The NHS
As a nurse who trained in London in the mid seventies I just wanted to hi light a few points that I feel are relevant and indicate the health of our NHS. My son broke his back three weeks before Christmas and was in hospital for 2 weeks. Not only did he break his back but this experience broke my spirit as I suddenly realised that my beloved NHS had changed and broken beyond all recognition and for all the wrong reasons.
Back in the old days, empty beds were as rare as rocking horse poo and wards and A/E was always full. We were no quieter back then to what we are now, we just manged it better and we cared more.
In the 1970's
Medical staff by enlarge ran hospitals not the corporate business managers that do now. Hospitals were always hospitals and never classified as 'hotels' as they are now.
Nurses,doctors, domicilliary, portering and everyone else who contributed to the 'heartbeat of a hospital' wore traditional uniforms indicating to everyone who they are. They wore those uniforms with pride and passion committed to making a difference. Many of those staff had been in their posts for years and worked alongside other members of their family as the hospital became their second family.
Patients were visited by their GP's after their stay in hospital. Plans were made then for their discharge and any follow ups by the traditional district nurse in her station wagon.
Some patients were sent to the seaside to convalesce in order to make their transition back home more manageable for all concerned.
No one was allowed to sit on beds! Flowers were removed from the wards at night and trained nurses had the privilege of spending time with their patients getting to know them. God help you if you were seen by Sister with a dirty apron!
Portable tv's were brought in by relatives of patients who were with us for the long haul. A hospital electrician looked them over prior to them being plugged in. Each patient had a headset for the hospital radio station who would regularly play some favourites and requests.
Nurses fought for a place to train and were thrown in at the deep end on a ward 8 weeks after initial induction and soon realised if they would make the whole 3yrs! 3yrs of working 37hrs week for their salary and training at the same time (very different from university).
Domiciliary staff ran the wards (ask any sister of that time and they will tell you they couldn't have done their job without their dedicated team). Pristine cleaning and sparkling wards were not just wished for they existed! Every member of staff knew every patient and was interested in their life and progress.
Tea rounds were done by the most able patients who insisted on doing the washing up and putting away.
Ward sister/Charge nurse did at least two daily rounds of all their patients personally and got very involved in the day to day nursing care.
Beds were stripped and changed every day without fail or protest from anyone including the patient!
Bedbaths were given to every patient unable to care for their own hygeine. Catheter care and mouth care to those less able regularly every 2 hours including regular turns.
Sherry was prescribed for more frail patients with a poor appetite and Stout for those that needed a bit more iron in their blood.
Free parking for all patients, staff and visitors. Kindly 'Friends of the Hospital' shops serving homemade cakes and tea.
Tender loving care and hand holding was a given and NEVER questioned. Medical staff talked to their patients and took care of their psychological needs as well as their physical needs.
Doctors talked TO their patient not AT their patient and respected the need for professionalism at all times.
Nurses used to walk the hospitals with their capes inside out singing carols to the patients at Christmas carrying tiny torches in lanterns. Competitions used to be held as to who could decorate their ward best! The consultants would carve the turkey on Christmas day for all their patients!
Relatives by enlarge would be thankful that their loved ones were being cared for by professionals who cared. Whilst worried many would say to me 'they are in the best place'.
Hospitals were safe, clean and welcome places to be when you felt at your worst. Hospitals were the place you went to, to feel better and to feel safe and cared for. Yes of course there were problems back then too, but by enlarge there wasn't much that couldn't be overcome or rectified.
That is just a snapshot of what happened back then in my experience.
Today 2015
A hospital is a hotel. Hotel management run them. Using both terms is both confusing and not reassuring for a someone sick.
No one appears to know who is a nurse or who is a meal assistant. Who is a doctor and who is a porter? Nurses dressed in shabby tabards, pop socks and trainers. British Airways Cabin crew have more respect for their profession, their uniform and what if stands for than nursing staff do! And who the hell is qualified? I spent 10 minutes explaining a medical issue to a meal assistant who I thought was a ward sister dressed in navy!
Nurses go to university to study medicine before they are let loose on the wards months later. When they eventually do get in front of a real life patient all of a sudden the romance of being a nurse is shattered and they leave! If they do qualify they are often over medicalised and not familiar with good old fashioned nursing care!
GP's don't even get informed that their patients have been admitted to hospital, not that they would bother visiting those patients in these busy times! Even when that patient has had a serious injury and is returned home, GP's still aren't told! It is up to the patient!
