Nurses in the NHS
I believe that nurses play a vital role in a junior doctors life. They work extremely hard with a smile all the time. They deal with patients the most and when the doctors have left after their rounds, they are the ones who explain everything to the patient.
They play a vital role in the NHS.
They have different bands as well - they start from band 1 and go up to band 9. We have health care assistants, student nurses, regular banded nurses, locum agency nurses, specialty nurses and consultant nurses- All of whom are vital to the proper functioning of the NHS.
Personally I have learnt the most from the nursing staff and foundation year 1 doctors. They have helped me throughout my journey in the NHS and I still find them very helpful.
Here are some top tips for building a good relationship with the nursing staff:
1. Always listen to them. If they are concerned about a patient, go and assess him/her.
2. If they ask you to prescribe a particular medication or even fluids make sure you do this as soon as convenient.
3. Help them if they are very busy. I once helped a nurse make a bed as the other nurses were busy and a new patient was coming to the ward. I am not asking all doctors to start doing this but if you see a nursing colleague struggling, help them out.
4. If you have requested a nurse to catheterize a patient and she is very busy, do it yourself.
5. If nurses do cannulas and take bloods - it is a bonus! Some nurses are trained to do cannulas and take bloods. Don't take this for granted.
This does not mean they will do it all the time. So if you see that your nursing colleague is busy, then cannulate the patient/take bloods yourself.
6. Treat them with respect. They are humans. And in this country, everyone is treated equally. So greet them when you come to work in the morning, ask them how their weekend was on a Monday and socialize with them whenever you have time.
7. Ask them if they need anything done urgently before the ward round starts and always ask them if they have any concerns before you leave the ward before your lunch break/ when you leave the hospital.
8. Attend ward socials. This is very important and you build a good relationship with them outside the workplace as well.
9. Remember! Always be professional and respectful. They always feedback everything to the consultant in charge. This is known as 360 degree feedback and as doctors (especially those in training who have e portfolios) , we need to get feedback forms about ourselves filled by the nursing staff. Whenever I have met my consultant after a particular rotation, (s)he has always fed-back what the nurses and ward matrons think of me as a doctor and colleague.
10. Try to prioritize discharges. They have a lot of work to do once we have submitted the discharge summary - they inform the pharmacists who dispense the medications which one of the nurses has to collect from the pharmacy, arrange transport for the patient, inform the next of kin/ care home/nursing home. They then explain what is mentioned in the discharge summary to the patient.
The bed managers and site managers want patients to be discharged as soon as possible if they are fit- so they chase the nurses and hence we , as doctors need to understand how important this is.
I personally prepare discharge summaries in advance as soon as they are medically fit but are waiting to be cleared from OT and physios. This makes it easier to complete the discharge summary once the patient is ready to go home.
11. Pamper them and they will pamper you! Take chocolates for them before a national holiday like Christmas or even randomly will develop a nice relationship. Always give chocolates before you leave the ward and go to a different trust/ department.
Patients always bring in chocolates for the ward staff and they are in the staff room. So when you are hungry or have that random craving, you can always head to the staff room.
12. If you have any concerns, ask them. They can always help. They know how the referral system works, where the nearest pods are for shooting bloods, etc. This is especially helpful if you have just started in that trust and are not used to the system.
13. Most nurses are locals of that area so they know a lot of nice places to visit and eat out at. You can always take guidance from them. They will know who the best and cheapest driving instructor is and what is the best internet connection. All these small things make a huge difference. So when you are free and the nursing staff is also available, talk to them about such things- They are very helpful.
14. Understand how much work they have to do - They help with breakfast, cleaning patients, making beds, administering medications, making beds, ensure all patients have had their MRSA swabs done, check blood sugars, manage sick patients by doing observations regularly, help with cannulas and venepuncture if they are trained and have the time, feeding patients, attending the consultants ward rounds, discharging patients and then writing down everything in their own notes. If you get the chance, look at their documentation. It is meticulous!
15. When nurses ask you to prescribe a medication, 95% of the time , they are correct. And it is our duty to detect this 5% and act in a non offensive manner if it happens. And if we make a mistake, they are reprimanded as well for not challenging our decisions. So don't take offence if they are second guessing your decisions, they are trained to do that. If this happens, take time to explain to them the rationale behind our decisions.
They play a vital role in the NHS.
They have different bands as well - they start from band 1 and go up to band 9. We have health care assistants, student nurses, regular banded nurses, locum agency nurses, specialty nurses and consultant nurses- All of whom are vital to the proper functioning of the NHS.
Personally I have learnt the most from the nursing staff and foundation year 1 doctors. They have helped me throughout my journey in the NHS and I still find them very helpful.
