Читать книгу In Stitches - Nick Edwards, Dr. Nick Edwards - Страница 21

Gordon Brown pours money in. The senior nurses on the shop floor sensibly think we need more A&E nurses and so more are appointed. Then interfering politicians are concerned that the new nurses may not be very efficient and they are not getting value for money, so the managers appoint a ‘staff efficiency evaluator’ and a ‘patient pathway flow monitor’.

This ‘staff efficiency evaluator’ and the ‘patient pathway flow monitor’ (separate jobs, mind) also need supervision and secretarial support, so a senior supervisor is appointed and a personal assistant. More money comes in from Gordon and so, to satisfy the finance departments, quarterly figures need to be produced on how efficient the new staff are, and how many ‘direct patient contact’ episodes are occurring. A business manager is appointed to the staff efficiency evaluation team for this purpose. So that the local hospital journal knows about how wonderfully efficient the new nurses are and how patient contact episodes are exceeding expectations (i.e. they have been told to document whenever they say ‘hello’ to someone) a marketing manager is appointed to the staff efficiency team. In truth, their job is to write a small article every two months for the pointless glossy-paged magazine that the hospital wastes its money on.

New concerns about the new nurses are brought up. Are they helping patients make choices to deliver a patient-centred care pathway? A patient-centred care pathway manager is appointed to the staff efficiency team. The election is over and the trust realises it has overspent vast amounts of money and now Gordon is not so friendly.

A ‘turn-around’ team are appointed at great expense. But they are geniuses and worth every penny of their grand a day. They show the light that no senior nurse or consultant could ever have seen. The answer is lying before our eyes … the nurses are not efficient enough, are not performing enough patient contact episodes and have lost focus on patient-centred care. An efficiency report is needed.

The report is produced – indeed, it is the workers’ fault. The answer is patient-centred streamlined efficiency. This actually means they make the nurses redundant … but, remember, we couldn’t possibly lay off the staff efficiency team as we will need to report to the finance team on how good our ‘staff reorganisation initiatives’ have been. We can’t sack the marketing manager from the staff efficiency team as we need to tell people about staff reorganisation with a positive spin. The remaining nurses still need guidance and so the patient-centred care supervising manager needs their job protected. The business manager not only keeps their job, but needs a pay rise for doing extra work – handing out redundancy notices to the nurses.