Sunday, 19 April 2009

Why Doesn't Nurse Anne and her Crew Work Somewhere else?

Let's see.

Okay let's start with my hospital.

First of all there are not a lot of jobs being advertised around here. Once upon a time a few years back a practice nurse job came up in the community. There were hundreds of applicants for that one post.

There have not been any staff nurse jobs advertised at this hospital for a long long time. The very few that do come up are on wards like mine and they are merely replacing people who are retiring, rather than increasing the staffing numbers. They are not even replacing all the people who leave, just a few. No change there then. I have covered shifts on these very same wards and would have to be dragged back kicking and screaming. It can get worse than Nurse Anne's ward. A lot worse.

The specialty areas such as CCU, and ITU etc are not hiring at the moment. When they do, I will be putting an application in along with many many others.

A&E. Ours is violently short staffed. I do not see any job postings for that department, and haven't seen any in years. James (an excellent newish qualified staff nurse on my ward) kissed some arse a few years ago and managed to get a job in our A&E dept.

From the very first day (with no nursing experience except 6 months adult medicine) he was in charge of bays down there with no induction, no named mentor, and no one willing to help him. There were traumas, paediatric cases, gynae cases etc. He was lost. He got real scared. He was really looking forward to working there. After a week he realised that he was never going to get any kind of orientation or a named mentor. If he asked a question the doctors complained that he was slowing them down. The nurses were like a freaking blur, running past at top speeds. He got yelled at more that week than he did in 6 months on my ward. He begged to come back to my ward. Is has to be pretty bad to want to come back.

There is so much that one needs to learn to be a nurse and you cannot learn everything that you need to know for every specialty during your school years and clinical placements. This has nothing to do with nurse training and everything to do with medicine and health care becoming more complex. And A&E is rough for people who do know what they are doing. The A&E charge nurse was no help to James. She was spending her days getting yelled at because of target breaches. James and I know that the real problem with waiting times in A&E are the lack of beds and staff over on the wards.......the delayed discharges.

James is back on my ward and thank goodness for that. I am so glad that they let him come back. He is a hard worker and very caring.

But this story illustrates the problem I have with just leaving the wards ( which is all I know) and pissing off to some specialty unit where I have no experience. I know for a fact that at my hospital that they will just throw someone like me (or James) in to the fray with very little in the way of orientation. The specialty units at my hospital also struggle with staffing. All it would take is one person to be off sick to find myself in charge of patients on a new unit my third day there. I would just be told to cope. I would just be thrown in to sink or swim.

It's like the day they covered sickness on my ward with a newborn nurse and expected her to take charge of 12 adult medical patients. So even if a job came up in the few specialty units that we have, I doubt I would apply. And to those of you who say "back in my day when you came out of training you could run any kind of ward anywhere" can piss right off. It's different now. The nurses today need to know more than you ever did in order to function and they have a lot more liability these days. They are working in a more chaotic environment then you ever did. Come back into the hospital and give it a try yourself my dear, otherwise you can shut up. Seriously, I want to see some of these retired old dears come to work on today's wards and take on 16 medical patients alone, taking on full liability for not getting paperwork done, med errors, missed assessments etc. I will grab a box of popcorn and observe them walking a mile in my shoes. It would be more fun than a night at the cinema.

There are nice units like the 12 bedded urology ward or the 8 bedded gynae unit. I'd like to try ortho. I would be there in a heartbeat if they posted a job. I check every day. I am going to die waiting I think.

When jobs come up at the city's private hospital everyone applies. Those jobs don't seem to be too forthcoming either.

Let's look at the other hospitals in the trust/area. I have looked. The answer is no way. The staffing levels are worse. The decent units are not posting jobs, I cannot afford the commute anyway. A couple of my nurses are refugees from those hospitals. We are talking 35 bed medical/elderly units with 1 or 2 nurses and 1 care assistant. ..left alone with an occasionally violent psyche patient who no one would transfer out...FOR A FUCKING YEAR. The two staff would spend the shift trying to keep this guy from hurting another patient. They did everything they could possibly do. Medics said he was a mental health patient and turned around and walked away. Mental health said he was a medical patient and turned then around and walked away. Yes, a couple of my nurses are refugees who escaped from there. That place nearly killed these women. They do not mind the cost of the commute to work on my ward. This hospital isn't posting any jobs that I am aware of anyway. I do look every day just out of curiosity. The person in charge of that trust will look you straight in the eye and deny that there is an issue with staffing and say that they are hiring.

Right so next nearest hospitals in other trusts are at least 2 hours away. Spouse will not consider moving or commuting. He has a stable job but the market is shit in his field. The housing market is fucked. My older children are nearly teenagers and do not want to be uprooted. These other hospitals don't have great reports coming from former staff. And they aren't posting any jobs for staff nurses, not as of the last time I checked anyway. When I look at the options around me I am thankful for what I have and where I work even though it is a hell job. At least I work with good people?

Does bedside ward nursing really need to be this horrible? Does it have to be? As long as it is, we will keep haemorraging nurses, and things will get worse, and we will lose more and it goes on and on and on.

We have newly qualified nurses at my hospital who have only been nursing a year and they are already starting the process to go to Australia. Some just quit. They are young, live with mum and dad and do not have kids and mortages yet. They can just throw in the towel and quit. Ask anyone what is the worst thing about it the 14 hour shifts? The life and death responsi bility? The fear of liability? Those things get us close to the edge. But the unrealistic expectations and abuse from the relatives of the patients is pretty much what sends you over.

I am still always looking around for other options. I am sure I will figure out an escape route soon enough. Something will come up. In the meantime I will do my best to take care of my patients, write letters to the powers that be, fill in incident forms and blog on here and vent away. The blogging makes me feel better anyway.


Anonymous said...

It was like that in the States in the 90's. It is becoming like that again. The jobs are drying up, even though the media is squalling, "Nursing shortage!" I think most every nurse can understand why you can't just pack up and move on. For one thing, it is extremely stressful to change jobs in this profession. Most every place I ever worked, I just got thrown out there to sink or swim. And sometimes, I sank. And nursing is NOT the same today as it was even 10 years ago. These dinosaurs who haven't worked in 30 years need to sit down and shut up. I think nursing is in the fix it is in because of these prehistoric specimens. My prayers are with you. I hope it gets better for you. I hate to think of someone having to be uprooted from their family to make a living in a decent environment. Most other people in the free world don't have the first concept of what it is like to work under those conditions. It is sad, truly sad.

Nurse Anne said...

Thank you. I find the idea of switching jobs in this region more frightening than staying where I am.

"These dinosaurs who haven't worked in 30 years need to sit down and shut up. I think nursing is in the fix it is in because of these prehistoric specimens"

I love you for saying that.

Happy1 said...

"Why Doesn't Nurse Anne and her Crew Work Somewhere else?"

'Same shit different field' springs to mind...

Anonymous said...

Accurate in every detail and can generally apply to any hospital I've worked in and continue to work in London. Appalling and very true.

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