NURSES.

The quality of care offered by the NHS has been placed under a magnifying glass over the past few months. Constantly being in the news it led me to question, why? One of the most let's say 'obvious' answers is of course under staffing. This was most definitely found to be the case with the Mid-staff's scandal where the Francis report had stated that "A chronic shortage of staff, particularly nursing staff, was largely responsible for the substandard care,". A lack of nursing staff = more demands on existing nurses = more stress and pressure = more adverse affects on individual attitudes = bad quality of care. This is what was found from the stories stemming from the Liverpool Care Pathway - where patients were often denied food and water due to a number of staff not being correctly educated on the LCP.

It has been predicted that there will be a serious shortage of nurses and midwives by 2016 and this will lead to obvious problems with care offered by the NHS, something the NHS will undoubtedly have to face. One of the biggest reasons for the shortage is thought to be the loss of our UK nurses to other countries. For instance, the US offers a starting salary of around £40,000 compared to the (around) £21,000 offered by the UK, not forgetting the year of experience they are required to also have. This has led the NHS to bring nurses and midwives from abroad, leaving them with almost the same problem.

For me, I have seen first hand the role of a nurse from my voluntary work and my view has developed as I've learned more about their duties. The role of a nurse is so broad and diverse as they need to be able to administer medication, offer emotional support and guidance, educate the family and the patient on the illness as well as making sure all the needs of the patient are met. Nurses truly are the definition of 'front line staff'. Where doctors have the responsibility of seeing through the patient from the diagnosis to the treatment and making decisions on the treatment provided it is the nurses that gets to care for the patients on a more individual level.

It's disheartening to see what has happened to the profession over the years and the issue is of high importance to be addressed. Hopefully, when this happens we'll start to see an improvement on the quality of care offered. :)

READ this if you'd like to know more. Let me know what you think.
http://www.theguardian.com/healthcare-network/2013/aug/20/need-graduate-nurses-nhs

The Liverpool Care Pathway, what's happening?

LCP.
I came to terms with this procedure not so along ago. I was on a shift at a local hospice where I volunteer at and during the handover with nurses I was told that a patient, let's call them 'X', was put on 'LCP'. Now, I'm going to admit that I had never heard of this 'LCP' before this time and I was instantly curious to find out what it actually entailed. So I asked. The reply was: 'LCP is for end of life care, when the patient is nearing the last few hours or days of their life'. The answer wasn't very detailed so I decided to look into it more myself.

Now, LCP was proposed by the Royal Liverpool Hospital and the Marie Curie hospice during the late 1990's. Let's get this straight, LCP is not a treatment but is merely a sort of process in which specific care is brought to the patients when their time of death approaches. The proposed idea was to enable the patient to have all their needs, be it spiritual, psychological and physical met by the senior doctor in charge of their care.

Problems started to arise when it became difficult to tell when a patient was nearing the end of their life. How could doctors tell? It was simply a guessing game.

I liked the idea of the LCP. I liked the idea of it being used as a 'framework' for good practice. I liked the idea that health care professionals would talk through plans with the patient and their families carefully and ensure that their needs would be met. I liked the idea that good communication between the health care team and the patient & their family would be a vital and key part of the proposed idea. Most of all, I liked the idea that the LCP was reserved as a last resort, a resort to which should be looked at when the entire team had reached a consensus that the patient was nearing death.

However (yes there is always an 'however') what I didn't like at all was the fact that these principles and guidelines set by the LCP were not being met. From the stories plastered all over the news lately I've grown to question weather the LCP is the way forward. They've been disturbing stories from patients families who have said that nurses would often deny the patient a drink and so patients would often go days without having their thirst quenched. This is simply inhumane and unlawful.

It's a shame that the LCP and their guidelines haven't been met by everyone as I think if it was applied properly it would be a very successful way to care for end of life.

From the concerns that have been raised by numerous different patients the health minister, Norman Lamb, has announced that the LCP will be phased out over the next 6-12 months. Instead, a individual and tailored end of life approach set by a senior doctor will be introduced, carried out and reviewed through its implementation.

It's a real shame that the previous guidelines were not met.

Let me know what you think. Comment, e-mail go for it.

Some more info for you below:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/212706/100715_letter_to_trusts.pdf
 http://www.mariecurie.org.uk/Documents/HEALTHCARE-PROFESSIONALS/Innovation/Liverpool-Care-Pathway_FAQ-23-August-2012.pdf
http://www.bbc.co.uk/news/health-23315865
http://www.dailymail.co.uk/news/article-2364029/How-Liverpool-Care-Pathway-used-excuse-appalling-care.html
http://www.bbc.co.uk/news/health-23301360