Whisper

The treatment seems incredulous to me. Totally over the top, but maybe thats a difference between the US and UK. We have enough trouble trying to restrain violent patients, and the rings we have to jump through to arrange that let alon a co operative patient. If this had happened in the UK the news papers would have been full of it, and very nurse would have yet more DOL training to attend.

My commute is just under an hour each way. I meant to only do it for 6 months then move or get a job closer to home..... that was over 10 years ago. I like the break between work and home. Helps to leave work issues there

http://www.patientopinion.org.uk/default.aspx was the site they mentioned on the dispatches show, I found some really great comments about my Trust.... and ignored all the bad ones :)

I thought the dispatches programme was not as bad as it could have been... They seem to agree that if nurses had fewer patients to look after we'd be able to do a better job!! Which seems to point the fingers for poor care back at the managers. But overall it seemed to be more 'patients moaning about staff' rather than confessions of nurses. I don't get on the internet much any more (credit crunch and all :)) but after this show I did look my Trust up on the patient opinion website...

I've had my blood taken once or twice1 but would have to be unconscious for an IO!.... or a bed bath

Students taking charge of a ward?! I can't ever see that happening again. not as they are 'supernumery' whisper But an interesting aside, i've just been on youtube to look up intaosseous needle insertion, and US paramedics, and the UK army practice such skills on each other!!! bed baths are one thing, an IO needle or drill is another thing entirely

I'd never heard of google scholar before, but its brilliant found loads of articles. Thanks

I work in a tertiary referal centre, a huge trust with two major hospitals, and outlying cottage hospitals. we can't catheterise men, unless we have been on a course, and to get on the course is a nightmare. Despite the hospital being built (at least the main building) in the '60's we have a lot of victorian attituides, the pillows for instance, despite the lack of sand all have to face the same way, away from windows and doors... only now we say it is for the ward to look tidy!!!

Thanks I tried that just now, no joy. So I've emailed the RCN its frustrating as I can get to most of the site just when I get to the FAST part ovid sp won't let me in. I guess it is a sign I should not be lazy and trawl all the databases my self!!

Has anyone else had difficulties using the FAST option on the RCN website http://www.rcn.org.uk/elibrary it keeps asking for a username and password and my RCN number won't work, just wondered if it was something really blonde like needing to register for that separately? I can't find an idiots guide on their site, and i thought everyone on here would be used to me asking dumb questions by now. So any advice or suggestions? Please

Its interesting how much regional variation has cropped up, even with in the UK, some trust seem to have a taken extending nurses roles much further than others. My last shift I was moved wards due to a bedding crisis, I ended up 'baby sitting' ( the bed managers words not mine) a twenty bedded ward, my self and an AN. My charge nurse apologised before sending me, I went there expecting the worst..... all the patients had transport booked or due for d/c next day back to care home. But it was fantastic, did 'proper' nursing (some one else had done all the planning) i was very tired but had a great day. The Staff nurse who took over from me on nights, laughed at how little i knew though about some of the patients condition, or when my pronunciation was off. She'd trained a good while ago, and her general knowledge was much better than mine, where as my knowledge base is very specific to where I work, I didn't like to tell her that I'd had to google many of the conditions, because I'd never come across them before. If what she said was true, about nurses being trained to work any where and being able to do a basic role on any ward, then we need to go back to the old system, because every time we move i feel like a fish out of water, the last time i moved i went to ortho, and ordered an air matress for a patient with a fractured NOF!!! Whisper ps, found out about ot using the matress just after i'd inflated on an empty bed, so nobody was harmed, except my ego

I had a house mate when I did my training, that had very poor personal hygiene, did a double shift, came home and slept in her uniform and went back and did another double the next day in the same uniform!! When myself and other house mates raised concerns with the univeristy we were acused of bullying and had to prove our characters, the student in question passed her course, and now works in a department I avoid and would not let any of my family attened, I know she's been taken to task a few times, but the trust is tied because they are afraid of getting sued (but they do receive complaints about her cleanliness from patients). 'Failure to Fail', puts the responsibility on the ward staff and mentors, but without university support, the de-skilling and general spiral downwards seem set to continue!

I 've just got back from a holiday in America, visiting a friend who I trained with. She has a much more extended practical skills list than i'll ever be able to achive, yet whilst i've stayed in the UK I've clocked up a lot of uni and in house courses, mentorship venepuncture facilitator etc. Some of my 'skills' are not things I ever wanted to learn, or a role I previously associated with nursing, but unfortunately they have become' necessary for my job'... i never wanted to host MDT meetings to persuade spocial services to find a package of care that wasted three hours of my shift, i never once wanted to be part security guard lokcing away property that has to be signed in by two RN and then escorted down to security, ( roughly a half an hour job) We now have six forms to complete one in triplicate if a patient dies, i often wish i could be left to do my job, without the paper work and '' new roles'' I'm sure I'd be ble to learn new clinical skills... I've fine with defibs, or looking after patients with tracheostomy or chest tube or pacing wires, tpn or ng feeds, takes me a little time to remeber how to work the machine, but i've never inserted one, or had the opportunity to learn, heck since i qualified i think i've catheterised about five patients!!! And to go on the course to learn how to catheterise men... you need to have 'reasonable experience'... so thats one course i don't think i'll be going on! stepping off my soap box now, students are often eager to learn the 'essential skills' but perhaps retention of newly qualifed nurses is so low, because once you qualify the quality time for care just vanishes in a wave a paper work and phone calls?

