Message from An Ex-Nurse friend of mine

RN's are leaving the wards in droves. A small number are going into nurse practioner and pen pusher type roles. A larger number of us are perfectly happy to take pay cuts to get the hell out. Lucky for us our husbands and partners tend to not work in health care and are generally the breadwinners.

The following is a message I got from a friend when I poured my heart out to her and it is an example of the types of emails I get all the time at militant medical nurse.

"That's why I got out of nursing. I let my RN license lapse when Becky was little, got a job as a secretary at a car dealership on minimum wage and felt so relieved.

When I worked in maternity on night shifts and if weren't busy they would pull me and send me to be in charge of a medical-surgical floor where I knew no one and nothing about medical-surgical and there were forty patients! And then the doctors were so mean and arrogant! I knew one doctor who said she deliberately wrote orders sloppily so she could read it any way she wanted if she was ever called to court, thereby letting the nurse take the fall. Their abuse of the nurses was horrific, and the patients were worse. I admire you for what you do. I know it's so hard the way things are set up. Aimee is thinking of nursing as a career and I tell her to do something else! I would never go back if I was starving even. Believe me I have had my share of financial troubles. But I won't go back. Take care."

This is from a nurse in North Carolina, where the pay and working conditions are generally much better than what you see in the UK. No wonder UK nurses are leaving...one or two become doctors, a few find jobs in the community, the rest escape healthcare altogether and so on and so on.

Doctors: Know Your Place Shut Your Face

Many doctor bloggers are talking a lot of shite. They seem to see the degree nursing issue as a threat and are convinced that BSc nurses want to be doctors. What a load of horseshit.

In Witch's post it was mentioned that apprenticeship is going out the window. If anything it is growing and will continue to do so. Even now there is usually only one or two trained nurses on the ward and everyone else is an untrained apprentice getting on the job training only. They are not training to be nurses yet as that is years away. They are training to be health care assistants. Theyhave the option to go to uni later on and train as a nurse using credits from their apprenticeship. Nice people a lot of them but the lack of knowledge is scary. Most of them have no desire to actually become Nurses.  They don't want to deal with the stress, the drugs, doctors, emergencies, etc etc.

Their lack of knowledge is appaling. That is because apprenticeship style training only is crap. Most of them are very nice to the patients. But then they do something stupid like open an IV pump up and take the tubing out (so that they can change a patient's gown and weeve the IV line through the sleeve) without clamping it...when potassium is infusing.  They don't understand a thing about heart failure and tell patients on furosemide that the sure do wee a lot.  Stupid things like that.

Let's be honest: Doctors do not know anything about nursing, nursing issues etc etc. Nursing is a completely different science and profession from medicine. Please stick to diagnosing, prescribing, where to get the best cocaine and cheating on your wife. Leave the nursing issues to the RN's.

 Let us nurses talk about education levels for nurses,

Let 's get some facts straight.

Degree nurse does not equal nurse who doesn't believe in doing basic care herself. Quite the opposite.

My university  required us to be in the top 10% of our high school class and have two years of university level science and math with top grades to get into their nursing program. They had 50 applicants for every one place each year. We were taught by masters (and higher) degree nurses who taught us the importance of being good bedside nurses.
 
The university nurse training in England has as much on the job training as the old style training did.
When California instituted nurse patient ratio laws ensuring that each degree educated RN have no more than 6 patients in hospital (ensuring that the RN can nurse them properly and avoid malnutrition etc) the number of applicants to their nursing program that year rose dramatically. Something like 80,000 RN's came back to the workforce as well. To do bedside nursing. Yeah.

Anyway I responded over here with the following.


Degree trained nurses are not taught to be above basic care. They get plenty in the way of hands on placements. They are always on the wards for weeks and weeks at a time.

There is not such thing as "the modern nurse who thinks she is too posh to wash". That is a myth perpetuated by fuckheads who don't know better or cannot understand the situation. I am degree trained, have nursed for many many years, and have worked with many new grad nurses.

