Nice people thread part 6 - thrice by twice as nice :)

MiddyMum

PasturesNew wrote: »

What do nurses actually do? What's a typical day on a ward where people have been admitted and are being sorted out .... and they're just there for a few days/a week until a Doctor comes along and says "that one can go home now".

I know where my old was there was a tea-lady who brought round drinks/biscuits .... and somebody else kept coming and taking blood pressures .... but I didn't even know who the nurses were. I can't tell a nurse from a cleaner as they all wear tunics these days. And the attitude seemed to be "I am here today, on this shift... only". So there was no sense of people nursing a ward, but a series of random one-dayers.

There was a "nurses station", aka reception, where a gaggle of random people were milling about and updating records; people who were nothing to do with the ward. e.g. a pedicurist might have been in to see one person, they'd sit there, update a computer record, then they might be off to a ward on another floor .... or somebody might have just pushed a patient in a trolley onto the ward and had gone to speak to somebody in a hidden room behind reception .... but there was no sense of "This person is in charge; ask here; start here; this is where visitors need to ask" it was all "Oh, I don't work here.... this isn't my ward.... I'm just passing through".

Nursing is a very challenging career, and one that I aspired to a few years ago as the intrinsic rewards of caring for the sick was very alluring. After a year of training I decided to not complete as working as a black nurse in this country can be very trying for many reasons. My colour had never been " that apparent " to me, as I grew up in an interracial household, with my step dad being white, and with that came white grand parents. However, on the wards I was subjected to the N word from patients more often than I would like to remember. On one occasion, I was the only student nurse on shift. Sister was doing the drugs round and I was assisting her, the ward was full to the brim: 28 patients. She gave me the responsibility of administering analgesic to a small bay of patients, while she did the other side. One patient in particular, told me that she did not want a black nurse, to which I informed her that I was the only nurse available. The medication I was about to give her was to stop her pain, and if she didn't take it from me, she would have to wait for the sister who was at the other end of the ward and wouldn't be available for at least another hour. (Drugs round takes at least a couple of hours on a ward like this, especially if you are administering opiates, it usually needs to be cross checked)...she reluctantly agreed to take the medication and snatched it from me. It was about a couple of months after this incident, that I made the hardest decision of my life to leave my training. There just was not enough rewards for me in nursing, personally.

As for what nurses do, well a lot happens behind the scenes. It can seem like they are not doing much, and admittedly some do pass on a lot of the workload to health care assistants, which is often to the detriment to the profession in my opinion. Normal 12 hour shift will go like this...

7.15am - 8.30am - Handover: Night staff will go round each bed with the day staff and talk through what has happened in the night, any changes, if Dr needs to be called for urgent review, if wound care needs to be given.
8.30 9.30 - Breakfast is given out. In my experience, the thoughtful nurses will help the Health Care Assistants with this, and some patients will need feeding, so the HCA or the thoughtful nurses will assist with that.
9.30-11.00 - Toilet, Bath & Bed Change. This will need to be done for the entire ward, some patients can wash themselves but on a general medical ward it is unlikely. So, depending on the nature of the ailment, the nurse will assist the patient into the shower, or give a bed bath and change the sheets on the bed, while the patient is still in it! (Quite a skill). This can be back breaking work, because if a patient has had a stroke, they may have limitation of movement in their limbs. Although, hoists can be used for the severely limitated. There is obviously shaving to do for the men and I used to like to put make up on for the ladies, as just that little extra would make them feel so much better.
11.00 - 1.00 - Observations, admittedly a Health care assistant would do this while the nurse is now doing the drug rounds..Drug rounds usually take a minimum of 2 hours. Observations is the blood pressure, temperature, respiration, it may even include mouth care, and assisting patients with going to the toilet. During this time, the doctors will come on the ward, and the nurses will assist the doctor while he goes from bed to bed discussing a plan of care.
1.00-2.00 This will be lunch time of course, nurse and health care assistant will hand the lunch out and assist patients with feeding.
2.00 - 4.00 Possibly, another drugs round/wound dressings to be carried out, it is usually nap time on the ward as patients may have been for physiotherapy and are usually feeling very knackered/deflated about the whole thing. If patients are bed bound, they will need to be " rolled " to prevent bed sores. Nurses will spend this time huddled at the nurses station (if there is a seat) and will frantically write the notes in the medical records. This can be hard to achieve, because usually relatives will call at this time, and time needs to be given to relatives as they are often very upset. Some patients will also ring the bell during this time also, and obviously some patients with dementia may wander out of the ward naked so you are constantly keeping an eye on the exit!
5.00 -6.00 - Supper time, again Health care Assistants and nurses will hand this out, and assist patients with feeding. Most patients will need their adults " pads " changing or go to the loo in this time, and will need assistance with that.
6.00 - 7.00 - Visitors usually come at this time, and they will always want to speak to the nurse in charge. Most relatives are very upset, and often need a lot of emotional support from nurses.

