A Price To Pay (part 11)

It’s time to get up. I hate getting up in the morning probably the same as everyone else who needs to get up for work. The difference is that I have twelve and a half hours ahead of me and I have a bad cold. My legs ache and I keep sneezing. I can’t stay off because Sister Poppins will moan because she expects the sick call the night before. I wished I could go out next week because all my friends are going to the theatre to see a great show and I will be working. I got my off duty just yesterday and as usual it is very late. I can never plan anything as a nurse. My mum and dad have still been trying to phone me and I am thinking that I had better call them or they may think something is wrong and phone the police. They are a bit like that, my mum and dad. My university mates have been in touch and it is great to hear from them. I met some nice people on my course but such a shame, such a change, they are all so different. I feel that they resemble battle wounded soldiers. They have seen so much in such a short time and I am no different but I am now seeing what is happening around me in the NHS! I know I was always destined to help people and that is why I am a nurse. The money has never motivated me but it would be nice to be able to live a reasonable life without debt and just get a little more for the job I do. Will that come to me, who knows? It is time for handover and I am sitting waiting. Everyone comes through to the office and I fix my squint badge with my name on it and I adjust my blond hair so that it is away from my face. I look up to see Sister Poppins and Mrs F Flat. I think I will be taught a bed bath today. Patients are obviously discussed during handover and I try to contribute but I am looked upon like I am the cleaner contributing to patient care. Sister Poppins ignores me. I do not respect her, I resent her and I do not like working here. I need to get out and go to employment where I feel welcome. Who wants a drop out nurse though? I think about possibilities but let’s face it I am stuck, I am in prison. What about my friends from university? The people I am in touch with are having a bad time and wished they had not done nursing. My friends are unable to buy a house and have a normal life; they can just share flats, great! I am told that I need to be a nurse today and not a care assistant. I get on with my job!

Coughs And Sneezes Spread Diseases

A patient is brought in from another ward and is placed in a side room. The relative is outside it speaking to Nurse Ratchet. Nurse Rathchet has a hand on her hip and still wears the nurses dress uniform. I wear a tunic and trousers. The trousers do not fit they are too baggy. I look at some paperwork on the desk and over hear them talking. Nurse Ratchet is not a caring person and the relative does not understand this infection and attempts to ask questions. Relatives and patients are outside our little medical knowledge ring. I think it is still important to realise that the public are far more informed than they used to be. The relative asks what infection her husband has and I hear the nurse avoiding the truth. I know that the infection is Clostridum difficile and the nurse is avoiding telling her. Maybe if nurses could be honest the situation would not be so out of hand. The public know when we are being secretive. It is obviously most annoying for anyone to have this condition but it is common and the only way to beat it is by being up front and honest. Let’s face it, the main cause is antibiotic usage and although people who are already very ill are often the most vulnerable it is antibiotics that are the cause. Why the secrecy? It can obviously spread around a ward fairly quick which is why patients get put into side rooms. Hygiene therefore, also becomes important. Hygiene is a big issue in hospitals especially with a high turnover of patients. In the area Jabba the hutt works, the old part of the hospital, hygiene is really bad. Sister Poppins runs a very tight ship and hygiene is very high on her list but sometimes to the detriment of the patients. The trouble is the design of many hospitals only supplies so many side rooms, so few patients can be isolated at a time. The trouble with poor hygiene too is that everyone uses equipment going from patient to patient. How many nurses go around taking blood pressures and do not bother to clean the cuffs and oxygen saturation probes in between patients? We can’t assume patients are clean. Patients quite regularly have a commode taken to their bedside but never have anything to wipe their hands. Doctors also walk about in their normal clothing going from bedside to bedside with their stethoscopes. I think they must hide somewhere to clean it because I have never seen anyone clean them. Why are doctors allowed to wear their normal clothes while we wear uniforms? Anyway, Nurse Ratchet’s tone goes up as she attempts to convince the relative that it is just a mild infection and it is very common. She avoids the name. It is a bit like the Scottish play that we dare not mention. It is like going back in time, don’t go out in the cold or you will catch a chill? Some nurses are just scared to say what the problem is. It reminds me of the patient that died and the nurse informs the relative, ‘I am sorry but she has gone.’ Before the nurse can explain the relative is shouting, ‘where has she gone how could you let her walk out?’ Nurses also ask patients ‘have you gone today?’ ‘Have you been?’ I remember the funniest I ever heard was with this male patient and the nurse is trying to ask tactfully about his bowels. The patient is not from this country so is confused by what she is saying. The nurse attempts many times with gestures and different ways of saying it. Finally, the patient catches on and with a smile and a glint in his eyes shouts. ‘Are you asking if I have crapped?’ The nurse’s face goes red and I need to leave the room because I am in fits of giggles. Nurse language is really awful and we should just say a thing how it is. Nurses learn to lie very quickly. When a nurse looks at the wound of a patient and there is this smell of rotten flesh with seepage and the patient asks the nurse how the wound looks the nurse screws up her face trying to avoid the smell while saying, ‘actually it is not that bad.’ We could not possibly say to the patient, ‘actually it smells absolutely awful and just looking at it makes me want to throw up.’ So lying to protect patients is common. But we do need to evaluate when lying is the right thing to do. MRSA is the other one that patients fear and so nurses avoid using the term. In this situation the relative raises her anxious voice and rather than reassure the relative, nurse Ratchet shouts back. Relatives are anxious and sometimes it is through this anxiousness that they become angry with nursing staff. So many attacks on nurses could be avoided from the start by the nurse showing patience and care. There are a percentage of patients and relatives though that will just have a tendency to lash out. People are unpredictable. Thankfully, I have never been hurt, so far. The relative gets angrier with nurse Ratchet and demands to see the doctor. Ratchet looks uncontrollably angry. The whole angry scene could have been avoided. Nurses often do not have people skills, sad, but true, there I said it. This same nurse Ratchet thinks I do not possess the skills to give a bed bath as she was discussing this with Mrs F Flat. The relative talks to the doctor stating that she plans to put forward a complaint.

