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Interesting article in todays Times regarding care assistants and recognition. Anyone else struck by the similarities in the assistants/FHPs/podiatry debate.....?
Quote:
These wonderful carers deserve to be called nurse
Care assistants do not do menial work: it respects the essence of our being
Ilora Finlay
Frightened of needing care, of losing control, of being treated in a way that strips a person of dignity? It’s a familiar worry.
Yet what is the true experience of those of us who have been dependent on those low-paid, unsung heroines of care — care assistants? It’s these assistants who provide a lot of core “nursing care”. Bathing, toileting, feeding, personal care of nails, hair, make-up, and getting dressed are what makes us feel a person of worth.
This is not menial work; it respects the very essence of someone’s being. And this is why it is utterly wrong for the Prime Minister’s commission for the future of nursing to propose yesterday that only those who are registered should be allowed to use the title “nurse”.
My own professional experience of care assistants is that they are very caring people — almost all women and often in middle age — with compassion and common sense, who love patient contact and whose skills are often underused. They have filled the gap left when the state enrolled nurse was phased out. Of course patients call them “nurse”, because often they are the only person who seems to be doing the hands-on care.
Those who hold level 3 National Vocational Qualifications are able to give oral medication, are doing the observations on patients that registered nurses have delegated to them and are the ones there with patients and families at times of distress. And people confide in them because they are warm, gentle and truly human and can provide outstanding care. How often they have had tears in their eyes when a person they cared for died; how often they have been the patient’s best advocate.
My own experience as a relative has been of carers prepared to go the extra mile, be flexible in their working times and in their approach. Paid only half the salary of many registered nurses, they carefully and patiently helped my frail mother to prepare for the day ahead. Thanks to them she was able to stay home and die at home. Their work is best summed up in my mother’s own words, written shortly before she died: “I smell sweet, not musty, well tended because carers attend to all intimate care. A week ago my wish to die resurfaced; yet my ability to live resurfaced too. I am at the end of my life. In bed and unable to do, but able to receive — and find an unexpected serenity in receiving.”
These care assistants deserve recognition. Registering them will ensure their importance is recognised, but they must not be viewed as inferior: they are the bricks and cement of care.
Baroness Finlay of Llandaff is an independent crossbench peer and Professor of Palliative Medicine at the University of Cardiff
Interesting article in todays Times regarding care assistants and recognition. Anyone else struck by the similarities in the assistants/FHPs/podiatry debate.....?
The problem is Mark, that once a person becomes a registered professional with a degree they no longer want to do the tasks, which previously were a part of the job, that they now see as menial and beneath their status, . However they also object when some other sector step in to take over that role and complain that those people do not have the qualifications to do the job that they do not want to do???
'Dog in a manger' and 'cake and eat it' come to mind.
Dave Smith
__________________
Descartes seems to consider here that beliefs formed by pure reasoning are less doubtful than those formed through perception.
Why can´t people be happy with what they are and if they want to be something else go do the degree or the education program and then you can use that Title.
My degree was 3 years I came out with a BHsC ( POD ). The association of NZ and Aust have said I´m able to use that title. I´m happy with that I don´t want to be called anything else. I would go back to Uni if I did. I would not expect a new title for free.
make me think this world is going madder by the minute.
Receptionist = Manager of 1st impressions.
The care assistant do a great job, will their life or work change if they get called something else. I think not... The patients still appreciate their work thats must count for more than a new title.
The problem is Mark, that once a person becomes a registered professional with a degree they no longer want to do the tasks, which previously were a part of the job, that they now see as menial and beneath their status, . However they also object when some other sector step in to take over that role and complain that those people do not have the qualifications to do the job that they do not want to do???
'Dog in a manger' and 'cake and eat it' come to mind.
Dave Smith
Yep, agree with that. Funny that it seems to be the NHS that created this artificial division in both podiatry and nursing.
The problem is Mark, that once a person becomes a registered professional with a degree they no longer want to do the tasks, which previously were a part of the job, that they now see as menial and beneath their status,
Quote:
Yep, agree with that. Funny that it seems to be the NHS that created this artificial division in both podiatry and nursing.
Hi Both
So the PATIENT CARING GOES OUT BECAUSE OF THE DEGREE ??
Gimme a break you two , I'm so bloody angry at those statements it makes me want to puke !!!
If you come into a caring profession at whatever level you should do it for the right reasons NOT POSING VALUE
I see nurses in wards that cant get off their fat arses to feed a patient that is infirm and cant feed themselves who wont get discharged coz their progress is not as expected ( no nutrition = no discharge)
BUT
All the relatives know "how much they earn and how hard done by they are!!!
