NURSING AND EDUCATION PLATFORM

This point needs exploring; I just churn info out now. Anybody is welcome to add.

Much progress in care has been delayed by many factors; one of which is the lack of definition of poor care. This ranges from errors to shear abuse. Indeed  some form of scale may be developed - traffic lights?

Why the importance? Different forms of poor care MAY have different reasons and occur more so in certain fields of nursing than others (qualityofnursingcare.webs.com  free updates)

Some may refer to it as "inefficiency" which usually indicates low numbers of beds or staff, for example. This may be more statistically measured. Whilst this may well cause some aspects of "poor care" such as omitted care, or errors , it will not cause others such as abuse- unless it contributes as there are less staff to monitor situations.  Errors may also occur when there is no short staffing  .

Politicians/inspectors do seemingly favour the efficiency/statistical perspective- "care is a commodity"; similar in other fields eg education. Are we to count the number of smiles per hour (Mcdonolodian approach?)

This failure to define such aspects, causes conflict and misunderstandings between individuals who in reality, seek similar ends.

There is no point defining what is QUALITY of Care, without first knowing what is POOR care.

Links to article "cruelty in nursing" lenin2u.wordpress    

Article on this site "Poor care IS poor care".

This topic really needs an international project- or any form of qualification will be negated.

A sample of some web info (2014). Carol Dimon/ Lenin Nightingale

NB hindu.com/news  one state in Indian will not accept nurse qualifications obtained from other states in India. Does the NMC accept them in the UK?

http://www.uemsgeriatricmedicine.org/uems1/bulgaria1.asp
 http://balkanblog.org/2013/11/28/police-planning-to-stop-counterfeit-degrees-aracinovo-mafia-gefakte-dokumente/
http://www.belfasttelegraph.co.uk/news/health/northern-irelands-hospitals-turn-to-romanian-nurses-to-fill-jobs-29882388.html
http://www.novinite.com/view_news.php?id=131919
http://www.uib.no/isf/people/doc/hovedfag/nursing/belova.htm
http://www.dca.ca.gov/publications/press_releases/2013/0527_rntranscript_doi.shtml
http://www.cgfns.org/services/ces-academic-report/
http://host-47.242.54.159.gannett.com/news/article/268708/189/Aisha-Wendy-Randolph-pleads-guilty-to-role-in-fraud-nursing-certification-scheme
http://www.arabnews.com/news/451886
http://www.thehindu.com/news/national/kerala/nurses-council-derecognises-outside-degrees/article5034991.ece
http://www.broadwayworld.com/westend/board/readmessage.php?thread=1066467&boardid=3&mobile=on
http://www.knittingdaily.com/forums/t/19403.aspx
http://www.fodors.com/community/united-states/buy-passport-visa-driving-and-other-licensedegrees-certificates-etc-450106-4.cfm

Care home itself according to policy Any issue. Refer some eg abuse to safeguarding bodies .

CQC No individual complaints. Do unannounced inspections. Monitor re CQC standards.

GP Consortia NHS funded residents.

Local Government Ombudsman Social care of residents but not healthcare

Health Service Ombudsman NHS funded residents in care homes. NHS owned care homes. Difficult procedure. Do not consider all complaints. Similar to LO.

Healthwatch Local Will enter care homes if concerns etc. Primarily for complaints re NHS homes , LA homes or NHS funded residents but will consider all . Support people to complain and refer to appt bodies eg CQC. Differs per local area.

Local Contracts Compliance or equivalent LA funded residents or private paying residents who pay via LA. Investigate complaints. Can block contract with care home.

Charity bodies eg Age UK Advise

Independent advocacy bodies Advise and mediate.

Information obtained by contacting each national or local body. Correct at time of writing but may alter with any further restructuring of bodies.

To access these individuals, try contacting the CQC who will refer you to them. Otherwise your adult head of social services, local council or ombudsman websites. There are also independent charity bodies. C Dimon c (2013)

Other regions UK differ. see qualityofnursingcare.webs.com for free info re this.

This commission aims to promote an international, positive image of nursing in the UK . Many call for discussion of positive aspects of nursing only, which whitewashes the situation of poor care. It is noted that members of this committee, are representative of the RCN in some way, which is a direct source of conflict (Nightingale 2014). "We will gather information from others" they say- the bias is usually  in the gathering and the reporting. Research may say what you want it to say. Aim to say how good nursing is-- that is what will be done. Blogs in this way, are more valid. The RCN particularly aim to keep the 3 year nursing degree which is inadequate (NHS future forum 2012), and many students complete the course at some Universities without undertaking certain fundamental nursing procedures (Dimon 2013).

This positive image propaganda, has filtered into nurse education UK. According to blogs, and comments from students, some universities/lecturers, are informing students that "poor care does not exist". Recall there are different types of poor care from errors, to false records, to shear abuse. Whilst some lecturers may well believe this to be the case, students are not being prepared for practice- they need discussions of actual situations and advice regarding what to do about it. Action to take, may differ depending which agency owns the establishment. This false image, fails to protect patients- and staff who try to do something about it. It also creates  a never-ending cycle of in-action. Many students leave the course due to their obervations on placement (Dimon 2013).

It would be beneficial to include ordinary nurses (not necessarily RCN members),students, care assistants, relatives and patients on this committee.

In other words- do not tackle the issues- just say "how good we are". Not to mention nurses in other sectors such as care homes.

http://rcnpublishing.com/doi/pdfplus/10.7748/ns2014.01.28.21.10.s4

Will have to share this positive example of care (well we think it is); patient been in hospital so many times in dreadful situations,she is known to the Foundation Trust hospital. If the menu comes round and she does not feel like anything, she writes something different eg apple crumble and custard. Despite suprise of many staff members, the kitchen do provide it for her!