Those That Can Do, Those That Can’t Teach.

I deal with all my patients, helping get them breakfast up, washed and dressed. The buzzers go all morning and I am fetching and carrying and juggling my work. There are many things I need to remember in my head all at once. I feel exhausted because I have the cold. I needed to organise my annual leave but I was scared to go near Sister to ask her anything in case she made trouble for me. She is not approachable at all. I spoke to one of the care assistants who reminded me that I have the right to my annual leave. I decided to write down my request of annual leave a few weeks ago in the manner she requested staff to do it. My request was left untouched while everyone else was getting theirs granted or nullified. At least they got theirs dealt with. I was getting tired and I had been working solidly for months without holidays. I asked for just three days off. Sister Poppins came over to me and very seriously said to me that she could only grant me an afternoon. Her eyes showed hatred towards me and I just could never understand why. I took the afternoon she gave me but was disappointed. There was no long lie in bed! I had looked in the annual leave book and noted that no other nurse was off and there was lots of staff on that day. I could not understand her, I knew she just did not like me and she wanted to make life hard. After all my running about I was called into the side room to watch a bed bath. My brain had trouble staying awake! She made such a meal of it. If I could spend this long over a bed bath none of the patients would be out of bed until afternoon. Nurse Ratchet spoke to me like I was a little naughty girl. I no longer felt like the little naughty girl. I felt like an adult who was being taught by someone who was attempting to keep me down by intimidation tactics. I did not let her bring me down or any of the other nurses and after many months of being treated less than human I was beginning to feel angry. Anger was welling up and it was not sudden, it was over a space of time. I would not show my anger, I kept it locked inside because it was not professional and if my anger gets the better of me then they have won. The trouble with anger is that it has to come out somewhere and just because I did not get angry back did not mean my anger did not come out. When I went home, my moods plummeted. I was not friendly and sociable anymore. My phone would ring and I would ignore it because I felt too unsociable to speak. My friends would still ask me out but I could never get out anyway. I was always given off duty for the weekend. I was cutting myself off from everybody. I was a loner, I really was in prison. From somewhere I gained this surge of energy to fight back and I continue to do so. I have not won yet but that means banning all bullying from work. In nursing there is a culture of nurses who think that being critical in a nasty way is helping develop the skills of the nurse. On the 17th October 2007 The Times Online had a story about the nurse of the year quitting her post as nurse “A “Nurse of the Year” is leaving her job because of the strain of working for the NHS in an atmosphere of “mistrust and fear”, in response to the article a nurse wrote in to state “They send the matrons down to put pressure on the staff which is causing more harm than good considering most of the matrons are in the job for the power trip.” The Sister’s are just as bad in many cases. On the 22nd of October there was an article titled ‘Pay a nurse peanuts and what do you get?’The discussion is about the columnist sitting vigil in ICU. From the outset ICU is so different from the wards and it is a very specialist type of nurse who is trained to work in ICU. It is also compulsory for a high nurse to patient ratio, which is also why funding ICU is so costly. ICU can never be compared to the wards. It is a little like comparing theatres to the wards as the skills needed can be so different. In both theatres and ICU much of the time patients are very heavily sedated so patients generally are not up and walking about. Theatre staff can be very good in anaesthetic rooms with very frightened patients going for operations. They are also very good in recovery. A lot of what happens in theatres is often hidden away and so poor theatre staff can be forgotten by patients. Still, in response to this article a nurse wrote, “I am tired of hearing about the poor under paid nurses, the angels. In many cases I have