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Negligent nurses?

CWR

Registered User
Mar 17, 2019
112
Altho' my mother has since passed away, one thing sticks in my mind. The second day of my vigil by mum's bedside. When I arrived, 2 members of mum's lunch club were visiting, and one of them, who had been a nurse, remarked that mum's lips were dry and went to see a nurse. She asked for a piece of foam to dip in water, and initially the nurse said she wasn't sure they had any. Finally she found one and dipped it in water and very carefully moistened mum's lips. I asked her , if she wanted more water, to open her mouth wide, which she did, and after a while of this, she opened her eyes and looked at us. She tried to speak, but was unable. What a difference to how she had been when I came in. If we had waited till nurses had realised that that was what mum needed, we wouldnt have witnessed mum opening her eyes, I am sure.
Likewise, with the patient in the next bed. She was in obvious discomfort, but no nurse came to check on her. A number of people have told me similar stories. I do realise that nurses are under a lot of pressure, but it isnt right that relatives and friends need to attend to their loved one's care.
Mum wasn't in hospital for long, so I didnt have the opportunity to see how common or other wise this is.
 

Moggymad

Registered User
May 12, 2017
458
In my experience (last November), the nurses mostly relied on the friends & relatives to give mouth care. I knew we were dealing with the last few days of mums life but walking in & seeing the packets with sponges & liquid hit me with the realisation that this really was close to the end. Nurses or HCA did use them occasionally on mum but once a family member arrived we were left to do it. It would have been better if they had explained what they were to my neices when they visited as they thought they were some sort of medication so didn't do anything with them.
The nurses were very very busy as it was an elderly ward & a lot of the patients had dementia. We could see how stretched they were so didn't mind doing these little things for mums comfort.
During the previous couple weeks when mum was eating & drinking tiny amounts they actually asked for the family to come in at mealtimes to assist as trying to feed mum took such a long time & she needed a lot of encouragement. We couldn't always manage this particularily at lunch times but someone always got there for teatime. Usually by then though mum was asleep again.
I must admit I just accepted that the staff needed help & just got on with it. They were grateful when we were there as it freed up their time for patients who were more demanding. I dread to think how it would be if you didn't get many visitors though.
 

sadman67

New member
Nov 7, 2019
8
dear CWR

sorry for your loss

unfortunately this does seem common practise with patients with Alzhemiers/dementia, my wife passed away in june 2018. she was admitted to hospital 3 times in the last two months and each time I had to assist with her care and feeding as my wife had lost the ability to swallow and the ward staff struggled to have the time it would take to get her to eat a small amount of food and I even had to help the nursing team when they tried to insert a nasal feeding tube on her first admission.

I had to use the mouth cleaning sponges and regularly had to ask the nurses for them when we had use all of them. when they decided to withdraw her medication and told me that they could not do any thing further for her, no one explained what would happen in regarding feeding medication etc. She passed away 3 days later thankfully peacefully

whilst I was used to doing her care as she had remained at home during her illness but it would have made the end easier if the medical staff had taken the time to explain to me what would happen in regards to eating or fluid intake. The pallative nurse came to see me the morning she died 4 hours before she passed away and did not seem to have much information

I agree that it does not seem right that the NHS relies on relatives and friend to care for patients and what happens to patients who do not have relatives to help out
 

Palerider

Registered User
Aug 9, 2015
1,313
North West
I am sorry this was your experience but it seems to be a growing experience of many and not just unique to dementia care.