We still have some IVs that nurses don't give, the policy is for medical staff to administer them only... although nine times out of ten nursing staff have to prepare the drugs. Some of them seem daft, that nurses can hang nasty drugs like amiodarone and Mg, but can't give short synacten!

I can't believe that this was allowed to happen, I work with students and train new staff nurses to give IVs, third year students we'll let mix and draw up drugs under supervision, even set the IVAC, but they are not allowed to touch, a patients venflon. You have to be qualified at least six months before you can start the iv pack. We store un diluted K+ on the ward, but it is kept in our CD cupboard, and even that is now in a small bag which does need further dilluitng, not the old style glass vials we used to have. It seems unbelieveable that such a mistake could happen. Even when we've been really busy, I've never left a student mixing an IV and they all know they can't give them. My trust had an incident with K+ years ago and spent a fortune on new pumps, because a student, removed an Iv bag from a pump without closing the gate, and the bag ran through stat, patient very ill and spent weeks in CICU. Now all our pumps lock off when ever you open the door even if you close the gate. I'm sure Liverpool will have serious training issues to attend to.

putting my dominant hand down first, feels really uncomfortable for me, would not be able to get the right depth... well at least on my mattress

I might have imagined it but last night I'm sure I saw some guidelines for venepuncture on the RCN website, now I'm at home and looking to print them off all I can find is the paeds guidelines. Cany anyone help, am I going mad???!!! Hopefully my ward will re open soon, so I'll have less time to ponder these things :) but it has come in handy... my KSF file is nearly up to date

sharrie its in ILCOR's 2005 recommendations its from a level 6 study (manikin) and the recommendation: "for people to be taught to place the heal of the dominant hand in the centre of the chest, with non dominant hand on top"

the desk at work has been well and truly resussed.... i wonder how many computer desks and chairs across the country, are now vitims of this abuse? but it seems to be the only way to tell which hand you use!

I don't have the full reffs in front of me, as I'm at work, but I'm sure they came from ILCOR. Will search it out and post it here.

I am attending a resus module at uni, and they were talking about how research suggests that your dominant hand should be the one on the patients chest. I never do CPR this way around, my dominant hand is on top, talking with a lot of other nurses, this seems to be the case, I think we've maybe trained our selves to do this, when we used to have to measure hand placement, tracing round the ribs. Now we can just guess for the middle, I'm sure new commers to CPR will be using their dominat hand, but for many of us it seems to feel wrong. Just wondered what everyone else does? I go on my ILS update next month, and I'll try to practice both ways on 'annie'

I think it sounds like a good system, it worried me slightly as we have enough trouble with people screaming post code lottery now... how will the headlines read when people are able to top up their health care package (if they can afford it ) rather than having to pay to go private for all their treatment. The french model of heath care is very similar to this, and I was impressed by how easy it is to see the specialists you need and the whole system seemed to work very well. But I'm not sure the system would work on this side of 'the chunnel'... would we really want to sacrifice the system we have which is not failing that quickly, to copy a french system which depite the great strides it has made in improving health outcomes, they still have one if the worst rates for Mrs A and other HAI's in the world. Picking up the piece if the sytem failed would no doubt be a difficult and costly exercise (for the NHS and tax payers), I'm sure that's why a think tank is needed, it sounds like a great way for the NHS to develop, but if you needed more than your vouchers worth then i could see how problems, and a class system could develop. The NHS was never designed to supply everyhting to everyone, but provide a free (at point of care) services for those in need, and for the last 60 years it has steadily been more and more abused, like the benefits system... something has got to give, or the whole system will crash!

I think nurses as a general rule make terrible patients. I know I certainly do.... I don't mention what I do for a living anymore, I think you get labeled as a bad patient, and I'd rather they judge me rather than my job. I usually say I'm an NHS employee, so I still get a Mrs A screen, but I let them assume a ward clerk or something similar. But I am a TERRIBLE patient, I just want to go home even before I arrive, and I have to be really ill (ie turning blue) before I consider getting help. Goodness knows how I'd manage if i had to have an operation, I be a DNA... unless i was escorted into the building. At the moment, I restrain myself, to lying to physios (yes i've walked around the ward twice this morning already, and done my deep breathing exercises every hour;) ) giving the PEFR a little nudge so its higher so I can go home sooner. and I clean everything, I think I devlop some kind of compulsion, i use bottles and bottles of alcohol gel. I try not to annoy the staff, but last year I insisted on making my own bed, whilst still attatched to wall's o2 supply!! I always remember a lecture at university when we were told, nurses were not just service providers but service users. I pray every shift not to get a patient like me.

I wouldn't have told anyone I was looking for another job, just given my notice. That's the common practice on my ward, if you speak to much about wanting to leave without doing it there are always people who'd take the opportunity to bad mouth.... but once you've got your new and better job, you've restricted what they can say! It's a shame that for such a caring profession we don't always get the support and are made to feel guilty for moving on. Congratualtions on your new job, I hope you enjoy it, and I'm sure (especially with the current job situation) your old wards vacancy will be filled quickly.

I've been working on my first ward for nearly four years now. I'm not really doing the same job, as AfC was brought in my role ( as a band 5) has grown and developed. 4 years ago I was learning to have a team of patients. Now I often co- ordinate the busy ward, manage complaiants as well as taking a team, and preceptoring the new band 5s!