found nurses on general wards very uncaring and bad tempered. We are told they are too busy to help patients with their food and take them to the toilet.” In my response to this, if I was working night shift, I could share some thirty two patients with just one other nurse and a care assistant. I would love to ensure that all patients’ needs rightly are cared for but I have no control over staffing levels. If it is any consolation I think it is a disgrace that anyone is left in their own urine or pooh! It is true that many nurses are uncaring and it is a shame that the bad ones ruin it for all of us. If the owner of this comment had to run around all night for twelve and a half hours with just two half hour breaks, clearing up pooh, sick and all other bodily fluids with lack of staff I am sure she would also be bad tempered. Some nurses are lazy and some take their frustration out on the patients, these people are the rotten apples. I am physically and mentally exhausted after each shift. Why should NHS management sit on their big fat salaries with no real insight into what we put up with? When it all goes pear shaped, I know lets blame the nurses. Someone also wrote “Nursing leadership and example at ward level are absent with professional advice, correction and challenge, if it's ever given, regarded as 'bullying'. This could only come from a Sister. When the pressure mounts, the Sister is standing well behind the battle lines at her desk with her nice civilised day time hours, being allowed to go home at four in the afternoon. She can also choose when she goes on holiday. This comment is exactly the management style I mentioned earlier. It is outdated and in need of repair. I am glad she mentioned bullying because in other occupations it is clearly recognised as that. It is one thing giving correction and challenge but when I am doing my work, I do not want someone coming up to me while I am with my patients giving me random maths tests out the blue. I also do not want correction in front of patients which is utterly demoralising. I also do not want to be shown skills that I can clearly do. I do not only want spoken to too when I am deemed to have done something wrong. What is also wrong with praise when I am doing my job right? I never get that! In the older days nursing did not have the high level of academia that it does now. I have served my time at university which the Nursing and Midwifery Council are happy with and this proves I can carry out my job, while extra courses keep my skills up to date. There is nothing in any written documentation stating that I must constantly be given maths tests or be shown basic care over and over when I clearly have the skills. I am an adult not a child. I am the registered nurse who is accountable for my own practice. I need to know my limits and if I mess up it is me that loses my registration. If these Sisters or any other senior member of staff demonstrate the wrong way to do things and I follow this practice, if they are wrong, is it any defence in court to say I was just copying the Sisters practice. They would then ask, ‘if you saw someone jump from a bridge would you copy it?’ Would the Sister stand happily beside me supporting me all the way? I doubt it; I would be on my own, in a boat, without a paddle heading into the direction of Lonesville. I need to know my own limits and my nursing parameters. If I don’t know I will ask. In the older days of nursing, Sisters may have used this challenge approach to gauge what level nurses where at. Many of these outdated Sisters do not have academic qualifications themselves. I now challenge them to gain a degree qualification on a minimum nursing bursary. Let’s face it, how many times do Sisters make mistakes. I see them making mistakes all the time. Who corrects and challenges them at ward level? The point I am making is we are all human and humans by our very nature make mistakes. What we do not want is costly mistakes, which is why I never carry procedures that I am not trained to carry out. If I make a small mistake in the ward, I do not expect to get my head blown off for it and screamed at. What I would like is for someone to take me aside and say to me that I made a mistake and show me what I did wrong. I can take it, I am an adult and do not need shouted at in front of patients like the naughty child. It is all about the manner in which it is delivered. Better management skills are required please? Sisters need to go back to school!

