Nursing Grades

Silverdragon102, BSN · Jan 4, 2004

The grading system is actually on it's way out here in the UK, when it initially came out yrs ago it turned many a nurse against each other. What the grading system was supposed to do ( as I see it) The pay is worked out on what you do. A D grade ( junior/new qualified RN) is not supposed to take charge of the ward, although on occassions if they have some experience they can take charge. An E grade (senior RN) can take charge frequently. F grade is usually a sister and takes alot of responsibility on the ward. G grade is usually the nurse manager and take whole responsibility for the ward.

The new system which is coming in from what I can gather pays according to the job that you do and how supervised you are.

this link might be able to give you a bit more idea on the changes happening in the UK

http://www.doh.gov.uk/agendaforchange

Whisper · Jan 5, 2004

Just wanted to add:

That a grade A nurse, is an Auxillary nurse, sometimes called care assistants.

bizzymum919 · Jan 5, 2004

When I hear about the A grade nurse, it reminds me of the CNA's/carepartners here in the US that assist the nurses, or a LPN who does the same thing as an RN, but cannot be a charge nurse and cannot push IV meds and hang blood products, but the core duties are the same.

I do not know why an LPN in the US cannot transfer to a UK hospital and work as a Grade A nurse and then progress to getting her RN certification. If the UK nurses had more assistants that can assist with baths, bed changes, wound care, phlebotomy, catheterizations, and taking vital signs it would give the nurses time to give more care for their numerous patients and relieve a lot of the stress.

They would not get the higher pay, but it would give people a better experience when they are in hospital and it will help the person while they are in school. I hear nurses speak about how they do not have enough time to spend with each of their patients, but with a competent assistant and team work, it will make your job a lot easier. Many hospitals here in the US are starting to use carepartners (usually nursing students about to finish) to assist the nurses and it is a win-win situation. The nurse gets an assistant to alleviate the load and the student gets practical experience.

Elaine :idea:

Mike RGN · Jan 5, 2004

Originally posted by bizzymum919
If the UK nurses had more assistants that can assist with baths, bed changes, wound care, phlebotomy, catheterizations, and taking vital signs it would give the nurses time to give more care for their numerous patients and relieve a lot of the stress.

Elaine

Is not the above caring for the patient?????????? :confused:

bizzymum919 · Jan 5, 2004

True, but from the amount of patients, with assistants you will be able to complete the administration of meds on a timely manner, and you can get more things done without feeling burned out by the end of the day.

Here in the US this is a big complaint that they need more help because of all the paper work needed to be completed for each patient and the administraton of medication because of the hour before and hour after regulation and making complete assessments on each patient, turning the total care patients every 2 hrs and the lab work and the patients with the break through pain...etc...etc... the nurses complain that they cannot keep up with it all. My mum who was a nurse in the UK stated that she had a heavy patient load, but the paper work was not as rigorous as it is here in the US. The US is sue-happy so everything must be documented, or they assume it never happened. Every bath, every bed change, every lab drawn, every medication, input/outputs must be documented, or one can lose their license due to medical error. And when one has 10-12 patients in an 8hr shift, it can be a bit overwhelming.

How is the paperwork for each patient done in the UK ?

Elaine

Silverdragon102, BSN · Jan 6, 2004

I think that the paperwork varies from my experience from hospital to hospital. I have worked in 3 hospitals to which 1 was totally computerised, this was from admission to discharge. the other 2 hospitals was computerised only after they had been admitted to the base ward, if the patient was admitted through the Medical Admission ward only paper copies was done, this was due to the fast pase and not enough time to put the information onto the computer.

Like I said this is just with my experience.

Anna

Mike RGN · Jan 7, 2004

The paperwork is also a problem in the uk and the same applies if its not documented it did'nt happen. I feel we should be as rigorous as you are in the USA we not quite "sue-happy" but its coming.

The paperwork varies from one hospital to another some rely soly on computers others never use computers, we still have separate records for each profession. Drs, Nurses AHP with a lot of reports repeated.

It something which is changing but like most things in the NHS takes time.

Getting back to the intial point, I still don't think putting unqualified carer to do the paient care is the answer, the essence of what nursing is, has to be the hands on care for the patient.

That why I became a nurse not to write about others peoples care, but to do it!

