Trust proposes specialist nurses help clean wards amid workforce … – Nursing Times

‘This is a situation that cannot go on indefinitely’
01 August, 2022 By
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A hospital trust discussed asking specialist nurses to help clean ward areas because of workforce pressures.
Senior staff, including nursing leads, at Luton and Dunstable University Hospital, part of Bedfordshire Hospitals NHS Foundation Trust, met during what the trust described as “some of the most challenging circumstances we have ever faced”.
“I think this shows very little respect for nursing generally and will not help retention”
Alison Leary
As a result, a document was circulated proposing that specialist nursing teams release staff for a whole shift, or “a few hours across a number of days”, to be counted in ward staffing numbers.
If specialist nurses were unable to be released for a whole shift, they may instead be asked to help clean ward areas, as well as the sluice room and utility and storage rooms, it stated. They may also be asked to support with answering the phones and with cleaning high touch points, such as door handles and light switches.
A copy of the proposals, which the trust said had not yet been implemented, was flagged by Professor Alison Leary, chair of healthcare and workforce modelling at London South Bank University, on social media site Twitter.
Professor Leary said the situation showed “very little respect for nursing” and would not help with staff retention.
“Specialist nurses are usually complex case holders and key to keeping people out of hospital,” she said.
“Assuming they can simply drop their work and it will have no effect on patients or the organisation is a very risky one.
“I think this also shows very little respect for nursing generally and will not help retention.”
She added that trusts must “plan workforces accordingly and should ensure they have the right amount of cleaning, administrative and housekeeping staff” to contribute to patient safety and care quality.
“We frequently hear of strategies like this one, usually associated with winter pressures,” added Professor Leary.
“It’s disturbing that I have had so many messages about organisations with large ambulatory caseloads in cancer and long-term conditions resorting to these measures in the middle of summer.”
Last week, the trust had also reported “unprecedented demand” within its urgent and emergency care services and issued a plea to the local public to ensure they were accessing the right care in the right service.
Some of the pressures had been related to a “general increase” in patient demand, alongside a rise in patients with Covid-19 and staff shortages, it said.
A spokesperson for Bedfordshire Hospitals Foundation Trust said: “As an organisation we do appreciate and value the important contribution that our dedicated nursing workforce (including our clinical nursing specialists team) makes in delivering quality patient care.
“As a result of the pressures we are currently experiencing, a discussion took place with senior medical, nursing and management leads to consider how we might ensure our ward teams could be given additional help during some of the most challenging circumstances we have ever faced.
“Fortunately, the actions detailed have not been necessary, and would only ever be considered where every option had been exhausted and following a wider conversation with those affected.”
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I cannot believe any Trust would under any circumstances ask highly skilled nurses to clean wards!!!!
We already clean equipment that housekeeping are not allowed to it’s the same old story when someone else’s job needs doing it’s the nurses who are expected to lift the burden no other professionals are asked to undertake such tasks
And then you wonder why there’s 50,000 nursing vacancies
Why only nurses? Why not catering staff, doctors, physios, or senior business managers? They all have homes which need to be kept clean, so they should have basic experience of cleaning chores.
I see several mental-models (which I’ll call hypotheses here ) revealed by such a memo. (1) Nurses don’t do much anyway and are probably sitting around doing their nails or surfing the web (2) The only contribution nurses make to patient outcomes is on the negative side ( mistakes, “patient safety” ) (3) Nurses require zero cognitive skill ( or “having a mental picture” as Air Traffic Controllers, say ) so interrupting their train of thought to answer phones or anything else won’t impact their effectiveness at their job (4) we don’t really care if this upsets nurses and they quit because there’s always more where they came from, and there is zero money lost in either recruiting or training new nurses since they don’t do much anyway (5) it’s really really hard to find people to clean doorknobs (at the price we’re willing to pay, that is. ) (6) Everything nurses post on weblogs about their work environment is all made up fantasy because what do they know, they’re nurses!! Personally I think all those hypotheses are clearly false, but the PERCEPTION given by the memo is that someone, no, that a majority of people at a senior level believe these hypotheses are true. This is somewhat consistent with upper management’s response in many hospitals to screaming from the floor that a new Electronic Health Record System is a disastrous misfit by either firing such loud-mouthed lazy no-good-niks or telling them to shut up , what do they know, as far as upper management can see, the EHR screens and implicit workflow is just dandy. I could react to and stereotype upper management as being spawn of Satan, etc., but I know that in many cases upper management is actually sincerely trying to do a good job. So, what’s going on then? More to the point, what’s broken that could be fixed? For one thing, there is a shortage of solid studies in the peer-reviewed literature of the value that spectacular nursing can provide in terms of patient outcomes. There are a few weak studies of ratios of patients to *nurses*, where by *nurses* is meant the depressed, underappreciated, understaffed, demoralized people trying to do their job in a toxic environment. There could be a study on the impact of spectacular nurses on donations to hospitals and grateful patients rewriting their wills to give large sums to hospitals. I don’t know how nursing hours are billed or accounted for in the NHS, but in the USA nurses are “overhead expenses” and their time is unbillable since, by implicit mindset and insurance regulations and policy, it is not relevant to outcomes any more than janitorial services cleaning the steps. Obviously screaming doesn’t reach upper management or the top political offices who do not perceive a “crisis”. Let’s be generous and assume those people are honest, sincere, well intentioned people. Again, there is a blatant disconnect here that has no obvious source. All of the above hypotheses should be rigourously examined by solid research studies, because if the are false, there is in fact a crisis and many lives are being destroyed or lost due to myths persisting disguised as “obvious truths” that “everyone knows.” Compassion and empathy and actually caring in a human emotional and real sense is something nurses are positioned to do and that literature says are very powerful healing forces. But we need studies, not yelling matches and camps/sides ( labor, management) each convinced the problem is due to evil people in the other camp. WHY are there no such studies? Let’s focus there.
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