Solutions to the nursing crisis in Edinburgh
The NHS will be in a crisis if the morale of Lothian nurses is not improved. It is no surprise figures last week revealed that nurses across Scotland feel under immense pressure with 74% stating they are increasingly stressed at work. Cameron’s tight budget has created this chasm within wards where nurses who are retired, redundant or relocated are not being replaced. Surely less nurses equal less quality care.
We have a generation of talented, skilful experienced nurses being forced into early retirement. These are the people who went into the job because they wanted to care; they were committed to the job. Nurses taught the old regime of “Matron knows best”.
We reported yesterday of one such example Pat Harper, whose sole run ICU Follow-up care unit has been axed. We discussed the loss this would be to the greater community of patients. We didn’t discuss the loss this would be to Pat herself. There is an agenda that we do not want to know what happens to the person, but I would like to take a minute and share her experience.
Pat Harper, Clinical Nurse Specialist, has spent over ten years running the Follow-up service. She is constantly praised by patients who have used her service, and until recently praised by her management. With the service axed, Pat no longer is needed. NHS Lothian has offered to relocate her. Until they can find a suitable place to “put” her, she is left alone in her former office. Being paid to sit still and do nothing.
Relocation is the buzz word being used by the health board. Not making people redundant, not paying them severance pay – relocating them. Already those on the relocation list are hearing tales of temporary work placements, two weeks here, there, being moved from nursing positions to answering phones. This does not save money, paying highly skilled people to type memos, and the health board will not answer what purpose therefore this system has. Front-line service care is saved, so those who are in that undefined bracket are safe.
This shows no respect to those who have dedicated their life to caring for others, climbing their career ladder and subsequently killing the morale of their older experienced staff. It is not a case of we cannot afford to run this service but rather this service and you are redundant. Undermining all contributions they have made for the entirety of their working lives, not to mention quashing all innovative contributions. This has created a generation of nurses watching their superiors being axed, not because they are incompetent, uncaring, or unable but because their specialist skills are no longer required. A generation too scared to step beyond the basic boundaries of their remit, unable to reach out and care.
Those left are working with no real support. Talented nursing staffs are being replaced by unskilled, care assistants, and unregistered student nurses. Their workloads are increasing exponentially. Assistance from beyond their own wards walls is non-existent; they are underpowered, uncertain and unappreciated.
Why is the government therefore surprised when standards drop? The ERI received a damning report this week about its standards of cleanliness following an unannounced inspection. Ward staff uncertain of when bedside phones and televisions were cleaned, ward toilets dirty. An official report, reporting what we already knew, the ERI is not working. Patient surveys confirm a low level of care, assistance and awareness.
Matron and her nursing staff would not have tolerated this. To become a nurse, your parents were interviewed alongside you. You were assessed and had to meet criteria set beyond grades, beyond extra-curricular work, based on your suitability to the role. Once in you worked your way up, and learned cleanliness and care was essential.
The ERI and other hospitals continually excuse low cleanliness ratings on the super-bugs, who are immune to everything, including the antibacterial wonder spray, and leaving them alone. Yet the super-bug is an excuse not known to our historical matron and her golden nurses, they just got a bucket of soap and water and washed down everything, every day.
I don’t think we can blame the nurses we have left for these conditions, nor can we blame the newly registered nurses who are stepping into a career fraught with spending cuts and job insecurity. We could blame the cleaning products, the kitchen, even the new uniforms which are looking more and more like pyjamas.
We can reminisce of the golden era, when nursing was a respected privileged profession, creating pride and patient care. When they wore a starched uniform and a cape, were regimented like the armed forces. Those golden nurses one by one are being targeted and relieved of duty, NHS stealing their last piece of dignity and respect for their career.
We can however blame the management for letting us get into this situation. We could go as high as the blaming the fiscal crisis, but in reality these problems have been hiding in the woodwork since the dawn of Thatcherism, selling the NHS piece by piece. We could blame Labour for putting too much money in previously: Cameron for cutting budgets, Clegg for not handing him the safety scissors. Blame it all on the coalition.
Or we could look locally, and realise that each decision in each hospital is different, England have kept support services where Scottish hospitals are focusing on the front-line. Those with short term fixable problems will be looked after, long term illnesses and those who need specialist clinicians will soon face ever-growing waiting lists.
Each health board has power, and ours used it to acquire beautiful landscaping and works of art it would seem. Over managed and undermanned that should be Lothian Health Boards slogan.