McDonalds Has Come to Nursing

I watched this bed bath and learned nothing new. I would have been of far more use helping patients get to the toilet. Nurse Ratchet looked smug as she went over to speak to Sister Poppins while rubbing alcohol gel on her hands. She could not make it clearer she wants that vacancy. The interviews for the job are to be held in a few weeks. What more misery will she cause until she gets the job? I go to lunch to meet up with another friend who is leaving nursing. If the ‘Nurse of the Year’ leaves nursing and all my university friends are leaving there must be some size of a turnover in nursing. Maybe we have the same staff turnover as McDonalds. Scientific management views society as moving towards the fast food restaurant by efficiency, the optimal method for accomplishing a task. Calculability, objective should be quantifiable (i.e. sales) rather than subjective (i.e. taste), Predictability, standardized and uniform services, Control, standardized and uniform employees, replacement of human by non-human technologies. Nursing staff are easily replaceable, we are drones. Agenda for Change has devised the roles. The job description is standardized and the human qualities do not matter anymore. So, for example a nurse who comes along with years of experience who has gone through years of university needs to start alongside those other nurses who have the minimum qualifications. It is no longer about the individual qualities. Anyone with a brain who is treated like a drone from day one will not last long in nursing because it is the equivalent of sitting at the checkout at Tescos. So, what happens is they leave and gain employment in an area where their skills and qualifications are matched. Management does not care if we do not like the job or we fail at what we do because it is like pulling off another bin bag from the roll. We are easily replaceable. The sad side to this is that it is patients that pay the costs. How much does it cost to train each nursing student and then when the wards are left short staffed when the nurses can no longer cope, it takes time to get someone new in. New staff are not always efficient because they have not been given adequate support due to the bad training on placements in the hospitals but when they make a mistake it is their fault, they are blamed and they are struck off. How about doing something to keep existing staff? How about ensuring students are supported properly and not in the current bullying manner that goes on which teaches students that to ask questions is dumb.

The Spider Fights The NHS

After my evening break I sit down and fill out my notes while all the relatives ask me questions and the phone rings incessantly. Relatives who are used to being fobbed off come in with an attitude from the start. Many of them see I am not like some of these other nurses who are hostile and cold. I build a rapport with them; I get given lovely cards and get many a thank you when I try my best. I am open and honest with them all. I am there for the patients but I am a wave going in a slightly different direction from many others. I will fight for my patients but I also need to fight this horrible old nursing culture. I have two swords to cut through all of this but I am just one woman on the bottom rung of a two rung ladder. I am willing to fight, how many others will side with me? The NHS is worth fighting for and if all these good people leave we will be left with a poorer service than ever. When I look through the charts I notice that other nurses have forgotten to fill out certain parts. I do not blame them, I understand that patients must come first but try telling that to the Sister. It is nearly time for the end of my shift. I have spent a long day with my patients and I also think it is good courtesy just to say good night to them. They are not all the perfect patients and I am not the perfect nurse. I will never be Sister Poppins. I am me, I am human. On the way out I bump into relatives who want to chat and who want my knowledge of directions. I see relatives when I am out and about on my days off and they remember my name. I see a few care assistants I know as I leave. They are puffing away on cigarettes before they go in to do their night shift. We smile and wave at each other. I am now not far from my car. I am now feeling hungry and I take a tissue out my bag to wipe my nose. My cold still feels bad. I keep worrying that my mum and dad will wonder what is wrong with me. I take my mobile out my bag and dial their number, my mum answers and I say, ‘Hi mum it is me, I am alright, I am off in a couple of days and will come along to see you both.’ I wind down the window in the car to wipe away the rain from my mirror. I notice a spider making a web in the rain while being bombarded with water. It slips several times but does not give up. Is that what Robert the Bruce saw? If it was good enough for him, it is certainly good enough for me. ‘If at first you don’t succeed, try try and try again.’ Bullying is a fight we need to be in together. We all need to be in it to win it.

