back to article NURSES' natural DESIRES to be SATISFIED, by technology

Nurses will get £100m worth of mobile tech including digital pens and other handheld tools, Prime Minister David Cameron and Health Secretary Jeremy Hunt have just announced. It is hoped that the digi pens and other piece of comms tech will let nurses spend more time with patients and less time sitting around filling in …


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  1. Anonymous Coward
    Anonymous Coward

    More time to spend...

    ...sitting round gassing with their fat, idle mates at the nursing station, ignoring drip alarms and thirsty patients, expecting a handful of lightly trained auxiliaries to do the dirty work and to communicate in broken English with the patients. It'll take a lot more than handing out a few iPads to put the care back into nursing.

    That's if my local hospital is anything to go by, of course.

    1. wowfood

      Re: More time to spend...

      Shame really, my local hospital by all accounts is very good. Nurses are nice and polite for the most part, doctors are almost always on hand, and if they aren't they have a good reason. I suppose it's luck of the draw. But it does feel that there are just a handful of hospitals that bring down the nation.

    2. Great Bu

      Re: More time to spend...

      The reason Nurses spend so much time sitting at the nurses station is that the amount of paperwork and form filling has increased by around a gazillion percent* but the number of nurses on a shift remains at the level we had in 1982.

      When I started nursing the average 7 1/2 hour shift consisted of 6 1/2 hours of patient contact followed by 1 hour of writing it all up. Now out of the 7 1/2 hours most of my staff nurses have to spend nearly 4 hours filling out forms who's only purpose is to reduce our legal liability (smoking rates, alcohol consumption, dementia screening, deep vein thrombosis screening, pressure care assesment, nutrition scoring, cannula monitoring, fluid balances etc. etc. etc.... all these are things that used to be done as a matter of course by nursing staff but now must be recorded on separate forms for every patient in order to reduce our public liability insurance premiums. When I started 15 years ago the average patient admission generated about 10 pages of records per day, that number is now closer to 50 pages per day ).

      The 'care in nursing**' has essentially been beaten out of most nurses by systems that prioritise legal liability reduction over actual looking after people - I have never seen a nurse fired for not having enough time to talk to a patient but I have seen some fired for not filling out forms.

      Any technology that can act to reduce the amount of time taken out of a nurses' day to fill out forms can only improve things (of course, the challenge is to make it something that actually works).


      ** It's all too easy to rant on about 'care in nursing' but like most of my colleagues I have little regard for the opinion of people who don't have the need to develop the emotional ability to alternate between dealing politely with a complaint that the tea round is a bit late today immediately after they had to tell someone that their mum just died as part of their everyday job.

      1. Anonymous Coward
        Anonymous Coward

        Re: More time to spend...@ Great Bu

        I didn't point out in my original views of our local hospital that my wife is an RGN, RM, has worked as a sister at the hospital in question, and has been a patient there. The fat wasters gassing at the nursing station aren't fillling out paperwork, they are doing nothing (and I'd point out that most wards have a small army of indolent filing clerks as well). I should also point out that this hospital was subsequently singled out by regulators for special criticism of its care of the elderly, which had nothing to do with paperwork.

        I'd agree that management and lawyers have made things worse, but there is a fundamental problem that too many nuses now don't believe in the provision of care, other than as some module to be passed as an evil necessity. They (and nursing "directors") think that cleaning the ward is beneath them, to be subcontracted out to the cheapest possible supplier. They think that feeding, talking to patients is something for Philipino auxiliaries to do. Even the stuff so many think that they should be doing (taking obs) is done indolently and infrequently.

        I also know of other hospitals where care is much better; but my original point stands, that technology won't make the standard of nursing any better, in the same way that technology often hasn't improved any other government controlled service (or for that matter quite a few commercial services).

        So I don't see technology as a cure-all on this.

        I'd suggest that any technology that reduces the amount of time a nurse spends filling forms will merely result in (a) even more data being gathered, simply because it can, or (b) a reduction in the hours allocated, in order to reduce costs.

        1. Great Bu

          Re: More time to spend...@ Great Bu

          Was there some secret other part of the article that claimed this technology was a panacea for all the ills of the NHS ?

          Or did you feel that these innovations were not worth instituting simply because they only improve things a little ?