Fkoff leave me alone get back to the real world of patient care!!
In my day in the NHS most of those would have been sacked on the spot and rightly so.
In this day an age we have ... political correctness sod the patient as long as we're alright and are EU / fall within budget correct irrespective of the well being of the patient .
IF YA DONT CARE FK OFF !! Go and be a secretary or whatever , leave the patient care to those that do CARE !!
Sorry I'm on a roll.
The true nurses are the ones on the specialist wards ( the old staff nurses / sisters) that are worth their weight in gold.
The general wards ( geri / ortho wards) are in the main staffed by spiteful overpaid girls that are more interested in their own importance than the care of the patient IMHO (of some 43 years in direct hands on patient care).
A degree to be a nurse now ???
Try wanting to go into the profession (and in this one) BECAUSE YOU CARE and want to make people well again, improve quality of life. NOT because you have a degree and really couldn't give a S***T about the patient.
The carers ARE in the main as described, they do a great job in looking after our elderly.
I have recent experience of a elderly relative in and end of life care home.
the care she received was exemplary from all the care staff and RGN's despite the NHS providing her with pneumonia and MRSA , she lived for 3 years ( of quality life) despite the NHS giving her 1 week to live on admission.
I could go on, but for the moment..... end of rant.
I hope this has an impact in the right places for the right reasons .
Cheers
Derek
"Political Correctness" is a doctrine, fostered by a delusional, illogical minority, and rabidly promoted by an unscrupulous mainstream media, which holds forth the proposition that it is entirely possible to pick up a turd by the clean end
Last edited by DTT : 4th March 2010 at 03:45 PM.
Reason: Grammar (sort of)
I don't always agree with Dek, and only partially agree here. However, it's worthy of note that a few years ago when working in the NHS I was asked if I would allow a nurse trainee to shadow me. On the day in question she failed to appear but was later found sitting in an office reading. Apparently, when asked why she had not fulfilled her responsibilities she replied 'I'm going to be a manager, I don't need to observe any clinical work'.
I have no way of knowing whether she 'qualified' and went to work at a certain Staffordshire hospital..........
I have a PhD and I care. I also have a deceased father that went into Stafford hospital for 3 days and came out with pressure sores on his heels and hallux and sh!t on his feet. Nice work the staff of Stafford, thanks. Pleased for you that you hit your targets. I was among the "complainers". I'd like to say rant over, but I think that one will stay with me for the rest of my life. I used to wear the Staffordshire knot with pride as a county athlete and rugby player, now I worry when my aged mother has to go to the hospital there. Sad, but true.
I also have a deceased father that went into Stafford hospital for 3 days and came out with pressure sores on his heels and hallux and sh!t on his feet. Nice work the staff of Stafford, thanks. Pleased for you that you hit your targets. I was among the "complainers". I'd like to say rant over, but I think that one will stay with me for the rest of my life.
Great nursing care then ??
That is my point :-
Quote:
I have a PhD and I care
I dont have a PhD but, I bet my patients get the same amount of care as yours.
I'm not knocking everyone (if you read my post ) you care and are degree trained and I bet dont mind cutting an elderlys toenails whether they have s**t under them or not ?
Neither do I !!
But
We/other professions have the poseurs who feel it is beneath their qualification ,status or whatever political correct term is in vogue at present ( read my signature) to excuse themselves from a mundane part OF THE BASIC PREMISE OF THE JOB THEY SIGNED UP FOR on the grounds they are over qualified for them to do it
The nurse Vs carer is the same thing IMHO = IF you do not want to do THE FULL MONTY = bugger off and be a whatever but dont leave the patients with a second /third rate service because of your degree.
Those of us that have been around health care for many years remember the days when to care was all that mattered = the proper job.
Simon I know you do a proper job, perhaps my rant will ring a few bells for others??
Cheers
Derek
"Political Correctness" is a doctrine, fostered by a delusional, illogical minority, and rabidly promoted by an unscrupulous mainstream media, which holds forth the proposition that it is entirely possible to pick up a turd by the clean end
Goodness Derek
Its not often that we see you go off on one!
To go back to the original post- the point being made was that carers deserve to be called nurses. I do not agree with that, however caring they may be , they are carers and that is what they took a job as. If we start to call them nurses , they will get confused with fully trained nurses (degree or not) who are entitled to use that title.
Now if we extrapolate with regards to FHPs - they cannot call themselves chiropodists because they are not registered as such and therefore will never be more than FHPswhich is exactly what they trained for.
I have to agree that the NHS have brought about the divide- those of us in PP are generalist-we do whatever needs doing as a part of the job. The new graduates are encouraged to think of themselves as 'specialist' as soon as they qualify.
