Friday, 25 January 2008

Reason's I don't miss Gen Med #3 - Nurses

Staff Nurse? Staff Nurse? Where are you?

Off trying to do three people's jobs, that's where.

One of the things that I found really difficult as a junior General Medical doctor was the sheer scale of understaffing of the nursing staff. Patients frequently had delays to their treatment and discharge and frequently failed to receive good care because there simply weren't enough nurses to look after them.

I clearly remember one morning, in my first few weeks as a qualified doctor when I walked onto the ward and realised that there were only two qualified nurses on the ward to look after our 30 patients. When one nurse goes on her break or off the ward we had a patient:nurse ration of 30:1, and I sooned learned that staffing at this level was certainly not an uncommon occurrence. It's awful, it's unsafe and it's unfair on everyone, staff and patients alike.

The nurses were understandably stressed and frazzled as they ran around simply trying to keep a track of the dozens of things that were happening on the ward. I felt bad asking them to do things (like give a patient medication) because I knew that they already had a million things to do and it would just add to their workload.

The operating theatres and intensive care unit, where I spend my days now, are certainly very well staffed. Starting work as an anaesthetist was like a breath of fresh air and I think staffing levels are certainly part of the reason I'm enjoying my job so much now.

I'd like to think that things are getting better on the medical wards, but it seems things are just as bad as ever.

- Michael


Mousie said...

Couldn't agree more. It seems to be a problem all over the UK.

We frequently end up helping out on the wards when we transfer patients upstairs for admission, because there aren't enough nurses to go round: be it checking drugs, putting up bags of fluids or helping out with sick patients. They are often desperate for another (trained) pair of hands.

It's scandalous. Don't ever get ill people.

Devil's Advocate said...

I just don't buy it. I worked in a non-acute speciality for 5 years and EVERY time I went onto the ward there'd be two or three nurses sitting at their station, gossiping and working their way through boxes of Quality Street.

Anonymous said...

In the hospital I work in (in Ireland) I think the nurses in A/E are by far and away the most over worked, under staffed and under-appreciated group of nurses in the hospital.

As a first year medical scheme SHO I'm faced with a dilemna this week. The closing date for applications for SHO Schemes in Anaesthetics is this Friday. Quite simple should I stay or should I go? General Med just feels like a mugs' game and everyone I know in Anaesthetics makes it seem to bright and happy...


Dr Michael Anderson said...

DA - I think you've been blessed. I think either your department was really well funded or you didn't have many frail elderly patients.

Anonymous - I'm enjoying anaesthetics far more than I enjoyed Gen Med. In fairness I think I had a couple of "horror jobs" when I was a medic and it was enough to make me jump ship. I think you get more appreciation and respect as an anaesthetist and the specialty is streets ahead in terms of training, job satisfaction, working conditions, lifestyle... I could go on.

But then again, I know anaestetics is not for everyone so it's worth you doing your own digging to find out if you think you'd want to do it as a career.

Personally, I'd say that since switching specialties, I've never looked back and, career-wise, I've never been happier (or brighter!)

- Michael

reality bytes said...

Devils advocate - the nurses you saw would have been the "nursing management" - easy mistake to make - after all they do give the impression of being REAL nurses because they wear the uniform - its just that they DONT actually do any work so although you may have seen a matron, ward manager and sister sitting around gossiping and eating chocolates................the 2 REAL staff nurses on the ward would have been running around like blue-arsed flys - trying to juggle the workload without killing anyone!