This is truly humanistic, personalised care.

We do know- if 20 patients all asks for 20 different puddings it would not be possible.

Pehaps a "pudding club" is called for??

I will not name the patient-or the hospital- in case somebody realises and intervenes--.

It is known that there are restrictions in all countries, on what may be published by the press and also on Television or radio. Some countries are more strict than others.Even the content of  education is controlled, especially history.

They restrict publications  by threatening with court action, or discrediting the story, author or editor. Whilst there may well be genuine reasons such as protection of privacy of high profile people, there are also political reasons. Would it be in political interest here in the UK, to discuss certain issues?

Then how has the press in the UK, been able to offer such articles detailing poor care , many may ask? This has actually been an issue for years. It is thanks to Fiona Phillips and cure the NHS, that politicians/  agencies linked to them via funding at least, had to be seen to be acting. Similarly regarding such cases as Jimmy Saville. Few members of the public, had heard of the cases prior.

Many are so indoctrinated and mislead, that they refuse to believe any such reports of secrecy, whatever the political party. Logically, of course, some information will not be made public- claimed not to be in the publics best interests. Then what of Freedom of Information? There are several alternative news sites , which offer the truth, but in the UK, many of these are now gagged. Some may well argue, but can you trust alternative news sites? Indeed the government could establish one by which they offer their versions, or obtain details of contributors or commentators. It is known that emails and data base inputs can be tracked , or web sites removed.

In short, many already comment that they do not know who or what to believe anymore. George Orwell must have been a very clever man to prophecy the whole situation in the 1950s .

This issue is extremely relevant, but little discussed- perhaps because it is so sensitive an issue?

Just heard of a children's orphanage overseas, visited by  a friend of mine.No government funding or support in that country, by the wealthy government- of the same race as the children and workers (unpaid) at the orphanage. Many of the children still sleep on the streets but go to the orphanage during the day.

The need for such care is an embarrassment in many countries (recall Brazil and the street children), to whatever government. With the aim for neoliberalism ie all responsible for themselves etc, this could well occur in other countries (UK). Hence governments will not be responsible for health and social care.

Further, when people come to countries such as UK/ USA, of course they will have different attitudes- when the aim in their country is survival. many old people do accept care as it is, because they recall the workhouses for example (Reference). Hence the attitude, of some, at least we or they, have  a bed and  a meal--.

More points re this topic are welcome. It needs exploring.

Just visited a patient in a FT hospital. Care was marvellous whilst we there there (nobody knew me), and the student on her first placement was amazing.

Point is staffing- 5 staff. 3 nurses (unless one was HCA- from agency), 2 HCA. 30-20 year ago, similar staff level for 30 pts on  a late shift BUT nobody had pre-delegated roles eg clean water jugs- we all rellied on somebody to do it unless we did it ourselves as care assistant or student nurse. I have known nurses do such tasks.On a late shift in hospital there would be 2 nurses; in care home- one nurse or for  a longterm care ward in a hospital.

Another point, when addressing staffing or other issues- look back in history.

Thus staff levels do differ according to what field we work in- and you can never perfectly predetermine the level. I have never known  a case with extra staff for the additional 6 admissions or whatever. Nor can you time care- ie simply assisting a patient to move up the bed may take far more than 10 minutes--. But yes- we do need a minimum below which (when unplanned) by magic, the nurse in charge can get additional staff from mars. Beam me up Scottie!

I really wish somebody would explore this issue, as it is of great relevance. These additional 2 examples from an anon nurse who worked with  a hospital, further illustrate the humaness that is so necessary with care but is restricted by red tape and regulations;

A patient on a ward offered me £5 for being so kind to her. I refused- according to NMC guidelines. She wanted me to buy myself a drink from her. When she explained, she had very little time left to live- I did take the money. When she did pass away 2 days later. I sat with my pint (or2) and remembered her. At least I gave her some pleasure of knowing that she had bought me a pint! There have been cases of nurses or care staff, refusing money or sweets etc from patients or residents who did not want to donate it to the establishment, and the patients have never spoken to the member of staff again.

Years ago, on  a hospital ward, I was taking round the menu  and offering patients choices of meal for the day after. One lady explained that she did not want anything on the menu but could she have part of one, with part of another? I explained I would ensure this would be so. After she asked me how I would do this I demonstrated by knocking on the pipes, which I said went straight to the kitchen in a form of morse code. How the patients laughed! Yes I did ensure she had what she wanted for dinner, and the kitchen staff were kind enouigh to provide it.

More explanation of such cases is provided here

http://caroldimon.co.uk/tales.php

I know many more staff have similar examples.

It is proposed that the word "private" be replaced by something else- by the government. Direct Orwellian double speak- call it "partnership" and people will fear less.

We already have VIRGIN owned hospitals, hiding behind the NHS logo.

Recall differences between private and statutory sector (also charity owned sector)- many fail to realise;

complaints system in private differs- even harder. Can give you one months notice of leave for complaining ie "we are unable to meet your needs"

Policies differ- NHS policies and requirements , only apply to NHS.

Private sector employs less staff and more overseas staff.

Agenda4change only applies to NHS- so private or even Foundation Trusts, are not required to apply it- this determines staff pay levels.

Whilst some private establishments do provide excellent care, as do NHS, poor care may arise in all establishments at any time. Poor care in the private sector may not hit the national headlines- nor does it result in  a Francis report, which only applies to the NHS.

The government ARE aiming for privatisation as ordered by the EU, and many business owners   do fund the governement or even, MPs may well have vested interests.

Where private equity trusts are concerned, nobody knows who is the actual owner 

Do have references for all of this. See especially lenin2u.wordpress

Lenin calls it "weasel words", 4bitnews