UKPedsRN

I want to work my hours in the least amount of days possible. I have been a nurse for 30 years, and I do not want to be at work 5 days a week, so 10 or 12 hours are the way to go for me.

Cutting corners is exactly why I am leaving my current position. I spoke to my manager to tell her why I was leaving. I was noticing that the culmative effect of everyone HAVING to cut corners is impacting LEVEL AND QUALITY care. She said she disagrees....how the hell would she know, she never gets off her FAT *** and works the floor so would have no idea. FED UP.COM therefore I am going elsewhere!

Hi everyone, I am working at a LTC facility and have a patient who was admitted from hospital to our facility with a number of conditions, diabetes, decubitus, history of aspiration pneumonia and schizoprenia (burnt out). Anyway, it took her a couple of days to settle in to her room and routine - to be expected. Her son was not happy about her being tramsfered to us, but he has since come around, and thinks she is recieving excellent care. I used to be one of her favorite staff, she would often do things for me, that she would not for other staff members, such as recieve her insulin or dressing changes. However that has all changed and we RN's are all struggling with her behaviour. She screams and shouts, if staff talk to other residents in front of her. She throws things across the room - her dentures, her cups, stuffed toys etc. She has now started screaming out, "I'll kill you" , when people enter her room, or even if she is there alone. She has lashed out a number of times at me. other residents are starting to become afraid of her, and meal times are now also becoming a chore for the staff, and unbearable for other residents. she was recently assessed by the psychiatrist, but he did not change meds or give us any advice. There are times when her behaviour appears to be simply controlling and manipulative... When she is verbally and physically agressive, I lower my voice and tell her that her behaviour is unacceptable. Her response is always to scream arghhhhhhhhhhhhh arghhhhhhhhhhhhh very loudly. I have no psych background, so would love some input here, on how to respond to her. Obviously when she is being disruptive I often remove her to her room. But I am at a loss as to what else I can try with her. Interestingly, her son has always maintained that she does not have schizoprenia, however her doc says she was daignosed in 1966. The husband said she was born with something, but could not remember.....he has signs of dementia also. A couple of weeks ago her son let it slip that she was diagnosed with manic depression when he was young. She is in her late 70's now. So, ladies and gentlemen, some ideas on what is going on, and how I can better handle her, would be very much appreciated. Thanks

I had the same thing happen to me 25 years ago as a student nurse awaiting my finals. I gave a young guy a tetorifice, and pooofff he was gone. Scared the heck out of me- thought I had killed a patient before even gaining my registration!! Luckily the staff nurse I was workign with explained it al to me.

It happens because too many wards in the UK are not correctly staffed, and good nurses end up so burnt out, too the extent that they are unable to attend to the basic needs of patients such as this. It is impossible to be the only qualified nurse for 10 plus patients and give patients the care they deserve. I have had similar experiences to this myself as a patient and for my family members, though not to this extent. My mother was close to death due to the lack of medical and nursing care recieved in a local hospital, and has suffered immesureably since with the after effects. She has another hospitalization coming up, to hopefully rectify the harm caused, and I am afraid that I will be reduced to having to discuss the level of care I expect her to receive and what I will do if she does not recieve adequate care. It saddens me that I have to raise this issue on her admission, but I feel I have to set the boundaries with all of her care, since I had to become her caregiver due to the care she recieved ( did not revcieve) It is a crying shame that more nurses are not standing up and shouting from the rooftops about the lack of care and levels of care they are reduced to giving. Instead, these nurses go off sick with depression, because the so called "Whistle blowing Policies" are not worth the paper they are written on. There are too many hospitals here in the UK where the blame game continues without abatement, because staff are afraid "to make a fuss", Because they are afraid for their jobs. I feel soo soo sorry for this young man,his mother and the nursing staff involved in his care.

