As you know those at the 'front line' of nhs care are being 'encouraged' to have both the flu and H1N1 vaccines.
So how come 75% of my colleagues do not want it?
As line manager, I am 'expected' to model good practice and attitude (according to the hospital management) by getting the jabs, then persuading those I line manage that they 'should' have it too.
I do not believe I am wrong (or paranoid) in thinking that if the shit hits the fan re - swine flu, human resources and over zealous managers will come up with the idea of either disciplinary actions or, more likely, financial penalty, for those not having it.
A scenario I can foresee is that a nursing assistant with a poor health record goes off sick with swine flu. I, as charge nurse, am then tasked with finding out if they have had their vaccines, and if not, why not. If there is no good reason given, then some phrase along the lines of "not doing enough to maintain health" or "refusing preventative measures to maintain health" will be used to justify either unpaid leave while off, or disciplinary procedures being commenced.
I am not so sure this is as far fetched as I first thought when started writing, as similar expressions have been used with employees when they have been off sick.
I recall a friend was off work with a depressive illness (severe), getting through the recovery phase, they were asked to go ice skating with a small group attending the a day centre she went to for support. While skating, she fell and broke her ankle, thus changing and prolonging her time away from work.
Her line manager and human resource person had a meeting with her and suggested she had been "participating in activity likely to hinder recovery" and as such sought to proceed to disciplinary.
Ah the joys of working for the NHS never cease to amaze me.
Sunday 29 November 2009
Tuesday 10 November 2009
charge nurse confusion
There are a lot of different people up and down the country, with very different jobs, but who are, or are seen as, charge nurses.
The role takes many different forms, from those who work 9-5 managing the ward, staff budget etc, to those who work shifts, and/or work with patients directly, almost exclusively.
Sometimes the title changes, be it charge nurse, ward manager, clinical manager, etc etc etc.
I believe in Scotland there is currently a review of the role of the 'senior charge nurse'. I have no idea if that encapsulates all the ward managers, clinical area managers, (even the occasional clinical lead, or nurse specialist?), but would be interested to hear how it is going.
Another difference I see in different clinical areas is that a ward can have one charge nurse, or many. I have personally always been a fan of the one charge nurse if it is an inpatient ward. At least then everyone knows who is in charge (within reason, see previous post).
I once had dealings with a 16 bedded acute admission ward with 4 charge nurses, all at the same grade and none identified as being 'in charge'.
Granted, the above scenario would be ideal if things were going a bit hairy, at least senior management would not be able to 'blame' an individual if budget overspent etc, but I just feel that each department requires an identified 'head', so that the 'body' knows what it is doing and where it is going.
Feel free to let me know if your department has one charge nurse, or many, and what works best for your area.
The role takes many different forms, from those who work 9-5 managing the ward, staff budget etc, to those who work shifts, and/or work with patients directly, almost exclusively.
Sometimes the title changes, be it charge nurse, ward manager, clinical manager, etc etc etc.
I believe in Scotland there is currently a review of the role of the 'senior charge nurse'. I have no idea if that encapsulates all the ward managers, clinical area managers, (even the occasional clinical lead, or nurse specialist?), but would be interested to hear how it is going.
Another difference I see in different clinical areas is that a ward can have one charge nurse, or many. I have personally always been a fan of the one charge nurse if it is an inpatient ward. At least then everyone knows who is in charge (within reason, see previous post).
I once had dealings with a 16 bedded acute admission ward with 4 charge nurses, all at the same grade and none identified as being 'in charge'.
Granted, the above scenario would be ideal if things were going a bit hairy, at least senior management would not be able to 'blame' an individual if budget overspent etc, but I just feel that each department requires an identified 'head', so that the 'body' knows what it is doing and where it is going.
Feel free to let me know if your department has one charge nurse, or many, and what works best for your area.
Thursday 8 October 2009
how many nhs employees to change a light bulb?
Actually, let's not bother with light bulbs, let's concentrate on something more sophisticated, quilt covers.
A hosptital ward requires new quilt covers for the beds, as the old ones have been washed to nothing. Simple you would think, find the budget holder (charge nurse) persuade them to sign off on a set of new quilt covers, et voilà.
Except, this is the NHS. The charge nurse puts request into manager, manager refuses, wants 3 quotes for pricing. Charge nurse takes the hump and puts this task way down their priority list (as a million and one other things to do).
