STUDENT NURSES AND STATISTICAL LIES

imagesCAQKTCWRKate Liptrot (yorkpress.co.uk, 5 January 2015) quoted Glenn Turp, regional director of the Royal College of Nursing (RCN) for Yorkshire and the Humber: “Nurses from overseas have always made a valuable contribution to the NHS, but the RCN is concerned that recent years have seen a worrying over-reliance on them.

“Many employers are now waking up to the fact that care can only be safe when you have enough nursing staff, but due to the cuts in training places which happened over a period of years the UK is just not producing the nurses it needs. We really need a long term solution that trains and retains the skilled staff we need to care for our own – not the sticking plaster solution that goes overseas to recruit nurses for short term gaps.”

The same article also quotes Dr Mick Phythian, a spokesman for York Defend Our NHS: “It’s sad we have come to this having been so poor at training nurses over the past years, and at stages even making them redundant. Now we are having to deprive another country of their nurses.”

The NHS Qualified Nurse Supply and Demand Survey (2014) gives some insight into what managers of Hospital Trusts would like to see  in terms of the training student nurses receive.:

More flexible ways to train to be an RGN whilst in service.

We also require specific training programmes for HCAs to allow them to take on additional duties which will give a new skill mix.

Review of nursing training to return to allocation by Trust to enable closer relationship with future workforce.

Bursaries to support Associate Practitioners in nurse training programmes.

As a community trust it would be beneficial if training providers could cover more in relation to skill and competency of managing out of hospital care.

That on completion of their training, newly qualified nurses are expected to work a first year in the hospital that provided their training.

Emphasis currently seems to be on pre-reg training (i.e. how many nurses are in the system) when actually we need to be thinking about the increasing specialisation of nurses in order to care.

In the short term we will need to be creative in role development nationally and locally. A pathway for non registered nursing to registered nursing with appropriate training pathways and funding streams would support long term gaps.

A summary of this survey might fairly be: We just want people who can competently do specific (specialised) nursing jobs at the cheapest rate. That is, an American system of a lower cost workforce masquarading as ‘skills mix’.

So, everything in the nursing garden is not rosy. But, wait a minute, doesn’t those very impressive statistics which show that almost all newly qualified nurses are employed as nurses 6 months after completing their course show that the student nursing garden is blooming. Not so. These are statistics for dummies, doled out by a branch of the gov.uk propaganda machine – the statistics for ’employment’ are not actually that; they are projections of ‘the most common job types students do six months after finishing the course’! Does anyone this side of Pluto believe the government track the whereabouts of former nursing students to ask them what they are currently doing, or whether they actually want to remain in nursing? They do not, as confirmed by a DH official (by email) when asked this question.

The Goebbels-like ‘statistics of success’also massage the fact that many newly qualified nurses are given 6 month temporary contracts, then dismissed, to make way for the next batch off the ‘newly qualified nurse’ conveyor belt of cheap labour.

Of course, such final year students are survivors, rather like those horses that finish the Grand National, usually knackered by the demands of combining placements with academic work. The national average of drop-out for nursing courses is 20%, when taking out the top 10% of nursing courses, in terms of the least drop-outs, the average drop-out figure for the remaining courses is 25%. (See previous article). Averages iron out the truly horrendous, of course – 40% of nursing students on some courses run for the exit door! Can’t imagine why!

The employment of newly qualified nurses in nursing varies widely across the country; but a most definite theme is that many Hospital Trusts specify the need for experience in the posts they advertise; it is only necessary to check the online job notice boards of 20 of the largest Trust Hospitals over a 6 month time period to ascertain this.

Those who would like to delve further beneath the cheap gloss that covers nursing might be interested to know that gov.uk statistics also show that at some nurse training universities the satisfaction level with the course is just over 50%; ‘feedback on work to clarify things I did not understand’- 25%! These figures are also likely to be bullshit – having been a guest lecturer at one of these establishments, I can assure everyone that these reported ‘satisfaction levels’ seem astronomically high when compared to the dejected look I witnessed on students’ faces.
lenin nightingale 2015

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Private Care Home Profit Made Simple

Lenin offers this simple, straighforward explanation of how private equity trusts investors receive  a guaranteed return (profit). Why else would they invest?

Consider  a 40 bed care home, in  a working class area ie with no private paying residents.

The home takes in £1 million  a year from the government.

From that, if owned by  a private equity group such as Four Seasons, £200 thousand goes to the management fee.

£100 thousand goes to the investors.

£100 thousand goes to the bank.

Therefore, only £600 thousand remains.

Staff wages account for 60% of this.

Therefore, £240 thousand remains. Half is for fixed costs such as food or electricity.

The rest 12% is sheer profit.

Consider however, this is if the home is full. The average occupancy for care homes is 82%.