Convalescence is now 2 days in hospital as opposed to one. Let's boot the patients out as soon as possible regardless of where or to who! No one cares, not really.
Sitting on beds seems to be the only place to sit with a serious lack of seating for any relatives, beds never got changed daily so what did it matter! Dirty linen was witnessed draped over the back of the patients chair for 3 days! My son didn't have his bed changed for 6 days until I did it myself with the help of an HCA whose uniform had seen better days. Flowers although the bane of our lives in the 70's are now banned from most units.
In hospital/hotel entertainment is now available for £6/5hrs - surely exploitation of the sick? No hospital radio that I could see.
Non existant cleaning by a private contractor (SERCO) who merely wiped a curtain rail once a day and then vanished as quickly as he had appeared. The room was filthy and never had the floor cleaned. Mould was present on the ceiling and around the windows. There was NO ventilation in the rooms. Electrical sockets literally hanging off the wall with medical appliances plugged into them. Handwash bottles covered in dirt and dust plus electrical boxing missing exposing cables. I have pictures of everything.
Tea rounds as and when by ? someone in a uniform that looked like a trained nurse.
In two weeks I never met the 'ward manager' aka sister in our day. Not once and although I am assured she was an excellent nurse, I never saw any evidence of any nursing let alone good! Nurses should nurse and not be locked away in an office playing with budgets. That is not what nursing is all about.
Catheter care? Pressure area care? Mouth care? Fluid balance observation? Gone and simply does not exist. Not in the two weeks I observed anyway! Basic nursing seems to be the responsibility of HCA's and trained nurses don't stoop that far down.....not in my day!! We did everything literally!
Parking costs £11+ day and the Friends Shop and others selling produce at double the high street price. Jellybabies £1.99 bag whilst in high street only £1. Hospitals have become like service stations, premium priced to target those without choice. Shocking.
TLC? What's that? Hand holding? Neither appears to exist in my experience. Not until I complained and eventually the Director of Nursing came to the rescue and actually sat next to my son and explained everything to him and that would be happening to him. He held his hand and listened. That for my son was the best and most valuable medicine ever and made a huge difference. The Director trained same era as myself and agreed everything had changed, not all for the better.
Far from listening to patients and treating them with respect, my son (not one to complain by nature unlike his mum!) reported HCA for being verbally abusive to a brain injured patient, it wasn't the first time he had witnessed this. He hasn't forgotten it even now and still speaks of it.
Non English doctors perhaps more used to their own culture shouting at junior doctors right out side my son's room and in the middle of the main concourse of the ward. Using language that was both inappropriate and also breaching confidentiality on another patient, I had to summon a nurse to break them up and move them to a more private place. I had never witnessed such an unprofessional event from one doctor in my life.
Today hospitals are scary, dirty and unsafe places to be. Relatives can be heard blaming them for creating more problems than solving. Hospitals are more expensive to visit than luxury hotels on a daily basis and appear to exploit the sick and the vulnerable. Someone i know has just spent over £200 for parking for 4 weeks. Today hospitals are a very different place to the ones I remember back in the 70's.
And lastly given the recent debate about the diversity of nationality of medical professionals. I would agree there are too few British nationals working in the NHS and too many private service providers within them fragmenting an already fragmented system.
God Bless the NHS but please let's not think it still exists and please don't expect anything from it, you may be sorely disappointed.
Rant over, thank you for reading! Just my opinion which I am sure not all will share but I will enjoy a debate with.
Back in the old days, empty beds were as rare as rocking horse poo and wards and A/E was always full. We were no quieter back then to what we are now, we just manged it better and we cared more.
In the 1970's
Medical staff by enlarge ran hospitals not the corporate business managers that do now. Hospitals were always hospitals and never classified as 'hotels' as they are now.
Nurses,doctors, domicilliary, portering and everyone else who contributed to the 'heartbeat of a hospital' wore traditional uniforms indicating to everyone who they are. They wore those uniforms with pride and passion committed to making a difference. Many of those staff had been in their posts for years and worked alongside other members of their family as the hospital became their second family.
Patients were visited by their GP's after their stay in hospital. Plans were made then for their discharge and any follow ups by the traditional district nurse in her station wagon.
Some patients were sent to the seaside to convalesce in order to make their transition back home more manageable for all concerned.