Eventually, manages to get three companies to quote for quilt covers (which is not in the c/n job description and is quite far removed from the 'nurse' bit of their title).
Quotes come back from manager with attachment from health and safety officer to double check quilt covers meet standard required for NHS property fireproofing.
Again, put down charge nurses priority list, but eventually gets round to finding out what the fireproof regulations are for nhs quilt covers and ensures quotes are appropriate. back to manager.
Manager decides the ward budget is already over spent and cannot afford quilt covers at this time, however, suggest filling in the endowment fund application forms (three of them) and requesting quilt covers via that fund.
Much form filling done, request sent off. Endowment manager emails charge nurse, very angry that endowments are being requested for what he sees as essential equipment.
Charge nurse pulls hair out in frustration.
Luckily, a very nice patient dies, his family would like to put some money towards the ward. Charge nurse has a quiet word about the big black hole the money will fall into, and family 'suggest'(with only the smallest bit of prompting) to buy some new quilt covers for the patients/ward.
The above is a true tale
A hosptital ward requires new quilt covers for the beds, as the old ones have been washed to nothing. Simple you would think, find the budget holder (charge nurse) persuade them to sign off on a set of new quilt covers, et voilà.
Except, this is the NHS. The charge nurse puts request into manager, manager refuses, wants 3 quotes for pricing. Charge nurse takes the hump and puts this task way down their priority list (as a million and one other things to do).
Eventually, manages to get three companies to quote for quilt covers (which is not in the c/n job description and is quite far removed from the 'nurse' bit of their title).
Quotes come back from manager with attachment from health and safety officer to double check quilt covers meet standard required for NHS property fireproofing.
Again, put down charge nurses priority list, but eventually gets round to finding out what the fireproof regulations are for nhs quilt covers and ensures quotes are appropriate. back to manager.
Manager decides the ward budget is already over spent and cannot afford quilt covers at this time, however, suggest filling in the endowment fund application forms (three of them) and requesting quilt covers via that fund.
Much form filling done, request sent off. Endowment manager emails charge nurse, very angry that endowments are being requested for what he sees as essential equipment.
Charge nurse pulls hair out in frustration.
Luckily, a very nice patient dies, his family would like to put some money towards the ward. Charge nurse has a quiet word about the big black hole the money will fall into, and family 'suggest'(with only the smallest bit of prompting) to buy some new quilt covers for the patients/ward.
The above is a true tale
Sunday 4 October 2009
who really runs a hospital ward?
There, the question is posed. Who is in charge of a hospital ward? In a local community hospital where I previously worked there were a number of candidates, some think they are in charge, some are in charge (but don't know it), and some are just clueless.
The main protagonists in this scenario are:
Consultant
Charge Nurse
Hospital manager
GP
On a day to day basis the charge nurse is 'seen' to be in charge. If the hospital manager is feeling pressured, then will often remind the charge nurse "you have 24 hour responsibility, sort it out". This tends to happen when things are going a bit hairy.
However, when wanting to reduce staffing levels or change skill mix then the hospital manager feels they are really in charge and will make decisions directly related to the work on the ward, so, maybe they are in charge?
But of course our medical colleagues always believe they are ultimately in charge of everything. They tend not to be involved in decisions around mediocre stuff like finances and staffing, but are definitely (in their eyes) the final voice when it comes to admitting, discharging and planning treatment for patients.
Quick quiz: Can you guess who deals with each scenario below?
1. Irate patient, is very angry and upset about treatment and demands to speak to person in charge.
2. Local politician recently treated and about to be discharged. Gives a brief press conference to thank the hospital. Who is standing beside him receiving the praise?
3. Mother of a local dignitary feeling a bit unwell. Does not fit the criteria for admission, but decision is made to admit to the ward?
The above is a very simplified look at what in reality is a huge problem for charge nurses. Charge nurses are constantly reminded from staff on the ward and their managers that they are responsible and accountable for patient care and safety on the ward (as well as a million other things). However, even on a day to day basis, managers, medics etc can all make important decisions which directly affect the running of a hospital ward without recourse to the charge nurse.
Who said it was going to be easy?
The main protagonists in this scenario are:
Consultant
Charge Nurse
Hospital manager
GP
On a day to day basis the charge nurse is 'seen' to be in charge. If the hospital manager is feeling pressured, then will often remind the charge nurse "you have 24 hour responsibility, sort it out". This tends to happen when things are going a bit hairy.