Education Is Not Just For Muppets (part 10)

As I walked past a porter in the hospital, he smiles and asks ‘well, were will you be based today?’ I tell him I am back to the old bit of the hospital again. ‘I do not think I have seen you in the same ward twice’ he laughs. ‘What are you today nurse or care assistant?’ ‘Actually, who knows,’ I say. ‘I am used all over and mostly as a care assistant,’ I moan. He laughs again and says, ‘I wonder when you will become a porter for the day.’ I have had my nurse training and now stagnation and degeneration. I heard a nurse say that if a ward is short of care assistants it is cheaper for them to use a band 5 nurse than to bring in an agency care assistant. I feel cheap! I have spoken to this porter a lot because I get all the accompanying the patients jobs to places such as the X-ray Department. The porter looks hard worked and tired but he always smiles. I have often moaned to him about Sister Poppins and he just laughs but he knows she has a reputation for being a tyrant. I feel sorry for the porters because they are on such poor pay for the jobs they do. They are always patient and they spend such a lot of their time walking at the beckoning call of everyone. The porter made me think of the character from the anti war film Platoon, Sergeant Elias, played by William Dafoe. He did his job and was a reasonable person. His quote from the film sums him up. “I love this place at night. The stars... there's no right or wrong in them. They're just there.” Elias the porter was just there too and always at the right time. I get to the old part of the hospital and feel the draught and watch the goose pimples appear on my arms. I look outside to see that it is raining again and I watch patients huddle in the doorway in their dressing gowns and slippers with a chimney of smoke going in all directions from their cigarettes. I go along the corridor and report to the nurses’ station. Jabba the Hutt catches the corner of my eye. She is sitting in the same place I saw her when I did my night shift with her. I wonder if she has moved at all since then. She is not eating biscuits but has a giant sized bag of tortilla chips. It is just after 8am and I ask what the plans are for me here today. She states that I am to help her today. I had a big sinking feeling, I felt like I was standing on a pile of mud and suddenly it turned to mush and I was being drowned in it. I am given many tasks all at once. I am as usual a care assistant cleaning, washing and toileting, the usual procedures. The only good bit about this is that I am being paid a nursing salary for a care assistant’s role. The downfall was though that I am actually a nurse and while carrying out any of these procedures even as a care assistant I am still liable as a nurse. I trained as a nurse and wasted many hours studying even being shown how to run a ward. The more I am used as a care assistant my skills will lessen as a nurse. As for job satisfaction there is none because I am task driven. Someone else is using their brain for me; I am a machine within a bigger machine. When I do get the chance to be with patients I do my best for them. I am not challenged I am bored! This is not what I trained for; I already had lots of experience as a care assistant.


University Challenge

Jabba does not smile, she moans at me to do her work while she sits there drinking coffee and eating crisps. I am now trying to make patients beds but there is no clean laundry. There are patients to go to theatre but there are no theatre gowns. Instead of making the beds with clean sheets we turn sheets around hiding food and blood stains and whatever else stains there are. I examined a couple of the mattresses and I was sickened to discover that they were dirty. These were beds awaiting patients. I also noticed the bed rails were disgustingly dirty. This whole ward was disgusting, it should be condemned. We are all taught very early on that we must use orange bags for clinical waste but there were no orange bags. I heard the ward was saving money. I watched as nurses and support workers tossed all sorts of disgusting waste into clear plastic bags instead of orange ones. Jabba kept dishing out the orders and I was her slave. Then out of the blue another nurse appeared she had been on some course and had come back into the ward. She looked at me, as I flicked through patients notes and said, ‘who are you?’ I informed her who I was and she abruptly told me that I should leave the nurses’ station because there was no room. She started asking me what I needed to know about the patients and then she told me about all her qualifications with a smug face. Talk about blowing your own trumpet. She then asked about my qualifications and before I even had the chance to answer she said, ‘yes you will know doubt just have a nursing qualification and no doubt be at the beginning.’ She had the manners of a pig. She looked like Miss Piggy too. In situations like this I never usually take up such a challenge because qualifications do not give someone better intelligence. On this occasion Miss Piggy needed brought back down to earth. I informed her of the qualifications I possessed and her face changed from one of smugness to one that looked like she had drank a full bottle of vinegar while sucking a lemon. I was a challenge because I had more qualifications than her. She started to ask me questions on nursing, just random questions. She was waiting on me tripping up but I didn’t. I had been through all this before with Nurse Ratchet and I decided to show her that I was actually more knowledgeable than she assumed. When she asked questions not only would I give the answer but I went on and on. She got annoyed with me and her Piggy face went from pink to red. She then told me to go and do something mundane and was on my case for the rest of the day. It was worth it though to bring her down a couple of pegs. I asked a care assistant if Jabba the Hutt got the vacancy she was after. The care assistant said she did not and that another nurse got it. There are nurses that are true gems out there as I stated previously and the nurse that got this job is a true gem, so I was pleased. It was lunch time and I helped to put out all the patients lunches. There was a patient there and she looked really dehydrated and I saw her jug of water had just been plonked down really far away from her, the water was warm. I would never drink it so I didn’t expect her too. She was not able to reach it and it would not have surprised me if she even knew it was there. I put down her lunch but she looked too weak to get her meal. I set her up so she could eat but she had very little ability, she was so frail. I started to help her eat and was told to stop by another nurse. ‘We do not have time to do that,’ she said. I asked if someone could take over and was told that everyone is busy. This annoys me, why bother having patients in hospital if they are unable to get a meal and lots to drink. It reminded me once when I was in A&E. I had not eaten or drank anything all day and got my first sip of water at 11pm. I was not on IV fluids either. I worked out that I had gone sixteen hours without water. I felt worse because I was dehydrated. It is basic common sense to supply fluids unless there is some reason not to. What is the point of pumping loads of drugs into patients if they also do not get basic nourishment? I was in this ward as a care assistant but I am a nurse. It is my duty of care to ensure patients are cared for, so I fed and watered this patient. The other nurse did not like it but why should the patient suffer. Oh dear I disobeyed orders again to care for a patient what punishment will I receive? I was sent off the ward to accompany patients to X-ray most of the day. I did not mind because I could have a laugh with Elias the porter and it was better than being shown how to do a bed bath all over again by Mrs F Flat.

