FOR nurses to say that older people are not safe in hospital is an indictment not just of the National Health Service but also of society's attitude to the elderly.
A survey by the Royal College of Nursing (RCN) of members across the UK has found that wards for older patients have too few registered nurses and are over-dependent on health care assistants with minimal training. Instead of one registered nurse for between five and seven patients, on wards for elderly people there was usually one nurse for about nine patients.
Inevitably, this means that the less urgent tasks are ignored. This included comforting and talking to patients, which 78% of the 1700 nurses who took part in the survey said they had not done adequately on their last shift due to low staff numbers. Also, 59% said they had not been able to spend enough time helping patients to become mobile and look after themselves. More shocking is that around one-third of nurses admitted they had not been able to complete the tasks of helping patients with food and drink or assisting them to use the toilet or manage incontinence, with 19% failing to carry out pain management adequately.
This reveals a distressing and unacceptable level of lack of care in ourhospitals that cannot be allowed to continue.
One problem is that staffing levels in wards for older people are lower than on children's or general wards because in some areas they are still regarded as geriatric wards requiring less specialised skills. This does not reflect the level of care required today when older patients tend to have more complex problems and need careful monitoring as well as help with bathing, feeding and mobility.
According to RCN Scotland director Theresa Fyffe, the current pressure on budgets is causing health boards to replace some nursing posts with lower-paid health care assistants, exacerbating the situation. However, where basic tasks are not being carried out, the answer might be better training for assistants rather than more nurses.
There have been calls for mandatory staffing levels of qualified nurses but these do not take into account variations between different hospitals. The RCN wants senior charge nurses, who manage wards, to have the authority to call on more qualified staff according to the needs of their patients. Such a system, with a pool of suitably-qualified staff in each hospital or area could be effective both in quality of care and use of resources. Health boards should beware short-term economies with long-term costs. Elderly patients who do not receive proper care will deteriorate rather than recover, resulting in a longer stay in hospital and care in the community. That leads to longer waiting lists and the cruel dismissal of older people as "bed blockers".
That negative attitude must be reversed. We must strive for a society that treats elderly people with compassion, respect and dignity.
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