Frontline staff to lose jobs

World International

Published

http://m.guardian.co.uk/society/2011/feb/17/nhs-hospitals-axeing-frontline-staff?cat=society&type=article

Sign of things to come, saw this in the papers today,

The government's repeated pledges to protect frontline NHS services

have been dramatically undermined by a wave of job losses at two

hospitals, with fears that as many as 1,000 posts could disappear.

Specializes in Spinal Cord injuries, Emergency+EMS.
update

had my aspiration interview and been offered a job on a neurosurgical ward which im ok with. my ward closes within 4 weeks

welcome to the house of fun ... although i don't work on a neurosurgery unit i see plenty of patients who have been through neurosurgical units

please please please

1. realise that neurological deficit means look long and hard at bowel function and overflow is not " normal bowel function " the number of patients i've had from tertiary neurosurgery units who are so constipated it affects them starting their rehab is beyond a joke.

2. also that aggressive early mobilisation of those with neuro deficit can be counter productive

3. but that doesn't mean leaving them in bed to get black heels, and sacral / occipital sores again things which tertiary neurosurgery units seem to be good at doing ...

Specializes in ICU,ANTICOAG,ACUTE STROKE,EDU,RESEARCH.
the Dear Leader ( Bliar) and the Glorious Leader (bottler Broon) are morons, what they did in 13 years of liarbore mis-rule created the unsustainable situation we are in today,

it's the political commissars that suck the funding out of the NHS but management never slim down management they just move people about and make up new jobs about making up new jobs, i forget the exact figures but under the Lairbore regime while numbers of clinicians increased the number and grading of management roles exploded almost exponentially.

will it ? or is this just a fact that the local councils have will and continue to fail in the provision of fit for purpose social care combined with GPs who are only proactive where there are QOF points to be had create a huge burden of inappropriate admissions and bed blocking ?

perhaps if the matrons took off their clippy cloppy shoes and put down their clipboards and actually fulfilled the parts of their roles that they are meant to do and that require Them to be registered this would not be as much of an issue

the blame on Nurses comes from the gutter masquerading as mid market press who have a downer on Nurses thanks to the kind of Rubbish that dear old Clare ' i WAS a Nurse ' Rayner and the like spouted based on clinical experience form 50 years ago, plus the Latter Day Lancelot Spratts who were upset that Nurses Dare question their divine rights as Doctors, because after all 'doctor knows best'.[/QUOTE]

Whoa, Whoa there!

there are many nurses around who trained "old school"- myself included-who will tell you that clinical nursing standards have fallen, partially due to the changes in nurse training and particularly the reduction in clinical hours and the supernumary status of students.

And many of those nurses are just the ones to question the doctors because the good ones have years more clinical experience, clinical decision making skills and knowledge than many of the junior doctors.

Don't throw the baby out with the bath water please!;)

welcome to the house of fun ... although i don't work on a neurosurgery unit i see plenty of patients who have been through neurosurgical units

please please please

1. realise that neurological deficit means look long and hard at bowel function and overflow is not " normal bowel function " the number of patients i've had from tertiary neurosurgery units who are so constipated it affects them starting their rehab is beyond a joke.

2. also that aggressive early mobilisation of those with neuro deficit can be counter productive

3. but that doesn't mean leaving them in bed to get black heels, and sacral / occipital sores again things which tertiary neurosurgery units seem to be good at doing ...

]

We have a seperate spinal ward but that is mainly ortho, out nearest specialist unit are shefield and southport.

did a placement as a student on the ward im going to liked it but i remeber the staff saying thy were having a lull period.

so we shall see.

Specializes in Spinal Cord injuries, Emergency+EMS.

Whoa, Whoa there!

there are many nurses around who trained "old school"- myself included-who will tell you that clinical nursing standards have fallen,

have they or are you forgetting that many of the patients we currently see would already have been dead in the old days ? the acutiy of the average inpatient unit today is ten or more times greater than 'in the old days' and that was described to me a year or two ago by possibly the 'ideal' observer to comment on this, a lovely lady in her early 80s who was fully compis mentis and who had had a full career as an RN and had retired 20 something years ago ... in a snatched quiet minute she said she was suprised at just how busy we were and how poorly some of our patients were ...

partially due to the changes in nurse training and particularly the reduction in clinical hours and the supernumary status of students.

don't you mean the INCREASE clinical placement hours ? or does doing domestic work and Nursing Auxiliary work ( over and above being able to gain direct experience in the things RNs actually do ) actually prepare people for clinical practice as an RN ?