Here are some top tips for building a good relationship with the nursing staff:
1. Always listen to them. If they are concerned about a patient, go and assess him/her.
2. If they ask you to prescribe a particular medication or even fluids make sure you do this as soon as convenient.
3. Help them if they are very busy. I once helped a nurse make a bed as the other nurses were busy and a new patient was coming to the ward. I am not asking all doctors to start doing this but if you see a nursing colleague struggling, help them out.
4. If you have requested a nurse to catheterize a patient and she is very busy, do it yourself.
5. If nurses do cannulas and take bloods - it is a bonus! Some nurses are trained to do cannulas and take bloods. Don't take this for granted.
This does not mean they will do it all the time. So if you see that your nursing colleague is busy, then cannulate the patient/take bloods yourself.
6. Treat them with respect. They are humans. And in this country, everyone is treated equally. So greet them when you come to work in the morning, ask them how their weekend was on a Monday and socialize with them whenever you have time.
7. Ask them if they need anything done urgently before the ward round starts and always ask them if they have any concerns before you leave the ward before your lunch break/ when you leave the hospital.
8. Attend ward socials. This is very important and you build a good relationship with them outside the workplace as well.
9. Remember! Always be professional and respectful. They always feedback everything to the consultant in charge. This is known as 360 degree feedback and as doctors (especially those in training who have e portfolios) , we need to get feedback forms about ourselves filled by the nursing staff. Whenever I have met my consultant after a particular rotation, (s)he has always fed-back what the nurses and ward matrons think of me as a doctor and colleague.
10. Try to prioritize discharges. They have a lot of work to do once we have submitted the discharge summary - they inform the pharmacists who dispense the medications which one of the nurses has to collect from the pharmacy, arrange transport for the patient, inform the next of kin/ care home/nursing home. They then explain what is mentioned in the discharge summary to the patient.
The bed managers and site managers want patients to be discharged as soon as possible if they are fit- so they chase the nurses and hence we , as doctors need to understand how important this is.
I personally prepare discharge summaries in advance as soon as they are medically fit but are waiting to be cleared from OT and physios. This makes it easier to complete the discharge summary once the patient is ready to go home.
11. Pamper them and they will pamper you! Take chocolates for them before a national holiday like Christmas or even randomly will develop a nice relationship. Always give chocolates before you leave the ward and go to a different trust/ department.
Patients always bring in chocolates for the ward staff and they are in the staff room. So when you are hungry or have that random craving, you can always head to the staff room.
12. If you have any concerns, ask them. They can always help. They know how the referral system works, where the nearest pods are for shooting bloods, etc. This is especially helpful if you have just started in that trust and are not used to the system.
13. Most nurses are locals of that area so they know a lot of nice places to visit and eat out at. You can always take guidance from them. They will know who the best and cheapest driving instructor is and what is the best internet connection. All these small things make a huge difference. So when you are free and the nursing staff is also available, talk to them about such things- They are very helpful.
14. Understand how much work they have to do - They help with breakfast, cleaning patients, making beds, administering medications, making beds, ensure all patients have had their MRSA swabs done, check blood sugars, manage sick patients by doing observations regularly, help with cannulas and venepuncture if they are trained and have the time, feeding patients, attending the consultants ward rounds, discharging patients and then writing down everything in their own notes. If you get the chance, look at their documentation. It is meticulous!
15. When nurses ask you to prescribe a medication, 95% of the time , they are correct. And it is our duty to detect this 5% and act in a non offensive manner if it happens. And if we make a mistake, they are reprimanded as well for not challenging our decisions. So don't take offence if they are second guessing your decisions, they are trained to do that. If this happens, take time to explain to them the rationale behind our decisions.
16. Last but not least - treat them like a friend, colleague and family member. They will treat you the same way!
I cannot praise the nursing colleagues I have worked with enough! They have been amazing friends and colleagues and are now family. They have played a vital role in my professional development.
Also read this:
https://nursingnotes.co.uk/junior-doctors-survival-guide-by-nurses/
FAQS:
In my home country, nurses did bloods and cannulas.
Yes, they did. They did not have to do OBS, do on the dot drug ward rounds, document in the patients notes, talk to relatives when doctors were not there, manage agitated patients, prepare beds for new patients, ensure the nursing staff was adequate on the ward over the next few days, do their own e learning and go through their own appraisals and the list go on.
So in summary - the nurses in the NHS work harder and are the backbone of the NHS.
I cannot praise the nursing colleagues I have worked with enough! They have been amazing friends and colleagues and are now family. They have played a vital role in my professional development.
Also read this:
https://nursingnotes.co.uk/junior-doctors-survival-guide-by-nurses/
FAQS:
In my home country, nurses did bloods and cannulas.
Yes, they did. They did not have to do OBS, do on the dot drug ward rounds, document in the patients notes, talk to relatives when doctors were not there, manage agitated patients, prepare beds for new patients, ensure the nursing staff was adequate on the ward over the next few days, do their own e learning and go through their own appraisals and the list go on.
So in summary - the nurses in the NHS work harder and are the backbone of the NHS.
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