Professionalise This!

I have come to the conclusion that nursing is not the profession that it promises to be. From around the middle of the nineteenth century the division of labour changed by establishing a grade of trained nurses. Trained nurses were placed between the doctors and the nurse domestics and they took on the work which had previously been carried out by apothecary surgeons. In 1916 the College of Nursing was formed. Although in contrast to doctors nursing achieved only small increases in autonomy and remuneration. Low pay is still the case today despite efforts to professionalise nursing with research and degrees. Nursing too is obviously made up of mostly women and nursing staff are the largest group employed within medical care making the likelihood of being given a salary anywhere near that of other medical professionals less than slim. Even in a previous study with nursing students they themselves divided nursing into ‘real nursing’ and ‘just basic nursing care.’ ‘Real nursing’ was viewed as that which used the knowledge of academia with which they were being trained for. ‘Just basic nursing’ was that which was done by auxiliaries and untrained staff. What appears to be happening is that the two types of nursing have become merged and hazy. Care assistants are being given more responsibilities while those that are educated to degree level are often being used as care assistants. The nurse is taught that she/he is accountable for all care and thus the job description of the nurse is actually very hazy. The nurse is expected to give all types of care which in theory sounds plausible but surely it is a waste of money training nurses to constantly be used as care assistants. A nurse can be used as a care assistant but a care assistant cannot be used as a nurse. Surely it is time to redefine the nurses’ job description. Student nurses do not go to study nursing degrees to become care assistants this is possibly why nurses leave the profession in their droves when they get the ‘just basic care’ parts all the time. They study to do the technical part of nursing.

Nursing Is Like Football, A Game Of Two Halves.

Now the other part which starts to emerge out of all this is that those with a degree can sometimes make those without them feel threatened. If a vacancy comes up, those with the qualifications are more likely to get it leaving those without, stuck in a job perhaps even burnt out. But because these older nurses have been there for so long they have perhaps came up through the ranks as an E grade, F Grade or even Sister. These people are in positions of power and rather than embrace and share knowledge with those that come in who are newer they are hanging on to their knowledge keeping it locked away. ‘It’s my football and you’re not playing’ syndrome. If we take away their knowledge which they have gained over the years what are they left with? So they retain their power by retaining their knowledge. Knowledge is power!Because they feel threatened they bully and use people like me as care assistants while they keep the knowledgeable ‘real nursing’ parts of the job for themselves. They are the ‘real nurses’ I am just a care assistant with a qualification in nursing.If the roles were clearly defined patients would be getting their basic care needs from care assistants including being fed if needed and encouraged to drink. Nurses could get on with what we are supposed to be doing. Demarcation of roles is required. I go back and forward to X-ray today and have lost count. Jabba the Hutt moaned at me but I guess she is sounding off because she did not get the job she went for. She did not get that job because someone came in with actual nursing qualifications coupled with experience and perhaps it shone through that she was a nursing gem. She will be Jabba’s boss; I can sleep well tonight knowing the patients are in safe hands. I throw my bag over my shoulder walking back along the corridor and past the dark doorway where patients are gathered smoking. I am beginning to see what is wrong with nursing but who will listen and pay attention? I go home to find a sealed brown envelope with my name on it. I tear it open to reveal a massive cheque. I had paid too much tax and Sister Poppins would not deal with it so I was on emergency tax for ages. I sat down thinking of all the nice things I could buy while the drudgery of today’s nursing gets pushed into a back drawer in my brains filing cabinet. Tomorrow is another day!

