"Tactical situations are managed well, strategic..."

What I liked

I came into Wexham after breaking my femar, and rushed through A&E, and straight from there to ward 1C. I was stabilised. Here for 24 hours and operated on next day. All of the services I received during this period was certainly acceptable, but I don't believe I was in much of a position to provide any feedback, however over the next, I certainly noted a few things that could be considered for service improvements.

The commitment shown by 'the nurses', (Health Care assistants and Nurses), can be exceptional, given that they are so short of staff, equipment, beds, etc, etc.

What could be improved

Having observed the various duties that the different grades of 'nurses' have to undertake, and some of the tasks that they are not, it should be seen a miraculous that things are kept 'on track' at all.

I experienced evening 'shift change', when there was only one 'proper nurse' in charge of just over 26 patients! This meant that overnight, she had to review / handout the meds, complete the obs, coordinate any bed moves, etc.

These nurses are being put under unbelievable pressure, whilst trying to do the job / vocation that they love, however, due to cost cutting / priority changes, they are now finding this almost impossible.

A few observations - whilst the nurses are trying to deal with their regular shift duties, they get involved in conversations about, broken equipment, catering, moving patients, etc. Yes, these tasks need to be dealt with, but why use the teams with the lowest number of resource??

We've also heard about cases when patients can't reach their water / emergency button, etc - I experienced this also. The catering team deliver their meal / drink whatever it is, then leave. If you don't realise immediately, you have to call the nurse to sort it out!!

Anything else?

From my professional position as a Business Improvement Manager, looking at the services I experienced and observed, there certainly seemed to be a number of opportunities for improvements.

'Doctors' - there seemed to be endless number of 'doctors' coming ward to see patients. I'm aware that the all doctors are 'not equal', however, they often cause the same amount of chaos to the ward staff!

- If the doctors visits could be better coordinated, the impact upon the ward staff and patients, could be significantly reduced.

Nursing responsibilities - it seems that there is a clear definition of who can do what, when it comes to handing out medicine, and there should be, but a review of other associated responsibilities should be considered. You have many Health Care Assistants (green & cream) uniforms, who are more than capable.

Planning for 'The shift'

This is the real 'known unknown'. 'How many beds do we have?', 'has anyone found that other wheelchair?', did we get the 'obs' sorted out', 'has that new patient arrived yet from recovery', etc (this is only a minute example of what these guys do, ranginjg from bed washes, through to providing medication and giving life saving drugs.

These are examples of tasks that throw off any schedule that the nurses had for shift, and things like this happen every shift, so they aren't exceptions, and should therefore be planned for.

To summarise my position, the nursing staff I experienced in Wexham, were outstanding, given the additional tasks that they had to carry out, so support the rest of the hospitals processes and ways of working.

One of the patients in my ward 'passed away' whilst I was there, and the nurses worked tirelessly with the gentleman to do all the could for him. It was a fantastic example of what motivated / driven nurses will do to ease the lives of their patients, it's just a pity that the the rest of the organisation didn't show the same drive in improving general working practices!!