Nurses under pressure struggle to do the basics

READER'S REPORT:

MICHAEL ALEXANDER

Last Updated 16:00, 17 July 2018

HUSH NAIDOO / UNSPLASH

I had the habit of spending 15 minutes at the end of the day writing my notes and updating a care plan that no one else never looked.

Twenty-five years ago, nursing in New Zealand was good.

I mean that the work was hard and that there was never enough staff, but we had time to laugh and get to know our patients, even though I often missed in the morning and that we were lucky. But hey, there was a good feeling in the room, a fellowship.

At the time, I had six, sometimes seven patients in a busy medical / surgical ward. But over time, demands have increased, while the number of patients has remained the same and, in some cases, has worsened.

They have increased so much that nurses have trouble doing basic care. I had a habit of having a completely dependent patient, perhaps a stroke victim or someone dying, while the rest of my load became more light from there. But now it's not unusual to have two or three patients like that, and most often, the care you know you can and want to give, is not possible.

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But when you take away the nurses, you away from the essentials of nursing, because there is nothing "fundamental" in nursing.

hands on a patient that you find so much; are they cold, moist, hot, feverish, dripping with sweat or is their skin soft, dry, flaky? When you turn them, do they wake up from their sleep, spit that mucus stuck in their throat, or show signs of pain?

Did you know that unconscious patients can suffer? It takes a qualified and experienced nurse to see them.

When you wash them from head to toe, you check their ears, nose, chin, shoulders, elbows, hips, bad, knees, ankles, heels, toes for pressure points. These are just some of the most common places that they can show, but they can be anywhere. During the time you do this basic care, you evaluate it; do they struggle to breathe? Is there a rattle in the chest? Are they dry and do they need liquids? Or do their kidneys simply fail?

This is the tip of the iceberg for a totally dependent patient. If they are not completely dependent, why not volunteer in a nursing home and try taking showers, dressing and feeding them? It's us nurses who evaluate their nauseated reflex, so I hope the food is good.

All these treatments require skill, experience and sometimes intuition, but they are forced to leave the bed to waste time. office tasks. Not only do we have more complicated patients, but working on paper / computer is ridiculous.

I had the habit of spending 15 minutes at the end of the day writing my notes and updating a care plan that no one had ever looked at. Now, it's not uncommon to spend 20 minutes to an hour doing paperwork. I'm not kidding when I say that these documents, especially care plans, are never looked at.

We never watched them because everyone knew what they were doing. You would write your notes, the next nurse would read them and if there was a special need or a difficult dressing, someone would write the details.

An example of wasted paperwork is admission and exit. I used to have a sheet of paper with "admission" on one side and "dump" on the other. It took an average of 10 minutes to admit a patient. Now, there are about five pages that take a lot of time when they are completed correctly.

Another task that has just been presented at the hospice where a friend works is a to-do list for a dying patient. It does not benefit anyone, because the nurses are already writing these notes in their notes, which allows them to double the paperwork, but that does not bother the management, as it gives them the impression of having done some something useful. However, if one of the nurses was to miss a cross on this list, she would have problems. A small mistake could mean that your career is over in the blink of an eye.

I had a friend, a 30-year-old registered nurse, who was so busy keeping her head out of the water during her shifts that she did not make her observations (blood pressure, pulse, temperature) all morning because there was too much to do, including dealing with a heart attack in the room. She has not yet lost her registration, but she lost her job for not having made these observations.

I'm not going to run out of beds, waiting, and patients are being sent home too early because it would take too much time, but you really have to spend time working with a nurse to get The slightest idea of ​​what's going on.

Some citizens think that everything is a question of money – and even if it is not – why would not that be the case? Before you are overworked, realize that the nurses are just breaking down and have been for a while. I think if they had offered an increase of $ 10,000 and a patient ratio of one registered nurse for 4 patients, you would have solved the problem.

But what would I know?

Good luck to all.

– Stuff Nation

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