The Authoritarian Cogs (part 9)

The Future is Orange

It was great; I had the best few days off for weeks because I just did not dwell on work. One major change in me is that I have been taking active steps to protect myself from bullies at work. Over the last few days I have been asking other nurses if they are members of a union. It is so hard to believe that hardly any nurses are members. It is amazing though how many of them sit there complaining. They moan about their pay and conditions but they do nothing about it. No wonder our pay is so low if they will not do anything to help. It is as bad as citizens that do not vote in elections. They moan then say that they are not interested in politics. Pericles said

“Just because you do not take an interest in politics doesn't mean politics won't take an interest in you.”

Politics affects everyone! What is so frustrating is that women fought hard to get equal rights for other women to vote and take part in politics and these people can’t be bothered to vote. One of the lamest excuses for not voting I have heard is, ‘I need to go out and do some shopping for my night out’. That is of course from a nurse that wouldn’t speak to me; I am just on the bottom rung of the ladder, so I guess she is following the culture of bad nurses that do not speak to those beneath them. Anti-social I call it! The nurse comes back into the ward to show others of her own genre and of the higher ranks, what she had bought with her incredibly large nursing salary, after seeing the night out as more important than voting. She was so proud of herself buying foundation make up for her face but the bombshell was that it cost over fifty pounds.One of the nurses asked if she was already wearing the foundation on her face. She replied that she was. You know I am very good at composing myself when I should not be laughing but when something is that funny, it is terrible trying to not to laugh. I looked at the nurse’s face and although she was making every effort to try to look good while pretending she had a high salary to fund these expenditures, nature has a way of showing these types of people for who they are. She had not voted and made such an issue about not voting, so this was her punishment. For the crime of not voting you are to be sentenced to have an orange face. She looked like an Oomaph Loompah with her new makeup. She enjoyed having everyone around her while she showed off her big expenditures at the nurses’ station but if she had not bothered to come back to work to impress her colleagues, she may have taken more care on what colour of makeup she chose and she would have had time to vote.


There Is Cake On Your Curriculum Vitae

I arrive for my handover as usual this morning but I feel less like the little mouse. I had armed myself with union membership and believe it is money well spent. I go back to work feeling positive and no matter what they do to me now I take advice from my union. Although, I may still be a victim, I am a victim who is watching everything now and waiting on the right time to fight back. I sit and await handover while Sister Poppins, Mrs F Flat and Nurse Ratchet speak amongst themselves, they are the ward mafia. They eventually come through to handover to join the care assistant, student and myself. I can hardly believe it, I am to be a nurse today with a small group of patients. I want to shout from the rooftops ‘I am a nurse.’ During handover, the doors had been left open, so the patients could hear everything. The mafia of nurses were discussing the resuscitation status of a patient. Nurse Ratchet says, ‘she will definitely not be for resuscitation’. Imagine lying in hospital and you hear the nurses discussing whether or not you were a candidate for resuscitation! I had just hoped the patient did not hear. Nurse Ratchet had heard that there was a vacancy and she was doing her best to impress Sister Poppins. She would rearrange cupboards, make us all look incompetent and wait for it, buy cakes, just for Sister Poppins and F Flat. I passed by the nurses’ station to see Nurse Ratchet crawl up, leaving her slug trail all the way over to Sister Poppins and F Flat. She said she had bought these lovely cakes for the two of them. How blatant! I spoke to the care assistant and asked about this cake buying nonsense. The care assistant said that Ratchet had been doing this for a while. She never takes in cakes for anyone else but just these two. Yes, I am sure she deserves the job. Imagine that on you CV? Became a nurse and worked hard trying to impress managers through the buying cakes for them, to become an F Grade.

