'Its all about
the blood, the sweat, the tears.
Attribute to the strength
built through the years'
Machine Head (1999)
This blog post is a bit of a hard one for me as I need to remember that this is not a platform for venting frustration and ranting. So I need to reflect on things and see the good as well as the bad.
My last few shifts have been difficult and very taxing. Over the 18 months we have lost a large number of experienced staff, including our Ward manager. As you can imagine, this has put strain on the staff that remained on the Ward. This wasn't just happening on our Ward, departments across our Trust were short of staff. To fill this short fall the Trust look to solve the problem by recruited over 200 international nurses. This was great numbers wise, but as a lot of these nurses were newly qualified, the skill mix became a problem. This brings me to my last few shifts. I am going to go back to my days at Uni and use my favourite form of reflection that I use in at work and also on the tatami when doing Judo - Rolfe et al 'What, So what, What now.'
'What' - The situation
I walked onto one of my last shifts and looked around the room and didn't recognise half of the staff. Experience went as follows:
Sister - 10+ years
Me - 10 years
RGN (international) - 18 months
2 RGN (international) - 10 months
RGN - 2 months
RGN (international) - 4 days
2 Apprentices - 4 days
2 Cadets - 4 days
2 CSW - 2 months
It also turned out that 7 of these were only on till 1.30pm. I exchanged looks with the Sister and knew that this was going to be a long day (I txt the wifey and told her to put a beer or 2 in the fridge ready for when I got home... I was going to need it). The lack of experience and language barriers that were present meant that the newly qualified and international nurses were missing simple, but important things. This is by no means their fault. I feel that the international nurses are brave and determined individuals. They have come to a new country with no real family/friends network to support them, new language to learn, new culture and a new social ways of living (I will never forget one of them saying that I was odd for going to a coffee shop on my day off and sitting on my own reading a book with a cracking coffee and awesome slice of cake... she has now seen the light though and goes to the same coffee shop and reads a book. hahaha). It also turned out that they were the only 2 people on the Ward who could do IV's, and the other 2 international nurses were both need observing still as then were finding their feet, while the newly qualified nurse needed supporting.
'So what' - Action plan and implementation
Following Handover myself the Sister and the RGN who had the most experience had a conflab in the back to formulate a plan. The myself and the RGN would each work with one of the 2 international nurses while he Sister would work with the newly qualified nurse. The aim was not to do the work for them, but to support them. They would run the bay and we would be there to help and guide them when and where needed. IV's would be split between the Sister and the RGN. Come mid afternoon the Sister and RGN were up to their eyeballs in IV's and 1/2 the staff had gone home. It was at this point that we realised that the newly qualified nurse was on her own in her bay as the people working with her had gone. The only problem was that she didn't tell us and had spent a few hours struggling to keep the bay in check on her own. We made sure that the 2 international nurses were coping in their bays and then had a huddle with the newly qualified nurse. The conversation involved prompting the newly qualified nurse to delegate jobs so that they could get on top of their bay (a conversation very similar to the one in my other blog 'Supporting the future'). A high five and handful of Haribo each (Haribo make everything better) and we got on with the jobs. These involved medication dispensed, discharging a patient and some wound dressing, this enabled the newly qualified nurse to get on with other jobs and get the care plans finished.
'What now' - Looking to the future
This is where we are now... what do we do to make sure that our new nurses are not left to struggle or feel abandoned. But on the flip side, what do we do to stop the experienced nurses from feel like they are being stretched to thinly and feeling like they are unable to give the standard of care they want to give. This is not easy to do and I know I don't have the answer.
Following this reflection of my last few shift I like to think that no matter how bad things seam there will always be a light at the end of the tunnel. Everyone has felt at some point over the past 18 months like we have hit rock bottom, but it will get better - 'From the ashes will rise the phoenix'
And so we come to the end of what may look like a negative blog, but I look at it as being realistic. If anyone has the answers then please send them on a postcard to me :)
'So what' - Action plan and implementation
Following Handover myself the Sister and the RGN who had the most experience had a conflab in the back to formulate a plan. The myself and the RGN would each work with one of the 2 international nurses while he Sister would work with the newly qualified nurse. The aim was not to do the work for them, but to support them. They would run the bay and we would be there to help and guide them when and where needed. IV's would be split between the Sister and the RGN. Come mid afternoon the Sister and RGN were up to their eyeballs in IV's and 1/2 the staff had gone home. It was at this point that we realised that the newly qualified nurse was on her own in her bay as the people working with her had gone. The only problem was that she didn't tell us and had spent a few hours struggling to keep the bay in check on her own. We made sure that the 2 international nurses were coping in their bays and then had a huddle with the newly qualified nurse. The conversation involved prompting the newly qualified nurse to delegate jobs so that they could get on top of their bay (a conversation very similar to the one in my other blog 'Supporting the future'). A high five and handful of Haribo each (Haribo make everything better) and we got on with the jobs. These involved medication dispensed, discharging a patient and some wound dressing, this enabled the newly qualified nurse to get on with other jobs and get the care plans finished.
'What now' - Looking to the future
This is where we are now... what do we do to make sure that our new nurses are not left to struggle or feel abandoned. But on the flip side, what do we do to stop the experienced nurses from feel like they are being stretched to thinly and feeling like they are unable to give the standard of care they want to give. This is not easy to do and I know I don't have the answer.
Following this reflection of my last few shift I like to think that no matter how bad things seam there will always be a light at the end of the tunnel. Everyone has felt at some point over the past 18 months like we have hit rock bottom, but it will get better - 'From the ashes will rise the phoenix'
And so we come to the end of what may look like a negative blog, but I look at it as being realistic. If anyone has the answers then please send them on a postcard to me :)
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