What can US and UK nurses learn from each other?

[brianbooth, RN]

I've been an Allnurses reader for too many years to recall; it was a recent post that pushed me into registering for the right to write: it was a very well-written article concerning a list of demands RNs might send their DONs. (Forgive me - I don't have the technical skills to provide a link, but I bet one of you can do it.)

One of those demands sent a chill down my spine. In essence, it said: the best-qualified nurses on the ward should not have to be distracted from their important work by having to deal with patients, hands-on.

Background: I am a nurse in the UK, 35 years come July 2, most of that time spent at the bedside. In between bedpans, I have been clinical editor at Nursing Times, nurse specialist covering three community hospitals, with the aim of raising clinical standards,a 'Government nurse' (working at our Department of Health as the lead on media relations and publicity around nursing), and as a project manager for a company called EMAP, which bought nearly all the main UK healthcare magazine titles in the late 1990s.

Since November 2004, I have been employed as a staff nurse, the lowest grade in UK nursing. I love it. I can't really afford it, but I love it.

Anyway. To quote Family Guy's Chris: 'What is the chase, and where do I cut to it?'

As I said, I've been following Allnurses for years. When American nursing gets a cold, British nurses sneeze; we have slavishly followed your educational model, and now we're on the path of giving the lead jobs to nurses with an MSc who don't want to get their hands dirty ('too posh to wash'). We abandoned enrolled nurse training (two years concentrating on hands-on practice), but now we are training 'clinical support workers' who are allowed to do dressings, give sub-cut injections, and are about an inch away from attending a half-day training course that will allow them to dispense medications.

From my experiences away from the frontline, I came to realise that the professor of surgery operates on patients regularly, while the professor of nursing might need to have the long fleshy things in beds explained to them ('we call them "patients", they chiefly get in the way of delivering care by your book').

Are we doomed over here, or are you fighting back?

[blondy2061h, MSN, RN]

The nursing university I attended required professors to work in patient care at least per diem to keep their skills. It was a better program for it.

[madwife2002, BSN, RN]

When I used to work in the UK I honestly thought that the US nurses were far advanced compared to nursing in the UK. Yet when I came here I found that we are so different it is like comparing chalk and cheese.

Initially when I first came here in 2005 I thought I had died and gone to nursing heaven-lots of RN's, lots of supplies, lots of help

Now due to budget cuts we are looking at less nurses, less and cheaper supplies and little help

Student nurses have very little to almost no hands on nursing

Only RN's/LPN's are allowed to administer medication

[sistrmoon, BSN, RN]

"One of those demands sent a chill down my spine. In essence, it said: the best-qualified nurses on the ward should not have to be distracted from their important work by having to deal with patients, hands-on."

What did it actually say? I read that thread and can't recall anything along those lines.

Oh, I just looked back. Referring to management. At my old hospital the "big manager" would actually work a floor shift every once in awhile. At my current hospital, never.

[Esme12, ASN, BSN, RN]

Was this it?

What I Would Love To Send to My Hospital's Inpatient DON

[LibraSunCNM, BSN, MSN, CNM]

When I used to work in the UK I honestly thought that the US nurses were far advanced compared to nursing in the UK. Yet when I came here I found that we are so different it is like comparing chalk and cheese.

Madwife I'm curious, other than the working conditions such as staffing and supplies, what are some of the differences in nursing practice you noticed?

[TiffyRN, BSN, PhD]

Only RN's/LPN's are allowed to administer medication

Maybe in your State, but not in many others (though usually restricted to LTC/ALF environments).

https://www.ncsbn.org/1725.htm

Texas:

Medication Aide Program FAQs (DADS)

Nebraska:

Nebraska DHHS: Medication Aide

North Carolina:

Medication Aides | North Carolina Board of Nursing

Wisconsin:

Wisconsin Nursing Home Medication Aides

Indiana:

ISDH: Frequently Asked Questions about Qualified Medication Aides

New Jersey:

Health Facilities Evaluation and Licensing

I could go on but it's kind of off topic.

[TiffyRN, BSN, PhD]

If the OP is referring to the thread that Esme provided a link for then I have read it twice now.

I did read this in the OP's post:

In essence, it said: the best-qualified nurses on the ward should not have to be distracted from their important work by having to deal with patients, hands-on.

What I read in the thread Esme quoted is that nurses should not be distracted by running to get snacks, entertaining visitors, stocking paperwork, and chasing doctors to remind them to pretty-please order the required order sets (VTE, etc. . . ).

I think it's a little ambitious to think any of these things will ever happen but it would leave time for us as nurses to provide the best care, hands-on.

[brianbooth, RN]

Charge nurses should not have to take patients unless there is a true emergency

Charge nurses are needed to control patient flow, triage admissions and assign them to rooms, handle patient/family concerns, help with lab draws/IV starts, help with admissions, and educate staff. When the charge nurses have patients, they suffer, the staff suffers, and their patients suffer.

This is the bit that drew my attention and prompted my comments.

[TiffyRN, BSN, PhD]

Charge nurses should not have to take patients unless there is a true emergency

Charge nurses are needed to control patient flow, triage admissions and assign them to rooms, handle patient/family concerns, help with lab draws/IV starts, help with admissions, and educate staff. When the charge nurses have patients, they suffer, the staff suffers, and their patients suffer.

This is the bit that drew my attention and prompted my comments.

Okay, so I understand a little better. I know there are differences in terminology between US & UK nursing. A charge nurse on a typical US nursing unit is one RN per shift who is performing the above described duties for anywhere from 4 to 25 nursing assignments. Some units are pretty small with

We have a day charge nurse who was trained in the UK, I think she said that if she had the same position over there she would be called a "sister"? Maybe that's outdated, it's been a couple of decades since she emigrated.

[brianbooth, RN]

Tiffy -Thanks for the clarification.

In all parts of the UK except Scotland, the title for a female nurse who has risen above the staff nurse level is 'sister' (a legacy of the time when hospitals were based in religious establishments); the male equivalent is 'charge nurse'. In Scotland, 'charge nurse' applies to males and females.

Following a big shake-up in the pay scheme in 1988, each hospital ward had one nurse designated as being in overall charge, with 24-hour responsibility. This post was renamed 'ward manager', but some chose to keep the title 'senior sister' or 'senior charge nurse'. When patients asked me about the title on my badge, I would say 'I'm a charge nurse with a budget'.

I don't know about the US, but our health service is riddled with people having nothing better to do than interfere in the running of the whole show. Instead of helping manage resources properly, they have instead spent their time on dreaming up names like 'ward co-ordinator'.

[GrumpyRN, NP]

I don't know about the US, but our health service is riddled with people having nothing better to do than interfere in the running of the whole show. Instead of helping manage resources properly, they have instead spent their time on dreaming up names like 'ward co-ordinator'.

You couldn't possibly be talking about the infection control team could you...?