We are not told the true cost of care.

Businesses are like pigs in a trough.

The government dish out the swill.

Care costs largely cover debt or profit   Lenin Nightingale 2015

These links are relevant;

https://lenin2u.wordpress.com/2013/12/21/who-owns-care-homes/

https://nursebloginternational.wordpress.com/2015/06/29/two-tier-care-homes/

https://nursebloginternational.wordpress.com/2015/07/26/working-class-nursing-homes-foul-smelling-hellholes-of-capitalism/

https://nursebloginternational.wordpress.com/2015/04/24/american-lessons-the-future-of-care-in-the-uk/

https://nursebloginternational.wordpress.com/2015/03/04/adult-social-care-budget-uk-for-whose-profit/

https://nursebloginternational.wordpress.com/2015/01/09/sour-carols-private-equity-firms-and-health-care/

https://nursebloginternational.wordpress.com/2015/07/27/home-care-visits-bbc-and-propaganda/

https://nursebloginternational.wordpress.com/2015/05/29/philippino-nurses-fake-certificates-and-job-orders/

Enter the Twilight Zone of Care For The Working Class

https://lenin2u.wordpress.com/2015/08/14/enter-the-twilight-zone-of-care-for-the-working-class/

Care for the working class is not “a financially sound investment”. Big companies opting out. What will happen to the majority of people who need care? See situations in eg China where relatives are legally enforced to care for their relatives.Note the lack of community care in the UK and the USA.

UK law permits any company to give  a resident notice of leave (eviction), if their money runs out- they get more money from private paying residents than Local Authority funding gives them.

As Lenin says, a return to Victorian Values .

NURSING HOME VIOLATIONS

how-to-avoid-the-worst-nursing-homes-in-2015-300x192I remember reading in annarbor.com/news about a case of neglect of a nursing home resident in Michigan that left an indelible mark on me. I had witnessed much poor and sometimes disgusting care meted out to elderly residents over the years [always robustly intervening; always being disliked by nurses who had become ‘managers’, thus, no longer nurses], but there was something about a patient infested with maggots that left a particular mark.

A nursing assistant found maggots in the genital area of a 66-year-old woman who had a urinary catheter at 5:59 a.m. on Aug. 13, 2011. A nursing home incident report said the patient “was offered a shower, which she refused, so she was ‘immediately’ given a bed bath by staff.”

However, in interviews with a state inspector on Aug. 30 and 31, a nursing assistant and the charge nurse said the woman did not get a shower because the nursing home did not have enough staff. Both the nursing assistant and the charge nurse told the state inspector the nurse used saline solution to rinse the area. But not all of the maggots came off, the assistant said.

Two nursing assistants told state inspectors that they had seen flies in wounds on the woman’s legs about two weeks before the maggots were discovered. One of them reported telling the unit manager and the director of nursing “she’s gonna get maggots.” The aide reported being instructed to document that the woman refused showers. The state report quotes the aide saying, “They let her lay there and they didn’t change her wounds (dressings) and they didn’t want to argue with her.”

A nurse manager came to the facility around noon to give the resident a shower the day the maggots were discovered. She told the inspector she saw “one or two maggots, but I think there were more.” She also said a “clinical corporate person” wanted her to document the discovery on the incident report as debridement. “They wouldn’t let me put maggots down on the incident report,” she said.

Another nursing assistant reported observing a nurse manager removing maggots from the woman’s genital area three days after the discovery of the maggots.

The woman was sent to the hospital on Aug. 28 and diagnosed with septic shock secondary to a urinary tract infection, chronic skin ulcers and kidney stones. Later tests and examinations revealed she had a broken hip likely due to bone thinning and extensive skin changes due to poor hygiene and refusing to be turned.

The woman told the state inspector that she was embarrassed by the maggot incident. She said she had told staff at the nursing home about seeing flies in her room and in the hall but no one did anything. She also said she told staff her catheter needed cleaning, but “they wouldn’t wash my catheter. There were times it was weeks before they cleaned my catheter.”

In its plan of correction, the nursing home stated the resident is now offered daily bed baths and her doctor and a family member will be notified if she refuses. Regular catheter care is also provided.

While the poor care that allowed the maggot infestation is perhaps the most shocking of the violations detailed in the September report, the state regards it as less serious than others cited. Violations are ranked on a scale for severity and scope, providing a measure of how many residents were affected and how many times a violation has occurred. Grades are given, with A being the least serious and L being the worst.

The discovery of maggots in the patient’s genital area ranked as a D, while the failure to provide a sanitary environment and failure to maintain the records were ranked Fs. The failure to monitor the fluid intake and output of a resident and failure to supervise residents in wheelchairs ranked as Gs.