I have yet to meet any highly educated nurse or any RN who thinks that he is above basic care. Most just are not in a position to do it. So I am thinking that maybe you are just a liar, or a goofball repeating statements that you don't understand.  To posh to wash nurses must be out there someone, but they are rare. It's not something I run into as a bedside nurse among other bedside nurses.

I trained at a well respected nursing school in the northeast. I had to have two years of uni level science and math and top grades to even be considered for their nursing program. I was able to take it together and stay in if my grades were high enough.. And even then they had over 50 applicants for every one place.

Our nursing instructors had masters degrees in nursing, doctorates in nursing and PHDs.
They taught us to be bedside nurses. They hated the medical model of care.

They taught us that hospitals should not be using care assistants instead of RN's and that highly educated nurses should do all care. They taught us that if we didn't do basic care ourselves that are patients would not be assessed properly and that would lead to poor outcomes. They taught us that nursing was a completely different science to medicine and that we were nurses not junior doctors. They hated the whole diagnose and prescribe thing like the devil hates holy water. Their degrees were in nursing, not  medicine.

These same instructors, despite holding master degrees and higher still did shifts at the hospital as bedside nurses. They attended our placements with us, and needed to be up to date. Therefore they stayed in touch with basic care and reality.
Not every school of nursing is this good but they should all be. 


They taught us that if we were ever working in facility where we were taking on more than 6-8 patients at a time that we needed to get the hell out of there and find a new job. "If you are working for a hospital that makes you take 10+ patients you will have no choice but to triage and delegate all basic care to care assistants. THIS IS BAD. Never EVER work for such a hospital". These were nurses with masters degrees who were teaching us these things.

"such a hospital" is every fucking hospital in the NHS and most of Canada and the USA.

The new grad nurses are very well aware that people think that they are too posh to wash. When patients are having an acute atttack of CCF and are short of breath these new nurses are putting people on bedpans and handing out meals rather than notifying the on call and getting orders because they are so afraid of being labelled as "uncaring" by visitors, health care assistants, and guys like you.  How sick is that?

Remember you only have one nurse for a large group of patients. If she isn't getting the diuretic drug etc for the heart failure patient who is going south then NO ONE is.

You wouldn't believe the scare stories that are happening because many of these new grads are on a mission to prove that they are not to clever to care and all that. I have seen patients with an HB dropping faster than a hooker's knickers not get intervention nor their blood  transfusions etc for hours and hours because the lone RN was getting grief off of visitors and patients for not getting the bedpans out fast enough.

You people need to stop it with this bullshit (perpetuating the myth that degree nurses are not into basic care) because people are getting hurt

I don't like your link but agree about NOT using degree nurses as pseudo docs. Is that clear?

Forget about the practitioner thing. I never met one personally. Even though I know many highly educated nurses I don't know of ONE who wants to be a practitioner. Not one. Not one.  I know they are out there but I don't think that they are as common as you fear.
If they forced all of us degree nurses into the practitioner role the vast majority of us would get the hell out of healthcare. Most degree nurses have no desire for the  frat boy, medieval world of medicine. Let's be honest: Medicine is simply about you guys swinging your dicks around to see who has the biggest one. No thanks. If I want to make more money I can uproot the family and go abroad and work as a nurse. Registered Nurses in other industrialised nations make more money than junior doctors in the UK.

 Read here and scroll down if you want to see how ratio laws requring degree educated nurses at the bedside with a very small number of patients brings RN's into the workforce and back to the bedside. And when the article in this link uses the term "Nurse" they are referring to university educated RN's.I agree with the doctors when they say that we should all just stick to what we know professionally. I will blog about issues in nursing and you guys please stick with the medical stuff. Blog about what you doctors know. Things like cocaine, philandering, cocaine, philandering, cocaine, philandering.

Re-Edited on 10/1/10 because of the glaring errors that result from my inability to type as fast as I think.  Notice that I did not take out the stuff about frat boys, cocaine, and sex addiction.

