Confused, well I'm referring to the days when RN's took care of hygiene, dressed wounds, fed stroke patients etc. Someone once said that these are unskilled jobs and that unskilled people can take care of such minor tasks.
Does anyone else feels this is wrong? It's these tasks which keep us in touch with the patient. For example, when we wash a patient we assess skin turgor. When we feed we assess the stroke victim's gag reflex. When we dress a wound, we observe each day its progress.
I realize that we do so much more, in some cases diagnose, treat/prescribe, or maybe we're nurse anaesthetists, but I feel that the absolute basics should always be a part of nursing. I am happy to delegate some basic jobs, but it should never be delegated because we feel it is a simple unskilled job for the unskilled health worker.
Bryn
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January 3rd, 2008 at 10:10 pm
I think we have gotten away from the bedside. We need to get back to the basics. If I am suppose to supervise someone doing these jobs, how do I know if they are doing them right if I can not or do not want to do those jobs. Another way to be able to supervise someone and to earn their respect is to be able to show them that I can do the job. Another way to learn about the patient and their family is to interact with them, and doing the basic jobs allows us to interact with the patient and family. You mentioned that these are simple unskilled job. If they are done properly they are not unskilled, they are complex and only seem like they are unskilled jobs.
January 4th, 2008 at 10:01 am
If we accept that nurses away from the bedside are doing jobs that need to be done, and these invariably require a qualified RN to do them, then moving to the bedside means someone else to do those other jobs.
Nothing in my job is ‘pointless’ (lots are pointless to me in a direct care manner – but someone else needs that info/data to make the place work). No-one would pay us to do jobs that didn’t have a value. The value of some of the stuff we do doesn’t seem to make sense to us; to someone else it does.
If you want to spend more time ‘bedside’ then who will do the other stuff? If it doesn’t need to be you, then I wouldn’t do it. But then, that’s when we end up with ‘beaurocrats’ who do the work we don’t need to do – but get paid twice what nurses get.
January 5th, 2008 at 1:53 pm
With stoke pts, first time assessment swallow eval should be a nurse or a specialist trained to assess swallowing, after that, it’s not a huge concern of mine. let someone else feed them, i have so many other things to do, medicate, wound dressing changes, document, etc. bathing, not necessary unless there is a bed sore. techs should be aware to inform the nurse if they see anything abnormal. thats what i was told to do when i was a tech. if a bp was high or any abnormal vitals, we were to inform the nurse. there is a trust factor there. its a team to take care of the pt. if the tech is feeding and i get medicine and clean their wound thats 3 things done faster than if i had to do them all one at a time by myself. yes i will help roll, or change a pt…but i am not one to just do it all…teamwork aids in the best overall care of the patient and u have to be able to see the bigger picture.
January 5th, 2008 at 10:57 pm
I agree Mandy, that ‘care’ is a holistic event and each of us plays a part that knows it;s limitations and where and when to take it to the next level.
If only we were all trained as consultants who could diagnose and treat whilst also emptying a bedpan, feeding a patient or making a bed.
January 6th, 2008 at 7:23 am
After four years temping in London, it’s really hard to trust someone else to do a part of the care. This is mainly because of staff shortages and a corresponding lack of reliable aides to fill this shortage.
I’ve had aides that copied vital obs because they couldn’t do a manual blood pressure. I’ve had aides who didn’t know what was a good or bad blood pressure.
When working in london, with anywhere from 7-16 patients I have to rely on others to do the basics, but the fact is that the job is rarely done as good as I would like it. The result is that I’m not happy with the care patients are receiving, but I am helpless to do anything as the workload is too huge. I’m am not exaggerating when I say that in an afternoon shift I’ve been stuck with fourteen surgical patients, plus another that was admitted around dinner time. The Aide called in sick and the got a second year student nurse to help me. Needless to say I soon left this job, in fact walked out at around seven pm after an argument with the charge nurse.
Anway, in my home hospital in New Zealand, we have maximum six patients per registered nurse. If you have a particularly heavy load, then you will have less. With this system you stay in touch with the absolute basics plus you have time to do the fancy stuff with all the new gadgets/technology etc. We have one nurse aide who circulates throughout the ward helping with bed making/washes etc.
On a more personal note, it is sad that we are too busy to do the simple jobs eg feeding patients. It is sometimes relaxing and therapeutic to sit with a patient, and spend some time talking, laughing, while performing a simple task. The more we move away from this contact, the more like a doctor we are becoming, eg assessing, diagnosing and treating. This is not what we are.
nursingaround.blogspot.com
January 7th, 2008 at 3:44 am
“the more like a doctor we are becoming, eg assessing, diagnosing and treating. This is not what we are.”
I do that already as a nurse. Then tell the doc what to write having already carried out the treatment.
January 15th, 2008 at 9:04 am
It’s not about doing everything yourself…it’s about prioritization. Maybe it’s different for me in the ER, but really, on any floor prioritization is a necessity. You can’t do everything yourself, and once you realize that, and get the aid to assist, or other staff to help with overall patient care, the better overall care the patient gets. If you are trying to do everything yourself it gets stressful and the patients sense that. Plus, if you are focused in on one patient, what about the others you are avoiding to sit and “chat”….I just know in the ER, I admit I can’t do everything myself, and with help, the patient gets the care they need. Prioritization is important!
May 11th, 2008 at 10:07 pm
i work on tele floor and after giving meds and assessing pt times up. I’m always out late by the time paperwork gets done. Nursing needs to be a team approach or there is just not enough hours in the shift to get work done. Cna’s are a big help and a valuable resource to the rn. The cna does fundamental nursing and RN relys on cna to provide info about pt. I think that this type of team approach is an excellent way to provide best care possible.