A follow-up visit from the state in October found all problems at the nursing home cited in the September inspection had been corrected, a state official said Thursday. However, another inspection on Oct. 27 found several new violations, although none as serious as several of those in the September report.

Angil Tarach-Ritchey, a registered nurse who runs her own private-duty nursing company in the Ann Arbor area and who has worked in elder care and advocacy for more than 30 years, is not convinced.

“This isn’t a problem that just happened and this isn’t a problem that’s going to go away,” she said. “How the care is provided in a facility stems from the ownership and administration.”

LENIN’S SCALE OF NURSING HOME VIOLATIONS

A TELLING RELATIVES LIES ABOUT THE STANDARD OF CARE
B BEING UNFRIENDLY TO RELATIVES
C NOT REPLACING FOUL SMELLING CHAIRS AND CARPETS
D NOT ORGANISING TRIPS OUTSIDE OF THE HOME
E EXPECTING EVERYONE TO EAT THE SAME TYPE OF FOOD
F ONLY BUYING THE CHEAPEST BOG-STANDARD FOOD [USUALLY CHEAP MINCE MEAT BY THE BUCKETLOAD]
G NOT TAKING RELATIVES’ COMPLAINTS SERIOUSLY – NOT GIVING TELEPHONE ACCESS TO HEAD OFFICE MANAGEMENT
H EMPLOYING TOO FEW STAFF [SHOULD BE MINIMUM RATIO OF 1:5 DURING THE DAY]
I NOT CHECKING FOREIGN WORKERS CERTIFICATES – THE NMC DO NOT DO THIS PROPERLY – NOT KEEPING PROPER RECORDS
J EMPLOYING ILLEGAL IMMIGRANTS AT BELOW THE MINIMUM WAGE
K TOLERATING UNCARING, LAZY, AND INCOMPETENT STAFF
L BEING COMPLICIT TO ABUSE OF ANY KIND; PUTTING PROFITS BEFORE PEOPLE

RECOMMENDATIONS

TAKE THE HIJKL’S INTO PUBLIC OWNERSHIP
PLACE ALL CARE HOMES UNDER THE CONTROL OF THEIR REGIONAL HOSPITAL
STAFF TO ROTATE BETWEEN CARE HOMES AND HOSPITAL
PUT AUDIO-CAMERA DEVISES IN ALL CARE HOMES
SCRAP THE CQC, ENABLE RELATIVES AND ADVOCACY GROUPS TO EVALUATE THE CARE HOME
PROSECUTE ALL SERIOUS ABUSE
SACK UNCARING, LAZY, AND INCOMPETENT STAFF – PROHIBIT THEM FROM WORKING WITH THE ELDERLY

lenin nightingale 2015

Future of the Young

Unable to afford a home ? Here are some initiatives-

Another issue we hope we are wrong about. Lenin prophecies in 10 years time, the majority of young will live with their parents being unable to afford  a home. More to come on this from Lenin. Trying to be positive, here are some suggestions- please send more !!

Club together with friends, buy a plot of land and use chalets/caravans and tent.. Live communally with a vegetable plot.

If you have a large garden- let a caravan out to somebody.
Move in with a relative or non-relative , in exchange for caring for them.
Be a roamer and find paid jobs along the way. Some come with accommodation.
If it suits you, join a religious commune.

Volunteer in your home country, or overseas in exchange for board and lodgings.
Fight for a revolution and nationalise all housing, or set a maximum price limit on rents and sales.

Useful links;

http://www.diggersanddreamers.org.uk/

Relevance of wider research

In response to comments for simplification (no disrespect- Lenin is  a very high thinker !!) ; this is the beginnings of an analysis. Please feel free to add by emailing me.

Care does not occur in a vacuum. That is to say, when caring for somebody, wider issues are at play. These issues involve politics in particular which may spread well beyond the establishment, local district, or even the country. Indeed, any issue such as communication or attitudes, never mind the obvious one of resources, may be influenced by politics.
Many question the relevance of a situation such as abuse of a patient in Japan, to a patient within the home country- in this case the UK. Despite socio-political or legal rules, which may differ, underlying aspects are similar . All cases include such factors as education, work rewards, staffing, or attitudes. Surely this indicates that different countries may well learn from one another?
Consider cameras .
If cameras work in America, which research indicates that they do, does this mean they work within the UK?
Fundamentally yes if one considers the improvements made- less incidents of abuse or falsification of records for example (Nightingale 2015).
Of course America has different states- as we know, rules and regulations do differ per state, as do attitudes and culture of individuals.
Attitudes– Looking at an extreme situation, consider Ghana for example, where mentally ill individuals may still be chained up. This is acceptable to the majority of people. An exploration as to why this is acceptable, encourages consideration of such aspects as beliefs, history, and education.
Another topic- nurses or nursing students on strike. Unheard of or unconsidered by many. Yet analyse the reasons why- low staffing, low pay, and poor care – does that not tell the UK something?
Is it time for nurses and researchers from different countries to unite ? Or is it too much (personal)  competition or threat  ?

