I’ve been doing a bit of spying today… Well, its not so much spying but more kind of undercover reporting! It all started yesterday……
I had to attend a meeting as the nurse representing my patient, with a couple of social workers plus the patient’s daughter in order to ascertain the best course of action for the patient’s discharge. We had to go through everything from the patient’s cognition, skin integrity and mobility, to nutrition and behaviour. Eleven categories in all, and the meeting lasted for about 2 hours (they can take longer)!
Anyway I had been warned in the morning that the daughter could be quite difficult and that she was also an MP (Member of Parliament). Great, everyone hates the good old NHS so no doubt she’ll put a complaint in and we’ll be slagged off AGAIN in the newspapers!
Well, I had the usual manic day and by the time the daughter had arrived for the meeting, I had hardly even looked at the patient’s notes. I escorted her to the meeting, and I noticed that she did seem pretty scary; very forthright and no-nonsense, but we joined the others and the meeting began.
The first section was behaviour. This is where I had to mention that her mother quite often pushed us away, shouted at us, and had in fact, tried to bite someone. This amused her greatly, and she said that her mum had always been a ‘stroppy old bugger’!
Anyway, we continued discussing each section, and myself and the Care Manager would put our perspective of the patient which very often differed from the other two (who had met the patient for 5 mins beforehand). This meant that we had to argue our case, stand firm and provide ‘evidence’ which we did!
Eventually a decision had to be made, and I was no longer needed so I went back to the ward with the daughter in tow as she was asked to come back in 15 minutes. On the way back, she asked me if I would have a word with the carer who was assigned to look after her mother. This carer was ‘live-in’ as the daughter lived in another county, and because she had promised her mother she would keep her at home, she paid this agency a lot of money for the carer to be available full-time.
Anyway the daughter had asked how often the carer visited her mother in hospital, and was told that she did come every day, but stayed only for an hour at most! This enraged the daughter so hence she asked me to have a ‘diplomatic’ meeting with her and the carer.
I agreed but dragged the Ward Sister in on it as well! I tactfully suggested that the carer might like me to help wash the patient as she was more used to her and maybe would not be so anxious and lash out. I also thought that my patient would benefit being fed her lunch by a familiar face (she had already been asked to this by the daughter, but had buggered off at those times)!
We agreed that she would come to help us from 10-5 every day starting today. The daughter was thrilled, and praised me up to the sister. The carer however, shot me daggers!
Fast forward to 10am. No carer. I had given my lady her breakfast of course but was waiting for the carer to come to help me wash her. 10.30, and in she breezes! She sullenly asked me where the washbowls etc were, and I showed her with a flourish – and left her to it! I had been summoned to break and there was another nurse in the bay if needed so off I trotted!
I came back not half an hour later and she had GONE! The daughter was on the phone asking me where she was, and did she wash her? I said that I gave her the bowl so I assumed she had washed her and that I didn’t know where she was. I told her to ring back after lunch about 1pm so I could give her more of an update!
Well just before 12.30 (lunchtime) the carer is back. I greeted her and she suddenly asked me,
“Do you wash legs?”
That’s a bit personal isn’t it, I thought! It took me a moment to twig that she meant did I wash patients’ legs.Still a bit weird, are legs self-cleaning and I never realised?!
I told her that yes I did wash patients’ legs as well as everything else, and then she informed me that she hadn’t washed my lady’s legs; When I enquired as to why not, she looked at me as if I were stupid and said,
“because she has dressings on both of them”.
Oh yes, the dressings that I took down two days before, as the ulcers had healed up but the skin was extremely dry and scaly and did not need to be bandaged.
I ‘diplomatically’ told her this, and mentioned that not only should they have been washed but creamed as well! That news pleased her no end. She huffed for a bit and played with her phone!
Lunch duly arrived, after about 10 minutes, and whilst I was feeding another patient I was checking that the carer was feeding her lady. She did manage to do this and got her to eat something which was good in itself. I asked her to write-up the food chart, but had to go through it with her as she thought I was joking!
Two minutes later, her coat was on…she was off to get her own lunch! Fair enough, it is hungry work sitting down playing with your phone, and glaring at people! I asked how long she would be, and was told she had to go into the town centre to get food (a bus journey away). I informed her that we have canteen and also a shop or cafe to get food. No of course that wasn’t what she wanted, It had to be KFC!
She disappeared for another hour or so. Meanwhile my new best buddy phoned me and asked me to give a lowdown on the carer’s movements. She was apoplectic when I relayed to her where the carer had gone for lunch, and resented the fact that it was most probably her money that had paid for the meal. (I think she was offended at the choice as much as the cost).
I did feel a bit bad doing my undercover bit but it does seem a pretty cushy number to me, this live-in carer arrangement! They get paid an absolute fortune, but it is a business and the patients are ‘clients’. How sad that they can’t even do the bare minimum for their ‘customers’ like give them a decent full body wash! (No offence intended to genuine and bloody hard-working carers).
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