Charge nurses needed on the wards.

I agree with Dorothy Sim's comments about basic nursing care, published in last month's letters ("What about basic nursing care?" p4). I trained as a community nurse in 1965 under the hospital system, then as a registered nurse (RN) in 1989 through a polytechnic. I appreciate aspects of both types of training. But I have seen all too often, and heard many more times, of instances where basic common sense is missing from our delivery of care these days.

I know of a patient, following carpal tunnel surgery on both hands and with both hands bandaged like boxing gloves, who was given two plastic bags and some tape to have a shower. She had to get another patient to help her put the tape on the bags. She also found it impossible to do up her bra when trying to dress herself.

As a student on a clinical placement, I checked on a patient, who needed to drink more, as his nurse had gone to lunch and the kitchen staff had delivered his meal and would soon take the tray away. I asked him if he was going to have his drink. He said, "I can't, it's too heavy to pick up."

I have seen a man with Parkinson's disease being fitted with a PEG feeding tube because he had lost so much weight from not eating in hospital. With good nursing care in the rest-home, he gained weight and we had the tube removed, as he was eating well if his food was cut up for him. A few months later, he had another hospital admission and, during his stay, I visited him during a meat time. His meal was sitting on a tray not eaten. When I asked him why he wasn't eating, he said "I can't reach it and I can't cut it up." The medical staff were again talking of inserting a PEG tube. There are many more such stories.

I believe there are too many health professionals working autonomously. There appears to be a doubling up of resources, which to me does not improve care or make for good financial management. I have seen diversional therapists doing assessments and care plans for residents when that has been my role and the assessments are already included in the resident's care plan. I would rather they spent the time taking a resident for a walk outside. Continence or psychiatric nurses will visit a resident without even letting us know they are visiting, or recording information about their visit in the resident's notes.

I would like to see charge nurses back on the wards and all staff accountable to them, instead of a patient receiving care based on a particular nurse's own standard. Charge nurses should be responsible for ensuring standards of care and ward cleaning are up to scratch. I also would like to see student nurses paid to work full-time on the wards for long periods of time, so they learn basic nursing care, cleaning standards and common sense. This would help with the nursing shortage and maybe improve the shocking standard of hygiene in hospitals today.

Ann Clark RN, BHsc(Nsg), Waihola,

South Otago