Throughout the shift, nurses may engage in health promotion actitives which may be talking to patients about smoking cessation and alchoholic groups. This is absolutely necessary and can be very time consuming, as I have seen with my own eyes patients with COPD wheeling their IV bag into the car park to have a fag, some patients just never learn.

What I just described was a straight forward shift, I am sure I have missed loads out. This ward would be considered a non busy ward! Although, I have to agree with you, there can be a lot of buck passing within the NHS and rather than someone just helping out where necessary, one may say that they don't work on the ward or that is not their patient as 3 nurses on a shift will all have individual bays to take care of. Although, in my eyes a nurse is a nurse and what bay a patient is in, shouldn't come into it! I actually had a nurse I was working with say that to me once as a student nurse; I was asking on the behalf of a relative (she was actually standing behind me at the time), as soon as she said it, I could have died because the relative was understandably fuming and she made a complaint.

Call me masochistic, but as some as you may know I am returning to the NHS but hopefully this time as a student midwife. I felt long and hard about it, as I initially wanted to go back as a student nurse ( I do miss looking after patients, racial abuse and all) but during my maternity placement it felt like I had come home. Therefore, I think being a midwife will be a much better fit for me.

MiddyMum

Oh dear, I apologise for the phD paper.

lostinrates

Tahts ok middy.

I think its abhorant that people used the 'n' word at you...,but you know, those vile pele just look for an excuse to take their misery out. Kf you were blonde it would have been bimbo or !!!!!!, overweight it would have been fatty or porky, and so on and so on for anything they felt they could challange.

Fwiw even my old very rural community had a black nurse (best in the practise purely coincidentally) and one of the things i like about where we live now is that it is a little more 'multicultural'. Its really not about skin colour though, like pn's ll, its about peoe them selves, and not who they direct it at. Could be anything they felt they could niggle at that they picked on.

LydiaJ

Just dropping in to let the NP know that DS has found out today that he's got into the top maths set.

Masomnia

That's really sad Middymum. I just can't understand the mentality of people like that.

In your situation I'd have been very tempted just to say 'OK then.' and walk off and leave them in pain... but that's probably why I'm not a nurse!

MiddyMum

lostinrates wrote: »

Tahts ok middy.

I think its abhorant that people used the 'n' word at you...,but you know, those vile pele just look for an excuse to take their misery out. Kf you were blonde it would have been bimbo or !!!!!!, overweight it would have been fatty or porky, and so on and so on for anything they felt they could challange.

Fwiw even my old very rural community had a black nurse (best in the practise purely coincidentally) and one of the things i like about where we live now is that it is a little more 'multicultural'. Its really not about skin colour though, like pn's ll, its about peoe them selves, and not who they direct it at. Could be anything they felt they could niggle at that they picked on.

I completely agree, on the whole I havent taken it to heart but in that moment when you are helping someone to achieve dignity and independence it can be very hard to see the point in it all, especially when they want you to go back to where you came from. One of my most favourite patients was a 98 year old man, he was lovely. A couple of days before he passed away, he told me, " What your kind do for our country is briliant ". This comment may come across as a little off to some, but to me, it was one of the best compliments I have had from a patient. A man, that was nearly 100 years old had probably seen many a thing in his time, and Britian was undoubtedly different to how he knew it as a child but in my heart, I know that what he said, was meant in good will.

LydiaJ wrote: »

Just dropping in to let the NP know that DS has found out today that he's got into the top maths set.

Well done to your son LydiaJ, maths was never my strong point!

Masomnia wrote: »

That's really sad Middymum. I just can't understand the mentality of people like that.