More on Degree Nurses

Want to fly into a violent rage? Or bang your head into a wall over the fact that some people have no clue? Read some of the comments here.

There was one good comment.

I haven't yet had the balls to look at the daily mail and their readers take on all this.

You will Need a Degree to become a Nurse

We just had a death in the family of the canine type, I have been reading BBC have your say, and I am in a real bad mood.

Here is the BBC article you have all probably read. I have been in mourning so I am behind with all this.

Here are the fucktwits on have your say.

I am in two minds about nurses being required to have a degree to qualify.

Let's talk about the pros first.

First of all a hell of a lot of research has shown that the patients of well educated bedside nurses have higher survival rates. Anyone who qualifies as a nurse will be thrown into a situation where he is own his own dealing with complex stuff, making life and death decisions and having to think fast on his feet with no second chances almost immediately upon qualifying. He will have to handle all this whilst getting interrupted on every 30 seconds or so throughout a 12 hour shift. Support? What a fucking joke. He will be the lone RN for a large number of patients with only untrained care assistants to help. This is how it's been for years. The matrons sure as hell won't come any where near the wards and it will be rare for our newly qualified hero to be on duty sharing a patient load with another qualified nurse to guide him. This is how it has been for years and it is getting worse.

Why are people in this country so silly? Why do they seem to have a death wish? If you don't think that your RN needs to be well educated as well as have a manageable number of patients you must have a death wish. You must want to die. You certainly don't really understand what a nurse actually is.

When I was overseas many patients would throw their registered nurse out of the room if she didn't prove on the spot that she had a university education. "Are you a BSN" "No sir I trained under the old diploma program" "Then get the fuck out of my room lady". Sad but true. Our older nurses are some of the best simply because they have decades of experience behind then and have proven that they have the tenacity to hang on in this hell profession. But people over there seem more switched on and seemed to have more of an understanding of what a nurse actually is. People in the UK do not understand what a nurse is.....

The old ways of training turned out good nurses for their time. The nurses that trained that way who are still practicing are excellent. They have decades of experience behind them and have grown with the changes. If you tried to train today's nurses like that however you would increase hospital mortality rates. The old training would not suffice now. As someone who has a strong desire to live and who will be a patient some day I have thought about this a lot.

I would thr0w a caring and empathetic nurse who couldn't get through pharma maths at Uni out of my hospital room . I don't give a goddamn about how caring or empathetic you are. I want to stay alive. If you are a caring and empathetic but not that bright I have less chance of surviving my hospital stay. I hope you are caring but first and foremost I want you to be on the ball because I know how much information you will be analyzing and how fast you will be moving and it is scary. I say this as someone who has been a nurse for well over a decade. I say this as someone who has seen patients die because their caring nurse was off helping hand out commodes. I say this as someone who wants to live.


Let me link to it again in case ignorant sickos like Jeremy "But what about the caring"Vine happen to be reading. It's all in the link...just scroll down. Or google nurse education and mortality rates.

Research has shown over and over and over again that hospitals that have a higher proportion of well educated nurses on staff providing direct patient care have higher survival rates.

If I had a registered nurse caring for me who didn't catch onto the fact that I was going into renal failure or was pre -arrest because she was lovingly off somewhere else bathing and making cups of tea for her other patients I would get her sacked and get her license revoked. I would also have a strong desire to beat her to death with a hammer.

Actually I suppose my next of kin would be handling that because I would be either in ITU as a result of failure to rescue before the problem got to big...or I would be in the morgue. If my nice caring but not so bright nurse doesn't catch onto my deterioration in condition who will? Anyone who is an RN will find himself alone with a large group of patients and no back up other than untrained carers. The carers won't catch onto my change in condition unless it is blatantly obvious. When it is blatantly obvious it is too late. This is why the nurses need to stay on task with assessments, labs etc. The docs are NOT around to do it, they won't do it and the nurse will take the heat over any failure to rescue screw ups. This is real life not television where the docs are always around the patients and the nurse is just their assisting. That is not real life.