NURSES WORKED TO DEATH

SleepDeprivation0813As reported in edition.cnn.com/2013, Beth Jasper was killed while driving home after a 12-hour nursing shift. Her husband brought a wrongful death lawsuit against the hospital, claiming she was “worked to death,” and that the hospital knew about it. The lawsuit claimed the hospital was regularly understaffed, nurses worked through breaks, and were routinely called into work while off duty. Her husband said: “They can’t continue to work these nurses and expect them to pick up the slack because they don’t want to staff the hospitals.” Beth Jasper may have fallen asleep before her car veered off the road, jumped an embankment and struck a tree. During her final shift, according to the lawsuit, Beth Jasper told other nurses she was “really stressed” and “hadn’t eaten.”

National Nurses United claim that Staff shortages and overextended shifts for nurses are a nationwide issue in America. “Chronic understaffing is rampant throughout hospitals around the country,” said Bonnie Castillo, the union’s government relations director. “It is probably the single biggest issue facing nurses nowadays, and it’s not only affecting nurses, but patient health as well.”

Corporations treat nurses as if they are sheep in a pen, awaiting slaughter.

Another lawsuit (reported in bigclassaction.com, 2013). claimed that US Nursing Corp failed to adequately compensate California nursing staff that were sent to replace striking employees. ‘According to the lawsuit, when US Nursing deploys its employees around the country, it places them in hotels and requires them to take buses to and from the hospitals. But the company allegedly failed to pay the replacement nurses for the time they spent on the buses or for the time they spent waiting at the hospitals before and after their shifts. Additionally, the lawsuit claims the nursing company deducted a 30-minute meal break from its nurses’ time sheets regardless of whether the nurses actually recorded those periods on their sheets or not, and irrespective of whether the nurses were actually able to take the meal break’.

Corporations treat nurses as if they are sheep in a pen, awaiting slaughter.

In Pennsylvania, the idea of a “corporate negligence” claim was recognized by the Pennsylvania Supreme Court in the Thompson v. Nason Hosp., 591 A.2d 703 (Pa. 1991) case, in which corporate negligence was defined:

‘Corporate negligence is a doctrine under which the hospital is liable if it fails to uphold the proper standard of care owed the patient, which is to ensure the patient’s safety and well-being while at the hospital. This theory of liability creates a nondelegable duty which the hospital owes directly to a patient. Therefore, an injured party does not have to rely on and establish the negligence of a [doctor or nurse].

The hospital’s duties have been classified into four general areas: (1) a duty to use reasonable care in the maintenance of safe and adequate facilities and equipment; (2) a duty to select and retain only competent physicians; (3) a duty to oversee all persons who practice medicine within its walls as to patient care; and (4) a duty to formulate, adopt and enforce adequate rules and policies to ensure quality care for the patients’.

How many UK hospitals fail to adopt ‘policies to ensure quality care for the patients’, by not employing enough staff, then flogging that staff to death? How many UK hospitals fail to employ competent staff?

Why has no UK trade union attempted to bring a class action against negligent hospitals, which abuse their members and patients alike? UK unions may ‘huff and puff’, but in reality are government-fearing cowards.

How much more is a failure to adopt ‘policies to ensure quality care for the patients’ the case in care homes for state funded residents?

Most nursing home neglect arises from either inadequate staffing or negligent hiring or supervision of staff, or both, so the real problem originates with the corporation itself, which should be addressed by “corporate negligence” claims.

Corporation-owned nursing homes for state funded clients are only interested in making money. Regional managers are awarded bonus payments related tpo profits made, not ensuring patients are well cared for. They routinely employ too few staff, and a poor quality of staff, working for the lowest wage, who all too often do not want to be there, but have been forced to work by the pressure put on benefits claimants.

Corporations should be made responsible for the care received by human beings in their charge.

Corporations treat nurses as if they are sheep in a pen, awaiting slaughter.

UK hospitals (soon to be owned by American corporations) treat nurses as if they are sheep in a pen, awaiting slaughter, but if nurses are prepared to put up with this, and are prepared to pay subscriptions to unions which bend their knees to corporations and government (the former controls the latter), then sheep they are, and will forever will be.

I will never tire of telling you this, in the hope that there may be a few who are not prepared to be treated so, and will form a nursing union of a militant tendency that will lead their colleagues out of the sheep pen they sleep in, awaiting slaughter.

Puppets of the Establishment, such as the RCN and UNISON, will not protect you.

Support Guerrilla Nurse!http://guerrillanurse.net/2015/08/01/who-is-that-guerrilla-nurse/

NURSES UNITE!
lenin nightingale 2015