No one was allowed to sit on beds! Flowers were removed from the wards at night and trained nurses had the privilege of spending time with their patients getting to know them. God help you if you were seen by Sister with a dirty apron!
Portable tv's were brought in by relatives of patients who were with us for the long haul. A hospital electrician looked them over prior to them being plugged in. Each patient had a headset for the hospital radio station who would regularly play some favourites and requests.
Nurses fought for a place to train and were thrown in at the deep end on a ward 8 weeks after initial induction and soon realised if they would make the whole 3yrs! 3yrs of working 37hrs week for their salary and training at the same time (very different from university).
Domiciliary staff ran the wards (ask any sister of that time and they will tell you they couldn't have done their job without their dedicated team). Pristine cleaning and sparkling wards were not just wished for they existed! Every member of staff knew every patient and was interested in their life and progress.
Tea rounds were done by the most able patients who insisted on doing the washing up and putting away.
Ward sister/Charge nurse did at least two daily rounds of all their patients personally and got very involved in the day to day nursing care.
Beds were stripped and changed every day without fail or protest from anyone including the patient!
Bedbaths were given to every patient unable to care for their own hygeine. Catheter care and mouth care to those less able regularly every 2 hours including regular turns.
Sherry was prescribed for more frail patients with a poor appetite and Stout for those that needed a bit more iron in their blood.
Free parking for all patients, staff and visitors. Kindly 'Friends of the Hospital' shops serving homemade cakes and tea.
Tender loving care and hand holding was a given and NEVER questioned. Medical staff talked to their patients and took care of their psychological needs as well as their physical needs.
Doctors talked TO their patient not AT their patient and respected the need for professionalism at all times.
Nurses used to walk the hospitals with their capes inside out singing carols to the patients at Christmas carrying tiny torches in lanterns. Competitions used to be held as to who could decorate their ward best! The consultants would carve the turkey on Christmas day for all their patients!
Relatives by enlarge would be thankful that their loved ones were being cared for by professionals who cared. Whilst worried many would say to me 'they are in the best place'.
Hospitals were safe, clean and welcome places to be when you felt at your worst. Hospitals were the place you went to, to feel better and to feel safe and cared for. Yes of course there were problems back then too, but by enlarge there wasn't much that couldn't be overcome or rectified.
That is just a snapshot of what happened back then in my experience.
Today 2015
A hospital is a hotel. Hotel management run them. Using both terms is both confusing and not reassuring for a someone sick.
No one appears to know who is a nurse or who is a meal assistant. Who is a doctor and who is a porter? Nurses dressed in shabby tabards, pop socks and trainers. British Airways Cabin crew have more respect for their profession, their uniform and what if stands for than nursing staff do! And who the hell is qualified? I spent 10 minutes explaining a medical issue to a meal assistant who I thought was a ward sister dressed in navy!
Nurses go to university to study medicine before they are let loose on the wards months later. When they eventually do get in front of a real life patient all of a sudden the romance of being a nurse is shattered and they leave! If they do qualify they are often over medicalised and not familiar with good old fashioned nursing care!
GP's don't even get informed that their patients have been admitted to hospital, not that they would bother visiting those patients in these busy times! Even when that patient has had a serious injury and is returned home, GP's still aren't told! It is up to the patient!
Convalescence is now 2 days in hospital as opposed to one. Let's boot the patients out as soon as possible regardless of where or to who! No one cares, not really.
Sitting on beds seems to be the only place to sit with a serious lack of seating for any relatives, beds never got changed daily so what did it matter! Dirty linen was witnessed draped over the back of the patients chair for 3 days! My son didn't have his bed changed for 6 days until I did it myself with the help of an HCA whose uniform had seen better days. Flowers although the bane of our lives in the 70's are now banned from most units.
In hospital/hotel entertainment is now available for £6/5hrs - surely exploitation of the sick? No hospital radio that I could see.
Non existant cleaning by a private contractor (SERCO) who merely wiped a curtain rail once a day and then vanished as quickly as he had appeared. The room was filthy and never had the floor cleaned. Mould was present on the ceiling and around the windows. There was NO ventilation in the rooms. Electrical sockets literally hanging off the wall with medical appliances plugged into them. Handwash bottles covered in dirt and dust plus electrical boxing missing exposing cables. I have pictures of everything.
Tea rounds as and when by ? someone in a uniform that looked like a trained nurse.
