How do we stop HCA's or Nursing assistants becoming disillusioned before they even START to climb the ladder??

For a start, educate nurses on the art of conversation:

Initially, like any job there is a breaking in period where the little things not included in training are learned. Things like how the staff there like to be communicated to, in order to maintain consistency with patients for their safety and best possible care. One issue here is that there is no small talk, no greetings in the morning and not even a assurance of staff being alright, both in terms of their health and their level of training, to do the task the nurse is asking them to do. This issue not only flies in the face of Maslow, but also contradicts things nurses do with patients regularly. How can we look out for our staff body, let alone prevent accidents due to their fatigue/lack of information if we don't even engage in small talk occasionally?

Without a general standard of how someone is when they're well, how can we possibly know when there's an issue?

Maybe regional dialect or language barriers in the past have made the nurses too fatigued to make new hca's welcome or they feel that they purely have to spend time doing this on staff that do have geniune language barriers.

How foreign investments increase this likelihood of disillusionment:

It only makes sense that some more time should be taken to ensure things are understood by staff who have recently come to the country; are learning newer terms, accents and even mannerisms. Not purely for the safety but if every order is met with a confused look, it would save time in the long run to clarify. With this extra, albeit necessary for obvious reasons, time spent specifically on those new to the country, it stands to reason that those fellow countrymen who are at the same level, would feel dissillussioned.

2 way interviews, informal. 10 things mandatory.

Shunning both, in pure socialist fashion, to ensure the lack of attention to wellbeing and education level is spread equally (yay equality!) thinly, should be avoided. For obvious reasons. Though if these reasons were so obvious, then why is communication so evaded at this point?

Nurses, largely thanks to academia, learned in the classroom and then were put out onto the wards with all the knowledge and a complete neglect of logistics.

This is relatively new and with technology moving on the way it has, some classroom learning may well be necessary. The pitfalls of the nurse feeling out of their depth has also been addressed in the form of nursing apprenticeships becoming more prevalent.

It seems though, the communication issues have not been addressed.

I propose one way to acheive this is to spend time having interviews with successful candidates, in an entirely informal setting, set about ten minutes where the manager leaves a hca and nurse alone and returns with the requirement that each know ten facts about the other. Mannerisms and accents, in addition to neutral  (all good) setting would quickly be found mutually.

"But we don't have the time!" Would be the initial reaction had anyone with any rank suggested this. But with the potential of miscommunication, conflicts, contradicting information in patients' files, going over the same tasks as colleagues...we don't have time not to.

The weekly "take the edge off" box:

We all see the obligatory hand sanitisers on the walls in corridors. We know their benefit to supplement good hygiene; minimise infection. However, how do we minimise conflict? Assuming the 2 way interviews do become a thing of the future, there may still be staff who don't get along. Time for another Benzies' hair brained invention.

Akin to the sanitation boxes, this one would be placed upon the wall, one per ward and have a bank of items behind it. Though it is only accessible once a week and depending on the staff member using it, it contains a vice they are permitted to succumb to. Though only once a week.

The take the edge of factor would do just that. Remove the sting from the tail of the roughest shift of the week. It can also allow managers to notice patterns; if staff are saving their turn of the box for a shift with a certain other member of staff then it can serve as a clear indication that the issues causing this need, require addressing.

This allows them to talk to the staff separately or at an appraisal and see what the common themes are; making an appraisal with the edge-taking-off-making staff member easier to prep for.

Now provided, these 10 things shared aren't favourite karma sutra positions and the box contents are more chocolate cake slice and less bottle of whisky, I don't see why these implementations can't avoid accidents both clerical and physical, and make for a more comfortable and settled environment for patients. Not least because the newer staff will feel more a part of the team and be less likely to head out of the door.