Stress at work and zero support

missbiggles1

drinkupretty wrote: »

I am a member of a union and am going to give them a bell but also wondered if there is anything else I could be doing in the mean time

This should really have been the first thing to do when problems arose - don't leave it any longer!

calicocat

I work in MH for the NHS.

What type of ward are you on ?? , where i am it is illegal not to have a qualified on the ward at all times...:eek: , i have never worked on a ward where this wasn't the case.

Is yours long term re-hab and a qualified isnt required 24/7 ?

Also , if you have no qualified on the ward and there is an incident (which it sounds like you do regularly), who is in charge , who is co-ordinating what has to happen next with the patient, who is assessing whether medication is needed, and who is there to administer medication......??...the place sounds well dodgey to me to be honest.

Find out if you are meant to have a qualified on at all times via a different route than your ward.

Find out the minimum staffing levels that have been set on the ward.

Find out if all memebers of staff working with you have PMVA training.

keep copies of any letters emails sent , try to email or fax everything so you have proof it got there .

Is your GP good, get a letter written buy him regarding what is stressing you and why, this will be very helpful for you and something they can not ignore, any back-up you can get from your GP is good. Your GP can reccommend working hours for you on the new fit for work note (old sick note revised), which they would be hard pushed to completely ignore.

Gp can also advise an Occ Health appointment be given.

Unions these days seem to be a waste of time from what i hear.

I can self refer to Occ Health....ring them and see if you can do it in your trust.


You shouldnt have to be working closely with someone who is targetting you , you can ask to be moved to a different ward whilst that patient is there. Demand a work stress assessment be done immediately.

Speak to unison ,they will certainly advise, how much more i guess depends on who is in your area and how good they are.

Lastly...be careful , as the NHS seem happy to ditch people left right and centre these days for the cheaper options (band 2's) , you shouldnt be working in these conditions, but play your hand well when dealing with them . Our sickness policy is just crazy now, so check yours out if anything has changed recently.


good luck , and for the record , i would be looking for a different ward to work on as that sounds really bad, i have never been on an NHS ward run like that...:eek:..and wouldnt put up with it.
I would feel my job is at risk due to poor management , the wrong skill mix on a ward, avoidance of staff needs and wellfare , probably lack of training....and the danger of a serious incident happening in the not too distant future with me being smack in the middle of it.

If your manager isnt backing you now, how would they be with an incident that they were looking to find a 'blame person' for??

CQC is another route , look up what the last reccommendations were for your ward etc.


Again , good luck , and keep fighting for your rights .


Edit , at work we have just been dicussing this ......who the heck gave out the night time medication on a 22 bed MH ward when there was no qualified on shift..the kardex audits..i could go on...?

We are all in agreement that you should put in for a transfer to another ward asap.

calicocat

I'm back, I couldn't get this out of my head as to be honest the place sounds like a shambles.

Re: being targeted at work by a patient (which on a normal ward wouldn't be allowed or boundaries put into place to minimise) , anyone working in this field will get this at one time or another granted, but you shouldn't be having to tolerate this every shift or for any prolonged period of time (ie :doing eyesight obs for an hour or more or escorts off the ward).

What you could do is send an email to your manager/matron( and whatever your above matron is called (we don't have those names anymore for management). In this email you state your concerns, what is happening, how this makes you feel (concisely) and importantly that you are working under conditions where you Don't Feel Safe...the I Don't Feel Safe is the important sentence.

Your employer has a duty of care to make you feel as safe as possible at work, and I would advise making sure the email goes above the matron too as they have been ineffectual so far.


Also, do you have to fill IR1 or incident forms in every time you get assaulted? You should be, keep copies of any of them pertaining to you, also fill them in if the ward has felt dangerous due to lack of staffing (again keep copies).

Also, if possible do a bit of hunting for information, you say you have been assaulted a few times recently. If the ward is short staffed this happens, have a look at records to see if this has escalated in general now the ward is chaos, or whether it is about this particular patient...(again keep copies).

Right, off to kip now and again stick up for yourself.

