A G E N D A 1. APOLOGIES FOR ABSENCE Ian Metcalfe 2 ...
A G E N D A 1. APOLOGIES FOR ABSENCE Ian Metcalfe 2 ... A G E N D A 1. APOLOGIES FOR ABSENCE Ian Metcalfe 2 ...
Board of Directors Part 114 June 2013However, there is a need and understanding that nursing staff haveto show flexibility and may occasionally need to change wardswhere an acute problem arises.Some wards reported that band 5 nurses were not prepared toperform more basic tasks, leaving this to HCAs, even when theHCAs were under pressure, which is not good team work.When we asked whether there was ever a time when there was noregistered nurse on the ward, all wards replied that at least one registerednurse is always allocated to every ward at night. Only one member of stafffrom Ward 22 and one from the Stroke Unit said that for very shortperiods, such as toilet breaks, might there not be a registered member ofstaff on the ward at all times.7.3.3 Support and help from the Clinical Site Team (CST)There were high levels of satisfaction for the help and support given by theCST. Answers for a timely response from the CST were also very positivebut some dissatisfaction was aired on a couple of wards.If the CST was under pressure and pushed, wards suffered. It wasgenerally felt that the CST could do with another member of staff, whichcould be the same as the twilight/roving band 5 or 6 previously mentioned.There is usually no dissatisfaction with the time taken for red alert calls tobe answered by the CST and doctor but nursing staff felt that amber callscould take a long time for a doctor to respond.Medical staff were a cause of repeated comment by most wards.Generally in this very busy admission period staff complained that it wasdifficult to get hold of a doctor and they often took far too long to come towards particularly for writing up drugs and intravenous regimes. Mostnursing staff felt there should be another doctor on for the wards at nightpreferably someone more senior. There were some comments that doctorresponse and answering bleeps was particularly bad at the night doctorhandover at 23.00.It is difficult to know what the doctor response times were when thehospital was less busy prior to September but since this increase inadmissions has continued for over six months one may have to concludethat this is the new norm and it would seem there is a strong universalfeeling amongst nursing staff and the CST that current levels of medicalcover are inadequate.Only one third of nursing staff felt there was adequate support for themwhen their ward was under pressure. How often this happens and if thereis any pattern of cause or failure of response was not ascertained.11The Hospital at NightQuality/Performance
Board of Directors Part 114 June 20137.3.4 Staff’s confidence in expressing concerns to managers aboutcareThere was a very strong positive response in 98% of nursing staff. Theystated that managers listened to their comments and views. The role ofthe clinical lead is key as the leader and co-ordinator of the team andbeing approachable and responsive to comments from staff is an essentialpart of the role.7.3.5 Job satisfaction85% of nursing staff said they left work feeling they had done a good job.60% of staff on the Stroke Unit were less happy about their role at night –when busy the essentials are not always done and patients not alwaysmade to feel special. Several staff on the Acute Medical Unit commentedthat a patient’s personal care sometimes took second place to clinicalcare. Because they are always busy, care was sometimes dependent onthe skill mix at the time. Most AMU staff felt they were under-staffed at thetime of the review.When we asked staff whether they ever left work feeling anxious thatpatients had not received optimum care, this produced a 50/50 split. Staffclearly want to perform a really good and caring job and many of theircomments reflect the circumstances of the job, like being too busy. Tosome extent responses depended on how the interviewee interpreted thequestion. The responses were more a reflection of how high a level of carestaff wish to give rather than the reality of the situation.Many wards commented on how well they worked as a team although onsome wards there were comments that band 5 nurses would sometimesnot help out HCAs with their more basic tasks. Some responsesmentioned that acutely ill patients were not being given the best care as ittakes too long to be seen by a doctor.What are the aspects of night working you find frustrating ornegative?The points below reflect general comments made by staff:Not enough nursing staffDoctors slow to respond. Not enough doctorsFood and breaks – when busy don’t always have a meal break.Poor food availabilitySleep pattern disruptionIsolation at nightResponsibility and decision making greaterVery tiring and strenuousStaff talking loudlySecurity staff and porters – calling a porter on the computer systemis slow and time consumingResponse to requested task often very tardy. Lack of porters12The Hospital at NightQuality/Performance
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Board of Directors Part 114 June 20137.3.4 Staff’s confidence in expressing concerns to managers aboutcareThere was a very strong positive response in 98% of nursing staff. Theystated that managers listened to their comments and views. The role ofthe clinical lead is key as the leader and co-ordinator of the team andbeing approachable and responsive to comments from staff is an essentialpart of the role.7.3.5 Job satisfaction85% of nursing staff said they left work feeling they had done a good job.60% of staff on the Stroke Unit were less happy about their role at night –when busy the essentials are not always done and patients not alwaysmade to feel special. Several staff on the Acute Medical Unit commentedthat a patient’s personal care sometimes took second place to clinicalcare. Because they are always busy, care was sometimes dependent onthe skill mix at the time. Most AMU staff felt they were under-staffed at thetime of the review.When we asked staff whether they ever left work feeling anxious thatpatients had not received optimum care, this produced a 50/50 split. Staffclearly want to perform a really good and caring job and many of theircomments reflect the circumstances of the job, like being too busy. Tosome extent responses depended on how the interviewee interpreted thequestion. The responses were more a reflection of how high a level of carestaff wish to give rather than the reality of the situation.Many wards commented on how well they worked as a team although onsome wards there were comments that band 5 nurses would sometimesnot help out HCAs with their more basic tasks. Some responsesmentioned that acutely ill patients were not being given the best care as ittakes too long to be seen by a doctor.What are the aspects of night working you find frustrating ornegative?The points below reflect general comments made by staff:Not enough nursing staffDoctors slow to respond. Not enough doctorsFood and breaks – when busy don’t always have a meal break.Poor food availabilitySleep pattern disruptionIsolation at nightResponsibility and decision making greaterVery tiring and strenuousStaff talking loudlySecurity staff and porters – calling a porter on the computer systemis slow and time consumingResponse to requested task often very tardy. Lack of porters12The Hospital at NightQuality/Performance
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