Monday, 17 January 2011

Hold me Back

Well at least Journalists are allowed to have their little temper tantrums.  If I even look tired at the end of a 14 hour day of watching people die and about 10 relatives will go down to PALS calling me a sour faced bitch who needs smile lessons. Imagine if a Nurse or Doctor shouted "fuck it" or threw something down and shouted "fuck this I am not doing anymore"?  The camera never turns off for us, the loss of temper or frustration never gets edited out and we are always seen.  And compared to journalists we actually have a good reason to lose our cool.

I very nearly lost my temper with some visitors the other day.  To the point that I had to lock myself in a toilet to ensure that I kept my mouth shut.

It wasn't anything more than the usual nasty ignorant crap we get from them DAY AFTER DAY AFTER DAY over an over again. But it was like the straw that broke the camel's back.

I work with a Nurse called Amanda.  She works 3 shifts a week from 7AM to 9PM when she isn't doing night shifts.

Amanda is super.  At the end of every shift she stays over unpaid by hours to sort things like necessary paperwork and order checks to give the next shift a helping hand.  No one has asked her to do this.  She does it because she cares.  Can you imagine working a 14 hour day and then staying on by a couple of hours unpaid?

What she does is really helpful.  When I come on duty after her I am more able to get on with direct patient care because her extra work allows me to do so.  If she didn't stay over to do these things I would have to do it rather than getting straight to my patients.  Then they would accuse me of neglecting them.....

Last night at 9PM Amanda handed over to me as I was taking over from her.  She stayed on and did a whole bunch of stuff (answered the phone, checked orders, went downstairs to get me some blood etc etc).  This allowed me to get started with the bedtime drug round and check in on my patients simulatneously.  It was a big help as I also had a really unwell patient on top of all the other stuff that needs to get dealt with minutes into a new shift.

At 11PM, two hours after the end of her shift, Amanda was still at the Nurse's station.  She was doing some computer work for us Night shift girls that needed to be sorted at that exact time.  New patients had been admitted 10:45 PM  and their details need to be entered into the computer as soon as they arrive onto the ward.  Amanda kindly did this for me (I didn't ask her to) and it allowed me to continue with eyeballing all 19 of my patients, drugs for all of them, assessments for all of them, and deal with unwell patient's new orders.  

Had Amanda not hung around at the end of her shift I might have been so tied up dealing with all that shit that I might have missed something with a patient that could have turned into a mega catastrophe later on.  Thank you Amanda.

As Amanda was at the station at 11PM two visitors who had stayed late walked by her and spat "there is another 'angel' sat on her ass at the desk ignoring patients".   Pretty harsh words coming from a couple of cunts who probably don't work at all or ONLY work 8 hour days 5 days a week.

Amanda is a saint but she is stupid too.  Never make the kind of sacrifices that she is making.  The public just throws it back in your face.  I very nearly told those two visitors exactly what I thought of them.

I was already in a foul mood that day.  Earlier in the week I had a patient go into congestive cardiac failure secondary to fluid overload.  Her IV fluids had to be STOPPED. Or she would have died.  We gave her some IV furosemide and she improved.

Cue the family seeing her IV fluids stopped and marching up to me.  "Why are my mother's fluids not running?".  I explained about the fluid over load and the CCF but I wasn't getting through.  These people had already decided that I was trying to dehydrate their mother to death long before they spoke to me.  So they walked away from me and went up to a cadet nurse (thinking she was a nurse) and asked her.  Of course a cadet doesn't even know what CCF and fluid overload even is.  Then the family marched up to the Nurse's station where a doctor (who didn't even know the patient in question) was sitting trying to review some notes on a patient that was referred to him.

"Those two Nurses (pointing at me and the cadet as if we are criminals)  are trying to kill my mother by refusing to hang another bag of IV fluids".  

I thought this was pretty funny considering that we need an order from a doctor to hang more IV fluids and we CANNOT just hang them because we think a patient needs them.    And of course the order to stop IV fluids had come from the doctors anyway.

The doctor looked like a deer trapped in the headlights. He didn't know the patient but here he had some crazy family member who assumed that he was responsible for all patients on the ward and that he   was also the "supervisor"of the Nurses.  I don't think I have ever been hired, fired, or supervised by a doctor in 14 years of Nursing.  This relative was looking at me real smug, as if she thought she was going to get me in big trouble with the boss.  The meaner she got, the nicer I was and that really made her go mad.

I explained the patient's situation to the doctor.  He told the visitor the exact same thing I did.  And she was happy with his explanation.


This has more to do with visitors having a prejudiced and 19th century view of Nurses than it had to with any concern they had for their mother.

In the old days criminals and prostitutes were pressed into Nursing when they didn't want to be there.  They needed close supervision and threats to ensure that they didn't harm the patients.  During the American Civil War (1861-1865) woman were considered out of place as Nurses and soldiers who misbehaved were put on "nursing duty" as a punishment.  That was your Nurse workforce.

Fast forward to today.  Medical care is so complicated that even the Nurses need a good education to deliver it.   I had to work my butt off to get into Nursing school overseas.  I had to have top grades and be in the top percentage of my class.  I had to pay a lot of money out to qualify and take an expensive state board exam.  I have to pay a lot of money out every year to stay qualified and continue to update my education.  If I didn't do all that I couldn't be a Nurse.

