So a couple of weeks ago my manager, the Senior Sister attended a Leadership study day where many of the senior nurse managers attended, including the Chief Nurse, Deputy Chief Nurse as well as a few others. They discussed that the Trust was having severe issues recruiting RN's and that my area of nursing, DME, is particularly struggling to recruit. So they discussed how they could tackle this issue amongst other things. One of the issues that was discussed was the ever increasing workload of the RN because of the nature of the job, patients becoming more complex to look after and because quite frankly there is a shortage of RN's so there is a lot more pressure on them with an increased workload.
My manager along with some of the other Sisters and Senior Sisters in medicine gave an account of the duties the RN has to complete each and every shift. Some of the things mentioned were washing patients, feeding them, meds rounds, IV's, dressings, complex discharge planning, admissions, referrals, care planning, paperwork etc. There were many more mentioned but these were just a few. The Chief Nurse turned around and said something along the lines of, "Why are Registered Nurses washing, toileting and feeding patients when they have so many other priorities. Isn't that what HCA's are for?"
I don't think this went down very well and I was absolutely seething when my manager told me. She stopped there, because I was getting incredibly riled up, but what she did tell me was that they expect higher standards from us running on skeleton staff and focused on menial, trivial things and ignored the burning issues on the wards.
Like I've just mentioned, I was so angry when I found out and if I had been there I would have made myself very unpopular by arguing back. How on Earth can management be so out of touch with what is really going on, on the wards? How on Earth can I continue to teach my students the importance of basic nursing care when our own Chief Nurse has a "too posh to wash" attitude? Am I missing something here? Is it me that is out of touch?
It is the RN's responsibility to ensure that a patient receives good, basic nursing care. It is the RN's responsibility to ensure that pressure areas are checked, monitored and documented. Yes, we cannot wash, feed, toilet and turn every single patient all of the time. But we need to work together as a team to ensure that we provide good basic care. Yes, whilst I am carrying out my nursing duties my HCA's can come and find me to check a patient's PA's. But in that time they have come to fetch me, finishing up what I am currently doing I could have probably repositioned the patient or toileted the patient quicker myself, checking their pressure areas as well as carrying out other basic assessments. It just wastes everyone's time in my opinion.
Basic nursing care is everyone's responsibility and we should ALL do it! I spend so much time teaching my students how important basic nurse care is! I tell them how many assessments you can make in the 15 or so minutes you spend washing a patient in the morning. You can assess to see if they look unwell, how they communicate, their mood, their pressure areas, continence, mobility, even nutrition because many patients ask for a drink, cannula's, and you can sometimes do a quick wound dressing if it is a simple dressing. You can plan and evaluate a patients care and management on that short period you spend washing them. If you are not hands on with your patients and you have no contact with them, how can you assess them accurately and plan the best care for them?
Am I just wasting my time teaching students good, basic care? Why should they take it seriously when our own senior managers think RN's are above washing a patient? Obviously I do not expect my students to spend all their time washing, toileting and feeding patients. I want my students to get the best learning experience possible. But I want them to know how important it is and how much you can assess and evaluate just by completing those tasks.
I am a Sister and washing patients, wiping bums, feeding patients and talking to them is not beneath me. I will do a set of obs if my HCA is busy. I will dip some pee if it's me that's obtaining the sample and send it off. I will even do some cleaning if I am stuck supervising the bay whilst I wait for my HCA to relieve me. It doesn't bother me. I would never delegate a task that I am not prepared to do myself. That's just a general unspoken rule of nursing.
Please tell me that this is not the common attitude of nursing managers everywhere and that this is just isolated? And that not all Trust's are just purely target focused instead of actually putting the patients first? Am I just being cynical and expecting too much? Is it me that needs to change my attitude?
I was absolutely disgusted, and if anything it has made me more determined to climb the ladder into higher management so I can change attitudes and bring some of them down from their pedestals and bring them back down to planet Earth.