In two weeks I never met the 'ward manager' aka sister in our day. Not once and although I am assured she was an excellent nurse, I never saw any evidence of any nursing let alone good! Nurses should nurse and not be locked away in an office playing with budgets. That is not what nursing is all about.
Catheter care? Pressure area care? Mouth care? Fluid balance observation? Gone and simply does not exist. Not in the two weeks I observed anyway! Basic nursing seems to be the responsibility of HCA's and trained nurses don't stoop that far down.....not in my day!! We did everything literally!
Parking costs £11+ day and the Friends Shop and others selling produce at double the high street price. Jellybabies £1.99 bag whilst in high street only £1. Hospitals have become like service stations, premium priced to target those without choice. Shocking.
TLC? What's that? Hand holding? Neither appears to exist in my experience. Not until I complained and eventually the Director of Nursing came to the rescue and actually sat next to my son and explained everything to him and that would be happening to him. He held his hand and listened. That for my son was the best and most valuable medicine ever and made a huge difference. The Director trained same era as myself and agreed everything had changed, not all for the better.
Far from listening to patients and treating them with respect, my son (not one to complain by nature unlike his mum!) reported HCA for being verbally abusive to a brain injured patient, it wasn't the first time he had witnessed this. He hasn't forgotten it even now and still speaks of it.
Non English doctors perhaps more used to their own culture shouting at junior doctors right out side my son's room and in the middle of the main concourse of the ward. Using language that was both inappropriate and also breaching confidentiality on another patient, I had to summon a nurse to break them up and move them to a more private place. I had never witnessed such an unprofessional event from one doctor in my life.
Today hospitals are scary, dirty and unsafe places to be. Relatives can be heard blaming them for creating more problems than solving. Hospitals are more expensive to visit than luxury hotels on a daily basis and appear to exploit the sick and the vulnerable. Someone i know has just spent over £200 for parking for 4 weeks. Today hospitals are a very different place to the ones I remember back in the 70's.
And lastly given the recent debate about the diversity of nationality of medical professionals. I would agree there are too few British nationals working in the NHS and too many private service providers within them fragmenting an already fragmented system.
God Bless the NHS but please let's not think it still exists and please don't expect anything from it, you may be sorely disappointed.
Rant over, thank you for reading! Just my opinion which I am sure not all will share but I will enjoy a debate with.
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Comments
I don't believe that something as important as cleanliness of our hospitals should be left in the hands of subcontractors who are all about chasing margins and maximising profits by looking to exploit the extremes of the contracts they sign. I know what it's like to work for and work alongside the likes of Serco and Capita and what their values are, and would not trust them with this.
Considering that we are spending record amounts of money on the system it appears that much of it is wasted.
Better bung another 100billion in , see if it gets any better
Or we could bung a bit of TLC, common sense and old school back in for free? I would be over the moon if someone gave the job to me! The answers and the solutions are there, its just that we are not looking in the right place!
Alternatively we could give the GP's and CCG's another 100 billion and watch them waste it! How incredibly sad. The NHS is fixable, we just need the passion and the people to fix it, money doesn't cure everything. I am sure campaigners such as the late Claire Rayner would be turning in their graves at the demise of their (and mine) beloved NHS.
Thank you very much
No getting away from the fact that we spend less as a % of our GDP on healthcare than virtually every other major western economy, and that's a measure of public and private spending.
Either we pump more money into the NHS or we find ways to encourage those that can to go private at least for minor or routine procedures.
However I wont deny there are major problems in how the NHS is run. A few nights ago there was a news report following a Doctor working in an A&E unit. The gist of the report was the acute shortage of Doctors and other medical staff willing to work in A&E units. More than that though I was baffled as to why this same Doctor was spending large amounts of his time on duty doing admin work like fixing duty rosters and contacting staff agencies to plug the holes in the roster. It got me thinking surely that should be the job of the army of admin staff these Trusts usually employ? Why are medical staff being lumbered with this sort of work?
Good question and the same can be asked of a trained nurse who is locked in an office playing with budgets.....old values have gone.
What I can say with confidence is that as a seventies London trained nurse I received a brilliant training (Thank you Royal Free and Barts) but then like many of us I married and had children with invisible disabilities so my nursing came in more useful for my own family than it did anyone else.....however I am now free of dependents and able to resume work in some capacity perhaps part time or community based however I am not allowed to return unless I re train .......some of it at my own expense.