I never would have made it if I didn't want to do it and take it seriously.

But members of the public still think that Nursing is a "terrible" job that losers are forced into doing.  Therefore they think they have to stay on top of us.  The viewpoint is also exacerbated by the fact that Registered Nurses are the lowest paid of the public sector professionals in the UK.   This isn't because they actually deserve less.  A hospital RN has a lot more on his shoulders than a teacher or a cop does.  Nurses  are undervalued in a system that is forced to make financial cuts on the frontlines of health care.  

In countries like the USA a bedside direct care Registered Nurse earns far more than a police officer and a teacher.  They earn more than most 3-4 year graduates upon the start of employment. I was out earning my stepsister ( who holds a master's degree in journalism from Medill) immediately upon my first job as a bedside  RN in the USA.  I provided direct patient care (all aspects of care from cannulation, to orders to shit cleaning) to a team of 7 patients.  I think that gives people over there the idea that maybe just maybe Nurses  are a bit skilled, important, and serious about their work. 

These negative views held by the British public are all the more inflamed and reinforced by the terrible state our hospitals and patients are in as a result of poor RN staffing, resourcing, incompetent management etc.

I hope that this blog has helped people to see that there is more going on here than the simple "Oh the Nurses are just a bunch of pigs who don't want to be bothered" scenario.

But I don't know I don't know if it is even possible to educate people about what is going on in our hospitals.  They just want someone to blame when the idea that their loved ones and themselves are not immortal.  They want someone to blame when they cannot accept that sickness and old age are ugly horrible things and that medical science doesn't have all the answers.

Reminding myself of all this helped me to keep my mouth shut and not go into smackdown mode when those people insulted Amanda.

Let's watch Bill O'Reilly meltdown one more time.  Isn't it just so stressful to be sat a desk reading for a teleprompter?  Christ if anyone at my hospital acted like this ever we would be gone. Immediately.

Imagine this little princess having to deal with constant interruptions whilst she was trying to calculate a drip to stop someone from dying and getting blamed for their death.

Here is another one.  Aren't these reporters so professional?  These guys would be the first one on the story if a Nurse panicked and shouted "oh shit" when she realised that her 16 year old patient stopped breathing.  I am sure that the patients and relatives would be running to PALS and the papers if they heard an explective come out of the mouth of a Nurse.  Makes me laugh.  He doesn't look like he is having a tough day at work to me.  None of them do.


Nurse Anne said...

Wish I had an edit and a do over button at work.

uknurse said...

This post reminded me about a complaint once made about a colleague of mine. She is an angel in every sense of the word - probably the most caring nurse I know. One hectic night shift in A&E she had gone 11 hours through the night with only a slurp of cold coffee, no food, no wee, no break to take the weight off for just 5 minutes. She was seriously flagging (as ANYONE would, burning that much energy without food or drink).

Towards the end of the shift, some relative called her a moody bitch (ironically the patient was horrified)and reported her the next day for not having a smiling face, and >>> for having a few strands of hair loose out of her pony tail, hanging around her face.

"She looked messy" apparantly.

I'd like to see how tidy these people look after a few rounds of chest-compressions in a hot and sweaty resus room, hungry, dehydrated after 11 hours on their feet.

Sadly, it all contributes to a new career path for me..........

Nurse Anne said...

I have seen the same thing happen to my colleagues.

The public is crazy.

The best is when they interrupt you when you are trying to get hypostop into a nearly comatose patient to ask about "what is happening" with their loved one who only just arrived to the ward.

Then they act all paranoid and accuse you of not wanting to "share information" because you wouldn't drop what you are doing and speak to them.

What these people need is a job where they work a 14 hour day and are put in the situation where stopping to exlain to "customers" what the "plan" is gets someone else killed and themselves held responsible. I want to see if they look nice and smiley at the end of those 14 hours as well.

Until they experience that firsthand, they will continue to be pretty dumb.

Nurse Anne said...

I nearly kissed my stepsister the other day.

She had a baby in America after a long labour.

She had the same RN with her all night.

And she says to me "the Nurse who looked after me for 12 hours straight was always so nice and professional. How do you people do that? If I worked for 12 hours straight all night long dealing with the same person over and over again I would punch somebody!".

I said all human beings would feel that way. Nurses are just superhuman 99% of the time. And the 1 % of the time that we lose it will end our careers in a heartbeat.

Dino-nurse said...

I have a little voodoo doll in my desk lol
The history of nursing in the UK is a little different due to heavy involvement by the church and other religious groups- it was often seen as a worthy profession for spinsters from wealthy backgrounds. Dear old Flo of course played her part. Biggest problem is the idea that if you pay too much then you will attract the "wrong" sort...apparently not the case with doctors. Its also female dominated, although thats not the case in all countries.
What we need is a proper fly on the wall style documentary set in ED and AAU- much like the recent channel 4 series about the cost of drinking etc in the young or that other one Coppers (so plod thinks that the great unwashed are a pain in the arse...who would have guessed!). What we get are soaps like Greys Anatomy and Holby City and this is what the ignorant believe.

Anonymous said...

very interesting video

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