          Nobody is claiming technology as a cure all, but it would certainly help to reduce the amount of time wasted on pointless activity like copying someone's demographic details from a computer screen onto a piece of paper by hand (I see this every day).

          The hospital you refer to would very likely have been able to deliver better care to it's elderly patients if the staff caring for them had more time to spend actually with the patients instead of just writing about them. I am innately suspicious of any trust that returns perfectly complete data on all the various monitoring tasks as it often suggests a trust which places a higher priority on those than on direct care activity.

          (on a side note, part of the job of someone working as a sister on a hospital ward is to provide leadership to their team in relation to efficient use of their time and what constitutes an appropriate task for anyone to perform.....)

          1. Anonymous Coward
            Anonymous Coward

            Re: More time to spend...@ Great Bu

            If you want to be picky, I didn't specify what technology was a cure all for - the article and the discussion had been about nursing and technology, so I'm not sure why you are suggesting that I wrote "for all the ills of the NHS". As this is a techie forum, you should know as well as anybody that technology never solves complex institutional and cultural problems.

            But that's merely a straw man, and without wishing to get too contentious, you are missing my main point. I've clearly said that in the examples I've seen, the nurses aren't diligently filling in bureaucratic paperwork. They are treating their work as some form of paid social life, to talk to their colleagues about trivia, and treating patients as a nuisance. Maybe you missed my comment about "ignoring drip alarms", for example. Not just one - about three or four going at any one time, when there's four nurses and a sister at the station, doing nothing. To confirm the comments of another contributor, when my wife was in hospital (with a suspected PE), she had to get out of bed to get drinks for other patients who were completely immobile, because the nursing staff were not doing it.

            Regarding "leadership", that's the one thing I see nothing of in most of the NHS. Sticking to the nursing side of things, the sisters have (in the hospital to which I refer), professional nursing staff, nursing auxiliaries, contract cleaners, and admin assistants to call on. There's no shortage of bodies. But for whatever reason, the key output of patient care is not being delivered, and one thing my own eyes tell me is that this isn't because the staff have too many forms to fill in. The key inputs that are lacking are organisation & control, and physical work.

            And one final thing: The better hospitals of which I have experience not only provide better care, but they do *more* paperwork, because they undertake additional analysis of their service, in a mindset that a company would class as "continuous improvement". In part that's the difference between a leading specialist unit and the smaller district hospitals, but it doesn't have to be that way.

        2. Anonymous Coward
          Anonymous Coward

          Re: More time to spend...@ Great Bu

          Absolutely. +1000 if I could. Some of my obs, again with tech as a counterpoint. My elderly mother again spent time in hosp, in a variety of wards in the same place. It seems it's the *British* nursing staff who are the indolent time-wasters, expecting the Philipino or Jamaican nursing staff to do all the hard work. The "foreign" staff all worked exceptionally hard and *looked for work to do*. As for the British staff, patient call alarms would ring and still they stand around gassing. The main ward have been using PDA-type devices for a while now. Each bay has a PDA sat at the end, and all staff can input and read data on them for each patient, but there's still a huge amount of paperwork.

          A relative of mine trained as a nurse, worked as a nurse, and now teaches nurses at a training hospital. She's appalled that the people she gets given to train consider themselves "too posh to clean". She reckons that it's after the profession became degree-orientated. No amount of tech will change this attitude.

          Oh, and the original ward my mother was in? She's been there many times, off and on. Late at night (and this is corroborated by another patient), the nursing staff have parties at the nursing station. By that I mean bottles of alcohol brought in, wine guzzled.

        3. Tim99 Silver badge

          Re: More time to spend...@ Great Bu

          My wife qualified as a Registered Nurse in 1969, and rose through the ranks of Staff Nurse and Sister in the NHS, and eventually, as a Matron in local government aged care. She makes the point that in the bad old days when she started, juniors (aged 16) sterilized bandages, made beds, cleaned dentures, and were directly supervised by qualified staff in day to day patient care activities. The nursing course was heavily practical and you were surrounded by patients.

          I understand that since those days, one becomes a nurse by taking a degree. Apparently one does not have to have much to do with sick people until near the end of the course. Some people who take the courses may be far too important to get their hands dirty, and consider that management is where they rightfully belong.

      2. Why Not?

        Re: More time to spend...