[Deleted User]

Hi I work in an acute 22 bedded mental health ward. During the day as a minimum we are supposed to have 2 qualified nurses and 2 HCA's. At night we have 1 qualified nurse and 2 HCA's. However due to poor staffing levels (lots of RMNs leaving and posts not advertised) often there is 1 RMN on in the day. Usually there is 1 RMN on at night but often they are agency workers who do not know the patients or the ward. Last night the agency nurse tried to give a client Clozapine without their pulse or BP being taken! (the drug can cause tachycardia so this is a no no) Even though I had just told her that her vitals needed doing first. Don't get me wrong there are some very good agency nurses out there, but having a nurse who knows the ward and patients are so much better for good patient care. If no qualified nurse is on the ward then during the day we will either get an RMN from another ward which will leave them short. If we only have 1 RMN they seem to think providing another HCA to make up the numbers is acceptable. If working at night and no qualified then whoever is the unit coordinator has to come over and dispense medication/ support during emergencies. But this then leaves their own ward without.
Permanent staff have all been PMVA trained, unless they are signed off due to medical reasons. If this occurs then it is up to the ward manager to ensure good skill mix of PMVA trained staff. However, often bank and agency staff are not PMVA trained which I feel is dangerous, but no one checks when booking them in, they are more concerned with numbers. When CQC inspected last month there were 4 RMN's and 3 HCA's on the ward. Amazing they can find the staff when they want too!
When I was being assaulted I emailed the acting ward manager who is also one of the high up nursing managers (we have not had a proper ward manager for 12 months). She and the matron are both aware of the assaults and issues on the ward but I might as well have been talking to a brick wall. The director of the unit was in charge of the disciplinary and I told her about the stress I was suffering and got nowhere.
We have incident reporting forms.. During the time I was being victimised by a client. We were told that band 2's could not complete these forms. I knew this to be incorrect and contacted my union who reported this to the health and safety department at trust HQ. They were concerned by this and also that the acting ward manager sent around an email stating that only the senior nurse could contact the police after an assault. This could be seen as covering up safeguarding issues and goes against duty of candour. Since this the policy has been updated and specifically says that all staff have a duty to log incidents.
My GP isn't much help either. I ended up complaining to NHS England about him because he started demanding to know why I was depressed, blaming my weight and babbling about taking me off my meds in the summer "because it's better to do when it's sunny" (!!!!!!?!!) I have only been on my meds since late last year, I am still getting side effects from them and still plagued by fleeting suicidal thoughts on an almost daily basis. It seems all the people paid to help don't give a toss. I fear needing hospitalised because I will probably end up on my own ward (this has actually happened with a student nurse and the offspring of a member of staff who works on the unit!)
No union rep in the unit, so I have to go to branch and they are so backed up with work, They are helpful as they can be but have very limited resources.

calicocat

It is not acceptable to have a unit coordinator come over to dispense medication or come over to help in emergencies.....does this leave you with no qualified once they skip off back to their own ward..?


If so, this is illegal :eek: and you could get the place shut down.

Bank and agency shouldn't be allowed to work on accute without Pmva training really, that is bad practice.

It's amazing what staff they can find for CQC visits isn't it.....and how many cleaners are drafted in.


Working with agency qualified who don't know the ward can be difficult, but is what happens when a ward is going through a bad patch. If they won't listen to you, let them got on with it...it's their registration, provided you have done what you can for the patient etc.

Wards do tend to go boobs up when there is no proper structure to the place and people are leaving left right and centre, sounds like your place is suffering from this and has no manager on top. Not a good scenario unless you have good band 6's.

Don't you have band 6's...? (is that your senoir nurse?), an accute ward should do, often 4 of them to be fair.

It sounds like the place is doing to the dogs, get a transfer as soon as you can.

print out the email from the acting ward manager who stated only senoir nurses can call police after an incident...that is bang out of order, unless she meant that the nurse in charge should be doing the reporting from a ward point of view to make sure correct info given. Any individual has the right to contact police about an attack on themselves.

Have you ever gone to the police following an attack..? You don't have to have them come to the ward to see you, you can go yourself after work, and will often get better results this way.


The doors to you ward I assume are on camera..?

This would also prove times when there was No qualified on the ward...I can't believe this is happening, the CQC could shut the place on the spot for that..highly dangerous practice and I have never heard of it...shocking behaviour.

Get yourself on the trust intranet and get looking at the jobs around if it continues.

Wards do go through bad patches, especially when people leaving and a certain patient mix etc. They are very stressful times (it's a high stress job to begin with anyhow). I hated my place around a year ago, but these phases usually go, and how you feel about it is normal.

Do you get Good regular supervision..? If your supervisor isn't any good change them (you have thr righht to), the thing is when the whole staffing are stressed supervision goes downhill.

This period may well pass, and can take a good 6 months to a year to get back to a good level. If it doesn't, get another ward to work on.

[Deleted User]

calicocat wrote: »

It is not acceptable to have a unit coordinator come over to dispense medication or come over to help in emergencies.....does this leave you with no qualified once they skip off back to their own ward..?
Yes the ward is then left at the mercy of us HCA's. We are not ligature cutter trained and only have basic life support training. It's very scary when this happens

If so, this is illegal :eek: and you could get the place shut down.

Which law does this fall under? Just so I can quote it to management.

Bank and agency shouldn't be allowed to work on accute without Pmva training really, that is bad practice.