Supernumerary status has nothing to do with the quality of placements, if anything it enhances clinical placement as ensuring the learner gets exposure to an " RN realistic " working day ... or once again the failing fail of poor mentors the fault of the university rather than the mentors who don't fail students where there is clear evidence they cannot or will not meet the expectations placed on them.

And many of those nurses are just the ones to question the doctors because the good ones have years more clinical experience, clinical decision making skills and knowledge than many of the junior doctors.

Don't throw the baby out with the bath water please!;)

unfortunately unless they have chosen to develop their practice some of the Older nurses are the ones least likely to take the initiative or question what Doctors have said -

Specializes in Spinal Cord injuries, Emergency+EMS.
]

We have a seperate spinal ward but that is mainly ortho, out nearest specialist unit are shefield and southport.

did a placement as a student on the ward im going to liked it but i remeber the staff saying thy were having a lull period.

so we shall see.

there are more neurosurgery units than Spinal injuries centres and then when you add in the Orthopods who do spines we cast far and wide - who does 'necks' in your trust neurosurg or ortho ?

there are more neurosurgery units than Spinal injuries centres and then when you add in the Orthopods who do spines we cast far and wide - who does 'necks' in your trust neurosurg or ortho ?

from my memory necks ie laminectomy ante/post are neuro but may be nursed on neuro or spinal unit why i dont know.

Specializes in ICU,ANTICOAG,ACUTE STROKE,EDU,RESEARCH.
Pizza lover I feel for you and I know when I qualified way back in 88 only half of us had jobs to go to. US and Canada takes time and the USA will take years due to high demand for visas Plus UK training does not always met their requirements as they require generalist trained not specialized like the UK

yes same for our group in 86 and there were only 5 of us!

Specializes in ICU,ANTICOAG,ACUTE STROKE,EDU,RESEARCH.
have they or are you forgetting that many of the patients we currently see would already have been dead in the old days ? the acutiy of the average inpatient unit today is ten or more times greater than 'in the old days' and that was described to me a year or two ago by possibly the 'ideal' observer to comment on this, a lovely lady in her early 80s who was fully compis mentis and who had had a full career as an rn and had retired 20 something years ago ... in a snatched quiet minute she said she was suprised at just how busy we were and how poorly some of our patients were ...

i'm talking about basic nursing care- hydration, pressure area care, bowel care (something you mentioned).

yes acuity has changed, but "in the old days" we had fewer staff and no hoists, iv pumps,or automated bp machines etc.

of course things have changed as medicine has developed due to research and we now have clinical standards and protocols etc. but i will stand my ground and say that basic nursing care is worse, for whatever reason.

don't you mean the increase clinical placement hours ? or does doing domestic work and nursing auxiliary work ( over and above being able to gain direct experience in the things rns actually do ) actually prepare people for clinical practice as an rn ?

no, i mean decrease. rn certificate traing in the 80s included 3,500 clinical hours.

supernumerary status has nothing to do with the quality of placements, if anything it enhances clinical placement as ensuring the learner gets exposure to an " rn realistic " working day ... or once again the failing fail of poor mentors the fault of the university rather than the mentors who don't fail students where there is clear evidence they cannot or will not meet the expectations placed on them.

if you're supernumery then you aren't getting a realistic picture of life as a rn

unfortunately unless they have chosen to develop their practice some of the older nurses are the ones least likely to take the initiative or question what doctors have said -

i agree, but those nurses were probably trained as ens and then forced to convert to rn. they probably provide excellent basic nursing care.

now there are too many "new" nurses who want to get up the ladder as quickly as possible and aren't interested in the basics anymore. the healthcare assistants are providing more and more of the basic nursing care and doing obs etc.

Specializes in Spinal Cord injuries, Emergency+EMS.