This is why I also I don't practice on a day to day basis, as I became more senior my patient contact reduced, I can still remember shifts as a Charge-Nurse that I never touched a patient :eek: (I now teach nurses and carers how to look after patients).

I don't know the answers, I like many others feel

The paperwork is too great

The workload is too heavy

We have too many patients

we need more nurses (qualified)

But still love the job ( most days)

Quality not quantity

I hope some of this makes sense it did when I wrote it but its early morning in the uk and I just finished work.

bizzymum919 · Jan 9, 2004

MikeRGN,

I had to share portions of your reply with the nurses that I work with. I am going to finish school in May and that is a requirement in order for me to work as a carepartner. I know I am unskilled at this time, but I think I am quality along with a lot of other nursing students on the verge of getting their license. I know a lot of people here with BSN's who are complete rubbish and would not know the first thing to do when dealing with a person with MRSA which is something quite basic, but that deals with actually touching a patient. I get tired of hearing that when they are an RN they will no longer have to bathe and turn patients because that is the nurse's assistant's job.

I agree completely about quality rather than quantity. Here in the US there is such a shortage of nurses that they are hiring anyone with a pulse and license.

I really appreciated the statement that regardless of the heavy paperwork, patient load, and hard work that you still love what you do. There needs to more of that type of attitude. A lot of nurses here in the US base everything on money. My school is filled with students who have their eye on the money rather than really wanting to help people. You see it by the way they treat the patients and how they try to scive off whenever they can. I could stay here in the states and make $50-60, 000 coming right out of school, but again, it is not about the almighty dollar.

Elaine

:)

Mike RGN · Jan 9, 2004

I know I am unskilled at this time, but I think I am quality along with a lot of other nursing students on the verge of getting their license.

Elaine
:)

bizzymum919

From your statements I think you have more skills than you credit yourself with, you certainly have insight into what a nurse is

Nursing is about people caring for people, the more skilled the people are the better the care will be.

However having a degree etc may mean that they know what to do, but how does that actually benefit the patient what we need are nurses who not only know what to do but do it as well.

MiladySkye · Jan 15, 2004

Hello,

I'm an LPN working on my ASN after 20 years of nursing. I was looking for info on how to relocate to the UK once I finish my schooling. I would like to move to the Somerset area, where I have been visiting for years. I see that bizzymum919 was relocating to the UK from the US and thought someone might be able to offer some advice. I've worked in pediatrics for many years as well as with the elderly. I've also done hospital staffing, but that was years ago when LPN's weren't so limited on what they could do as far as IV's and C-lines. I would eventually like to go on to get my BSN or MSN but I, like some have expressed here, fear losing contact with the patients, which is what I love about nursing, that human contact and comfort that only hands-on nursing can provide. If anyone has any info to share, please let me know.

DavidFR, BSN, MSN, RN · Jan 27, 2004

Originally posted by Mike RGN
The paperwork is also a problem in the uk and the same applies if its not documented it did'nt happen. I feel we should be as rigorous as you are in the USA we not quite "sue-happy" but its coming.
The paperwork varies from one hospital to another some rely soly on computers others never use computers, we still have separate records for each profession. Drs, Nurses AHP with a lot of reports repeated.
It something which is changing but like most things in the NHS takes time.

I have nightmares when I remember the endless reams I use to have to write in the UK. When they introduced those pointless care plans, and those assessments with those ridculous headings "Expressing sexuality" etc. Patronising rubbish.

Here's how it works in France, where fortunately people have not adopted the Americanised 'sue, sue, sue' approach.

On admission you don't waste time geting patient details. An admin person gets them for you. You do a nursing assesment and write it down briefly (from your head on a blank piece of paper, because you're a knowledgable professional and the hierarchy, unlike in the UK, doesn't think you need a patronising, imbecilic nursing model to work from). And unlike in the UK, you don't pry into their personal lives unless invited to do so.

If you give a drug, you cosh to say it's given. Nothing more. You write NOTHING systematically. You have a sheet called "Transmissions Ciblés" (Report targets) where you document major changes. You record your obs obviously. That's it. You go whole shifts writing virtually nothing. It's bliss. You spend the time doing what really matters.

I have never received such excellent VERBAL handovers from nurses as I have in France. Good comunication. If you are not a good communicator to start with, mountains of enforced paperwork are not going to improve that.