I swear to god that if I , as a patient, caught my RN making tea and making beds rather than dealing with the things that the carers cannot help her with I would be on her ass like flies to shit. I want to live. So should you. The older trained nurses we have now have been around the block about a 1000 time and done a lot of continuing education. They certainly know what they are doing. Don't worry about them. What I am afraid of is a 19 year old here in 2009 who wants to be a nurse getting trained like they did in 1972 and then getting thrown onto the wards in the current situation.

Now that I said all that about dying and needing intelligent nurses let me explain why I think that the all degree qualification for nurses rule is stupid and pointless.

Management does not actually want to staff the wards with trained nurses. On any given shift the majority of staff are untrained carers who do not understand your diagnosis, history, complications, the way your symptoms present and your drugs. The knowledge of all these things is extremely important to nurse a patient properly.

Currently, most of our actual nurses are NOT degree trained. There are 3 kinds of nurses. There are the ones that trained long ago under the old system (most of our current nurses fit into this group), there are nurses who trained in 3 years at uni and obtained a diploma, and there are nurses who trained in 3 years and got a degree (the latter is the smallest group).

I have a degree, my ward sister has a diploma. We are both RN's. We will rarely ever work together because of management. They are dicks. When I am on duty I have a large number of patients with only carers to help and when she is on duty she is also in that situation. They won't ever pay for any more than one RN to be on duty for the same large number of patients whether that RN is old fashioned trained or university trained. Management only wants to hire untrained carers and they want to have as few actual nurses as they can get away with.

This is why nursing care is so bad and a degree won't mean much if they are going to continue to staff the wards in this manner. I want my nurse to be smart, but if she is on her own with 15 patients we are both fucked.

It wasn't too posh to wash registered nurses who wanted these untrained carers brought in to the hospitals. Registered nurses are left with no choice but to delegate all basic care to untrained people. We hate this. It screws things up for me. It screws things up for the patients.

Hope that your nurse is smart enough to get a degree, and hope that she has a manageable number of patients so that she can stay on top of basic care as well as everything else. This is what the nurses want. It is all linked. When this becomes the norm staffing wise, nursing care in our hospitals will improve. Until then, no expensive quick fix band aid will succeed.

Happy.

It's not all bad. There is that .1% of the time that my job is great.

We lucked out times two the other day. First of all we had 3 staff nurses on duty. Usually that would not be enough. But something else happened that was lucky.

The same random force that can throw all critically patients at you when you are more short staffed than usual can also throw all stable patients at you when you are well staffed.

Actually there was a third lucky thing that happened. The bed manager will usually float a nurse away to another unit if we have more than 2 on duty. But she didn't on this day.

Only two people were on IV meds. No one was acutely ill.

Since there were three staff nurses we decided to put one staff nurse for each group of 14 patients with yours truly in charge and coordinating.

This allowed the staff nurses to get on with the care uninterrupted while I sorted the doctors rounds, the phone calls and intercepted any interruptions before they got to the primary nurses. I answered call bells, assisted the HCA's and made sure that the primary staff nurses were left alone to concentrate on their drugs and the rest of their job. I got their insulins and IV's out of the way for them to save them time. I helped the HCA's with daily care.

I babysat a confused and wandering patient to keep her from escaping to the motorway on foot and half naked yet again. The previous day when there were only 2 staff nurses on it took them until 11:30 AM to get all the 8 AM meds out. On this day because I was there to intercept interrutpions and deal with problems they were done at 09:15 AM.

When our main consultant showed up for his round I approached him, introduced myself as the nurse in charge and told him that I would be attending the ward round for the whole ward and I knew all the patients very well. I had done two night shifts recently and had time to read all the notes etc. He looked surprised. I explained that I was an extra nurse today so we are coping well, and that there would be two staff nurses on the ward attending the patients while I was on the round (which takes 1.5 hours). He was really pleased.