When I qualified back in the seventies nurses were governed by the Central Nursing Council for Nurses and Midwives often abbreviated to the GNC. We were given our certificate of registration and a silver badge to prove our training .....we paid a one off fee and that was it!
Now that has all changed and nurses have to comply with even tighter regulations and attend regular study days often on their days off at their own expense (I have proof) which puts many of us off going back to work. There is an army of trained old school nurses out there unable or unwilling to re enter a profession that has changed beyond all recognition.
The saddest thing of all when my son was admitted was that he looked at me with eyes wide open and said 'Mum why on earth do you enjoy this kind of shite?'. How could anyone want to do THIS (meaning nursing). With tears in my eyes I replied 'because I genuinely care about people who need some help and TLC and want to help'. And that is the simple truth. I never took on a career in nursing for the money.....unlike doctors....I never took a career in nursing to be seen as a martyr to the sick and vulnerable. I took it on because I really wanted to and had a passion. Its really as simple as that.
Well said. I wonder how much of the caring element was lost when nursing became a profession rather than a vocation.
I don't think it is just a problem with the staff and the way the NHS is run. I think there is also a problem with the public's attitude to the NHS. We have issues like drunkenness and obesity - people failing to take personal responsibility for their health - and we have people who clog up NHS resources for the most minor things. They do not have a thought for the health of the NHS itself. An example, perhaps:
http://www.expressandstar.com/news/2015/01/05/calls-for-probe-into-999-calls-after-ambulance-called-231-times-to-stourbridge-address-in-just-one-year/
Pretty much all of it very sadly. I wish I could be proud of our NHS but right at this minute all I can do is cry. However after the tears comes determination and we can put this right ....but we all need to stand up for our once wonderful NHS and fight for it BIGTIME...the health of our NHS is in my opinion a reflection of the health of this country which currently is imo classified as 'critical'.
I can only speak from our own experience and that of another 3 patients I know about. None of our GP's were informed. I physically took the parent/carer/family copy of the paperwork to the surgery a week post discharge. Yesterday we went to our GP who was amazed at the news as he didn't know...my son was discharged on December 18th, even with Christmas and snail mail, it is unacceptable.
What may be supposed to be happening in reality ISN'T happening, sadly.
You mean when nurses started to be paid a halfway decent wage rather than a pittance?
However, on the other hand, the standard of care means people are surviving more illnesses and accidents and living longer and healthier lives with more expensive treatments and drugs.
No wonder acquired infections are rampant. I fork out money I could use, monthly for medical insurance, I would be frightened to go into some bug infested hospital.
Nursing is a highly skilled job, with modern nurses having far more responsibilities thrust on them than in the "old days", and they are required to have the qualifications to match.
As such they need good pay to reward those skills and responsibilities - and pay is far better than it was, fortunately.
I hear what you say on this subject, and hanker after the days of directly employed cleaners and the like myself - but the main battle is against those who wan to destroy the NHS for ideological reasons and replace it with a profit-led health system.
I think the fact it is shoddily run, HUGE money wastage and inappropriate spending are the main reasons why it is like it is. It is probably not as underfunded as people think (although still underfunded I would say), but it is all spent wrongly.
I agree there is an army of people out there who wish to replace or disguise the NHS as a profit led system.
Nursing has always been a highly skilled job and whilst I agree that modern day nurses are expected to do more I would ask why? We had to re train on new pieces of equipment and make the move from mercury thermometers in pots behind beds to modern day Dinamapps and equipment that was new HOWEVER we didn't rely on computers for anything back then and relied on paper and pen ....which made life far easier and gave nurses time to do what they do best CARE.
And what pray tell are 'Doctors assistants' who now inhabit the ward environment. It was the responsibility of the nurse to 'assist' the doctor with whatever they needed to do, that is how we learned!! Now many of these procedures are done without even a nurse being present!
I remember the moans and groans we all used to have as doctors littered our pristine wards with trays of needles and syringes that they didn't dispose of properly or leaving the notes on the desk and not locking them away in the trolley....but that was down to the nurses.
I remember going from the days of open surgery to endoscopy, it was a huge shift but we adapted and retrained as we went. Then there were the times we all converted to doing IV certificates in order to give IV medication without the need of a doctor.. the anti was always raised....as it is now....but we simply adapted to fit.
...:D