Goodness Derek
Its not often that we see you go off on one!
Quote:
to excuse themselves from a mundane part OF THE BASIC PREMISE OF THE JOB THEY SIGNED UP FOR on the grounds they are over qualified for them to do it
Degree or not does not excuse the exclusion of care
And yes I am "off on one" BECAUSE I DO CARE and watch the "nursing care" given to the likes of Simons Dad with total disgust and abhorrence of the poseur value that would appear to come with a degree at the expense of simple care and understanding of patients needs.
You can wind it all up if you want CM but look around you look deeper into the clinical NHS and then tell me I am wrong ??
My fault is I have been around in health care for 43 years and remember the old ways before targets and budgets.
In those days the patient MATTERED and their care was paramount.
Can you say the same applies today ???
One of the main reasons is as I said IMHO , the degree vs CARE anomaly
Quote:
The new graduates are encouraged to think of themselves as 'specialist' as soon as they qualify.
Then perhaps the teaching is wrong if the "specialist" mantle excludes the basics of care ??
"Political Correctness" is a doctrine, fostered by a delusional, illogical minority, and rabidly promoted by an unscrupulous mainstream media, which holds forth the proposition that it is entirely possible to pick up a turd by the clean end
Last edited by DTT : 5th March 2010 at 04:08 PM.
Reason: exclusion
Derek
With respect, I am not on the wind up- I am merely getting back to topic which is Baroness Finlays desire to see carers able to call themselves nurses. However no one seems to want to discuss this point exactly.
You seem to have taken David Smiths comment, and gone off at the deep end about pods not wanting to do the basics. AsI have said, in PP I am sure that we all do anything that comes through the door- it will only be in the NHS that they will not do the basics. That was not the point of the original post.
I never said that I agreed with encouraging graduates to consider themselves specialists on qualifying. Like you, I have been in health professions for 40 years, and yes things have changed and probably not for the better- I am not sure that degree routes were the right way to go for any of the allied medical disciplines where clinical skills should take precedence over academic ability.
Cornmerchant
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You seem to have taken David Smiths comment, and gone off at the deep end about pods not wanting to do the basics.
I have gone off the deep end at the whole system that would make a degree the qalifying reason for entry into any caring profession rather than the person entering that profession because they care.
No-one wants to do the apprenticeship anymore. That is the point being made in the article. In my days around hospitals there were Nursing Auxilliaries,student nurses SEN, SRN,s which then went to staff nurse sister . In that system you started at the bottom doing all the menial tasks and went up from there.
Simon s Dad would have been an admission of bad nursing care ( because he hadn't been turned enough) and questions would have been asked ans action taken to see that no other patient suffered that way.
Now I go into the end of life care home and see patient after patient being discharged from hospital with the most terrible pressure sores and these "carers" do the basics and in many resolve the pressure area's to make the patient comfortable and well looked after in the time they have left.
I see them regularly weeping because one in their care has died =genuine care for anothers passing.
Ask yourself. Which is the better NURSE the ones in the hospital or the carers in the home ??
The home cares are doing "the apprenticeship" the degree would appear to relive you of the need to do that.
"Political Correctness" is a doctrine, fostered by a delusional, illogical minority, and rabidly promoted by an unscrupulous mainstream media, which holds forth the proposition that it is entirely possible to pick up a turd by the clean end
In my opinion you have all missed the point raised by this lack lustre Times article.
The Prime Minister's suggestion is to protect the public from Nurses. Registration is not an honour, it doesn't bring just rewards. It governs your whole behaviour inside and outside your professional life by regulating your fitness to practice.
Baroness Finlay remarks that carers are unsung heroines ( what about the heroes? There are quite a few male care assistants too) and describes what the Government defines as social rather than health care; another Government cockup. So why isn't she lobbying for nursing to be holistic once again?
In passing she comments on their salary being half that of registered nurses but does not offer a solution other than bestowing the title "nurse" upon them. Nurse of Social Care could still be paid a minimum hourly rate. The division of social and health care is all about saving the NHS money so why doesn't she bring the appropriate pressure to bear on the Government from her lofty position in education?
The recognition Care Assistants deserve is in the reward they should receive.
Double their hourly rate and without a doubt you would have your recognised and flexible care assistants, more likely to hold down their role for longer as they would be able to afford to. They don't need the restrictions of practice a regulated title would bring. They'd then still be able to keep old ladies smelling sweet and not need daily consent and a witness to carry out intimate care.
For a Professor of Palliative Care she seems rather naive and ill informed.