I like going on the ward rounds. It's easy to trail after the docs and answer questions and take notes. I won't even consider attending if it means I have to abandon my patients for hours without having another RN keeping on top of their care. That is just hasking to get hauled before the NMC. I always learn a lot from ward rounds and it helps me get a better handle of what is going on.

Not only did we get everything done but we got it all done well. The patients were happy and the next day a relative gave us a beautiful thank you later. We even had lunch midway through the shift. That was cool.

Just one extra staff nurse and lower acuity allowed for this!

We have approached management asking if we can always have a senior nurse in charge and coordinating every shift just for this reason. Two words: Shot down.

But I will enjoy these rare days when they occur. On these days I am glad that I am a nurse.

Paranormal Ward

So once upon a time I was one nurse to 80 million patients and.....

I just had to start off with that line because that is how every damn post on this blog starts.

But this post has nothing to do with all that.

I had the idea to blog about possible paranormal experiences of health care workers but I put it off for months. I felt like most of the readers on here seem sensible and probably wouldn't care for supernatural stuff.

But what the hell. It's Halloween. Let's rock out with the ghost stuff. Grab your sweets and let's go.

Some of these things really happened to me and some have happened to colleagues and friends. I know I know: Dying brains hallucinate and so do tired nurses.

1.I was a brand new graduate nurse on a cardiac unit once. Didn't know my arse from a hole in the ground nor did I believe in anything stupid like ghosts and supernatural happenings. The older nurses who precepted me set me straight and made me a half decent nurse. They also nearly made me goddamn believer in the paranormal.

Peggy was my mentor and we were on duty together one evening. She had been a nurse for 40 years and was cool as a cucumber. We were looking after a man called John. He had some cardiac problems. John, a 48 year old man, was one bad dude during his life. Real bad. He had been in and out of prison for everything from drugs to rape to violent attacks on innocent people. Nurses always went into that room two at a time and security was outside.

John got better. He was discharged home by his very competent doctor. He was waiting for transport back to maximum security. He may have been an evil dick but he was orientated and with it times 3 normally. No confusion whatsoever.

But all of the sudden we heard him start screaming his head off "Help Help Help". Peggy and I legged it to his room.

"You goddamn bitches better get that motherfucker in black out of my room" says John.

"We don't see anyone in your room John so calm down and tell us what is happening. Are you feeling unwell? Are you have chest pain?" says I.

" NO i AIN'T GOT NO PAIN. Listen to me you fucking whores. That dude is standing right over there in the goddamn corner. He is wearing black and he is looking at me. GET HIM THE FUCK OUT OF MY ROOM." says John.

Peggy and I went through the motions of looking behind the curtains, in the bathroom etc. No dude in black was seen. John, however, thought he saw him and was getting really angry...fearful I think. We tried to reassure him as much as possible and stepped back in the doorway. He had denied any pain etc.

"Anna get the crash trolley" says Peggy quietly.

I couldn't believe what she just said. "He's fine, maybe he has developed an infection and he is confused. Why do you want the crash trolley?"...I giggled.

"Anna that man is seeing the angel of death, the bad one. Get the trolley and put the crash call out." says Peggy. She said this in a very serious tone she gave me a little shove in the direction of the crash trolley we use for resuscitation.

Now I am laughing at Peggy and saying "You are nuts..he's not gonna....

And as I was in mid sentence John's eyes went real wide and he collapsed in his bed. I may have been a newbie but I knew a sudden cardiac arrest as soon as I saw one.

Now I ran for the crash trolley. John did indeed pass away.


2. I looked after a lady named Jane once. She was about 96 and had supposedly been mostly non verbal and immobile following a stroke a year ago. Now she was in the hospital with something else and she was dying. I never heard her speak. One day I was walking by her room. I heard a weak female voice saying "Milly, Milly, come here my love how I missed you"! Hand over my heart I went into that room and she was sat on the end of her bed arms outstretched...a look of pure joy on her face. Her eyes looked like they were watching someone move about the room. I had never seen this woman move let alone speak so after my initial shock faded I asked her Milly was. She didn't answer. She just laid down on the bed and went back to sleep with a smile of contentment.

