Wednesday, 17 June 2009

A Journalist Becomes A Nurse: repost

I am probably committing a major blogger no no but I just feel the need to repost this article.

It was written by an editor of The Wall Street Journal. He made a career change into nursing at age 40. Long story short he had only 3 patients and he found it difficult. He says he felt like a moron compared to the other nurses at times. He couldn't cope with the physical or mental demands. He needed cash. He got the hell out and went back to journalism.

Why am I re posting this: I recently read a comment where someone (possibly a journalist) made a comment about nurses being intellectually incapable of handling a debate. Nurse at my university (overseas)were held to higher standards than other students academically. We were told that we had to be better than your average student because of all the life and death responsibility in difficult conditions that we would have. When we graduated we had higher starting salaries than most other new grads started on after 3-4 years of Uni. Other countries do not hold the same kind of contempt for people that go into nursing that Britain does. The class system here has a lot to answer for in my opinion. Many people with degrees in other fields flunked right out of nursing school.

What is my response to non-medical people who are horrified at the idea of their bright child wanting to become a nurse?

Your child can be bright and academic and go to nursing school. The school won't take you if you can't hack it. Your child may even find it difficult. When they qualify they can go to the USA or Australia and make lots more money than you do. They are certainly going to have to use their brain on the job more than you ever did.

Bedside nursing is not a job for stupid people. Really it isn't.Walking onto the ward as an uneducated simpleton who cannot think with the responsibility that an RN has in the 21st century is insane. And it is a good way to get you in a lot of trouble with the law. If you kill a patient and then try to defend yourself by saying "oops I didn't know because I am just a stupid nurse incapable of doing anything but mopping brows" you are not getting off the hook.

Anyway I am rambling. Read on if you can stand it.

This is the kind of stuff we need to see from British Journalists. Unfortunately they do not have the gonads, the brains, or the work ethic and integrity to handle nursing.

Here are some excerpts.

"In 2002, at age 40, I left my job as a page-one editor at The Wall Street
Journal, my professional home of 15 years, to take a giant leap of faith -- in
myself. Like a lot of people, I questioned my purpose after Sept. 11, 2001.
Jolted from the complacency of a comfortable career, I became convinced that I
could achieve selfish fulfillment through devotion to service -- to the
individual, to the community, to the vulnerable.I considered teaching. I
considered law, medicine, pure science and research. But my thinking always
returned to the nurses I had watched care for my mother a few years earlier,
when she lay in an intensive-care unit in her final illness. I marveled at the
way they melded an aloof, precise professionalism with a mysterious human (and
humane) instinct. They seemed to operate in a purer space, beyond worldly
distractions. I would be a nurse."

"My skills were those of any new nurse. With easily shattered confidence, I
could start an IV, administer medications, bathe a bed-bound patient and change
linens, change dressings, insert all sorts of catheters and tubes, read lab
results and electrocardiograms. I knew to be vigilant against infection,
pneumonia, pressure ulcers, medication errors and the many other lurking threats
to hospital patients. On the burn unit, pain control loomed large. I also knew,
as both executor of treatment plans and patient advocate, to keep a close eye on
what doctors ordered. They make mistakes, too.

But in those first months, I felt stupid and slow, and thus dangerous. I
hadn't yet mastered the ruthless efficiency of thought and motion that lent
veteran nurses the appearance, at least, of enviable ease. Next to my crazed
back-and-forthing, they floated around the unit, maintaining a cool composure no
matter what crisis erupted.

.Basic nursing duties were enough to keep me on my feet until dawn: initial
head-to-toe physical assessments; hourly vital signs and other monitoring tasks;
medications; bed baths and dressing changes; regular suctioning.

There could be no skimping, no coasting through a shift because of a
headache or trouble at home. For 12 hours, I belonged to people whose survival
was at stake. A sloppy physical assessment could later explode in disaster if a
potential problem -- a bum IV, an incipient pressure ulcer, abnormal lung sounds
-- went unnoticed. Rooms required meticulous inspection, too, to ensure that
vital equipment was present and functioning: A missing bag mask -- attached to
those blue vinyl footballs you see TV doctors and nurses rhythmically squeezing
in emergencies -- could cause lethal delays.

Good lord, this man only had 3 patients and some of them were no where near as sick as my 10-15. Please please please read the whole article.

Tuesday, 16 June 2009

Good God, we had a nice week.

A couple of really good things happened this week. First of all I have earned a hell of a lot of comp time for working unpaid hours over the end of my shift. The hospital cannot pay overtime and has demanded that we take the time back. I did a couple of 8 hour shifts. It's not like being at work at all. I loved the 8 hour shifts. I was able to come home and still have part of my day.

I cannot go into to much detail on here but between restructuring at the hospital etc we not only ended up with a few closed beds but extra staff from another unit. Usually we get their patients but not their nurses. It's really true, sometimes managers do not fuck up and the gods of nursing shine down on us. I am sure that the closed beds etc wrecked havoc in the rest of the hospital but on my ward, things were smooth.

Not only did I only do an 8 hour day but I had only 5 patients. Only 2 of them were acutely ill. That's right. A non nursing colleague of mine came onto our ward, looked at the numbers and said "Whew, Annie is going to put her feet up today". No chance my friend. I wanted to see if I could still nurse patients properly when I have a controllable work load and time on my side.

I immediately set out doing everything as it was meant to be done, my patients got a thorough nursing assessment and I caught onto a lot of stuff that was a bit worrying. It scared me to think about how much we miss on our usual rush days. When the consultants came for their rounds I was ready with any info they needed about the patients. I knew those patients inside and out. I knew every drug they were on, everything that happened since admission, every test result, what their normal level of orientation and mobility was like, social circumstances etc. I had a chance to read all their notes. It doesn't take a lot of doing to read up on a handful of people.

