oreo75

I was redeployed 6 months ago & am not happy in my current post, I am starting to think about going down a band, but was wondering about pay. Do you end up going to the bottom of the lower band or do you end up being moved across or at the top of the banding depending on where you are on the pay scale. Don't want to start asking this question at work, as I am still thinking about what to do. I hope this has made sense.

I just wondered how many patients other nurses in the uk are expected to look after on a shift? I'm not so much interested in ItU but more wards. I feel our nurse to patient ratio is unsafe, if I have patients I look after 14 on a shift. I work on a busy orthopedic ward, which is trauma, so a high percentage of elderly confused sick patients. Other wards I have worked your usual is 8 patients but when you are short shift (maybe about once a month) you may have a work load like this but this is every shift. There is a reason behind this, & I have on several occassion address the nurse/ patient ratio to the ward manager, where I've been told we used to do it like that but we don't have the staff to have few patients, which I can see that point but rather then covering with band 5 bank staff we are covering the shift with band 2 band staff & not just using band 2 when we cant' get band 5 cover. Back to my reason for posting, today came on shift my ward manager was on so I didn't have to be in charge (I'm one of the ward sisters) I was allocated my 14 patients the other nurse on is newly qualifed, has a pin & this is her 3rd week on the ward & 1st week not being supernumery. The ward manager then says this am that she has a meeting & I have to oversee the other nurse as well as look after my own patients, which 2 of which were sick, plus 2 discharges & 1 admission. One of the patients came back infected so had to be transfered to the infection control ward, which the other nurse didn't know what to do, so rather than have the time to show her what needs to be done, I had to sort it out. So in reality I didn't document on the other 14 patients I was in effect looking after them. This is an awful day, but quite normal for the ward. I love being a sister & have been in post between this ward & my last ward where I was acting for a year now, but I can't cope with the patient ratio, & feel like I'm giving poor care & poor standards of documentation & am worried for my career. These ratios might be the normal in many places & need to know if maybe I can't cope with nursing any more. Also if anyone has advice on how to handle this situation then I'd be grateful.

If you are planning to work as a HCA while doing your training try & not let the uni know you are doing this or planning to, as it's something that is looked down upon. For reference's I'd be looking to use ward managers from your placements. When I was a student, it was really looked down upon by the tutors from the university, the uni know I was working & everytime I saw my tutor it was mentioned, but without doing it I couldn't of made it to the end of the course. I think working as a HCA is a good idea as you then know what it's like to be a hca, you will gain extra skills & knowledge & you earn money, you need to make sure you get the balance right.

In the hospital where I work if they come as as a emergency or elective surgical patient they go to a dedicated MRSA ward (which treats, surgical, orthopaedic, ob-gynae), if they have a past history of MRSA. If they have been able to obtain 3 clear swabs over the previous year from being on the MRSA cohort ward or from clinics, then they would be admitted to which ward was most suited to there needs.

Sometimes you might need to have your manager complete paperwork before you go though the gateway, so it's not as automatic as it seems. The trust I work at has this system, I'm in the process of trying to get my old manager to complete the paperwork, so I can get the back pay I'm due.

Congratulations to everyone, keep phoning the NMC & chasing them up. I don't know if it does help but at least you know what is happening

I'm handing in my notice tomorrow but I'm so worried about doing it. As I didn't tell anyone on the ward that I had gone for another job. I even had my apprisal 10 days & didn't say anything. I'm at present acting up into a band 6 post & have managed to secure a permanent band 6 on another ward, I feel guilty about going as the ward manager keeps says about when she can have me in a permanent post but at the end of the day it isn't definite that I'd get the job & I don't feel that she is a very good manager. Just trying to find an excuse as to why I'm leaving now.

I was in my first job for a year, I then moved to a cohort ward dealing with every speciality as I saw it was an opportunity to gain experience with everything to help me move to a sister post. I'd say you need to have at least 6 months of working before having time out so you have time to consolidate your skills but the longer the better.

I do not know how many cases there have been due to cannulas but someone is just as just as much risk of developing a MRSA bacterima as from a cannula as from a central line because this a point of access for bacteria which maybe isn't going into a central vein but is still going into a vein the same goes for catheters these are invasive devices that are allowing bacteria to enter the body & cause infections. I think you are wrong about infection control policies have little evidence behind them, try speaking to your infection control & prevention department nurses, and you will find the policies are set on evidenced based best practice, also some of the best practice policies are now becoming government policy so will mean you will have a legal requirement to ensure things are done (but can't remember what at the moment, but I will check). The bare below the elbow policy is a government policy, you should not be wearing a wrist watch at all, no matter what your dominant hand is, it has been shown that there is a heavy bacteria growth under watches. Not only is it infection control risk due to the bacteria but also a moving and handling risk as you risk injuring the patient with it.

like most here we have the option of tunic & trousers or dresses. I wear dresses cause I find them more comfortable the trousers have elastic waists & come up really high.

it's a cohort ward that has MRSA patients

My dream job has come up at work, I'm currently working as a band 5 on a cohort ward which I love, it is a new unit which opened about 5 months ago & when the whole directorate was reconfigured in the summer I asked to go to this unit which was opening (one of only two people to ask to go) everyone else that works on the unit are the staff from the ward that closed to make way for the new unit. We have two band six's at work one of them is acting in the role at the moment, and they have decied that they don't want to work on the unit & have applied for another job but does not want to apply for the band 6. So there is a band 6 coming up which I really want to apply for, I spoke to the unit manager & the only band 6 who has got loads of experience, the unit manager is happy for me to have the job & asked me if I would like to act up into the role for 6 months which I said yes to. I had a chat to the band 6 who I said that I'm willing to do what ever they need me to do to be prepared for the role. My only problem is that there could be another staff nurse on the ward that would want the job, she has been qualified for longer than me & she was on the ward before it was closed. Which is an advantage, but I think I've got somethings on my side such as the band 6 as already said about speaking to the unit manager to get me into the acting up post & she said to me about applying for the band 6 post on the unit. So I need ideas to make stand out to show I'd be the right person & to show how much this post means to me.

I completely agree but not only staffing levels they should look at skill mix. Where I am they say we are fully staff but our skill mix is awful, so in essence we've had 4 band 5 nurses on the ward as the other band 5's are all newly qualified so need loads of support. So many shifts have gone uncovered, so days we've had 1 band 5 & a newly qualified. At the moment the managers are saying we are not doing a good enough job as we've had complaints, but with staffing levels like we've got is it any wonder! It's a shame they don't just look at who was looking after the patient but the bigger picture of how many were on duty at the time. I sometimes wonder if they would sooner I complete patient paperwork than get a patient a commode etc.. I just want to add I work on a surgical ward with 24 beds where most of the patients need 2 people to see to them, it's a very heavy ward with some sick patients.

Staff would only be swabbed at outbreak when the outbreak is caused by a single strain. When a patient is swabbed, any MRSA positive result is then sent away for grouping as usually when 2 patients on a ward are MRSA positive they usually have 2 different strains. As for the staff being swabbed, there have been trials were staff were swabbed & they showed no higher rates than the general public (being approx 6%) & when they were they were still able to work & did the treatment. Usually if staff are swabbed they have to swabbed at the start of the shift otherwise they is a greater risk of them being positive but not being colonised or have the bacteriema but have transient which will be washed off when you next bath/ shower. I'm currently working on a MRSA Cohort ward in the UK, & have to have intensive infection control training to work there, so my MRSA infection control knowledge is good.

Have you thought about speaking to someone more senior to your ward manager. They might be able to see the bigger picture & if you can speak to them & explain how it would help your career development, it might help.