This happened a few more times and other nurses saw it. I never saw a look of such pure joy on any person's face. As Jane deteriorated, the Milly sightings increased. The medics didn't believe us. Finally I asked Jane's grandson who Milly was. He gave me a strange look and told me that Milly was Jane's little 2 year old daughter, the apple of her eye.

Milly was the only daughter after 4 sons. Milly died at age 2 when she fell out of a second story window while Jane wasn't paying attention. This was decades and decades ago. Jane never got over it and refused to speak about it. She blamed herself. The grandson was shocked that I even knew the name since Jane was no longer verbal. Hell even when she could talk she could not mention Milly without violently weeping.

This is when I started to get that maybe there is something out there that we cannot see. I do not believe that anyone ever dies alone. They come for them. As a nurse you soon realise that when a patient is dying it is like a family reunion of all their deceased loved ones around that bed. The closer they get to death..the more we the living seem like a fuzzy dream, and dad who died in 1930 seems like total reality as he stands over the bed with a smile and a reassuring wink.

On a number of occasions I have walked into a patient's room to see her smiling from ear to ear "My brother Paul who died in the big war was just here visiting me".

This kind of statement always perks my ears up and I take a close look at my patient because 9 times out of 10.......

Sometimes out of the corner of your eye you will kind of see or sense others in the room of an extremely sick patient. It's weird.

I was caring for a dying 87 year old woman not so long ago. She was dying in a really awful manner. The care assistant and I were changing her gown (haemoptysis and maleena). The patient was not really aware of us but my god, she was having a beautiful conversation with someone we couldn't see. I felt like I was intruding on a very emotive but happy family reunion. From what she was saying, it sounded like she was talking her to mother and auntie.

Of course of course...dying brains hallucinate and all that.

Some people claim that the wards are haunted. I have only ever seen things out of the corner of my eye and such. I walked out of the drug room and then walked back in quickly because I forgot a syringe. The room was tidy when I left it but 10 seconds later when I walked back the room every drawer was emptied onto the floor. The staff at that place were convinced it was haunted.

I took care of a little old man who used to pull my ponytail all the time and laugh. He died on my ward. Every time I walked past his bay for a few nights someone yanked on my ponytail.

I worked with a care assistant who swore that she would have reoccurring dreams about an old fashioned horse drawn hearse. Whenever she dreamt this before work there would be a death on the ward.

A very anxious lady named Helen died on the ward downstairs. They took her body away and then the room was empty. But the call bell kept ringing and ringing over and over again. The room was indeed empty!! Maintenance was called in...but they could find no fault with the call bell system. Finally one of the older nurses shouted "for god's sake Helen you're dead, just cross over and stop messing with that bell". It stopped.

There was the nursing home built over the site of a Victorian orphanage where all the Alzheimer's residents saw the same thing: A little boy in a navy suit and a little girl in a green dress running around the facility acting up and being silly and naughty. The nurse's got sick and tired of the residents asking them to deal with those brats in the old fashioned clothes who were jumping on the bed. How could the nurses deal with children they couldn't even see?

There's more but my children are raiding the sweets that I thought I had hidden so well. Happy Halloween everyone.

A Comment That Says It All. Awesome.

I received this comment on the post below this one. WELL SAID ANONYMOUS!!

Anne,

The UK's health care system is totally screwed! You should try to get out. I hate suggesting that because I know you care, but they are asking you to do the physically and humanly impossible. You should have a pharmacist in that hospital AT ALL TIMES. You should have a pneumatic tube system to tube your meds to a tube station on your ward. The overpaid pharmacist who has plenty of time to ass-sit and talk badly to the nurses should be calculating your damn dosages and mixing them. That's what he got all the damn education for, right? There should be a full-time staff of housekeepers to clean beds between patients and wash mattresses and empty trash. There should be a staff of dietary aides to distribute trays and snacks. You should be able to NURSE, and that's it. And you should have the staff to do it safely. Patients are sicker now. Your whole system is antiquated and dangerous to you and your patients.

