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Back to basics in the hospital wards
9:00pm Tuesday 22nd February 2011 in Health
NURSING has certainly changed since Kathy French trained nearly 30 years ago.
Back then, when nursing officers entered a room, the nurses had to stand up as a mark of respect, and many were scared of ward sisters.
Basic care and making sure patients were comfortable was a core part of her day-to-day duties and drummed into her.
Over the years this focus on basic care in nursing was, at times, pushed to the side amid a mountain of paperwork and pressures.
Today, Colchester Hospital University Foundation Trust has revisited the traditional methods of providing care and introduced patient rounding, where nurses check on patients every two hours to make sure they are comfortable, have enough water, can reach it, have eaten, need help to get into a more comfortable position and need help to visit the toilet.
The system has started with elderly patients in the hospital and Mrs French says they are now looking at how it can be transferred throughout the mainstream wards.
Many people would say this is what nursing should be about in the first place, and Mrs French does not disagree, but she is all too aware of how nurses’ jobs have changed over the years.
She says: “There used to be a great emphasis on basic care when I was training and we were reliant on training in hospitals. Nurse training now is more academic and university-based. You would go around the ward every two hours or so and that was what the job was more about.
“Now, we do provide the basic care, but sometimes there is more and more pressure put on to frontline staff. We are very busy. There is a lot of admin to do. Every month there are different policies and there is a lot more involved in providing evidence you are delivering good care.
“It is a bit of a juggling act for staff and we have to be careful we are not asking them to feed the beast with all the information and detracting them from doing their job.”
Patient rounding, widely used in America, was brought in after the trust realised that last May 144 elderly patients had falls during their stay in hospital and in June the number was 125. The trust’s target was no more than 96.
More recently, a national report from the parliamentary ombudsmen found there were gaps in the way some hospitals around the country care for elderly patients.
Mrs French says: “We like to think that it does not happen here in Colchester.”
She adds the trust is good at reporting fall incidents, and reports even the most minor of falls, such as if a patient trips, or if they slump to the floor even when they have support to walk.
She says: “But we were concerned about the harm that could be done to patients even with the smallest of falls, so we brought in patient rounding. It’s about making people think about basic care.”
Since introducing the new system, the trust has noticed a sharp decline in falls – with Birch ward seeing a drop in half each month.
Mrs French says: “It’s about refocusing nurses’ attention and being proactive to patients’ needs.
“If you are getting to the patient before they need to ring the bell for help, it actually gives you more time to deliver the care you want to give.”
Mrs French says by providing the basic level of care, patients’ experiences are likely to be more positive. She adds: “There is evidence to show this helps patients recover more quickly, too.”
Mrs French does not want to see a return to her training days of frightened student nurses in order to provide that basic level of care, but she stresses hospital staff must be professional at all times when dealing with vulnerable people.
She adds: “As nurses it is our gift that we are able to communicate in a way that is caring and compassionate.”
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