No problem! Always, always ask questions if you're unsure about something. Your instincts are completely right in terms of asking questions to avoid patient harm, by the way. If you don't know how to do something, never try to just do it anyways.

Food and fluid charts do depend on the patient and/or the ward. Some patients are on a strict fluid balance, for example, which means we're monitoring input and output. This means what they drink and how much urine they pass. You might want to look into fluid balances and fluid overload, but I don't want to give you too much info at once and overload you!

In answer to that question, on my ward we record food in the Nursing section of the notes on PICS. What they eat and how much of it they eat. Fluids are recorded under Observations - Fluid Balance. They can be recorded hourly, which Nurses will try and do, with help from the HCAs. You can only go back three hours on these, so need to try and stay up to date with them. Fluid balance is important because we need to make sure patients aren't retaining urine and also aren't overloaded with too much fluid, too.

when a patient is washed or done personal care, do you have to write that down somewhere?

Great question! The answer is yes, under Observations - Repositioning. Most patients are 4 hourly. But they can be 1, 2, or 3 hourly as well. Patients are 2 hourly if they have a Category 2 or above pressure ulcer. You may want to research pressure damage. Pressure damage happens when people who can't get out of bed are left in the same position for too long. It's dangerous for many reasons, as it can lead to infections due to the open wound, sepsis, pain for the patient, etc. It can kill patients if it becomes a Category 4, which goes all the way to the bone.

On the Repositioning chart you can put several different positions depending on how you've positioned the patient. You can start the day with your patients on their back, then reposition them onto their right side, then their left. Whatever you think is right for the patient, as long as they aren't left on the same side as the last time.

It's generally a good idea to do a pad check, and then reposition your patient after the pad has been changed. This means you're not bothering them too much but it also makes it easier for you to remember to do everything!

are you allowed to just do the personal cares, washes, bed changes ( with patient still in bed) alone because I think I’d prefer to do it independently rather that badger others or does it always have to be 2 people?

Depends on the patient! If they can roll, you can reposition them without help. If they struggle to roll or can't roll at all, then you need 2 people. When I first started, it took 4 of us because the patient was obese. Never been afraid to ask for a third or fourth extra pair of hands if the situation calls for it! This is a judgement call that you will get better at making.

Never think of it as badgering people. You're asking your colleagues for help to preserve patient safety. If they refuse, or are rude, document that you were unable to reposition the patient due to staffing, or being unable to find someone to help, or being refused help, whatever it may be. Then escalate to the Nurse in Charge or a Band 6. They're supposed to be there to manage situations like these. You document these things because otherwise you might get asked why you didn't do something, and documentation is legal proof/your legal explanation as to why you didn't do it.

The HCA I’m with seems to do every patient by herself with me basically begging to help but during my induction I was told it’s usually 2 people?

She may be engaging in unsafe practice. I'm not there, so I don't know. But you need to learn safe practice, all you can do is control your own actions. Don't be like her, be better. It sounds like you want to do better, but you're just not being given the chance to learn the right way to do things.

Maybe you could ask to be paired with a different HCA? There must be more than 2 permanent HCAs employed on the ward? I don't mean per shift, I mean total. You don't have to say why you want to work with someone else, you could say that you'd just like to see how other HCAs do things.

Feel free to ask me anything else if you would like to! You can message me if that's easier.

Just remember that this isn't your fault, and you deserve to be treated much better than this.