NURSING AND EDUCATION PLATFORM

Agency nurses are used within all areas eg prisons, care homes, hospitals- NHS/FT/private or community etc. Being an agency nurse demands great skill at adapting to individual situations and practices within all establishments. It also gives the nurse an opportunity to learn within the field and challenge him or her to deal with various issues and situations. This blog will recount a number of situations that an agency nurse was confronted by. The anon nurse did meet many excellent staff of all levels who were very apologetic about some situations. There were also others who were not so good. As an agency nurse, you can have some option of where to work or indeed, the establishment has some option of who to use. The incidents did take place many years ago and regulations have changed since then. However, the situations may still occur.

 It was the night shift. I arrived at a care home to be greeted by 2 apologetic care assistants- this was their first day at work and one only had experience - within a vets. There were 4 patients to be fed by enteral feeding , which I was unfamiliar with and one patient needed constant care. I was met at the door by the previous nurse who left and handed me the keys. No wonder she failed to give me a handover report.

Another care home. Nightshift. The 2 carers met me at the door- sorry there is only us here. It was the first shift of one carer. Midnight looms- a taxi arrived. the carer grabbed her coat and ran, exclaiming "sorry it is not for me!"

 Many care homes use a lot of overseas nurses and care assistants. On shift in one home, 2 staff were from different regions of Africa. They relayed messages to one another via another member of staff. The 2 regions in Africa did not get on due to different political orientations, so they could not have anything to do with each other. Many forget that within some countries such as Africa or Poland, different regions are extremely different as reflected by cultural attitudes.

 One trainee overseas nurse in one care home, brought a bowl of porridge when asked to bring a pressure care mattress.

 I arrived at a care home for the night shift; great- I was told there were no drugs to do. Why? They had not arrived from the chemist--

 One hospital, the nursing officer often rang me on shift to check everything was OK. Not in others.

Night shift in one hospitals. A patient passed away with half hour of my arrival. Like any unfamiliar nurse, I consulted the procedure files. I rang the doctor on call to certify death. He announced he would not come until the morning. Now, any nurse or carer knows, that it is indignifying to leave a person who has passed away, on a ward and you cannot inform anybody until he or she is certified. Anyway, the doctor did come out! i wonder if  a new face does sometimes make  a difference- or was he trying to pull the wool over my eyes? I know there are some nurses who are now qualified to certify patients, after training.

If you go regularly to the same place, staff may adopt you, especially if you assist them with general care of patients. makes it easier for you also as you know the patients and staff.Day shift. the agency nurse arrived at the care home. During the shift, a syringe driver needed replacing. Training for syringe drivers was additional to the nursing course. this nurse rang the home manager and insisted that she come out- which she did. As an agency nurse- or any nurse- you need to have bottle. Similar situations may occur with other aspects- hoists differ within all establishments, procedure, care plans etc

Night shift in care home. You always get those organised carers. "This is how we do it, you do what we say". They never met me before, "No, I am the nurse in charge you do what I say".

Day shift in a care home. The case of the ghostly chair. If carers did not approve of the poor agency nurses as soon as she walked thorugh the door, he or she was informed to sit in certain chair in the lounge- from where the owner could see her through a window and report her to the inspector for not doing anything.

Working in different establishments, you notice many different practices. Restricted incontinence pads in the day, with residents obviously needing more and carers afraid to oppose the ruling. Of course I informed the inspectors who promptly paid a visit. The fridge that was locked . The cheese that was weighed by the owner. The home that left a written handover as common practice; the nurse had gone. The home that split drug capsules - I refused so was in trouble with the resident but did leave notes and informed the chemist. Such issues are difficult as an agency nurse as you may never return to the home again and there is nobody to discuss it with at the time.

One prison, I queried the drug dosage with a Dr who happened to be there.  Shortly after, I recieved a letter threatening disciplinary for giving the wrong dose. Not me, the drug chart was unclear and staff had been giving incorrect dose. My letter in response, soon ended the battle. No- I would not return to the place again. Somebody was seeking promotion.

Night shift ina hostel as a nurse. Arrived there to find  astaff member waiting with keys who told me to have a rest. all residents had been taken out over night and it was too late to cancel me. Hope they had  a great time! cancel an agency shift too late and it still has to be paid for.

Night shift in  a home for 30residents. a care assistant greeted me with the words "there is only the 2 of us, instead of 4". if I had known, i would not have agreed to do the shift- you can do that in the agency. Fortunately- i knew the home well. 2 staff had gone sick and all efforts to cover them failed but the manager was not allowed to ring agency. After informing the Area health authority, in case anything untowards occured like 2 emergencies at once, we had  a very busy shift without  a break in the 12 hours. Many tube feeds to do and poorly residents. Nor wopuld day staff agree to come in a couple of hours earlier- I rang them myself. Happens a lot.

Worked one day in  a nursing home. Care assistants pleaded with me to take action regarding the condition of  aresident's legs. They had been like it for 6 weeks and no doctor had been rung by the nurses, who happened to be from overseas. I rang the doctor who came and also expresed alarm that she had not been contacted, Of course I made full records.This tale tells us a few facts. Care assistants do report to nurses (not always we know) . When no action is taken, the care assistants are at  a loss regarding what to do. I knew nothing about the manager in this case. If they too were registered, it may well place on them additional responsibility and awareness- hopefully by standardised education .Overseas nurses are inadequately trained when they arrive in the UK (Dimon 2013). Regualtions, procedures and culture differ. In some countries pain patches do not exist for example, nor do specilaised nurses such as tissue viability nurses. Pressure care equipment and procedures wil differ in many countrirs. Indeed in some, doctors are not involved at all in nursing homes (have references). Apart from that, attitudes differ to eg pain . This all warrants further reserach but nobody will do it. Far easier to ignore the situation and blame overseas staff by requiring their attendance at NMC hearings.