Anyone else found that their hospitals have banned agency nurses from booking shifts until the last minute?
We, as of this week, are only able to book bank nurses and all agency nurses must be booked through the head of nursing.
I'm quite worried about it, currently, we are below staffing levels (or is that always), so rely on regular agency, also, the agency nurses have had wage cuts due to the agenda for change.
Seems mad to me since we rely on them for patient safety.
we have been told on our ward that we have 5000 pounds per month for agency staff we currently spend over 10,000 so we have to cut it in half. we have almost 10 vacancies we cannot recruit to. once we have spent the money we can't have any agency staff. my manager, my self and the other deputy have to subtract the money spent on agency on a daily basis and we must stop when we have reached the budget. so tell me what we should do when all go off sick. we have fought and fought and fought to no avail. our trust has to claw back over 11 million, not because we overspent our budget because we came in even, but because hampshire overspent last year and we have to help recover the money. can you believe it
kay
i needed to delete a post that was quoted, it was in violation of the tos of this site.---suzanne
Feels a bit like doomsday for the poor NHS. Makes you wonder why Blair has not committed himself to the NHS budget after 2008. Could it be because there will be no NHS after this time ??????????????????????????
My trust has also banned agency staff, suposedly.... the a&e staff numbers are suposed to be going down to 4+1 on nights, this only leaves one person for the whole of minors and three on majors, if the ward is open this could possibly go down to two on majors, which is all very well untill you have patients!! you need two ppl to do the cleaning for the mrsa prevention, im not sure what were suposed to do when we have traumas/caridac arrests or patients that need nursing care
Just wondering where in the country you work, I work in a busy London hospital and our staffing is generally 8-10 in the morning and 14 till 8pm, then 11 on a night shift.... and trust me, even with those staffing levels, sometimes its not enough. Our A&E used to see an average of 240 a day, lately its been around 300, many of them being the sicker type of patient.
My trust has also banned agency staff, suposedly.... the a&e staff numbers are suposed to be going down to 4+1 on nights, this only leaves one person for the whole of minors and three on majors, if the ward is open this could possibly go down to two on majors, which is all very well untill you have patients!! you need two ppl to do the cleaning for the mrsa prevention, im not sure what were suposed to do when we have traumas/caridac arrests or patients that need nursing care
i left the nhs and now work part time as a agency nurse.i should have done it years ago.my former co workers in the nhs are suffering.just an example i did a night shift in a&e and shifted 7 patients to the obs ward.at 4am in the morning the doctor tells the sister in charge why the bloods on patients was not done and he was very irate,this is after the bloods he had taken heamolised on this patient
the patient was one hour prior to breaching(we have four hours in the uk to clear patient out of the department). the sister went mental i just stepped back and took one look and thought to myself she must be cracking up from the pressure of management.
they have system should a patient be longer than 4 hours in the department a written explanation should be given as to why.i think to myself what the :angryfire is going on in this hospital.the nhs is not on its last legs its on its knees.the biggest embaressment i suffered was when i took charge of a list in the OR and whe had ran out of mops to clean the floor between cases in my theatre/OR.i come from africa and could not believe this was happening in the uk.i went of sick because i was so physically ill at what happened.
The only reason we are allowed to have a patient stay in the department for more than four hours is because they are being actively resuscitated - and we are only allowed two of them per day!!!! The NHS now states that 98% of patients must be in and out of the department within 4 hours, no matter what. That is going up to 99% soon and they are apparently going to eventually impliment a 100%
The in's and out's of it is that they lose a ton of money if they don't make the targets, therefore the pressure is on the nurses to get them moving on time. No, it doesn't make sense in a critical situation and I think every one of them should be an exception, but (and this is a big but), I completely agree with the four hour target outwith this as it ensures we get more doctors (we doubled when the targets came in) and it means that patients don't lay on trolleys all over the department for 12+ hours as I seen when I first started.
they have system should a patient be longer than 4 hours in the department a written explanation should be given as to why.i think to myself what the :angryfire is going on in this hospital.
Specializes in renal,peritoneal dialysis, medicine.
The only reason we are allowed to have a patient stay in the department for more than four hours is because they are being actively resuscitated - and we are only allowed two of them per day!!!! The NHS now states that 98% of patients must be in and out of the department within 4 hours, no matter what. That is going up to 99% soon and they are apparently going to eventually impliment a 100%
The in's and out's of it is that they lose a ton of money if they don't make the targets, therefore the pressure is on the nurses to get them moving on time. No, it doesn't make sense in a critical situation and I think every one of them should be an exception, but (and this is a big but), I completely agree with the four hour target outwith this as it ensures we get more doctors (we doubled when the targets came in) and it means that patients don't lay on trolleys all over the department for 12+ hours as I seen when I first started.
no what happens is they dont lie in a&e on a trolley for 12 hours they do it on the admissions ward instead on assessment trolley which they use as beds when they are full (ie every night) but his doesnt count as they are out of the department. :angryfire
now that my soapbox is out i may as well continue and say that i also find how the sucess of the nhs is measured is a load of rubbish. for example waiting lists and a&e targets. Day surgery in my trust has months where they have to get certain waiting lists reduced, the consultants get paid a massive fee to come in on a weekend, the nurses get paid triple time and the catarct waitng list gets reduced this happens most months for many minor ops, this makes the hospital look good, but the money has to come from somewhere! so other services and essentials (like staff) tend to suffer a&e trolley times are flawed, as i said before moving a patient in and out of the department is not good patient care but it looks good as the 4 hour wait is not breached, again the hospital looks good, then the government can say that waitng times are down so the nhs must be fine, well all i can say is robbing one department of staff and finances to make targets is not good for patient care, in fact it makes them suffer and i for one have had enough of it all
i guess the issue of banning agency nurses has not been reflected upon. agency nurses are a last resort to boost the numbers on an adhoc basis.being overspent is not the fault of nurses and believe me if we were budget holders and overpsent we would be criminally laible for misappropiating fund as it is in the corporate world.as a nurse now working in the corporate world dont be fooled into believing that cost cutting measures is down to us as being filtered down by management to us,were are service providers.we look at a patient and treat according to regulatory guidelines.
take a look around your department and see how top heavy management is then work out how they justify their positions,by creating more paper work for the poor old nurse to digest.this is the illness within the nhs.
