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I worked closely with both HCAs and SENs during the transition period. It was on an acute trauma and surgical ward in a big DGH. Both groups of staff were caring for acutely ill post operative patients.

The ENs were able to explain why they did particular physiological observations and what they were looking for. They told me what the possible changes in the patient's condition might be and how they could spot them. I felt they were safe bedside practitioners on the whole.

In contract, the HCAs started collecting their physiological data from the top of the observations chart and they worked their way through to the bottom conscientiously enough, but they understood nothing about physiology and hadn't the least idea what it all meant and how the data they collected linked together to indicate the patient's condition and changes over time.

Frankly, I was scared! I would hate to have a loved one cared for like this. It's not about doing the tasks alone, it's about understanding what's going on.

A machine to monitor patients is as good as its internal algorithms. People are much the same, just warmer to touch...