Your entire profession should be up in arms and banging on your Prime Minister's door and demanding that someone get up off their ass, unstick their head from said ass, and totally wipe the slate clean and start over. That is how screwed up your system is. I would not work in an NHS hospital. I'd serve fries at a fast-food restaurant before I'd go face what you face every day. The powers that be in your organization do not want you. This blog is wonderful, but the people who are not nurses DO NOT CARE. It isn't happening to them, and they don't have to face that nightmare every day. And your nursing leadership DOES NOT CARE. They're not blind to what is happening, Anne. They are simply evil. They see just fine.

I am so thankful I am not a nurse living in the UK. I am so angry for all of you. I read your blog all the time, and I say this as someone who cares about your wellbeing. I am deeply concerned for you and all the nurses in your situation. I hope this does not make you mad. But I know you are not being listened to. Nurses are finally being treated half-decent here in the states (still a long way to go though). Nothing changed until there was mass exodus from the profession. And we are not out of danger yet over here. The powers that be will not listen until all of you make them listen.

I wrote a little bit below Anonymous's comment and I will post that here as well as add some more thoughts:

A pharmacist in hospital 24/7? HA HA HA HA. It would be a cold day in hell before anyone mixed our IV antibiotics for us. A cold and frigid day in hell.

I had several patients on IV Benzlpenicillin 2.4 grams, IV Flucloxacillin 1 gram, and IV metronidazole all at the same time. The Metronidazole comes bagged already (the only IV antibiotic that is ready to go) and was only 3 times a day. So we were lucky with that one. But yeah, holy massive amounts of antibiotics.

But the Benpen and the fluclox was 4 times a day and oh my god..... The benpen alone comes in little bottles of 600mg in powder form that you have to dilute with sterile water and mix and add to an IV bag of saline. It takes AGES and AGES. I feel like I spend most of my time mixing drugs.

Many doses get missed because the nurses can't always screw around mixing them when we have 20 patients all screaming "nurse".

Granted that giving the IV meds are priority because the patient is not getting their doctors' ordered treatment without it and therefore won't get better BUT try explaining that the all the screaming relatives that don't understand why we are not sat at the bedside changing mama's gown the second she spills a drop of juice on it. We get no back up from management with these
people complain. No one explains to them the reality of the situation.

And we don't have anyone to answer the phone either.

Not to long ago I was working on a shift with 2 RN's and 2 kids for over twenty patients. The phone rang non stop. We always tried to answer the phone when we could. Most of the calls are from relatives asking questions we cannot answer. Instead of accepting that they just get someone else in the family to try. They don't seem to get that giving any kind of info over the phone is illegal.

But the one phone is a long way away from the patients. If you think about the logistics of walking away from the patients every 2 minutes to answer the phone you will see what I mean. We already had a least 6 patients who required one to one care, one because he was acutely ill and the others were just extremely confused as well as very mobile. So just those 6 people outnumbered the staff already. One was so confused and mobile that he ended up leaving the ward and was wandering in the street nearby. Had to call the cops.

During all this we were only managing to answer the phone about a third of the time. It was ringing constantly. Lo and behold one caller got real pissed off that he couldn't get through and called management ranting and raving about the nurses not bothering to answer the phone. Management (the same fuckers who decided that we can't have a unit clerk anymore than half day weekdays) apologised profusely to the ignorant man and let us have it. The man (a relative of a stable long term patient) came up later during visiting hours sneering at us because "the chief promised that you girlies will be knocked into line if you don't bother answering the phone".

So yeah. That is how it is. You are right that it is all beyond the grasp of non nurses and that people do not care because they do not live it day after day. Striking isn't the answer because an ignorant public who does not understand the situation would not back us up...they would turn on us even more. They would be bored to tears with this blog and not read very far so a wake up call for them isn't happening in the foreseeable future.

This blog does have a purpose and an ending...I'm just not there yet.