How hospitals kill and get away with it, all the time

Infections, drug resistant bacteria, patients lying in their waste for hours on end. Medications given at the wrong time, not at all, or even the wrong drug. Why is this becoming more of a problem. The answer is simple, even though management can't seem to grasp the idea that having enough staff saves lives.

Sixteen surgical patients is more than enough work for two registered nurses, let alone one. I couldn't keep up with any of the things that needed doing, as there were patients fresh from the operating room, patients ready to go into the operating room, as well as all the intravenous fluids to give plus all the intravenous drugs and other oral medicines. I didn't have time to do any of the remotely humane things, like help feed patients who can't help themselves. The number of times I've seen untouched dinner trays sitting beside, but just out of reach of helpless patients is countless. Also countless is the number of times I've seen patients lying in bed all day, or sunken into their lazy boy chair, with their chin resting on their chest, and their wound dressing sitting on the floor, while the wound itself leaks a straw colored liquid tinged with red.

But sometimes I am given an assistant, usually a student nurse trying to make some extra money, or someone who decided to give up packing groceries at Sainsbury's and after a few months of training is supposed to be able to make my job bearable.

No nurse that I know likes seeing these things happen, we try our best with what we have, but it is so often survival nursing, and not the caring nursing which we really want to be. Management seem to forget that it's the caring side of nursing that saves lives and reduces complications. A perfect example of this is the stroke patient.

Mr Jones was 65yrs old and had a mild stroke affecting the left side of his body. By mild I mean he could still move his arm and leg, although the finer movement of his fingers was lost. With rehab, physiotherapy and good basic nursing skills he could come out of this with most his parts working.

0700hrs I begin a quick ward round to get my patients ready for breakfast. I have to be quick because I have patients who need to be ready for theater by 0715hrs. This is one reason I hate it when medical patients are mixed with surgical patients, everyone has a tight schedule to keep. I sit Mr Jones up in bed and place his bedside table in front of him, ready for when the breakfast trolley comes around.

0715hrs The theater porter moans at me because Mrs Smith isn't ready to go to theater. "She's in the toilet. You're welcome to tell her to hurry up" I tell him. He shuts up. I take Mrs Smith to theater five minutes behind schedule. The nurses in theater are a vicious lot and kept me waiting another ten minutes when I got there. I eventually return to the ward.

0735hrs Mr Jones has slipped down his bed and fallen asleep with his head on his chest. I grab an assistant and together we sit him up again. He grabs the cup of tea that has been placed on his table, but it's cold. I offer to get a new one.

0745hr I still haven't got Mr Jones his tea because I ended up answering two call bells and helped two people use the commode.

0810hrs Not sure where the time has gone, but I'm due to give my patients their intravenous antibiotics. I remember about Mr Jones and his cup of tea, but have to put it aside as I spend the next half an hour injection medicines into veins.

0850hrs I finally get a chance to check on Mr Jones. He's slumped in his bed again, his breakfast untouched and the cold cup of tea still sitting there. I look for an assistant to help me get him up, fed and watered. I make a promise to myself to make sure this gets done. I search for five minutes until I find someone available to help me.

0900 I am back at Mr Jones' bedside and have him sitting out on a chair. The movement has obviously stirred him up as he begins to cough, a moist, infectious sounding cough. I make a mental note to make sure to tell the doctor about this. The last thing he needs is pneumonia.

0903hrs One of my patient's bells is ringing. In fact it won't stop ringing. It's probably an elderly patient who has sat on their bell, but I have to go and investigate, it could be urgent.

0904hrs It's not urgent, it is only Mrs Bailey sitting on her bell. She apologizes profusely. I'm about to go back to Mr Jones when Mrs McDonald, the woman sharing the four bedder room with Mrs Bailey, says she urgently needs a commode.

0915hrs I'm back at Mr Jones' bedside. I've warmed up his toast in the microwave, and have a fresh cup of tea. I begin to help him eat when Sharon, the charge nurse comes into the room. "Have you done your medications yet?" she asked me. "No, I've been too busy" I reply. She frowns at my remark. "What are you doing with Mr Jones?" I thought it was obvious, "Feeding him" I replied. She seemed to disapprove of what I was doing. "Your assistant can do that. You have more important things to do." With that she ushered me out of the room and I began to do my medication round.

1030hr Medication rounds for sixteen patients take forever. It doesn't help that there are always medicines missing from the trolley and half my time is spent tracking them down. I finally checked on Mr Jones and he's fallen asleep in his chair, his chin on his chest. His breakfast trolley has been removed, but I know for sure that he has had nothing.

1045hrs I was supposed to have a morning tea break, but instead I spent it feeding and watering Mr Jones. It's the only attention he's received all morning.

That was a typical morning in a London med/surgical ward. Conditions are often worse. Over the course of two weeks Mr Jones developed a nasty pneumonia. His breathing became so labored and his lungs so shattered from infection that he eventually stopped breathing. The doctors and nurses made quite a heroic effort to save him, but to no avail.

Mr Jones could have been saved. All he needed was a bit of proper care.