The content of the recent Ombudsman’s report on care of the elderly in the NHS was, sadly, not a shock to me. All the scenarios described were similar to incidents I had witnessed or could easily imagine happening. But, contrary to what the report says, I do not believe that it is a universal problem with attitude towards the elderly, but that it is all, directly or indirectly, down to staffing.
The situation on my own ward is one that is mirrored across the trust, and indeed across the country. Low morale, high stress levels, short tempers and neglected patients all result from the fact that we do not have enough staff to provide complete and adequate care for our 26 very dependent patients. On a night shift, we have two nurses and two HCAs (unless we can "justify" a third HCA by proving that one or more patients are very restless and therefore safety will be compromised if they are not monitored one-on-one). So each qualified nurse is responsible for 13 patients. If one patient becomes seriously ill during the night, and needs constant attention from a trained nurse, the other is left with 25 patients. No one can argue that this is a safe nurse-to-patient ratio, and yet this is our norm, it's deemed as acceptable, and is echoed across the trust. The RCN’s guidelines are that, on an acute adult ward, no Registered Nurse should be responsible for more than five patients on a day shift, and eight on a night. Californian nurses went on strike over nurse-to-patient ratios, and were successful in getting legislation passed for safer staffing levels (one to five). This is not something I can see happening in the UK. There is no appetite for a fight, and even nurses who do long for change believe that they “cannot” strike, for fear of compromising patient care.
Channel 4 is airing a Dispatches programme on 21st February about food and nutrition in hospitals. Patients and their relatives have gone on camera, detailing their “appalling” experiences of meals in...
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