        Sorry not my experience, the elderly gentleman in the bed next door to me would have starved (the auxillaries took the plates he couldn't reach away full) or died of thirst his water jug wasn't filled day to day, if it hadn't been for his fellow patients.

        When I went to get a clean water jug and extra pillow for him I had to interrupt 4 nurses discussing eastenders. and drinking tea. They didn't seem to be involved in paperwork.

        I wouldn't mind but the hospital seems to be completely incompetent at paperwork as well.

  2. Anonymous Coward
    Anonymous Coward

    Paperwork is like storage

    Tends to fill out to the max. So if you increase the capacity for doing paperwork....

    Best not try and "fix" that with some fancy project eating up a lot of dosh to spend on approved pork barreling suppliers. Instead, look through the organisation and the workflow and applicable laws and policies, and improve on all that. Then you might consider more tech, but since basic governmental tech use tends to the lose usb sticks on the bus variety, more easily carried off devices are not likely to suffer less in that regard.

    1. Anonymous Coward
      Anonymous Coward

      Re: Paperwork is like storage

      Why would a politician do some work, when they can throw some non-committal cash at something and let somebody else do the work, grabbing a headline in the process?

  3. Charlie Clark Silver badge

    Technology for technology's sake

    Who is it who makes them fill out the forms in the first place? One thing the Tories have consistently managed to do in meddling with the NHS is increase the bureaucracy. While some bureaucracy is essential for quality assurance, most of it has been about making it easier to make pretty charts in Whitehall.

    They could put the money into more schemes like at Queen Elizabeth in Birmingham, couldn't they? Of course not! Silly me, where would be the kickbacks there? More digipens and machines that go ping!

    1. Tom 38

      Re: Technology for technology's sake

      Tories == increased paper work?

      Think you are mixing up your political parties. The explosion in metrics, measurement and bureaucracy happened when Labour started spending increasingly insane amounts on the NHS. Labour wanted numbers to beat the opposition with, with league tables for everything to demonstrate how much more their spending was doing. Everything must have a KPI.

      This, combined with the introduction of hundreds of PCTs, is what has increased the bureaucracy from that of the early 90s. Even Labour thought that many PCTs was wasteful, they halved them in 2005..

    2. Anonymous Coward
      Thumb Down

      Re: Technology for technology's sake@Charlie Clark

      "One thing the Tories have consistently managed "

      I think the evidence is fairly strong that all incoming governments regard the NHS as needing some helpful input from politicians. Blair and his cronies spent the first few years of his administration moving the NHS deckchairs around first to undo the previous Tory changes (GP commissioning), and then to reintroduce them under a different name (PCT commissioning), now the current lot have decided that their remarkable managerial skills are in demand (back to GP commissioning), and I guarantee you that the next shower of p*** will also feel the call to "modernise the NHS" in some way.

      However, if there is the need for more money for health, maybe you should go back to Blind Gordo, and ask for a refund on all the expensive NHS PFI deals that were signed by the last government. According to the Graun, NHS PFI deals achieved about £12bn of capex, but will result in total payments of around £80bn (neither figure including the £12 billion wasted on failed computing projects). After allowing for government borrowing costs and maintenance, that's around an incremental fifty billion quid that the taxpayers of this country are forking out for no benefit because the liars and cheats of the last Labour were using PFI to try and play down their reckless spending in many other areas.

      In that context, £100m on a few tech trinkets is nothing, is it?

      1. Tom 38
        Thumb Up

        Re: Technology for technology's sake@Charlie Clark

        Yar, the hardest thing to do ever is to get power back, which is really what the Tories are trying to do right now. Course, you can;t say that because the people currently with power like to keep it, so there has to be some magic trick with new terminology.

        Anyway, the net result should be larger regional bodies, run by doctors, doing what is required to make a health service, not fulfil box ticking statisticians in Whitehall. If only that is what we would ultimately get :/

        Political parties are easy to predict. The conservatives want everything to work, but don't want to be in charge of it, responsible for it, or change anything too drastically. If they could get out of paying for it as well, that would be gravy.

        The Labour party want to improve everyone's lives by working out precisely what is required of everyone, measuring how and what each and every one of us is doing, and legislate to measure us.

        The failing of both is that they invariably go too far to the extreme.