Usually the medics can barely find one of us to do the ward round and if they do, we are barely able to answer a simple question about the patient "John Smith? Oh. Is he my patient? Let me look through my handover sheet. You ask if he has passed urine yet......Um I don't even know what he looks like". It's no wonder that they think the nurses are all retarded.

The rounds went well. My patients were happy. I felt like they were getting the safest care I can provide. The drug rounds took 15 minutes rather than the usual 2 hours. Less patients means less people phoning and less time running to the phone.

Not only did we have a 1 to 5 ratio but we had an extra nurse to coordinate. She wasn't from our unit and there wasn't much happening so she busied herself with the important jobs that never get done basically.

I had one extremely sick woman who needed many interventions. The family made a point of thanking me for taking such good care of her, and they told me that knowing that she is getting good nursing care makes their sad situation bearable. They said that they thought that I had worked really hard and that they appreciated it, especially considering the horror stories that they heard about the place.

Of my 5 patients only one needed to be fed and the HCA and I fought over who was going to do it.

5 patients isn't always going to be easy. Had they been critically ill I would have been run off my feet. It's not always the number of patients you have but the acuity as well. I was lucky in the fact that I had a smaller than normal number of patients who were not very acute. Woo hoo.

And that's it. Soon the new units/beds etc open, all the beds will fill at lightening speed and the nurses we have will all be spread out even more thin than we are now. I got a letter from management addressing my concerns about the usual state of the staffing ( I last wrote to them months ago). He was pleased to inform me that we are getting 0.5 of a cadet. Uh uh.

Monday, 15 June 2009

A Powerful Comment

I believe every word of this comment that I am going to post below. These problems are more common than you think. A young male patient attacked my charge nurse and gave him a fracture and the judge let the lad off the hook. He attacked the charge nurse because it was "taking to long" to get discharged. The nurse was tied up giving IV meds to an unwell patient. What was management's response? "What did you do to make the patient so angry that he needed to do that?" Came from the same people who don't understand about staffing the wards properly. They don't see nurses as human beings....kind of like the members of the general public who walk onto a short staffed ward and start raving about the fact that grampa hasn't had his 8AM antibiotic yet (it is 8:03). "Are you nurses too stupid to understand that drugs need to be given on time?"

This comment was placed on this blog under the Why don't nurses smile? post.

Nurse Nancy said...
I used to work in A&E in a very busy city
centre hospital. (I had 15 years experience of working in A&E.)There used to
be 2 hospitals with A&E depts but it was decided that the city really only
needed one. They therefore closed one down and now all the patients had to go to
one department. Same number of staff on duty though.

Who would have thought that waiting times would get longer, that patient
care would suffer, that the staff turnover would increase as people could not
cope and left and that the general level of violence towards staff (due to long
waits etc)would double. I particularly recall one shift where I was the nurse in
charge with 5 other staff nurses working with me. We had four critically
injurred patients from an RTA each requiring their own individaul nurse and Dr.
This meant that there was just me and another staff nurse and a HCA to care for
all of the walking wounded who now had an even longer wait because all of the
medical staff were tied up in resus with the RTA.

The two if us also had 17 other trolley patients to care for, all of who
were acutely ill or injured, as well as trying to carry out dressings etc for
the walking wounded who actually did get seen. On top of all this we had to try
to get patients to x-ray - some of who were unsafe to be left on their own - eg
patients with dementia who had fallen and fractured things and had no relative
or care home staff with them.

Whilst i was running round the department with a broom up my arse sweeping
the floors as well i was approached by a woman who was concerned that her son
who had been brought in by ambulance had still not been seen by a dr having been
there for 3 hours (he was drunk and agressive). I have to admit that she did not
think that i was taking her concerns very seriously decided that the best course
of action was to shout at me that I was a fucking blonde haired cunt and punched
me in the throat causing me to fall back through a curtained trolley bay onto
the lap of some poor old man. Her and her son decided not to hang around after
that so at least we were one patient down.

I remember standing in the middle of this heaving and chaotic department
and thinking would anyone notice if i just sat in the middle of the floor and
had a nervous breakdown. What happened to the nice lady who assaulted me? She
got a conditional discharge for 6 months (let off in other words) and had to pay
me £50 compensation at a rate of £2 a week. What happened to me. I now
work in the civilised realm of a primary care trust as an advanced nurse
pracitioner for the elderly - nice work if you can get it!!

15 June 2009 06:21

Direct Quote from an NHS Pen Pusher.

No, I am not going to post the identity or link or any such thing. If you don't want to believe it then that is fine with me. This is a direct quote word for word from an NHS pen pusher.

"I have worked in the NHS for nearly 10 years. I am one of
those non-clinical, overpaid bureaucrats who are regularly slated in the press.
I totally agree. I got into the job by accident, stayed because of the
security/salary/maternity pay/benefits . I'm desperate to
do something more useful than sitting at a desk, sending the occasional email
and trying not to fall asleep at meetings.The trouble being that there are NO
part-time jobs ANYWHERE.So I should be grateful for my job, I suppose.But some
days I want to phone up The Sun and tell them how scandalous it is that people
like me get paid to do nothing but push paper around, --make up-- write business
cases and go to meetings 'for information'.

Militant medical nurse is not at all shocked. This person is not a nurse manager by the way (for those of you who want to blame all the problems we have on the ward on different factions in nursing). The author of this quote is just a pen pusher.

Isn't it nice to know that when we are running our asses off , not taking breaks in order to up the chances of getting around to all of our patients and getting interrupted every 30 seconds for 14 hours straight ......that some pen pushers are getting paid to do sweet fuck all..................