I think the title to your thread is misplaced though. When I started in the NHS nearly 30 years ago it was a different world to how it is now and this is the same in social care as well. We, the nurses had time to care and the ethos was very different to how it is now. Perhaps you should change your title to 'negligent executives' as these are the people that are now shaping how services are ran and delivered. Sadly there aren't many of us old school nurses left, who know and understand what you have outlined and we are failing as nurses because we are being pushed into a new concept of care that has nothing to do with nursing
 

RosettaT

Registered User
Sep 9, 2018
377
Mid Lincs
I had quite a battle when my OH was in hospital. Not washed until 2 in the afternoon, not fed just left with his food (out of reach). Then they raised a chart to monitor his in take because they said he wasn't eating drinking and when I questioned why he hadn't had anything they claimed the chart hadn't been filled in.
That's when I put my foot down. To be fair to the nurses there was only one with a HCA for 10 patients and no dementia ward so I don't think they fully understood the problems dementia patients have.
There were numerous other things in the 12 weeks he was in too but I learnt a lot and now know who to speak too about concerns.
 

Palerider

Registered User
Aug 9, 2015
1,313
North West
I had quite a battle when my OH was in hospital. Not washed until 2 in the afternoon, not fed just left with his food (out of reach). Then they raised a chart to monitor his in take because they said he wasn't eating drinking and when I questioned why he hadn't had anything they claimed the chart hadn't been filled in.
That's when I put my foot down. To be fair to the nurses there was only one with a HCA for 10 patients and no dementia ward so I don't think they fully understood the problems dementia patients have.
There were numerous other things in the 12 weeks he was in too but I learnt a lot and now know who to speak too about concerns.
Yup its dreadful, its all about 'more for less' these days and I empathise with anyone who feels they can't speak up. I don't know what happened over the years but the focus is on flow (getting patients treated quickly and out) rather than care. New nurses don't believe me when I tell them how many staff nurses there used to be on a ward compared to how it is now. This new way of care has become normalised with those who aren't old enough to remember the way things were. It was never perfect, but at least patients were cared for, bathed/showered, hair washed, clean mouths, men shaved and wounds dressed......sorry I am beginning to rant
 

CWR

Registered User
Mar 17, 2019
112
I am sorry this was your experience but it seems to be a growing experience of many and not just unique to dementia care.

I think the title to your thread is misplaced though. When I started in the NHS nearly 30 years ago it was a different world to how it is now and this is the same in social care as well. We, the nurses had time to care and the ethos was very different to how it is now. Perhaps you should change your title to 'negligent executives' as these are the people that are now shaping how services are ran and delivered. Sadly there aren't many of us old school nurses left, who know and understand what you have outlined and we are failing as nurses because we are being pushed into a new concept of care that has nothing to do with nursing
I apologise if I caused any offence. You are right; it is down to decisions taken further up, but those the patients relatives see are the nurses, and so they are easier to blame . I have been reading Christina Patterson's website-she has a lot to say about this. I see that it is wellnigh universal now, this new ethos.
 

Palerider

Registered User
Aug 9, 2015
1,313
North West
I apologise if I caused any offence. You are right; it is down to decisions taken further up, but those the patients relatives see are the nurses, and so they are easier to blame . I have been reading Christina Patterson's website-she has a lot to say about this. I see that it is wellnigh universal now, this new ethos.
No apology needed you haven't caused any offence, we live in times that are far more challenging than they used to be thats all. The blame game always ends up at the nurses feet -yes sometimes it is a nursing matter, but many times it isn't just a nursing issue. I don't know what the answer is, but this is why I no longer work in main stream nursing, because I was fed up with not being able to do my job properly. How nurses manage to last as long as they do in todays world I don't know, but no wonder recruitment has dropped off. I think the new governent is going to have a very difficult job filling the 50,000 vacancies in the future.
 

Quizbunny

Registered User
Nov 20, 2011
107
It is a nurses job to ensure the well being of patients in their care. If a patient is not fed, hydrated or kept clean and dry then there is no excuse in my opinion.

until my relatively recent retirement I worked in the NHS and over the years have seen a definite lowering of standards of care.
 