However, when wanting to reduce staffing levels or change skill mix then the hospital manager feels they are really in charge and will make decisions directly related to the work on the ward, so, maybe they are in charge?
But of course our medical colleagues always believe they are ultimately in charge of everything. They tend not to be involved in decisions around mediocre stuff like finances and staffing, but are definitely (in their eyes) the final voice when it comes to admitting, discharging and planning treatment for patients.
Quick quiz: Can you guess who deals with each scenario below?
1. Irate patient, is very angry and upset about treatment and demands to speak to person in charge.
2. Local politician recently treated and about to be discharged. Gives a brief press conference to thank the hospital. Who is standing beside him receiving the praise?
3. Mother of a local dignitary feeling a bit unwell. Does not fit the criteria for admission, but decision is made to admit to the ward?
The above is a very simplified look at what in reality is a huge problem for charge nurses. Charge nurses are constantly reminded from staff on the ward and their managers that they are responsible and accountable for patient care and safety on the ward (as well as a million other things). However, even on a day to day basis, managers, medics etc can all make important decisions which directly affect the running of a hospital ward without recourse to the charge nurse.
Who said it was going to be easy?
Saturday 3 October 2009
What makes a good C/n?
I have worked for many charge nurses ( and I include sisters in this title, but feel free to argue) over the years, some have left good impressions,some horrendous, and some are just vague recollections.
For me, the best have always been those that seem very relaxed about life, and never appear under pressure. They sit, watch and listen a lot, but never seem to do much. In my eyes, this breed are becoming harder and harder to find in the nhs as the pressure from 'managers' drives them to become more task orientated.
Tasks, as in produce reports, audits, attend management meetings, personnel hearings, financial returns, etc etc etc, not 'tasks' as in spend time with the staff on the ward, or heaven forbid, spend time with the patients and their carers/relatives.
I worry about student nurses sometimes (not often). The charge nurses they mostly see now are really what were always 'managers'. Charge nurses are more likely to be judged as being good, or at least competent, if their ward or department is financially viable, as opposed to what experience they can give the patients, visitors, staff etc.
Blimey, I am sounding like an old fogey, hankering after days of yore. Bollocks to that.
For me, the best have always been those that seem very relaxed about life, and never appear under pressure. They sit, watch and listen a lot, but never seem to do much. In my eyes, this breed are becoming harder and harder to find in the nhs as the pressure from 'managers' drives them to become more task orientated.
Tasks, as in produce reports, audits, attend management meetings, personnel hearings, financial returns, etc etc etc, not 'tasks' as in spend time with the staff on the ward, or heaven forbid, spend time with the patients and their carers/relatives.
I worry about student nurses sometimes (not often). The charge nurses they mostly see now are really what were always 'managers'. Charge nurses are more likely to be judged as being good, or at least competent, if their ward or department is financially viable, as opposed to what experience they can give the patients, visitors, staff etc.
Blimey, I am sounding like an old fogey, hankering after days of yore. Bollocks to that.
beginings
This blog will be the thoughts, experiences and life of working in the nhs, from a charge nurse perspective.
My reason for starting this blog is that over the past year or so I have read many nursing blogs, however, they all seem to come from either a student nurse perspective or some clinical specialist or other who sounds as smug as a pregnant woman (it's a song, don't blame me, yet).
I hope to tell tales from the charge nurse point of view, which to my mind (and yes, I am biased) is the fairest of all, as the charge nurse is always caught in the middle between the 'troops' and the politicians (managers).
I may, or may not work as charge nurse (either now or ever) but I will confess to access to at least one who has many years experience , mainly, but not exclusively, in mental health nursing and in a variety of settings.
Enough of the waffle, enough covering my back, lets get this shit started....
My reason for starting this blog is that over the past year or so I have read many nursing blogs, however, they all seem to come from either a student nurse perspective or some clinical specialist or other who sounds as smug as a pregnant woman (it's a song, don't blame me, yet).
I hope to tell tales from the charge nurse point of view, which to my mind (and yes, I am biased) is the fairest of all, as the charge nurse is always caught in the middle between the 'troops' and the politicians (managers).
I may, or may not work as charge nurse (either now or ever) but I will confess to access to at least one who has many years experience , mainly, but not exclusively, in mental health nursing and in a variety of settings.
Enough of the waffle, enough covering my back, lets get this shit started....
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