01 March 2009

I have the time

Perhaps there are important people out there reading the Grumble blog. Not long ago Dr G was complaining about how patients were left to starve on the ward. Food was given to the patients but nobody was helping the patient eat it. Things were so bad that the junior doctors became so fed up having to give patients intravenous fluids that they began doing rounds helping patients to drink. Watering rounds they called them. That is what was happening but Dr G might just have thought it unwise to mention that particular one at the time. Does anybody listen to Dr Grumble? Perhaps. Since Grumble first raised the feeding issue we now have 'protected meal times' when all other work ceases so that patients can get fed. Superficially it seems like a good idea but it does not actually address the fundamental problem which is lack of nursing time on medical wards in particular. It frustrates Dr Grumble that in today's hospitals for every major problem there is some knee jerk management solution. But the solution never involves more resources. It never addresses the fundamentals.

So how do you address the fundamental problem of lack of nursing time. They have the answer in the United States. It is another quick fix management solution. It is called scripting. It is really very simple. All the nurse has to do is say to each patient, "Is there anything else I can do for you? I have the time." The reason this has been introduced is that surveys (conducted, of course, by some outside company) have shown that patients do not think the nurses have enough time to deal with their needs. So the idiotic knee jerk management response is to get the nurses to say they have the time. Mark the Grumble words. This will be seen in the UK as being such a good idea it will soon be rolled out across the NHS. But, like all the other similar initiatives, it completely and utterly fails to address the underlying problem and hacks off the staff no end.

Unfortunately hospitals, both in the US and the UK, are now focussed on superficial images rather patient care. Shopping for medical care and competition by flat screens has now come to the UK with the focus moving towards thick-pile carpets which cost relatively little and bolster images and away from more nurses which cost a lot and are less visible.

If anybody was wondering how Dr Grumble's patients heard the news about Ivan Cameron's sad death so quickly, it was from the large flat TVs recently installed in the Grumble waiting room. This is really not what hospitals should be about. Shop floors workers know that. Even in the US. Money really needs to be directed towards patient care and not towards creating marketing images.

With thanks to Nurse Anne who triggered this post.


FatGirl said...
This comment has been removed by the author.
FatGirl said...

Sorry original comment deleted due to hilarious spelling

OMG Ok I work on a ward with protected mealtimes. It sort of works but doesn’t overcome the problem of it just not being possible to feed more than one person at a time. The thought of going around saying "I have the time" when it is clearly not true just makes me crazy. This just makes me think of last employers who had management consultants come in (at high cost) to see how we could speed up our patient turnover. After several weeks they came up with the radical solution of employing more nurses and more doctors. Money well spent!

the a&e charge nurse said...

I have time, 3hrs, 59 minutes and 59 seconds.

Smiffy said...

bedridden patients who have to wait too long for a commode know that nurses do not have the time for other attentions they might like.

Happy1 said...

"Is there anything else I can do for you? I have the time."

*rolls on floor laughing*

Why would I lie like that...surely lying to patients is not strictly professional...or constructive.