Sam Luvit

Registered User
Oct 19, 2016
5,672
East Sussex
My mum was a retired dementia nurse, she often moaned about “management” instead of “matrons”

During her stay following a stroke, I’d often walk in to find mum passing drinks or holding cups with straws for other patients on the ward, telling them how important it was to drink plenty. She wouId also tell the various staff they needed to cut up food, or put a plate within reach

Mum didn’t mince her words when fighting for the patients .... even though she was one herself at the time :rolleyes:
 

notsogooddtr

Registered User
Jul 2, 2011
907
It is a nurses job to ensure the well being of patients in their care. If a patient is not fed, hydrated or kept clean and dry then there is no excuse in my opinion.

until my relatively recent retirement I worked in the NHS and over the years have seen a definite lowering of standards of care.
No excuses but there are reasons. Chronic understaffing being the main one.
 

Quizbunny

Registered User
Nov 20, 2011
107
No excuses but there are reasons. Chronic understaffing being the main one.
I agree that understaffing is rife, but as a nurse you are still responsible for your patients care. If that patient does not recover, or even dies prematurely as a result of not receiving food or drink, or from being plonked in a chair in a nightie with no slippers and the thinnest of blankets whist sitting in their own waste, you can point to the government as being ultimately responsible but that persons nurse still bears duty of care.
 

notsogooddtr

Registered User
Jul 2, 2011
907
I agree that understaffing is rife, but as a nurse you are still responsible for your patients care. If that patient does not recover, or even dies prematurely as a result of not receiving food or drink, or from being plonked in a chair in a nightie with no slippers and the thinnest of blankets whist sitting in their own waste, you can point to the government as being ultimately responsible but that persons nurse still bears duty of care.
My daughter is a nurse, she gave up a well paid career to train as she wanted to make a difference. 5 years down the line she is about to resign, it is impossible to do the job she feels patients deserve. The ward is never properly staffed, she often works a 12 hour shift without a break. To be blunt the NHS has not kept pace with the changing demographics, the number of very old and frail people in hospital was unimaginable back in 1945.I fear the NHS is broken beyond repair without massive investment.
 

Quizbunny

Registered User
Nov 20, 2011
107
My daughter is a nurse, she gave up a well paid career to train as she wanted to make a difference. 5 years down the line she is about to resign, it is impossible to do the job she feels patients deserve. The ward is never properly staffed, she often works a 12 hour shift without a break. To be blunt the NHS has not kept pace with the changing demographics, the number of very old and frail people in hospital was unimaginable back in 1945.I fear the NHS is broken beyond repair without massive investment.
I agree with you. For me the problems began with Project 2000 and the changes to nursing that followed.
 

Palerider

Registered User
Aug 9, 2015
1,313
North West
I agree with you. For me the problems began with Project 2000 and the changes to nursing that followed.
I think therein lies some though not all of the problem. The training is far removed from where it used to be -in the hospital and I never hear anyone mention about being the 'patients advocate' anymore.

Yes a nurse holds the duty of care for their patients, but how can this be recognciled with less qualified staff and increasing time-pressures for those who are competent nurses?

Edited: forgot to say I found this article by Jo Brand, herself an old school trained nurse, I think she hit on some relevant points

https://www.theguardian.com/commentisfree/2012/dec/07/cold-nurses-blame-nhs-management
 

sadman67

New member
Nov 7, 2019
8
unfortunately front line staff are the ones who have to take the brunt of the frustration of patients and relatives. at the time of my wife passing I was extremely angry with the ward staff and really felt that they were to blame for the lack of care. But looking back now and having gone through the complaints procedure at the hospital I understand that the majority of nursing staff and HCAs did their best with what they had, but the more you go up the line the less care and understanding there was. It was a great feeling at the end of the process to have a face to face meeting with senior nursing and hospital managers and tell them how their decisions had impacted on my wife's end of life. I do not know if it changed anything but at least it gave me some closure as I felt I had let my wife down because I had not been able to save her
 

CWR

Registered User
Mar 17, 2019
112
My daughter is a nurse, she gave up a well paid career to train as she wanted to make a difference. 5 years down the line she is about to resign, it is impossible to do the job she feels patients deserve. The ward is never properly staffed, she often works a 12 hour shift without a break. To be blunt the NHS has not kept pace with the changing demographics, the number of very old and frail people in hospital was unimaginable back in 1945.I fear the NHS is broken beyond repair without massive investment.
I worked in a college of nursing and midwifery in the 90s, when it was seeking accreditation with a university. I think that the rot began then. Yes, it is good if nurses are aware of broader issues, but at the end of the day, nursing care is what matters, not their grasp of the finer aspects of sociology.
 

