current affairs

Work as an HCA for a year—I already do that!

The controversy surrounding the conduct of nurses working in the NHS at present is rife.  It seems that every day a new headline appears about how the quality of care offered by the NHS, and n

The controversy surrounding the conduct of nurses working in the NHS at present is rife.  It seems that every day a new headline appears about how the quality of care offered by the NHS, and nurses in particular, is failing to meet acceptable standards. The horror stories of patients left to sit in their own excrement or left without water, have shocked the nation, but are the torrents of blame that are being cascaded directly onto nurses, being put onto the right people?

As a first year student nurse I am directly on the receiving end of some of the Government’s new ideas to tackle the perceived problem in the NHS when it comes to care and compassion. I am the first to admit that during my time working on the wards of a community hospital I witnessed levels of care and acts by one nurse that were often inappropriate and sometimes downright dangerous. This conduct, though inexcusable, was isolated to just one nurse, yet all nurses are being tarred with the same tainted brush. 

I am happy to say that my experiences of the other nurses that I have had the privilege of working with thus far in my training have obliterated the current image of them being presented by the media as they have been hardworking, caring, compassionate and endearing individuals.

One of the issues making headlines in the media at the moment is the Government’s new idea that all student nurses should spend one year training as a health care assistant (HCA) before embarking on nurse training. I would love to know what the person that came up with this outlandish and downright stupid idea thinks student nurses actually do. The NHS is so grossly understaffed that student nurses are being used as HCAs already and the NHS would probably collapse without them. 

During my first placement at a community hospital, dealing mainly with elderly patients, I personally was used solely as an HCA. This ward was so hideously understaffed that it was not unusual for me to have to attend to the care needs of up to eight patients on my own. Most of the patients that come to community hospitals are there, not due to acute medical needs, but because there is simply nowhere else for them to go, due to the fact that they can no longer care for themselves.

My daily routine, being used as an HCA, bearing in mind that I was there in a supernumerary capacity, would go something like this: feed five out of eight of patients who cannot feed themselves, go to patient number one, wash, dress and mobilise patient, move to patient number two, start washing patient but have to answer call for help from HCA as patient number five is trying to leave ward, return to patient number two, finish patient’s wash and get patient sitting comfortably in chair.

I would then prepare wash things for patient number three, answer patient number four’s call bell, make patient number four cup of tea, return to patient number three, wash and dress patient, ignore patient number six’s call bell as patient number 3 teetering precariously between the bed and chair, answer patient number six’s call bell, decide to wash patient next as they are soiled, return to patients one and two as they have soiled themselves, gratefully accept help from nurse who has now finished medicine round, nurse goes to wash patient number eight, go to patient number five to find old surgical site has reopened, get nurse, assess and redress surgical site, leave message for doctor to come, help patient number five get washed and dressed, go to patient four who has soiled themselves, and go to patient six who doesn’t want to be washed at the moment as it is now lunch time.

I would phone the doctor again as patient number five’s surgical site is bleeding through dressing, dish out lunch, feed five out of eight patients who cannot feed themselves, try and prioritise answering call bells as seven out of eight patients need their pads changing but nurse is on medicine round again, phone doctor again as patient five’s surgical site is still bleeding and the patient is not feeling well, do all of this with an empty stomach, full bladder and painful feet and back that have not quite recovered from yesterday’s 13.5 hour shift.

Need I continue?

When I started at this community hospital placement the staffing ratio was approximately one nurse and one HCA lower than was recommended and the ward was housing twenty-two patients. Two weeks after I commenced placement the ward was forced to open up to thirty patients, no extra staff were supplied. Alas, at the moment I am again experiencing the Government’s drastic cost and staff cutting measures.

My current placement on an acute surgical ward has bed space for fourteen patients. Staffing ratios have just been changed from three nurses plus one HCA to two nurses plus two HCAs. However, some bright spark has failed to hire any new HCAs so the realistic staffing level is currently two nurses plus one HCA. Inevitably this leads to complex and downright scary situations.  For example one of the patients on the ward became critically ill with a pneumothorax (collapsed lung) and so required constant, uninterrupted attention from one of the nurses. 

This left one nurse and one HCA to thirteen patients. The nurse that was left was carrying the emergency bleep meaning that if there was an arrest call (which thank goodness there wasn’t) she would have had to answer it leaving an entire ward with one HCA and no nurses – not a good situation to be in if you are a patient.

It seems that nurses and student nurses are currently taking the brunt of a public that takes the NHS for granted and does not pause to think of the actual people and personalities that are behind the nurse’s uniform. As a student my supernumerary status has been ignored, I am allocated a measly bursary of £83.33 per month which doesn’t even cover my placement travel costs and still I am forced to listen to comments like that on ITV’s Loose Women that student nurses do nothing and I am constantly told that my generation is ‘too posh to wash.’

It is a comment that I ironically heard on a news programme after leaving a patients room where doctors had been desperately trying to revive him, while I was scrambled around on the floor cleaning up blood, clots and vomit in the hope that the doctors would not slip and injure themselves—then we really would be screwed!

For all my woes and moans I think that the NHS is a wonderful thing and it is something that I cherish and hope, with trepidation, will be available for future generations to benefit from. I just hope that the public and the Government can recognise that the problems lie, not in the nurses, but in the lack of them. 

For now I shall continue with my training delivering the best care possible to every patient that I meet and with all the sincerity and compassion that I have to offer.

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