We do nursing assessments just different. Not every nurse will do lung/bowels assessments that is generally the role of doctors or nurse specialists, not saying some nurses don't do it just not a normal part of their role.

Although not nursed on a ward for a few years, know staffing levels have gotten worse though, my normal shift was 2 RN's for 28 patients, 2 sometimes 3 nursing aux (CNA) work load varied depending on type of ward you worked on ie medical or surgical but was responsible for everything including ADL's, medication (all, IV stuff, nebulisers) dealing with multi disiplinary teams, relatives, friends, cleaning, feeding if required. Tend to be jack of all trade master of none :) very good at moving beds around whether it be on the ward or transferring patient to another ward. Could say much more but really need to work in it to understand it

Wow..I have a lot of respect for you guys. I don't think I would have ever become a nurse if I knew I had to take care of 14+ patients on a daily basis.

Sorry to hijack the thread, but is there any move in the UK to limit nurse:pt ratios like there is here in the U.S.

nurse -patient ratios are an anomaly in comparison, i can take care of 4-5 patients on a med/surg floor on nights over here and still do a lot more work than back home in the uk, even with huge patient ratios.

over here every patient is always very needy, with constant iv meds, be it nausea, pain or antibiotics, its not really a comparable situation.

to get back to your original question, assessments in the uk are more patient centred as to re-assessing the patient's problems, and overall health, more care plan orientated, not just going through a head to toe assessment and documenting it. sounds a bit strange but as sd says you have to work in it to understand it.

Hiya, I have taken your post and put it into a thread of it's own as it is an interesting topic.

At the moment there are no moves here (I think) to mandate nurse:patient ratios and to be honest if you read through some of the posts in the UK forums you will be able to pick up some of the discontent about high patient numbers and low / inappropriate skill mix.

I have one ward that I manage that on a night shift works with 2 RN's and 2 care assistants. This is a 38 bedded ward this worries me greatly.

I would be interested to hear others experiences and maybe then I'll tell you what I have planned for my little area (can't say too much today but will be able to shortly)

I agree with Cariad. I work much harder here as the pt's are constantly being attended to and their orders change hourly sometimes. I work on a tele floor and only have 4 pt but sometimes they are so sick and are having so many tests done that I may not see the other pt;'s as often as I would like. I do find that the way it is easier than the UK is because where I work we are not really encouraged to do researched based practice there is one right way of doing it and that is covered by protocols so it makes things a hell of a lot simpler. You dont have extended roles you are there to look after your patients and that is what you can focus on. Breaks are short and you 'mind' your collegues pt's but rarely do anything for them apart from give pain meds which is endless.

Once in a shift I gave pain meds IV 24 times to 4 different pt. So that in itself is time consuming. Initially I used to try and educate pt's on pain medication and the best way and type to give. Now I dont as much because the pt's want pain meds and dont really care about anything else so I give them what they want and what they are prescribed.

i also feel like that, back home the pain meds would be to get a patient through a period of pain, over here its whatever they want give it to them, even for example a young girl the last night i worked who could get evrything known to man, could hardly verbalise the words to ask me for pain meds, but they were due and even although i cleared it with the charge nurse to give what i thought was overdose levels, it was her right to get them. back home its more part of a nurse's role to educate the patients as to whats good for them and whats right.

There was a petition written to our Prime Minister but the response was that Government didn't think that it was appropriate for them to mandate to hospital Trusts what the ratio of nurse to patient should be. they said that Trust managers were in the best position to ensure that their wards were staffed apropriately!!

Hospital managers don't give a monkeys!!

I know this is a topic regularly discussed within the Royal College of Nursing but it hasn't come to a final decision or a formula or anything like that - not yet, but hopefully it will happen eventually.

I hear what you guys from the USA are saying & I respect the fact you work really hard but it is truly not safe to have the number of patients the NHS expected me to have & still nurse them properly or safely. That's why I left.

Where I am now I have 5 private patients (who are probably on a par demand wise to some of your USA patients). I don't have any other back up (HCA etc) so I haveto carry out all tasks from washes to meds, obs to bed changes but, although I'm running around all shift, I can manage them safely & can carry out all my xpected tasks. Plus I even have time to talk to them!!

What happened to me on the NHS was that nothing really got done properly. washes were what I referred to as "face, fanny & feet", the med round regularly took 2 hours due to interruptions etc & was very unsafe really. Obs were hap-hazzard at best & really we were just doing crisis management! The very sick were attended to at the expense of the slightly more stable. Not satisfactory in my book at all.

I agree with Cariad. I work much harder here as the pt's are constantly being attended to and their orders change hourly sometimes. I work on a tele floor

not a fair comparision with those working on level 0 beds

something that has struck me about discussions on acuity is that there doesn't seem to be the range of different acuity areas that the Uk has

as wellas as the acute . subacute split acute beds i nthe Uk are one of 4 levels of criticalcare provision

level 0 is the ordinary ward / floor

levle 1 has more staffing and monitoring - telemetry areas - 'well' CCU patients , some respiratory patients on CPAP/NIV , 'step down' areas fro m critical care

levwl 2 better staffing, invasive monitoring, single system organ support ...

level 3 being 'full' intensive care

My area would have been level 1 according to the above but it was staffed as level 0! Or should I more correctly say AT level 0

reading the post on poor staffing in the NHS has a 3rd year very scared. I'm very pleased to be on an medical ward some poorly but more should be discharged and only here due to social reason patient. however ive been warned the precetorship is a joke and i'm wary of having 8-12 pt especially complaints.i do know frpom talking to a short course midwife RN that the respirator ward isn this trust is pure crisis mangament and a risk to a pin

the workload over here is not always comparable, last night i had 6 patients, one who was on a heparin drip, one post-op, two getting ffp's and platelets and several units of blood between them, which took all night, two with naso-gastric tubes which needed flushed. and hiv and hep-b +ve, never took care of all these conditions at the same time in the uk. and its more team nursing so more help in the uk. you are very much on your own over here to do it all.

Ayla as a newly qualified you will get plenty of support (I would hope) I know our newly quals get 4 weeks supernumery and then allocated a mentor. We also do monthly study days for our band 5 development program, make sure you ask at interview what support you will get.

I've just appointed 2 newly qualifieds they are great, it was a the best day of last week actually as they interviewed with some experienced nurses. The expereinced nurses had done not preparation and it came across that they almost expected the jobs when they were interviewed which irritated me. where as the newly quals had obviously done ots of prep, but they felt they didn't stand a chance so when I gave them the news one squeeled down the phone at me and the other cried. Fantastic. :yeah: