Thursday, 10 January 2008
Temper Tantrums
I think I am really losing it as a Nurse. I am still very compassionate but a hardened shell made of diamond has formed around every compassionate and empathetic bone in my body. I want to stand in the middle of my ward and shriek, scream at the top of my lungs: THIS IS REALITY. IT SUCKS BUT THIS IS HOW IT IS AND I CANNOT CHANGE IT. THIS IS NOT HOW THINGS ARE SUPPOSED TO BE AND I CANNOT CHANGE IT. NOW PUT ON YOUR BIG GIRL PANTIES, AND DEAL WITH IT LIKE A FUCKING GROWN UP.
The things some of these people bitch about...Their unrealistic expectations for one to one care....The belief that you are going to get one to one care in hospital.....the belief that the nurse you are sharing 35 patients with can revolve the world around you and your families schedule without fucking killing someone.......
I'm just a nurse who wants to do my job well and take care of my patients.
My assignment of patients wasn't so bad, that turned out to be a blessing later. My colleagues day sucked. It was her and myself for 28 patients. My 14 were in good shape. They were mostly walking wounded. One poorly patient went to ITU. No upcoming discharges. I was able to get in and do a good assessment on everyone at the beginning of my shift and get a good handle on everything. I was able to do this because I went into work early. Only 2 of them were on IV meds. No confused wanderers that day. It was good. I enjoy days like this because they are so rare. I recently got a couple of beautiful thank you notes from patients. The cards were waiting for me when I went into work. I feel bad because I know the care could be so much better.
My colleague had the other 14 patients who were tougher. She ended up with a death, 3 critically ill patients and 4 palliative care patients whose families were angry and inconsolable. I was able to spend most of my shift helping her out since my assignment was so good.
We have no free beds on the ward but are slated to get an admission at 3PM for minor surgery the next morning. The admission comes in and we sit her in lounge. She appears to be a very well lady. She is raging because there is not a bed yet. I told her it is okay as long as she is here and we can sort out her stuff and prepare her for theatre la de da. Called the bed manager and said please find this lady a bed.
Well a bed did become free around half past 3. We knew it would really. A patient in the side room died. The family was there. They were hysterical.
A relative of the dead patient was so distressed we nearly sent her to A&E..She was a young adult and when told that her dad died she lost control of her bladder. The rest of the family was no better. More family came in to say goodbye. We couldn't lay out the body and get it moved to the morgue because the family was laying on top of the corpse and couldn't bear to leave him. This went on for hours and hours. I was so heartbroken for them. It's not cool to say "look we have a new admit that needs this room, please leave". We gently tried to tell them that they could see him in the chapel of rest and encouraged them to get a cuppa while we sorted out dad and prepared him to leave the ward. They were having none of it. They would not budge. They would not converse with us. I don't think their English skills were great. This was the only bed we were going to have. There were no other beds free, or that could be made free.
Bed manager was aware of the situation there were no beds anywhere else. That's what she said anyway but she is also a well known liar.
Meanwhile the new admission in the lounge was getting increasingly PISSED OFF. WE were not going to tell her that there was a body in her upcoming bed
that we couldn't move. I could tell that she was the kind of person who would completely flip out about that.
By 5PM she was in the lounge crying because she was told to come into hospital for her op and expected to come into a bed and see her doctor straight away. She was to have a hernia repair the next day. I left 28 patients to hook her up with magazines, food, a TV some blankets to get comfortable and apologized profusely regarding the bed situation. I told her she wouldn't see her doc until tomorrow morning anyway even if she was in a bed. It did no good. Every 5 minutes she came out of the room to berate us, call us useless for not getting her bed ready. Then she called her husband and he came in ranting and swearing. Then she called her sons and they rang the ward every 5 minutes ranting swearing and threatening us. So did her sister. I guess they thought that this would get her in a bed faster.
This went on until 9PM. She had to go into the bed where the body was, there was nothing else we could do. We couldn't throw the recently bereaved family out. There was 7 of them and 2 of us. Site manager was aware and said his hands were tied. Thanks for the help you fucker. It was 9PM when we finally were able to lay the body out, get him transported to the morgue and clean the room for the new admit.
If you want to know why your nurse isn't answering your call bell, spending time with you etc etc....it is because they are messing around with this stuff.
This woman was crying and cursing saying that having to wait for a bed like this was the worst thing that ever happened to her in her life. I had to try so hard not to laugh at her. I brought her a dinner tray in the lounge and she threw it on the floor. I am sorry. The lounge she was in was nicer than the room itself. She had comfortable chairs etc. She wasn't ill. She had food, water, TV and a phone. She was coming in and out to smoke.
My colleague suggested that we should give her full responsibility of 3 bays by herself, then she could have something to really whine about.
By 8PM I came so close to grabbing her by the hair, digging my nails into the back of her head and dragging her to the room with the corpse in it so that I could point to it and the grieving relatives and say "NOW THAT IS A REAL FUCKING PROBLEM". "NOW THAT WOULD BE SOMETHING TO GET UPSET ABOUT".
I came damn close. Maybe it's time for sick leave.
Thank god my 14 patients were all right. They saw me for about 2 seconds each. If one of them had deteriorated, it would have been missed. If any of them peed the bed they sat in it for the duration of my shift.
Edited to Add: I just made a few phone calls and have an appointment with my GP tomorrow. I am now off sick. I hate complaining to my GP, since she probably has too deal with 100x more bullshit at work. I hate feeling this way.
I have had close relatives die horribly. I have had medical problems myself and as stressful as that was I feel ten times worse and more anxious about going into work. I can't handle the abuse and getting sworn at all the time. I don't get to throw tantrums and cry when I am feeling like that. I'll get complained about if I so much as forget to smile. Maybe if they just offer me a chocolate cookie that will make it all better and force me to smile.
http://www.timesonline.co.uk/article/0,,2087-2450166,00.html
I am not going to follow my own advice and put on my big girl panties and suck it up anymore. I am still job hunting so maybe something will turn up. I will even go and work at Asda if they are hiring. If the house sells first we are out of here.
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20 comments:
I'm not sure if I've commented here before, but I've been reading for a while. I suppose I just wanted to say I'm sorry things are so awful you feel this way, and thank you for all that you do. Take care of yourself for now. Bendy Girl x
I'll be allright. Just a little burned out right now.
I feel sorry for the patients that's all.
They are the ones who should get the sympathy....except for the ones who go out and smoke and come back in throwing tantrums...I don't feel bad for them.
1 nurse for 14 patients - that sucks big time.
I know that I do not have the patience that you and your colleagues possess to deal with your appalling working conditions and even worse your total lack of "managerial support".
I am practically crapping myself. I called out sick and haven't seen my GP yet. GP may very well tell me to put on my big girl pants and suck it up!!
Dear oh dear.
Yeah he signed me off.
I am so anxious about that place I can't sleep or eat.
I can't even go into some of the stuff that went on recently because I'll blow my cover...my location would become so obvious.
My nursing registration is only safe as long as I stay away from the wards.
You know, what really makes me riled is that I, having failed to find a job read this and think "why the fuck is this happening when I will get my nice shining new PIN and have no where to use it".
You really need to get the high up's to come down, and fill in incident forms all the time this happens. If that does not work, then go to the press. Only make sure you don't become the next Karen Reissmann.
Oh believe me I have got big plans for them. But it will be after I secure a job away from the NHS.
I am off with stress and fear and anxiety. The only way to protect my nursing license and my sanity is to stay away from there. I come home and I slink away to my room..I can't deal with husband or children I just need to be away from people...sometimes I am like that for days.
I know I know I have been saying it for months but the resignation letter is typed and I have a couple of interviews next week. Non nursing non health care jobs. Just to tide me over until this godforsaken house sells and we can go abroad!!
You want my job nursing student? oh wait, they are not and will not hire.
By the way congrats on qualifying!! You will be a great nurse.
like the blog... lots of sympathy and why do these tantruming people always apologise after the event, after theyve occupied your time and done the damage to everybody elses care? its squeaky wheel syndrome - you end up running around for the needs of a vocal minority while the demented old man and the wee lady who has chest pain but doesnt want to bother you go steadily downhill...
Sometimes I want to show the complainers the situations that are competing for our time and attention: I remember a day as the only doctor on a 22 person ward being harrassed and followed all morning by a very well 21 yr old who had come in with a mallory-weiss tear from alcohol induced vomiting and wanted me to take his bloods NOW and discharge him: - which I would have cheerfully done if I hadnt been trying to rescusitate and arrange ITU care for an elderly gent in septic shock and explain to his distressed family what was happening. The young guy actually followed me in to the elderly mans bedside! although beat a hasty retreat when he saw the moribund gasping sick patient and beat a hasty retreat... He was really shamefaced and aplolgetic when i did take his bloods and sort him out (after the sick man had arrested in point of fact) and althoug still furious that he had followed me about shouting and barged in on the patient and his family in some ways I was glad that he had done it as he certainly had seen a bit of the reality of what we all deal with and would hopefully have a bit more consideration if he became a patient in future
Anne
seen your comments around the blogland, I agree on everything you say about nursing care, having spent two years as an auxiliary and a year as carer in a private home I've seen the best and the worst of nursing care.
If the general public actually knew how hard the job is and how low staff:patient ratios are things may change, but I really don't see that happening any time soon.
I hope things get better for you soon.x
Anne, be careful, take a look at this over at the Ferret's place........the NHS is very adept at hanging whistle blowers out to dry ;o(
http://ferretfancier.blogspot.com/2008/01/open-honest-culture.html
The managers can bank on nurses making the best of an impossible situation, because historically we have never been able to organise collective resistance to unsafe ratios, etc.
When there is a clinical incident who gets to fill in the yellow form, why front line staff, of course ?
And how often are the managers implicated in these complaints......... try never ?
After the clostridium outbreak in Kent [resulting in 90 deaths] who took the rap........well x2 HCAs got fired, and a nurse and HCA was disciplined, but no action was taken against any of the managers it seems.
http://www.guardian.co.uk/society/2007/nov/13/mrsa.nhs
Anne
I'm really sorry, but not a bit surprised, to hear that things have got on top of you. I'm outraged at the situation you're put in on a daily basis - it's disgraceful!
Believe me when I say, that many patients do realise and respect the fact that the nurses are doing their best in difficult circumstances. Please don't feel guilty that you couldn't do better for them. As regards the difficult patients, you have my complete sympathy - I can't believe the way some people behave and the fact that there is no 'system' in place to deal with such patients.
And I feel very sad to hear that the 'bereaved' are now expected to tailor their individual grieving rituals to that of an NHS schedule. While that family may have been extreme in their behaviour, I admired them for sticking to their guns. I also admired you for facilitating them despite the huge pressure that you were under.
So, Anne, all I can add really is to say I'm sorry that nursing has come to this and please make sure that you put yourself first for a change - because no one else will!
Take good care.
Hi
First post I've ever read on your blog.
I remember now why the wards were stressful and really why outpatients is SO much better for me.
And your managers were where??
I hope you are ok and look forward to reading more. I sound like you are a fnatastic nurse... a lesser nurse wouldn't have helped her colleague at all.
Thoughts with you.
Your article has been very nice and informative for the peoples.They asked different method.
Thanks....
regards, saad from
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