TARGETS i hate the word.what ever happened to qualitative patient care and not quantative(watching the clock).a consultant or MD as it is known in the USA told me to get my patient off the commode because she was about to breach,i said no and walked off. i have been a witness at and NMC hearing no matter how many years of experience you have they will make feel as if you have never been a nurse before. get yourself a copy of the NMC 2002/2003 quarterly brochure i think the article might be on line.the long and short of it is they wrote "nurses and management get on fine in a days work,when it goes pearshape the relationship disintegrates,....in most cases they will never back up a nurse when their is an error or an detrimental occurance to a patient"
look at california and some other states opting to take the nurse patient ratio and that has been lesgislated.in Melbourne Aus its law only four patients per nurse Scotland is considering the idea.in the uk we won thats why i am moving to california.
in conclusion i think you might be misguided CLAIRE as to more doctors being available to look after patients how many of them will be unemployed on the next rotation just ask around because of the change in their training.
stress is now being recognised as a occupational disease. the nursing times of august 2005 puts the figure at an alarming rate.to say you can only be allowed two breaches a day is inhumane and against that patients human rights. :imbarwhat are you going to do if i have an MI say sorry sir you are about to breach and move only to enlarge my infarct heavan help us.you take the focus away from caring for a patient and your care goes out the door.ask your junior doctors if they do a complete and full assessment on every patient knowing the back of their minds they only have 4 hours to clear the deck.
these kinds of working conditons if you are a nurse puts your registration at risk its not worth it.they have yet to sack a nurse or degrade his or her salary for not reaching targets. try and pull that stunt of in a court of law or at a NMC disiplinary hearing. feel free to phone nursing and midwifery council if they will entertain the thought of patient injury due to lack of care or not enough time.
the chap i testified against was struck off and now work in jordania.ignorance is no excuse and to say my manager said i should do it, does not work they dont hold your registration you do!!!.its all about what you did that was safe regardless of time.:imbar
i myself work as an agency specialist rn in a&e throughout london and have noticed a decline in the amount of agency work,especially for november,when you expect work to pick up.also with the a4c,agency pay rates have dropped dramatically,i.e.,sunday rates i use to get 29.30 p/h now down to 19.30 p/h.Also,nurses with 5-10+ years experience,who don't have a postgraduate ENB course in emergency are now banded as band 5-equivalent to a d-grade,similar to someone with 6 months experience,but,even if you are in band 6,alot of hospitals are still being payed as band 5 only.Also,the NHS and PASA have developed new guidelines for agency nurses,1 stupid rule is that agency nurses need all blood tests done in a UK labatory,i.e.,hep B titre levels etc done overseas,in my case done in australia,are no longer valid!!!! As an australian RN i can vouch for the staff-pt ratios.They are in place in most states in australia to protect nursing staff,i.e.,provide a safe working environment and work load.In my view the UK will NEVER have staff-pt ratios as if they did,can you envisage the cost to trusts and the government!!!! it is just not viable financially for them.Also,it is now compulsory for nurses to have practical manual handling experience,another new rule,more than likely in place to reduce the ability of nurses to legally claim compensation against the NHS.In my view the Nursing Union in the UK is weak,do you see them actively see them in the news??? pushing for better wages and conditions for nurses??? when is the last time nurses went on strike for better pay and conditions in the uk??? In australia the australian nursing federation,the nurses union is constantly in newspapers and on television,and nurses as a general rule are alot more proactive about wages and conditions,hence staff-pt ratios,and as a result pt care is generally alot better.As mentioned by others,new roles such as medical care practitoners and physician assistants will be utilised in the NHS,many will be health science graduates,and will come in at band 6 and band 7,so will jump above junior nurses,even though they may be straight out of university.... just shows the value of nurses really.
i dont want to be bashing the uk nurses as i am a foreignnurse myself who sought to leave the nhs.
i feel that the culture in my profession over here is reactive and not proactive.we will swallow all the garbage that some one with no medical knowledge tells uswhat to do. were are never going to get ourself out of this problem and start thinking like autonomous practioners. we have the training,knowledge and the patient intercation to make effective decisions on how to deliver safe care. not someone with a degree in management at a tender age telling me how reach targets and cut corners. they should be better off working at a fast food joint.:angryfire
think about the gaurdian newspaper 2003 cmae up with the facts their are 198000 beds in the nhs and 210 000 managers.at an average national salary of 35 000 or more 73.5 mil. dont blame agency nurses
madwife2002, BSN, RN
26 Articles; 4,777 Posts
we have been told on our ward that we have 5000 pounds per month for agency staff we currently spend over 10,000 so we have to cut it in half. we have almost 10 vacancies we cannot recruit to. once we have spent the money we can't have any agency staff. my manager, my self and the other deputy have to subtract the money spent on agency on a daily basis and we must stop when we have reached the budget. so tell me what we should do when all go off sick. we have fought and fought and fought to no avail. our trust has to claw back over 11 million, not because we overspent our budget because we came in even, but because hampshire overspent last year and we have to help recover the money. can you believe it
kay
i needed to delete a post that was quoted, it was in violation of the tos of this site.---suzanne