Dimpsy

Registered User
Sep 2, 2019
1,040
I'm a 1970's trained nurse.
Early morning cup of tea - breakfast - wash (bed bath if required) & dressed or clean PJ's/nighties. If possible, patient out of bed, sat in chair - bed made - and the rest of the day to the same well ordered regime.
So - lunch - afternoon rest on bed - cup of tea - then tea (sandwich etc) relatives visiting - then hot drinks - lights down.
Throughout the day, patients were toilleted, either assisted to the bathroom or offered bedpan/bottle, with doctors rounds and the drug trolley timetable.

Last August my mum spent a night on a (6 bedded) medical ward in the county hospital, and I stayed with her - awake all night and privy to what was going on.

During our afternoon/evening/night/next morning, not one of the other five ladies was taken to the toilet or offered a bedpan or commode. Because of the lack of asking the basic question (do you need the loo? Y/N) I assumed the ladies were wearing incontinence pads, but then again, there was no obvious 'behind pulled curtains' toileting/cleaning up ritual going on, so who knows.

I walked my AZ mum to the bathroom when she needed to go and washed and dressed her, there was no offer of help from the nursing staff. I guess they were relieved I took ownership of my mother's needs.

Breakfast was either cereal or toast by some random person with a trolley (who was he exactly?).

None of the nursing staff took notice of what was eaten (or not), fluid intake and output seemed of no importance and basic NURSING CARE was non-existant.

Despite the same location, Florence Nightingale is not a relative, but I uphold her values of care.
Nothing fancy, just empathy for basic human needs (we all have them, in sickness and in health) and sympathy for those with needs to be met.
 

Palerider

Registered User
Aug 9, 2015
1,313
North West
I'm a 1970's trained nurse.
Early morning cup of tea - breakfast - wash (bed bath if required) & dressed or clean PJ's/nighties. If possible, patient out of bed, sat in chair - bed made - and the rest of the day to the same well ordered regime.
So - lunch - afternoon rest on bed - cup of tea - then tea (sandwich etc) relatives visiting - then hot drinks - lights down.
Throughout the day, patients were toilleted, either assisted to the bathroom or offered bedpan/bottle, with doctors rounds and the drug trolley timetable.

Last August my mum spent a night on a (6 bedded) medical ward in the county hospital, and I stayed with her - awake all night and privy to what was going on.

During our afternoon/evening/night/next morning, not one of the other five ladies was taken to the toilet or offered a bedpan or commode. Because of the lack of asking the basic question (do you need the loo? Y/N) I assumed the ladies were wearing incontinence pads, but then again, there was no obvious 'behind pulled curtains' toileting/cleaning up ritual going on, so who knows.

I walked my AZ mum to the bathroom when she needed to go and washed and dressed her, there was no offer of help from the nursing staff. I guess they were relieved I took ownership of my mother's needs.

Breakfast was either cereal or toast by some random person with a trolley (who was he exactly?).

None of the nursing staff took notice of what was eaten (or not), fluid intake and output seemed of no importance and basic NURSING CARE was non-existant.

Despite the same location, Florence Nightingale is not a relative, but I uphold her values of care.
Nothing fancy, just empathy for basic human needs (we all have them, in sickness and in health) and sympathy for those with needs to be met.
Did you pass on your observation to the ward manager? This is one reason why I have fouight to keep mum out of our local hospital when threatened with admission