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jackthehat | 13:08 Fri 12th Nov 2010 | Body & Soul
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I’m not being sarcastic and I’m not wishing to denigrate, but what do nurses actually do ?

Whilst I was in hospital, the nurses;
Took my blood pressure,
Took my temperature,
Changed my surgical stockings,
Changed my Saline drip,
Changed my bedding,
Administered injections,
Dealt with ‘bed-pan’ issues.
I had my medication given to me by specific, possibly senior, nurses.
I had my water-jug and meals brought to me by what appeared to be auxiliary staff or nurses.
Cleaning was by agency staff.

I was supremely grateful to each and every one of them for their kindness and care but it did set me thinking that I often hear about the hours of study, etc. that nurses are obliged to undertake.
However, none of the above activities seem to warrant such ‘study’; with a couple of hours instruction even I could become reasonably competent to perform them.

When it became apparent that there was a problem, the nurses were only able to alert a Doctor who then alerted a Surgeon who then alerted MY Surgeon. There was nothing ‘clinically’ that they could do without authority.

Would the wage-bill to the NHS be reduced if we were to revert back to the model of 50’s/60’s/70’s where nurses were enthusiastic and caring but essentially ‘non-medically trained’ ?

I’m sure that there is a bigger picture I am failing to see..............?
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icg76, with respect I think if you carefully read through this thread noone has doubted nurses abilities or their caring. It is the system that has been criticised.Your last sentence of your second posting actually backs up all we have been saying.

Please don't let our individual circumstances on housing come into this thread. Many of us have worked hard all our lives for very little reward.

Please don't be angry x
Agree Lottie. How much a nurse earns is not part of the question.
I'm a Urology nurse and I have to admit I was originally outraged to read this question (as nicely as it may have been put). Thankfully, I had the good sense not to submit my kneejerk reply but rather to sleep on it. I qualified 3 years ago with a Bachelor of Nursing from university. It was a hard 3 year slog. I studied Physiology, Sociology and Psychology amongst other things. Everything in nursing has a rationale and in this day and age where social elements have a huge impact on people's health status, we nurses need to be all rounders. Many of the tasks JackTheHat mentions, can be undertaken by nursing auxilliaries - extremely valuable members of the multidisciplinary team. However, in my ward, the nurses undertake many of the roles traditionally held by junior doctors. This is because our trust is so cash strapped that we do not have our own doctor but instead rely on doctors coming from other areas. If we were to wait on them, people would die! Please be aware that this is a very busy surgical urology ward. It is a daily remit of mine to check blood results for abnormalities and take appropriate action. I could not do this accurately without the knowledge I gained at university. In addition to this I chase up CT scan, Xrays, Ultrasounds and a plethora of other examination results. I take the blood samples should the phlebotomoist not turn up or should the doctor (who eventually turns up) be unable to get the sample (often!!!). There are a whole range of activities that go on behind the scenes that your routine in-patient will be unaware of or oblivious to. JackTheHat, you only understand what you can see and this is not your fault. But in addition to the many nursing tasks undertaken which have been mentioned by others in this thread, there are 3 times as many going on in the background. There is so much legislation now, that our time is spent on paperwork which hopefully keeps our a**** out of court!!!! Nurses in the old days were task orientated and as point
Where's the rest of my answer gone?
Cont'd.....and as pointed out by others on this thread, any monkey could be trained to do them. But times have changed and staff shortages mean that nurses often take on (unofficial) extended roles. This happens everywhere but it does not change the fact that patients like JackTheHat have no visibility of these. Every day I wonder is this the day that someone dies because of the stresses and strains foisted on us by the NHS penpushers/government. Thankfully, the many nurses like myself who willingly take on the roles not within their remit, it has not yet happened. To those of you who defended us in this thread, thank you all. To those of you who criticised or did not understand, I forgive you. You could not possibly know what you cannot see. And sorry Molly, but nurses are HIGHLY trained in first aid, life support and many in advanced life support. Thank you all for listening. I can exhale now......:-)
Ok foodluva but you can't expect people not to complain when, like my Uncle, patients are not fed. And like my Uncle got body lice in hospital....
I agree ummmm. It's disgraceful!
There are some very good nurses. I met plenty. There are some bad ones though..
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foodluva - I am not talking about nurses with degrees. Or perhaps, I am...........
Perhaps the NHS would not be so strapped for cash if it were to recognise that a good portion of a nurses daily tasks require NO in-depth studying or higher qualification; and therefore no hike in salary to reflect this additional hard work and learning ?

I don't think I am alone in seeing the NHS as a top-heavy rapacious monster where there is an increasing number of chiefs and a diminishing number of hard-working indians who, in turn, are being given expectations far above that which is entirely practicable or possible !

