainly problems resulting from neglect of duty and a failure of basic nursing care…

    But far m0re problems result from inadequate staff/patient ratios and anybody who thinks otherwise is being daft. We might eat too much Quality Street, but nobody on my ward (emergency surgical admissions & very busy) stands around reading Heat magazine – we don’t have the fcuking time. We also run a tight ship – under the baleful eye of an excellent Senior Sister who isn’t frightened to fight for decent staffing levels. As a result, we manage. It’s as simple as that.

    That isn’t true elsewhere. One of the most depressing memories I have from my training days was a night shift on an Elderly Care Ward where six additional beds were opened up (due to pressures in A+E). This meant that two Staff Nurses and two Auxiliaries were now responsible for a total of 32 patients – many of them confused (and mobile with it), or requiring all-care (often palliative). Given those kind of numbers, no staff nurse has a hope in hell of doing their job properly. I’ll happily blame and report where blame is due – but I will not blame frontline staff who are being asked to do the impossible.

    Anyway, I’m not even sure it’s about the money (though cinderella services like Elderly Care have long been underfunded). Frankly, I hear an awful lot of people complaining about jobs they would never do themselves. And if I was in charge of Dave’s woe-begotten Big Society project, I’d make everybody do national service as a care assistant. It would do wonders for the issue.

  16. Anecdote: when my wife was in labour with our firstborn, the midwife (third one that day, due to shift changes, natch) asked if a student could come in “to observe”. Who could object?

    The student came in, and the two of them started chatting about someone’s new flat, and where they were going for their holidays. After a few minutes of this, I suggested they might like to concentrate on the patient rather than their personal affairs.

    I was threatened with being expelled from the ward! The gossip continued; the patient suffered.

    There is State Healthcare in a nutshell.

    Of course, the plural of anecdote is not data; unless, perhaps, it’s a very large plural.

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