In your situation I'd have been very tempted just to say 'OK then.' and walk off and leave them in pain... but that's probably why I'm not a nurse!

Believe me, sometimes I felt like saying that but above all, I know she needed me and I had a duty of care, and that came before my feelings at the time.

PasturesNew

I thought half that stuff was done by what used to be called Auxiliary Nurses (in the 70s/80s) - the sheet changers, bum wipers etc. I could understand if an Aux had been round and done it all and a patient suddenly wet themselves, threw up on the sheets and pulled out their tubes... but if that happened I'd expect the nurse to just 'organise' an Aux (standing to hand) to clean it all up, while they calmed down the patient and reattached any tubes etc. IYSWIM.

MiddyMum

PasturesNew wrote: »

I thought half that stuff was done by what used to be called Auxiliary Nurses (in the 70s/80s) - the sheet changers, bum wipers etc. I could understand if an Aux had been round and done it all and a patient suddenly wet themselves, threw up on the sheets and pulled out their tubes... but if that happened I'd expect the nurse to just 'organise' an Aux (standing to hand) to clean it all up, while they calmed down the patient and reattached any tubes etc. IYSWIM.

A good nurse will do everything, including toilet duties. They are about..Thats why I mentioned the notion of thoughtful nurses in my original post. Thoughtful nurses will never just pass on undesirable duties to another staff member. Auxillary nurses are now called Health Care Assistants, they are there to assist the nurses with their duties, but not to simply just do their job for them, although this line has well and truely been blurred now and I do think some nurses are now taking the pee in all honesty. Some nurses will happily spend all day at the nurses station writing notes, whilst delegating to others.

LydiaJ

The nurse I knows best ended up completely worn out working on understaffed wards, frequently working a whole shift without so much time as to go to the loo. She found it demoralising to be looking after so many patients that she wasn't able to give them the level of care she believes they each deserve.

In the end, the exhaustion and the childcare complications of doing shift work became too much for her. She's a community nurse now, working much more sociable daytime hours. She's still crazy-busy from the beginning of her shift until she leaves (usually long after she's supposed to finish) but at least she now has a bit of head space as she drives from one appointment to the next. She does dressings, drugs, catheters, and lots of other things for patients who are at home and unable to travel to the surgery.

lostinrates

MiddyMum wrote: »

A good nurse will do everything, including toilet duties. They are about..Thats why I mentioned the notion of thoughtful nurses in my original post. Thoughtful nurses will never just pass on undesirable duties to another staff member. Auxillary nurses are now called Health Care Assistants, they are there to assist the nurses with their duties, but not to simply just do their job for them, although this line has well and truely been blurred now and I do think some nurses are now taking the pee in all honesty. Some nurses will happily spend all day at the nurses station writing notes, whilst delegating to others.

Yep, thats what we found at the private in the nhs place...the mainly eastern european nurses were horrified that the english nurse's response to blood being spilled was 'i'll call housekeeping' not, i will get onto it AND call house keeping. She was not a bad nurse, she just felt that the floor was not her remit.


Fwiw, on that occasion my mother was really, really rude to the nurses. When left alone i told her off and she apologised. The nurses were so kind to her after her apology and when she left were all hugging her.


When i was very very ill, after an op i was offered supper. I asked if i were really allowed to eat that night and they said yes, they recommended i did even, so i ate some food ( i think it was soup and sandwich). It was not easy for me to make my self understood back then and i was so plleased.

Anyway, i ate it and in the wee small hours projectile vomited. The vomit actually hit the wall infront of me:eek::o. As well as going all over me. I was trying to aim, and call the nurse and everything and it was just gross.

I was deeply ashamed, crying, embarrassed and unable to do anything for myself. The night nurse when she finally came was livid. She took the top sheet off and replaced it and left me like that, filthy, stinking.

The morning crew found me still awake and crying, ashamed and unable to move (i had two drains in me either side of the bed so could not even shift left or right to even try to mop up myself. They were kind but i have to admit the shame of that and the fury has always stayed with me. Going into hospital is not fun. Its not a choice, usually. Being sick messily really ain't fun either, and i was ashamed enough without being left to stink in it. I am quite lucky really that i did not get sore round where the drains in me were and stuff. Even my hair was covered.

Yeaurck. I hope no one is reading while eating their supper!:o