Took them 9 months to get my registeration to me, and that was with alot of chasing up. I trained i the UK, and was re-registering after 15 years abroad

1rrrn - what if doctors and nurses got control of the system instead of the insurance companies trying to ram people through the production line? what if drug companies had fair prices and fewer side effects? it is going to get better for patients and therefore nurses! but, i wouldn't count on 1000 bed hospitals being there forever. what planet are you on? universal healthcare will mean the government trying to ram people trhough the production line - i know i work in the nhs. doctors and nurses have very little say in anything here- government targets must be met at all costs, and if the illness/diagnosis you have doesnt have a target - well you may as well forget quality care. the drug companies will continue to make their money, irregardless of who is paying them, the drug companies extract billions out of our government every day. having worked in the nhs and in the us, i can tell you where i would prefer to have my insurance and my health care and it is not the nhs!! and i can also say that my worst employer in the us was 50 times better than any of my employers in the uk.

Does anyone use the Early Warning System in the US? And how would you say it works in conjunction with System assessment, does anyone think that EWS could be used alone and the systems assessment not necessary. I argue that EWS is a great tool, but alerts you as a practitoner only when sysmptoms have not been picked up early enough, but I am willing to accept I am wrong. I would be interested in hearing other opinions. Thanks

When I left the US to return to work in the UK, the EWS was not being utilised in the US. Not sure how to word this question. Now that I am working back in clinical in the UK, we are using the EWS and wondered what US nurses feel about the EWS and if their thoughts on system assessment and the relationship between the two. hope this makes sense

Hi all, Nurse in the UK here, would like as much feedback as possible. Who transfers the patient from PACU to ward in your hospital? How long does the process take? What delays the process? Do you think there is a better way to do this? I ask after spending the day on a ward here in the UK, where two RN's and two HCA's were caring for 28 patients. One RN is called down to PACU to transfer the patient back to the ward with a hospital porter. When I got to the PACU three RN's with three patients, and five gathered around a computer talking. Also had to wait for 5 minutes for the porter to arrive to help transport the patient. Recalled my time in the US, when the PACU nurse and the Transporter transfered all the patients to the floor, this was in each of the hospitals I worked in over there. I am thinking along the lines of time management and effective use of staff, so any input would be gratefully received. Also if you are aware of any research articles, if you could point me in the right direction, so that I can review, before I try to address this issue, I would be grateful/ Thanx

Hi Knitwhitt, Could you share the info you use on the laminated card you give your students? Also, if anyone has any links to research articles on how reporting findings to physicans when assessing patients.- I would appreciate them. Thanks

I have just spent the last two hours here in University in Necastle, searching for articles on nursing assessment, interventions and reporting findings to Physicans - without luck. Do you have any links I could use? Thanks

Thanks for your comments and references. I am still plugging away at this paper, hopefully I can make solid arguements and notice will be taken. Thanks

My thoughts exactly, however I know that some of my english colleagues do not see eye to eye with my on this topic, hence my post. Although they do assess their patients, do not think that they dont, it does is not a systematic approach as is done in the US My current thoughts are we talk alot about holistic care, yet if we are not assessing the whole patient, how can we do this? My refelctive piece is going to be far longer than what was requested at this stage. I would love to hear from more nurse educators - oh and another question - when was systems assessment introduced into the nursing circuculum? In 87 when I left the UK for the US, we did not do assessments neither did we cannulate or give IV drugs, we now do the later. Thanks

Hello all, I am a UK trained nurse who worked in the US for 13 + years, I am now back in the UK and am writing a refelctive essay on the differences in practise in the two countries. One of the issues I am covering is system assessments. Nurses here in the UK do not complete formal systems assessments during the shift. They do a part assessment, but do not listen to breath or heart sounds, neither do they listen to bowel sounds. Obviously I have my thoughts on this and am trying to present why I think it is important for both the nurse and patient that this is done. I would like to know from nurse educators a couple of things a) How important do you rate this practise and skill b) At what point in the circulum is it taught and for how long c) Do you think you can effectively nurse a patient without completing a head to toe systems assesment at least once during the shift - When I worked in CA we did them every four hours - That was ten years ago, perhaps things have changed. I look forward to any responses! Also if you have any assessment forms that you can share, I would include in my paper. Thanks