I really don't need your forgiveness.
foodluva...You have put your point across very eloquently and all I can say is "how times have changed"

<<Bachelor of Nursing from university. It was a hard 3 year slog. I studied Physiology, Sociology and Psychology amongst other things.<<<

Does it really take 3 years to study the above to become a compassionate nurse?

<<This is because our trust is so cash strapped that we do not have our own doctor<<<

A busy surgical unit with no resident House Surgeon is scandalous and I just wonder if nurses are indeed covered for litigation, should it be necessary.

I fear that he NHS needs a review as it appears that a very expensive organisation is haemorrhaging money away form patient care.
JackTheHat, it's such a thankless job sometimes that it's hard not to take it personally when criticism abounds. It's intersesting you mention skillsets and pay, because I hear that there are plans to introduce 'lesser grade' nurses who will cost less and be able to undertake much of the role of the traditional staff nurse.

Sqad, you are right! Compassion is not learned at uni. It's inherent! I did not get my compassion from uni. And re-the lack of doctors, I am talking about junior doctors. The ones that you require presence from all day to undertake the medical requirements of the ward. We have plently of surgeons but they do not do the job of junior doctors who in my experience are invaluable! And you are also right about good nurses and bad nurses - there are plenty of both. It's just unfortunate that the legacy of the bad nursing care follows the good nurses wherever they go. I love my patients and my job and strive to give the best care. The lack of cash or misappropriate allocation of funds, makes it really hard for me to do the job I want to do. Sorry if I have ranted today!
foodluva

<<And re-the lack of doctors, I am talking about junior doctors.<<

So am i......House surgeons are junior doctors, unless they have changed their names.........what happens if a patient gets a clot retention?....in my days it happened a lot with suprapubic prostatectomies, although I do realise that more TURs are done.

Are nurses covered for medical negligence?
JTH, hear hear
JTH: how right you are..... Nursing is not an academic exercise requiring university
education. The misguided 'Project 2000' of the 1990s opened the wrong door for nurses.
The universities were glad to get this strengthening of student numbers, providing someone else wrote the syllabus and curriculum, then hey presto!
Nursing skills are acquired by training, not education, much like an apprenticeship. I learned all my original basic skills by working 6 days a week on the wards, 'standing next to Nellie'. There was plenty of time later to pile on a few degrees, and start the long climb up the academic ladder. These, needless to say, were not nursing degrees.

Many, like me, saw the light early. When nurse abandoned the title of Sister (an honourable title) to become 'Ward Managers', the writing was on the wall. Staff Nurse went the same way, and nurses became dehumanised by Grades 1 to 7 etc. Now thrive the Managers... but hospitals should not be run as commercial enterprises,
with profit-and-loss considerations. They are humanitarian places, far removed from the cold world of business. But try telling that to any politician,
Jack, a very good point you make. And I agree...
As I pointed out, its not just the NHS doing it (they certainly haven't done it to OT's and physios who are supported by increasingly large bands of NVQ qualified staff often called healthcare support workers) Nurses through their Union (RCN) have done it to themselves. Most nurses may not have been aware of the RCN's agenda, or if they were aware, didn't realise the ramifications of what they were doing.
The current NHS review (Liberating the Talents http://www.dh.gov.uk/...AndGuidance/DH_117353
aims to do just that though - pruning so much of the top-heaviness and putting the commissioning and funding responsibilities for heatlhcare services back with the GPs by 2013. The PCTs (where a lot of the top-heaviness was perceived to be) are making massive cuts before they vanish in 2013 - my own employer has to save millions before 1 April and the only way to do that is to cut services, ask GPs to stop non-urgent referrals to hospital, and to make 80 people in the PCT redundant in the next few weeks - mostly by reorganisation and by stopping doing things. There are clinical posts in all the Trusts at risk too as organisations have to streamline to save money, and role redesign is a big ask for the future. The Assistant practitioner role is developing the care assistant role (almost like the old EN, did I hear you say?!), so the registered nurses can undertake the tasks they were trained for. Just at the moment though, money is such an issue that (IMO), general nurses are hugely pressured. The specialists here on AB have highly-honed skills which I admire enormously, but the generalists deal with so much of day to day nursing, supported by their HCAs. More power to their collective elbows.
piggynose....LOL
boxtops this is now the third (?fourth) attempt to get GPs to fundhold for the NHS. I am not saying its not a good idea, just that there doesn't seem to be general enthusiasm among GP's to do it. Actually I am not clear why its a good idea...GP's are contractors...like building contractors, nor employees of the NHS. They won't have the time or the skills to do the work themselves so will have to create a structure to do it for them...I guess if they aren't employed by the NHS though, the NHS can be seen as having much less of a component employed for management as the GP's will be employing them...maybe that's why its a good idea...won't cost any less though.

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