  4. Anonymous Custard Silver badge


    That means the notes made about a given patient – provided they're written legibly – can be collated easily and will only need to be written out once.

    If nurses handwriting is anything like doctors, then there could just be a flaw in the digi-pen utilisation here?

    And having occasionally had to help my pharmacist wife decode some doctors scribbles on scripts and notes, methinks perhaps the digi-pens could end up creating more work later on when people actually try to make sense of the notes made.

    1. ElNumbre

      Re: Handwriting

      Expect more patients to come in with a prescription to 'Eat up Martha'

    2. Hyphen

      Re: Handwriting

      Assuming you don't also work for the same place, does your pharmacist wife know how many InfoSec rules she's breaking showing you that? ;-)

  5. wowfood

    Just a thought

    Place your bets now. A nurse leaves her ipad with confidential patient information stored on there (allegedly) how much will the ICO fine the NHS because of this? And with the increase in the number of fondleslabs amongst nursing staff, how many of these fines will actually be placed per week?

    I'm betting the government makes back its 100 million loan in fines within the first year.

    1. Alan Firminger

      Re: Just a thought

      Perhaps patient data will be wirelessed directly to the hospital server.

      1. Michael Dunn

        Re: Just a thought

        Encrypted, one hopes!

  6. Elmer Phud

    Carrots and sticks

    "Nurses will get £100m worth of mobile tech including digital pens and other handheld tools, Prime Minister David Cameron and Health Secretary Jeremy Hunt have just announced."

    What for the half-dozen nurses left in the NHS after a 'restructuring programme' to cover the cost of the tech?

  7. Anonymous Coward
    Anonymous Coward

    hospitals, hospitals, hospitals ...

    I get totally sick of the uninformed view that healthcare=hospitals, nurses=hospitals etc etc. In a hospital you're usually no more than a couple of steps from a terminal - and building a terminal into every bed is not outside current technology.

    We're talking about patient's clinical notes here. Hands up all those who don't want nurses to keep your clinical record up to date with your current condition? No-one? Didn't think so.

    Now, can anyone come up with something positive instead of all this carping? For instance, can anyone work out how to get remote access to care notes (with due regard for encryption, confidentiality etc) for DISTRICT NURSES and other healthcare professionals in the patient's home, where most of the care takes place, leaving a copy of the care plan there for other professionals involved in the patient's care from other providers - eg GPs and the social worker who calls and the carers who come in to look after the patient and (Deity forbid) the ambulance crew who might be called if the patient takes a turn for the worse? Without lugging around a laptop and printer on top of all the other medical kit s/he needs to carry? Oh, and the patient lives on the other side of the hill from the transmission tower so there's no WiFi or reliable mobile phone signal. Also, the commissioners have just said the district nurses need to see 3 extra patients a day or we'll lost the contract.

    Any answers? Didn't think so. That's why we need to invest in developing stuff like this.

    1. Great Bu

      Re: hospitals, hospitals, hospitals ...

      Didn't they bin this idea a while ago ( ?

      NHS staff (in or out of hospitals) dream about integrated health records - it would be so much better for all an individual's records (Hospital, GP, District Nurse, Mental Health, lab results, prescriptions, pharmacy records, radiology reports etc etc - from anywhere in the country) to be available at all times, but the complexity and cost of getting any such system to integrate sucessfully with every existing solution turns out to be more than we were willing to spend on it.

    2. Anonymous Coward
      Anonymous Coward

      Go on, piss and moan...

      At least you've *got* the NHS. I didn't realise how good I had it until I moved to the States, which has a health care system like a bloody third world country in comparison.

  8. shotgunn
    Thumb Down

    Just what we need.

    I am a staff nurse and where I work everything is electronic, from our documentation to our prescriptions.

    We use laptops for medication rounds and recording the patient care given, and is a more efficient tool than paper based nursing notes allowing a quick review of previous events and info.

    It makes the paperwork side alot quicker than handwritten notes, but the digi-pen idea will just make the job harder. Not only will you have to write the documentation, then you would have to sync with a base station between each patient to avoid the wrong details being saved.

    So you have on average 10 patients with at least 2 enteries per shift, more time lost for hands on care.

  9. Mike Richards

    Treating the symptoms

    So they're not getting rid of any paperwork, just giving them a piece of technology that is likely to go wrong, have a flat battery or just break.

