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Ward care in crisis?

5th February 2007

The problem the NHS is facing in providing effective care on the wards is about more than nursing shortages.

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Consultant anaesthetist Katherine Teale argues in the British Medical Journal that ward care needs to climb the agenda for both medical and nursing staff.

Doctors may be uninspired by life on the wards, but nurses can be unwilling to cross the divide between their domain behind the nurses’ station and that of the patients on the ward proper.

While the call of paperwork may be deafening, the statistics speak louder, she says. Three of the four most common causes of delayed discharge relate to care: healthcare acquired infections, pressure sores and medical errors.

On top of this, patients complain they rarely see a nurse, days can pass without contact with senior medical staff and everyday needs are rarely provided for easily.

‘The news is full of stories about high technology surgery and expensive new treatments, perhaps what we should all be focusing on is the poor care that patients often receive on the wards,’ she writes.

While training is offering students time to practice their communication skills, the crisis on the wards is down to lack of trained staff, little continuity of care, and poor leadership.

New ways of working mean trainee doctors are no longer called on to perform tasks like ECGs. These have been taken over by nurse practitioners - who in turn have handed on many of their traditional tasks to untrained healthcare assistants, who now spend more time with patients, but are unable to answer questions from patients or check progress.

She concludes that doctors and senior medical staff need to make their presence felt on the wards and by the patient's bedside. Making ward care better has to be the responsibility of both the nursing and the medical staff.


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