GB
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The problem is Mark, that once a person becomes a registered professional with a degree they no longer want to do the tasks, which previously were a part of the job, that they now see as menial and beneath their status, . However they also object when some other sector step in to take over that role and complain that those people do not have the qualifications to do the job that they do not want to do???
'Dog in a manger' and 'cake and eat it' come to mind.
Dave Smith
You summed that up beautifully! My thoughts exactly.
So the PATIENT CARING GOES OUT BECAUSE OF THE DEGREE ??
Gimme a break you two , I'm so bloody angry at those statements it makes me want to puke !!!
If you come into a caring profession at whatever level you should do it for the right reasons NOT POSING VALUE
I see nurses in wards that cant get off their fat arses to feed a patient that is infirm and cant feed themselves who wont get discharged coz their progress is not as expected ( no nutrition = no discharge)
BUT
All the relatives know "how much they earn and how hard done by they are!!!
Fkoff leave me alone get back to the real world of patient care!!
In my day in the NHS most of those would have been sacked on the spot and rightly so.
In this day an age we have ... political correctness sod the patient as long as we're alright and are EU / fall within budget correct irrespective of the well being of the patient .
IF YA DONT CARE FK OFF !! Go and be a secretary or whatever , leave the patient care to those that do CARE !!
Sorry I'm on a roll.
The true nurses are the ones on the specialist wards ( the old staff nurses / sisters) that are worth their weight in gold.
The general wards ( geri / ortho wards) are in the main staffed by spiteful overpaid girls that are more interested in their own importance than the care of the patient IMHO (of some 43 years in direct hands on patient care).
A degree to be a nurse now ???
Try wanting to go into the profession (and in this one) BECAUSE YOU CARE and want to make people well again, improve quality of life. NOT because you have a degree and really couldn't give a S***T about the patient.
The carers ARE in the main as described, they do a great job in looking after our elderly.
I have recent experience of a elderly relative in and end of life care home.
the care she received was exemplary from all the care staff and RGN's despite the NHS providing her with pneumonia and MRSA , she lived for 3 years ( of quality life) despite the NHS giving her 1 week to live on admission.
I could go on, but for the moment..... end of rant.
I hope this has an impact in the right places for the right reasons .
Cheers
Derek
The previous statement by David was not condoning the behaviour- merely making a comment about it.
My mother has been a nurse for 35 years and she genuinely cares about the patients. Some of the young girls finish the university degree but barely know how to change a bed pan. All that theoretical knowledge mostly goes to waste as their ability to diagnose/prescribe anything is very limited.
I do find it sad that many of the people that would have made fantastic nurses are blocked out because they cant pass the difficult university exams or can't afford university fees.
But i also want to highlight that some patient's expect the nurses to still brush their teeth or feed them- that's old school. When a nurse has 6-10 patients (or more) she doesn't have time to do that. That's where a relative or a carer comes in, and i think they should have a title different to 'nurse'. Patients can call them whatever they want (my mum get's called sister sometimes) but what's wrong with the title of carer? They are someone that is caring- is it really such a bad word??
IMHO the biggest mistake made within the nursing professions was the removal of the
State Enrolled Nurse.
2 years training . They did the bulk of the care.
The SRN/RGN now degree status are responsible for the medical management of the pt. So need a degree level of education.
The Anciliary Assistants were responsible for cleaning and food delivery.
So you have upgraded the training and responsibility of the RGN/SRN.
You have removed the middle ground, the SEN
And you have essentially untrained anciliary staff caring for pts. And you now have contractors dealing with cleaning.
So you have ONE HELL OF A HOLE IN THE MIDDLE.
Also Managers in NHS earn over 100k salaries and are obsessed with targets.
So today the pt is an obstruction in the efficient management of a Factory Hospital.
Many staff are demotivated and disillusioned with the impact of the feudal style of NHS management today.
In dealing with frail elderly the PRIMARY TREATMENT IS FOOD AND WATER.
Today with multi pathology pts who will not die, how do you run an efficient hopsital?
I will not pretend to know the answer.
One suggestion is to ask how anybody behind a desk benefits pt care. if the reply is um well erm .
Shoot them!!!!
The savings in resources could be redirected to the primary role of TREATING THE PATIENTS AND GETTING THEM WELL ENOUGH TO GO HOME, or into a suitable environment that meets their social needs.
David
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IMHO the biggest mistake made within the nursing professions was the removal of the
State Enrolled Nurse.
2 years training . They did the bulk of the care.
The SRN/RGN now degree status are responsible for the medical management of the pt. So need a degree level of education.
The Anciliary Assistants were responsible for cleaning and food delivery.