Misswoosie to answer your points, you have missed the point about acuity and the pressures on staff, you have also missed that any unit that staffs safely finds itself being used as a reservoir for staff to be pulled to other units , I work on a Spinal injuries unit and despite the fact we may have a dozen or more tetraplegics and/or seriously ill ( i.e. level 1) patients all that 'bomber command' ( as some of the consultants in particular have started referring to the Operations centre) is that we have 10 or more staff (4-6 RNs and 4-6 HCAs) on an early ... so we are an 'easy target'.

The lack of equipment in the past does not make up for the vastly increased acuity of patients on the average ward, inotropes , sliding scale IV insulin , NIV are all common place on level 0 or level 1 units at present , even though in the recent past this would have been interpreted as 'single organ system support' and consequently level 2 (HDU ) care ...

You have also missed the point regarding clinical placement hours, 2300 hours of placement targeted at RN outcomes vs 3500 hours a significant proportion of which saw Students used as Auxillaries or Domestics , an RN needs to be competent in basic cares , but what benefit does the student get from being forced to do basic cares while missing out on developing skills, knowledge and experience that is required of the RN

You appear not to understand what supernumerary actually means it is not an opt out clause and any mentor or Link lecturer who allows it to be needs to be disciplined , if a student wants to say 'no' to something they need to have a good reason why.

the fact you refer to developing the workforce in terms of 'forcing' ... also forgets that a significant proportion of ENs were those who dropped out of RN training in the third year.

you also seem to fail to understand what the purpose of the HCA role is, and the fact that HCAs are the 'trained' staff and the RN is an educated Professional rather than a simpering handmaiden to the all mighty Doctor.

Specializes in ICU,ANTICOAG,ACUTE STROKE,EDU,RESEARCH.
Misswoosie to answer your points, you have missed the point about acuity and the pressures on staff, you have also missed that any unit that staffs safely finds itself being used as a reservoir for staff to be pulled to other units , I work on a Spinal injuries unit and despite the fact we may have a dozen or more tetraplegics and/or seriously ill ( i.e. level 1) patients all that 'bomber command' ( as some of the consultants in particular have started referring to the Operations centre) is that we have 10 or more staff (4-6 RNs and 4-6 HCAs) on an early ... so we are an 'easy target'.

The lack of equipment in the past does not make up for the vastly increased acuity of patients on the average ward, inotropes , sliding scale IV insulin , NIV are all common place on level 0 or level 1 units at present , even though in the recent past this would have been interpreted as 'single organ system support' and consequently level 2 (HDU ) care ...

You have also missed the point regarding clinical placement hours, 2300 hours of placement targeted at RN outcomes vs 3500 hours a significant proportion of which saw Students used as Auxillaries or Domestics , an RN needs to be competent in basic cares , but what benefit does the student get from being forced to do basic cares while missing out on developing skills, knowledge and experience that is required of the RN

You appear not to understand what supernumerary actually means it is not an opt out clause and any mentor or Link lecturer who allows it to be needs to be disciplined , if a student wants to say 'no' to something they need to have a good reason why.

the fact you refer to developing the workforce in terms of 'forcing' ... also forgets that a significant proportion of ENs were those who dropped out of RN training in the third year.

you also seem to fail to understand what the purpose of the HCA role is, and the fact that HCAs are the 'trained' staff and the RN is an educated Professional rather than a simpering handmaiden to the all mighty Doctor.

Well you seem to have it all worked out. Good luck with your career.

Just a tip- try to be a little less personal in future on this forum :)

Specializes in Resuscitation, CCU, HDU, ICU, ER.

When I qualified in 1994 few of our group got jobs immediately, I spent arround 5 months doing bank work then got a 35 hour job contract then after a year got full time.

My current trust is cutting staff training (which I provide) at the same time as trying to get external contracts to provide training to other trusts, I have a feeling I will be looking for another job soon

Specializes in Advanced Practice, surgery.
Misswoosie to answer your points, you have missed the point about acuity and the pressures on staff, you have also missed that any unit that staffs safely finds itself being used as a reservoir for staff to be pulled to other units , I work on a Spinal injuries unit and despite the fact we may have a dozen or more tetraplegics and/or seriously ill ( i.e. level 1) patients all that 'bomber command' ( as some of the consultants in particular have started referring to the Operations centre) is that we have 10 or more staff (4-6 RNs and 4-6 HCAs) on an early ... so we are an 'easy target'.

Zippy do you mind if I ask how many patients your 10 staff cover

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