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Blog of a Community Nurse

A place to offload some of my nursing triumphs and tribulations!


DAY ONE OF MY NURSING BLOG JOURNEY

Good afternoon! This is the start of my blog about my journey as a nurse, who is
a mother, a wife, daughter and sister. I want this blog to be a place to safely
offload about things in the nursing profession that make me happy but also the
things that make me mad!

I have never done a blog before so please forgive me if the format or writing
style doesn’t make sense. I hope to improve as time goes on.

Today, I am feeling quite disheartened about the nursing profession. Over the
last few days I have been endlessly pouring over job websites to see what
opportunities are out there. As professions go, nursing should be a wealth of
opportunities to branch out in different fields. However, without revealing my
location for anonymity purposes and data protection, my area is quite rural
which makes branching out more difficult. The way that the NHS is run, I really
have been thinking about changing career because no matter what I do it’s never
enough. The news today in the UK has been talking about NHS England rolling out
a scheme where members of the public as well as ‘us’, the ones that live and
breathe the NHS everyday, to offer our voice as to how to bring the NHS back to
a ‘fit for purpose’ service. Being in Scotland, it doesn’t appear that we are
under this scheme yet to offer our opinions. I shall do so here!

My biggest irritation is the management structure of the NHS. I find that there
are far too many managers not managing the NHS well. Paid far too much and have
very little medical knowledge or backgrounds. My first suggestion is to remove
these top tier drains on NHS finances and have nurses, doctors etc manage the
NHS. People that know what is happening on the ground at the frontline. The NHS
was set up to provide equitable health care on a needs basis, we now have a
system that is run like a business with money being wasted on consultancy
services, paying agency staff ridiculous wages (we have an NHS nurse bank – why
not pay them better?) and upper management being given performance bonuses when
the NHS is failing! In what business would bonuses be awarded to staff not
meeting targets? The last government’s corruption and underhand dealings with
the NHS was just pivotal in pushing the NHS towards a more private healthcare
structure like the US. Don’t even get me started on the PPE contracts with
well-known Tory politician’s wives etc. We now live in a world where it’s okay
to screw over our fellow man and this has never been more apparent in the NHS.

People (with the media’s help to inflame these ideas) want to blame immigrants
for the economy, the strain on public spending and healthcare but working in
hospitals and the community I see how vital they are to our NHS. Most immigrants
want to work and our NHS has been held up by these individuals for many years.
The strain in NHS services has somewhat been down to many immigrants leaving the
NHS to work elsewhere or return home. This has led to a knock-on effect on care
at home services. As a community nurse, one of my greatest passions is providing
palliative care. And one of my greatest heartbreaks is not seeing the services
to meet the needs of these patients. Many people wish to die at home but there
are not enough carers etc to help facilitate this. Not every family feels
equipped to care for their loved ones at home and sadly their loved ones end up
being admitted to hospital. Caring for a family member at home is an amazing
gift to all involved but it is also mentally and physically exhausting. We have
a wonderful hospice service however a small number of beds means that this is
reserved for palliative patients with really difficult symptoms that are hard to
manage in the community.

Mr Starmer says we should now be looking at care in the community, I’m sorry but
have I been in a dream for the past few years or is that not what I am doing in
the community as a ‘Community Nurse’. For the public who may not know what we do
as Community Nurses, here is a quick run down of some of the things we do:

 * Support people with diabetes (administration of insulin if patient or family
   not capable of doing so)
 * Provide wound care (chronic wounds or post-surgical and trauma) and I am not
   talking about simple little wounds! Some wounds are so bad that you can see a
   patients’ bones or you can fit your arm in the wound! We sometimes have to
   use an expensive piece of kit called a VAC to close these wounds, essentially
   it is a Vacuum which sucks the wound closed by encouraging circulation to the
   area and pulling healthy tissue upwards.
 * We provide expensive pressure relieving equipment (some costing hundreds if
   not thousands of pounds to the taxpayer) to prevent life limiting (some can
   be life ending) pressure sores/damage. The majority of people use the
   equipment appropriately and follow our advice however it can be so upsetting
   when you return to check on a patient and find a cushion shoved in a corner
   and they have developed a red patch or wound on their pressure area. ‘Well I
   didn’t like the cushion’, well now we have to spends weeks if not months
   trying to heal a nasty pressure ulcer. Weigh up the one off cost of a
   pressure relieving cushion against the amount of dressings etc and you see
   where some of our NHS budgets are going. It’s important to note that some
   patients develop these wounds irrespective of equipment but for the vast
   majority these nasty wounds are entirely preventable and is not only the
   responsibility of the nurses but all those involved in the patients’ care as
   well as the individuals themselves!
 * Administering IV antibiotics via invasive devices such as PICC lines (a
   step-up from a cannula which a patient can have in for months, this makes our
   job easier and the patients’ life easier as they do not need to be an
   inpatient and have painful cannulas repeatedly inserted)
 * We also disconnect chemotherapy devices called ‘Surefuser pumps’ which are
   clever little devices that deliver the rest of a patients chemo over 24hrs so
   that the individuals do not need to stay overnight in a hospital bed
 * We set up syringe drivers with controlled drugs such as morphine etc to
   provide 24hr symptom control for palliative patients or patients nearing end
   of life. In hospital it requires two trained members of staff to check the
   controlled drugs however in the community that is not possible and we
   regularly do these on our own which is a huge responsibility and scary
   sometimes especially if a patient is really struggling and unsettled.
 * We complete documentation to support a patients need for care at home
   services

This is just a snippet of what we do on a daily basis and when you kindly ask me
if I would like a cup of tea when I’m in your house and I regretfully decline,
please do not be offended. It is not because I do not wish to sit and have a
quick break and chat with you. It may be that I am heading to another visit
straight after where I need to set up a new syringe driver or I have had a call
to verify a death or my colleagues stuck in a house where they have found a
patient on the floor or they are in a complete mess and need help to wash or put
some food in their fridge. We are a ‘jack of all trades’ and love doing so but
when we hear that there needs to be a shift to hospital care at home, it makes
us community nurses incredulous! What have we been doing for the past few
decades?

Sorry for the huge rant but I needed to get some of this off of my chest before
I self-imploded! I hope some fellow community nurses and all other nurses would
like to comment and give some of their gripes and grievances or positive
experiences too. Speak soon.

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