  10. Nev Silver badge

    More waste.

    Anoto style digital pen/forms could work.. But they won't.

    It's an NHS IT scheme. I predict an overspend on stuff that will never work properly.

    Who remembers the "Clean me!" keyboards costing 100s each?

    Load of old Jeremy Hunt.

  11. JaitcH

    NHS and Technology ... Never Works

    You would have thought by now the government would accept that the NHS and technology don't work.

  12. Vic Sub

    got me good

    I, like you, have just been trolled by ElReg's headline.

  13. Anonymous Coward
    Anonymous Coward


    No! Fail, fail, fail, fail, FAIL.

    We tried to implement digi-pens at one of our hospitals (private). At great expense we got all the stationery produced, bought all the pens, did X, Y and Z to get it in.

    Once it was in, what happened? Nurses misplaced the pens and started picking up biros to fill out the forms - as one put it "I don't care how it gets onto the computer, I've filled the form out". (this bit scared me as the paperwork would get filed assuming it'd be on the system)

    When the nurses HAD the pens, there were issues getting them to synchronise with the database, though this was mainly because the nurses kept continually forgetting all the training they had been given in getting the information downloaded. This put massive pressure on our helpdesk with shouting nurses demanding that we do it for them (and then time spent telling them how).

    The pens would BREAK. We found them to be no more or less durable than a normal biro. But once it broke, you had to order replacements (or locate spares), the person filling out a form would have to shred it and start again, etc.

    Now, whilst I'm not a fan of the way things are done at the minute, we at least make sure transcription is done by non-medical (usually admin) staff. We try not to waste nurses' time with anything unnecessary like that, just as long as the information is filled out.

    Plus, it didn't save massive amounts of time for our admin staff anyway - we found the handwriting recognition failed more often than it succeeded, so some poor bugger would still have to type up from a digital copy (and they didn't much like the alt-tabbing involved!)

    In all, a very, very expensive waste of time. This will not help the NHS.

    1. Richard 12 Silver badge

      Absolutely right

      I've been on some jobs where these digi-pens were used.

      And they were used in special circumstances for exactly one purpose - partial or even complete sign-off of expensive wares.

      Like ships.

      Getting out the special paper and digi-pen was a sign that Something Big was about to happen, and some part of a contract was about to be completed.

      Every single digi-pen event represented a lot of money changing hands, and that's why they used them - multiply redundant copies of "Yes, pay the supplier a few million pounds"

  14. Anonymous Coward
    Anonymous Coward

    When I was in geriatric nursing, there seemed to be three "natural desires":

    1, smoking break, as often as possible

    2, exploring each other, you don't want to know how often I went to pick up towels and stuff for the afternoon replenishment only to interrupt two nurses in a state of giggly-fiddly

    3, let's just say some of the girls were a little fonder of doing the afternoon "bathing" (well, mostly standing in a shower; resident naked, us dressed) than might seem healthy. Of course if said nurse was wearing a white dress that tended towards translucency when wet, loop back to point 2.

    So, forget intelligent pens, let's have £100m worth of cigarettes and dildos. Then they'll be satisfied!

    Anon, because...

  15. Alan Firminger


    If these ideas will help nurses why are the police not similarly assisted ?

    1. Anonymous Coward
      Anonymous Coward

      Help the police?

      What, with cigarettes and dildos?

      1. Anonymous Coward
        Anonymous Coward

        Re: Help the police?

        Police might prefer cigarettes and doughnuts|coffee|kababs...

  16. Paul Hovnanian Silver badge

    Nurses' Desires ....

    Sorry. My mind wandered there for a bit.... Geisha/Nurse.jpg

    1. Anonymous Coward
      Anonymous Coward

      At least that is nominally SFW...

      Unlike my ill-advised image search for "nurses, cigarettes, and dildos"... 8-o

  17. JBullet

    Is it JUST ME or does the TITLE of this ARTICLE indicate that NEW KEYBOARDS are necessary at EL REG?

  18. Clyde

    What's this with the fat wasters comments ?

    See an old hospital film from the 1960's or thereabouts - check out the waistlines and body shapes of the staff.

    Compare to what you see in hospitals nowadays.

    Then understand why they are called "the good old days".

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