Not in the brochure

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As the financial year draws to a close, it is traditional for the NHS to ditch any attempt at real, long term sensible savings and go for ridiculous every penny counts savings. As a result of which it appears to be acceptable to run wards on less staff than I would deem ‘safe’. Less staff than are sufficient to do the job properly. Less staff than you need.

I am exhausted. I’ve been exhausted for the last few days, but it has come to a bit of a head today. I’ve got violent, aggressive patients, and we had 5 staff on. One in charge, one bank (who’s actually one of our staff nurses), two (including me) staff nurses and an HCA. Oh, and a third year student. That’s for 29 patients, the large majority of which are confused, several of whom are aggressive, most of whom are incontinent, a not insignificant number of whom have diarrhoea…

When you’ve got so few staff, little things start to get on top of you. I can’t think of a single day I’ve been on in the last week and half when we’ve been fully staffed, and I’m so tired it’s unbelieveable, and so, being spat at, swiped at, sworn at, and (and this is the clincher) having shit-covered nails dug into my arm so hard they broke my skin has really left me feeling utterly fed up. And I admit, it started to tell in my general standard of care. I was so tired (no break either, although I did decide to sit down in the office and eat my sandwiches while writing something akin to notes, although their level of detail was somewhat low) that I just started not to really care; I just wanted to come home and sit down. Which is not what you want.

Cynicism and sarcasm can only get you so far. And incidentally, despite copious amounts of cleansing and finally on arriving home a cleansing with TCP my arm still hurts, and I’m going back in the morning to probably be cursed by the nightstaff for all the half-done jobs, and I don’t know where I’ll get the empathy and caring from. All I feel is exhausted, undervalued and unsupported.


Kate is lord and mistress of all she surveys at