Wednesday, July 15, 2015
A student nurse shared a story with me that brought tears to my eyes. She reminded me that it doesn’t matter how clinically excellent you are or how many “A” grades you get. Equally as important is how you treat people.
Dear Mrs. Thompson
I want to share an experience I had in the beginning of this semester during clinical. There was an old man the nurses had put in the hallway (I'm assuming to watch him, because he kept trying to get out of his chair). He was confused, and didn't look very well. He had bruising, dry skin, dry lips, and he appeared very pale; his hair was thin and very disheveled. The only attention he got was when he tried to put his legs down from the chair, a CNA, or a nurse would tell him "No" and put his legs back up. I would walk past him, and want to stop, but I was so busy with my own 2 patients, that it prevented me (at least I felt; admittedly because I wanted to "make the grade in clinical").
At one point, I couldn't take it anymore, and I stopped. I decided to sit next to that little old man, even though he wasn't my assigned patient, and I looked at his armband for his name, and I said "Mr. so and so, my name is Nan, and I'm a nursing student. I would like to sit next to you for a few minutes, if that’s ok?” He nodded just a little, so I sat down. I rubbed his forehead gently. And, you know what Mrs. Thompson, he calmed.
Over the past year the way people are cared for has been put under the spotlight. A series of reports have highlighted concerns about poor care, a lack of privacy, dignity and respect for people and failure to treat people with compassion.
When reporting on the Dignity and Nutrition themed inspections in the State of Care report, CQC identified one of the factors that underpin poor care: an attitude to care that is task based rather than person centred. It describes task based care as being impersonal and not what people want. Instead they want to be treated with respect, dignity and compassion. Kindness and compassion cost nothing.
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Friday, July 10, 2015
Let me paraphrase the backstory: This man (one of the greatest men I've ever known, incidentally) fell off of his roof last month and broke several ribs along with a collarbone and some other injuries, leaving him in the hospital for three days and off work for a month. Fortunately, he is doing better now, but here is the story he tells of a great blessing he got (with names removed):
I'm certainly not the most knowledgable nurse I know. In fact, I've tagged a few nurses in my ER that I can go to when I have a "what on earth was that" moment. They usually know the answers and keep me in line...
I really can't say that I never make mistakes. Sometimes I look at a chart after a patient has left and think, "I hope the lawyer doesn't see that." I forget to go and get the cup of ice and the extra blanket that I promised. I treat a patient for three hours before realizing that they don't have a name band and I've given several medications. I miss more than my share of IV sticks. I almost always show up 1 minute late no matter what I do. To save my life I can't remember the name of the patient in room 23. I had a nurse ask me if I had charted the black eye on that patient who just got shipped to the level 1 hospital... I hadn't even noticed it.
So why is it, then, that I have had many patients say to me: "you are the best nurse I've ever had"?
I don't say this to brag - if I wanted to brag I wouldn't admit to all that stuff up above - but because I think that maybe I've found my nursing superpower: empathy
Following intense pressure from the RCN, including a near unanimous vote at Congress to oppose the halt to NICE's work on safe staffing, NICE have confirmed it will still publish its work on recommended nurse staffing levels for accident and emergency departments, despite NHS England asking NICE to stop their work. NICE recommendations are due to be published at the end of July.
RCN commissioned research identified staff shortages in A&E departments – in some cases between 10 and 20 per cent. Given the pressures on staff in A&E departments, these recommendations will be timely and a welcome step by NICE.
This is new guidance to help hospitals and healthcare providers improve quality and safety by linking recommendations — from previous HIQA investigations and reviews into healthcare services — with National Standards that they are expected to meet.
? 22 recommendations in all seven reports relating to the importance of the correct model of care (this represented 9% of all 232 recommendations)
? 14 recommendations relating to the importance of integrated care
? 40 recommendations were about the need for formalised accountability and governance arrangements
? 14 recommendations relating to management arrangements and eight linked to workforce competencies.
? 16 recommendations in four reports related to evidence-based healthcare
? 16 recommendations relating to standards on monitoring effectiveness of care
? 14 recommendations on systematic monitoring arrangements for identifying and acting on opportunities to improve care
? 19 recommendations in all seven reports relating to the standard on acting on recommendations of investigations.