So you have upgraded the training and responsibility of the RGN/SRN.
You have removed the middle ground, the SEN
And you have essentially untrained anciliary staff caring for pts. And you now have contractors dealing with cleaning.
So you have ONE HELL OF A HOLE IN THE MIDDLE.
Also Managers in NHS earn over 100k salaries and are obsessed with targets.
So today the pt is an obstruction in the efficient management of a Factory Hospital.
Many staff are demotivated and disillusioned with the impact of the feudal style of NHS management today.
In dealing with frail elderly the PRIMARY TREATMENT IS FOOD AND WATER.
Today with multi pathology pts who will not die, how do you run an efficient hopsital?
I will not pretend to know the answer.
One suggestion is to ask how anybody behind a desk benefits pt care. if the reply is um well erm .
Shoot them!!!!
The savings in resources could be redirected to the primary role of TREATING THE PATIENTS AND GETTING THEM WELL ENOUGH TO GO HOME, or into a suitable environment that meets their social needs.
David
I speak from an australian NSW back ground. But here it seems to be going the same way: too many chiefs not enough indians.
I also have to add, if all a patient needs is food and water- why are they in a hospital??? they should be in a nursing home.
They were admitted to Hospital due to dehydration and mal nourishment.
Why are they not in a Nursing Home??
They do not want to leave home.
They refuse for no real reason
Family do not want house sold to fund place in nursing home.
There are many reasons.
I always advised people approaching this stage of life the following:
Choose your own nursing home now. Or wait for a family member to choose it for you, or even worse Social Services will put you where ever there is a vacancy.
So choose your future before it is imposed upon you.
One aspect of Aus i feel they got right was the Retirement Villages. I used to go to a couple of them and they were really great. Nice one or two bedroomed bungalows in a complex with medical and ancilliary services. Good management and many activities to participate in. Here in UK we could look at this.
Personally speaking my own future would be sell house move to a complex and enjoy the lack of responsibility for that. Enjoy life.
David
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yes over here we do have the bungalo system but they are very expensive especially if they have advanced medical equipment and nurses on site.
An elderly patient that's in hospital but just needs food and water is a common scenario even here. The relatives wont take her/him, they can no longer stay in their house alone and there's no space in a government funded nursing home. Meanwhile the media breaks a story about a patient with chest pain being sent home due to lack of beds.
Being 25 it's a while before I have to think about my nursing home, like you said there's nothing worse than that decesion being taken out of your hands. Most people just don't want to think about it.
I'm a bit late to the discussion, but I have the unique postion of having a foot in both camps (sorry!) I originally trained as an old style Orthopaedic Nurse (SRN ONC, four years training)and worked as a staff nurse on A&E before having babies, I then worked in the private sector in various nursing homes. Once they were all at school i thought about going back to hospital work.......BUT they had moved the goal posts and I would have had to practically retrained and as I had no degree (shock horror!) I was never going to get further than the lowest grade. SO I trained as chiropodist, privately, and worked through the Diploma and got my HPC registration on 'grandad rights' of, by now 15 years experience, 200+ patients and a thriving practice. ...Still no degree......so you can imagine my amusement, when whilst doing some locum work in a private clinic, a new qualified 'Pod' still wet behind the ears, called me an 'assistant' to a patient, and told me that 'orthotics were out of my scope'............just because I didn't have a degree......he was genuinly suprised that I was his superior that day.
However, and this is my main point, the patients have a greater perception on my skills because I'm the wrong side of 50 and they know I have been practicing for twenty odd years.
In the private sector it is all about reputation and most new clients come recommended by previous satisfied customers, they are not interested whether you have a degree, they just want a good caring service and these days value for money.
It is not OUR fault there is this divide, it is a Governmental level misperception that education at degree level is the only way. A lot of the course work for nurses and podiatrists is sociopolitical and frankly, irrelivant. I had thought of doing the the BSc but at my age I don't think it would be right for [i]me[u] or be of benefit to my current clients.
Double their hourly rate and without a doubt you would have your recognised and flexible care assistants, more likely to hold down their role for longer as they would be able to afford to. They don't need the restrictions of practice a regulated title would bring. They'd then still be able to keep old ladies smelling sweet and not need daily consent and a witness to carry out intimate care.
GB
Double the hourly rate and the type of applicants would change and almost certainly not for the better. More of the applicants would be attracted by the financial reward and unless the selection system or interview was genuinely capable of selecting the 'best' the percentage of inappropriate appointments would increase and the standard would be likely to deteriorate.
Care Assistants = Nurses = Podiatry Assistants = Podiatrists FHPs = Chiropodists
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