It's amazing what staff they can find for CQC visits isn't it.....and how many cleaners are drafted in.


Working with agency qualified who don't know the ward can be difficult, but is what happens when a ward is going through a bad patch. If they won't listen to you, let them got on with it...it's their registration, provided you have done what you can for the patient etc.

Wards do tend to go boobs up when there is no proper structure to the place and people are leaving left right and centre, sounds like your place is suffering from this and has no manager on top. Not a good scenario unless you have good band 6's.

Don't you have band 6's...? (is that your senoir nurse?), an accute ward should do, often 4 of them to be fair.
We have 3 band 6's. One is on long term sick with stress, one has just started and the other seems to be of sick or on annual leave a lot
It sounds like the place is doing to the dogs, get a transfer as soon as you can.

print out the email from the acting ward manager who stated only senoir nurses can call police after an incident...that is bang out of order, unless she meant that the nurse in charge should be doing the reporting from a ward point of view to make sure correct info given. Any individual has the right to contact police about an attack on themselves.

Have you ever gone to the police following an attack..? You don't have to have them come to the ward to see you, you can go yourself after work, and will often get better results this way.
Yes I have but got nowhere. Police hide behind the capacity excuse. Even when the doctor is stood right there saying there is capacity they seldom want to know

The doors to you ward I assume are on camera..?

Yes and swipe system registers who goes in and out and when

This would also prove times when there was No qualified on the ward...I can't believe this is happening, the CQC could shut the place on the spot for that..highly dangerous practice and I have never heard of it...shocking behaviour.

Get yourself on the trust intranet and get looking at the jobs around if it continues.

Wards do go through bad patches, especially when people leaving and a certain patient mix etc. They are very stressful times (it's a high stress job to begin with anyhow). I hated my place around a year ago, but these phases usually go, and how you feel about it is normal.

Do you get Good regular supervision..? If your supervisor isn't any good change them (you have thr righht to), the thing is when the whole staffing are stressed supervision goes downhill.
No I don't. I have had 1 supervision in the last 12 months and have never had an appraisal which are supposed to happen every year. I asked for both these until I was blue in the face, they never happened so I gave up
This period may well pass, and can take a good 6 months to a year to get back to a good level. If it doesn't, get another ward to work on.

I answered in red in the quotes

calicocat

Not sure about legal question....but I will find out at work for you tonight provided the place is as quiet as it was yesterday.

You should have fish knives on the ward? I don't think anyone receives specific training for ligature/cutting, you just get in and cut the thing off, and basic training LS is normal, if you ever get worried or stuck ring 999 for an ambulance.

Mmmmm..........lots of staff off sick, the ward has issues for sure.

The police...this can very much depend on who sees you and the Sergeant in charge. Plus...if your area is like mine, to be fair the police get sick of the problems of an acute ward. Both ends are understaffed and stressed out. I'm in a big city at work, the other friday night there were 8 police on duty.....8...for a large city..!! I was stunned. We are all being stretched beyond sensible often.


Supervision you should be getting, however this does go boobs up when a ward is collapsing. You can ask for supervision from another ward.


Right, off to get ready for work, I will try and get some useful info for you.

calicocat

I cant post links for some reason , probably as i do this from a mobile .

Look up Accreditation for inpatient mental health services (Aims) , standards for inpatient wards working age adults.

NMC code of prctice.

Policies pertaining to your Trust re:staffing levels and skill mix. These will be in the operational section of your policies . If you cant find what you want ring NMC or CQC and ask them.

The only way you would maybe get away with no qualified on a ward would be at times one qualified may be looking after two floors of the same ward ?

Hope this helps ...get investigating .:)

purple12

Just knock off a quick email to CQC - I'm sure they'd be interested and it doesn't need to wait for all the other options to be exhausted.

Can be done anonymously http://www.cqc.org.uk/share-your-experience-finder

All trusts have to publish their staffing levels on NHS Choices - if you look up the hospital site, it'll have to publish what the actual staffing levels are. Most trusts also publish monthly in their board papers.

Some trusts have schemes to contact CEO/Nursing Director directly with concerns about patient safety and staff safety - take advantage - you've been to your manager but jump over them if you need to. You've gone down the routes available and hasn't helped. There should be a non-executive lead on safety/concerns too - might be worth hunting out.

I used to work in a Mental Health trust - and having worked in various health and social care settings, it was, ironically, by far the worst in managing the mental health difficulties of staff. It used to make me quite angry.

good luck and i wish you all the best

[Deleted User]

Thought I would pop by with a little update. I ended up getting signed off sick with stress for 2 weeks and changed to different antidepressants. I spoke with my union branch who are supporting me with a formal grievance. Time will tell how that works out.