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
Thursday 8 October 2009
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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