Archive for July, 2011

More Nurses (fewer soldiers): 25 July

July 25, 2011

We, the people, we, the Church, need to press for fewer trained killers, more trained carers. It’s what God has always wanted for His people.

I posted these words on November 25th. A couple of weeks ago my wife Sarah had 6 days in hospital, experiencing an understaffed NHS ward.

Sarah had had leg and back pain for some months. Her GP saw some signs for concern about the possibility of ‘cauda equina’ syndrome: paralysis from the waist down and double incontinence. An urgent (two weeks) referral was made to ‘the spinal people’.

Sarah saw a hospital doctor eight weeks later. He looked at her MRI scan. ‘Operation first thing next Monday’ was his surprise, alarming, decision  Unexpected problems with putting a tube down Sarah’s throat, for while she was under general anaesthetic, meant that they kept her under for longer – in Intensive Care, the only place with ventilators. Intensive Care was well staffed, with cheerful, relaxed, motivated nurses.

Next day Sarah moved to a normal ward, with a machine which allowed her to give herself a shot of morphine when she needed it. After another day she went onto oral morphine, which she could have every hour as she requested. Except that…. Two nurses working together needed to give her the morphine. When were two nurses free at the same time? Not often enough for adequate pain management.

Tramadol, another painkiller, was suggested on the ground that it only requires one nurse to administer. Sarah tried and it was no help. Medication according to staffing level, not patient need.

A couple of days later someone else in the ward was recovering from a similar operation, similarly having to wait much longer than an hour for oral morphine. Other elements of nursing care for which the nurses had no time were: not being available to take newly mobile post-op patients to the toilet, discharge planning, communicating non-urgent messages at changeover and / or to the ward doctor (some of which then became urgent.) This is not counting ‘spiritual care’ the ‘helping a person to feel personally recognised’ which is now part of all nursing training but has no hope of being delivered with current staffing levels.

The ward nurses worked as hard as the Intensive Care nurses but looked very different: they tried their best to be cheerful, but were never relaxed, often looking harassed. When I worked in a hospice the nurses told me that they never wanted to go back to working in a hospital. Hospice levels of nurse staffing are much higher than hospital levels. Nurses feel they can do the job they want to do. Adopting hospice levels in NHS hospitals would be too expensive. But the present levels are too cheap. Patients and nurses feel cheap, misused. Not at all what God wants.

Roger Harper