Tuesday, February 5, 2013

Hospitals, Over Worked and Under Worked Staff, and Nightmares...

When I saw this article, I thought about all of us that are chronically ill, and how we often make our way to the hospital one way or the other for surgeries, procedures and tests. We go sometimes more than others depending on our health matters, and nursing is a scary thing now. Nurses are so over worked, under staffed, honestly I think in ways not as educated (or kept up with the latest). and NOT PAID in many places as they should be. I have witnessed it myself on several occasions, and saw mistakes that were related to especially under staffing, and NON or not good communication through the nursing staff and physicians. This article was an eye opener and brought much to the table about just how bad this is and how it will only get worse unless something is done to stop it. After are some of my comments...
Of around 600 nurses who responded to Nursing Times online poll last week, 57% described their ward or unit as sometimes or always “dangerously understaffed”. In addition, 76% said they had witnessed what they considered to be “poor” care in their ward or unit over the past 12 months – of which nearly 30% said they seen it happen regularly. One respondent said: “It is becoming more and more stressful for a nurse to nurse. Safety is always at the forefront of my mind but it is becoming increasingly difficult to ensure that all patients are kept safe while in my care.” More than half, 55%, of respondents thought nursing was facing unfair criticism over standards as a result of previous well publicised failings at Mid Staffs. But most thought that while the Francis report would have a negative effect initially, generating more criticism, it would lead to positive changes in the long run – leading to better staffing and regulation. Nursing Times asked about a number of issues raised during the inquiry such as staffing, patient safety and culture. Overall, 73% of respondents said they had completed an incident form over the past 12 months because an adverse incident, or risk of one, had occurred. Worryingly, 76% said they had not received feedback or a response after submitting the form. This reflects evidence heard by the inquiry that incident forms filled out by nurses at Mid Staffs concerned about staffing levels ended up in the bin. Of nurses working on general medical wards, 85% said the average ratio of patients per registered nurse was eight or more – of these just under half said the ratio was 10 or more patients per nurse. The Royal College of Nursing has said a ratio of eight or more patients per registered nurse is associated with patient care regularly being compromised.
In addition, 43% of those who worked on general medical wards said the ratio of registered nurses to healthcare assistants was either 50:50 or worse. The RCN recommends a ratio of 65:35 in favour of registered staff. More than 80% of respondents believed there were more “Mid Staffs” out there while, around a third were not confident they could rule out similar failings happening at their trust. More specifically, 23% said they were “at risk” of a similar situation occurring at their trust and 12% that it was already happening at their trust – either in isolated parts of the organization or right across it.

http://www.nursingtimes.net/5054462.article?referrer=e1

Here are some of my thoughts and actual situations involving staff, nursing and doctors....
This is shameful and very frightening to all of us, but especially to those that seem to have chronic issues that keep us more in the medical offices, hospitals, surgical wards, and so forth. I can attests to at least 4 situations since I began having so many surgeries, appointments, and being and in and outpatient to at least 4 TIMES since 2007 that there were BAD issues, that in fact got reported, and the hospitals in two of them did massive investigations, one in fact just went to the medical board for review. These for the most part, did NOT BEGIN with nurses really, but more about DOCTORS, lack of information to the nurses, lack of knowledge more about my particular surgeries or illnesses, but it was also due to the nurses severely being tied down to way too MANY PATIENTS EACH! There is NO WAY an INCREDIBLE NURSE CAN HANDLE THE AMOUNT OF PATIENTS I have watched them try and juggle. Not ones that have lots of medications, IV's, surgical wounds, need to be helped up, possibly need all kinds of those things that sometimes nursing assistants can do, but the poor assistants are also bogged down, and lack the time to help get people up, walking to the restroom, and so forth. There have been a few times, I did kind of blame a nurse just because she did not go back and READ orders, BUT even THEN, I know it was because she or he were probably snowed under. So, it is a push pull kind of situation. They maybe doing their undying best, BUT they can only juggle so many patients at once. I know that due to the number of society, especially elderly, those with so many chronic illnesses, earlier in life, the medical field is totally bogged, BUT we NEED TO EDUCATE, PAY VERY WELL, GIVE INCENTIVES FOR THOSE WHO DO A SUPERIOR JOB, and put in our medical offices and facilities many more qualified candidates. Thank you for the article... it is a difficult subject to discuss, but I know I am not the only one that has had issues either in the hospital or at the office of a doctor.

more in regard to nursing homes:

Nursing homes are even worse for the most part! I also hope and pray I NEVER have to send anyone there or go myself. Talk about understaffed, underpaid and they are not even trained properly. That is a situation that Medicare needs to work on as much as many of the others. The nurses at the homes are truly understaffed. They only put "qualified" for paperwork basically, and have people sometimes that are really NOT even NURSING TRAINED to handle lot of patient care. When my GrandMother fell, and went for a "temporary" stay for a broken hip, there were circumstances beyond the control of my Mom, and her two siblings, and my Grandmother could not stay by herself anymore. She also began to have dementia issues, and would leave the stove on etc... and even though Mom went there daily, and she lived only across town, it was almost impossible to care for her and know she was safe by herself. BUT honestly, I think she may have been better off at home, with home health care nurses and that type of thing. At that time the home health agencies and so forth were just beginning, so it was not something that was thought about I do not imagine as much like in my GrandMother's case, but Mom said that Granny would not be helped up to be fed, and her plate would just be sitting there, she got pneumonia from "laying" too much, they were supposed to have her up and walking, not laying all the time, half the time Mom said you could not find not one NURSE, or most of the time STAFF member. She walked in on a couple of the staff and overheard a terrible conversation about some patient they were talking horribly about in their "break room" when they were supposed to be on the floor taking care of patients. It was just nuts. One time my Mom's sister came and took my GrandMother OUT of the home for a short drive, but she did not SIGN HER OUT!!! Mom said it would have been hours and no one would have known she was even missing, but Mom happened to go by about that time to check on her. She went to her room and my Granny was GONE!! NOT one person knew where she was, and did not know my Aunt had even came in and took her. Of course my Aunt got in trouble for not signing her out, she said she did not know she had to, but it was insanity... It is just a situation that will get worse very shortly, if something is not done to get us the qualified staff, that are educated, continue to be educated, regulated, PAID well, NOT over worked, and treated also with respect.
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