Fawlty Towers

Nurse Ratchet saw herself as the great nurse expert. One time I had to care for a patient with a serious wound which required a lot of wound packing. The patient had a wound chart and the tissue viability nurse had checked her out and came up with a plan for her wound dressings. There was a planned protocol for her. I began following this but Nurse Ratchet came through and told me to change the protocol. I insisted that the tissue viability nurse had given her this protocol and I would rather follow it. She scored out the protocol and changed it herself to the one she thought was best. I spoke personally with the tissue viability nurse and got it changed back. The reason Nurse Ratchet was doing this was to show she was capable of the F Grade post. Great F Grade she would make by increasing the length of wound healing, in patients. I worked with the care assistant most of the day. This care assistant was actually quite nice; he just wanted to do his job. He had no time for Sister Poppins and moaned about her. As a nurse there are certain things we do not discuss, it is like an unwritten law. We save patients from natural worry about the procedures that occur after death. While working with this care assistant we sadly had to comfort a patient who was dying. Before this patient became so ill he was quite a lively character and even a bit mischievous, we see all sorts but he was good fun. He would ring his buzzer to get a nurse through so he could tell a joke. His jokes were outdated but something about him made me smile when he told them. He reminded me of Frank Carson and had a cheeky grin. He did die and the difficulty when someone has died is sometimes sneaking the body away without upsetting other patients and relatives. In some hospitals it used to be customary to leave the body for a little while to allow the soul to come out but as the NHS does not have enough beds it is normal not to delay moving the body unless the family wishes to spend some time with the person. A nurse has not finished her duty until she has carried out the final act of care. The final act of care is to clean the body and wrap them in a sheet adding labels of who they are. When the sheet is wrapped across the face it always makes it very final, I always hate that bit. It is the nurses’ duty to treat the patients with the same respect and dignity they received while alive. Nevertheless, it is often a bit of a juggling act handing the body over to the porters to take to the morgue. This day when the patient died we had finished the final act of care and were awaiting the porters. It was lunch time now so it was not really a good idea for the porters to collect the body. By the time the porter arrived there were visitors in and typically staff were also still on lunch breaks. The care assistant was also on lunch and so was Mrs F Flat. Sister Poppins was hiding in her office. I had quite a few patients to keep an eye on. Anyway, the porter arrives and he waits halfway down the corridor with his trolley, remaining discreet. I go into the bay and as usual close all the patients curtains but beside one bed is a female relative. I say that I hope she doesn’t mind but I am just closing the curtains for a minute. She could not have been more inquisitive, she was asking why they were to be closed and she would prefer to sit outside the curtains. My job was to keep her in the curtains but she was having none of it. I heard a sudden shout, from the bay next door and go over to ask the porter if he doesn’t mind waiting until I see what is going on. A doctor is on the floor next to a patient who had decided to get up out of bed but had fallen over. Meanwhile, at the same time, the inquisitive relative is asking what is going on and is pacing up and down the corridor. I help the doctor get the patient back to bed with the aid of a hoist and go back through to see the porter still waiting. I go back through to the other bay to see that other patients have now opened their curtains. So I ask the inquisitive relative if just for two minutes she would sit by the bed of her father so I can close her curtains. I then re-close the others. I inform them that I just need to move some patients. The inquisitive relative finally co-operates and sits down. Finally, we get the body out the ward without causing upset. This is not Fawlty Towers it is the NHS.

Join the Nursing Army

Afterwards, the bed is cleaned and made ready for another patient. I carry on with my nursing duties then I hear the buzzer and as usual go to see who it is. I go into the bay to see the buzzer light on in the empty bed where the patient had recently died. Who could have pressed the buzzer as it was now fixed to the wall and all the other patients were sleeping? Mrs F Flat wants to see me so I go through. She informs me in her flat monotone voice, while staring at me with her cold eyes, that tomorrow she will show me the correct way to do a bed bath. I can’t wait to receive my enlightenment about where I must be going wrong. Mary Poppins has watched me all day but has not spoken a word. She never says, hello or good morning, to me despite the fact that I always let on to her. Nursing is like being in the army. The Sister was my sergeant; our colours on our shoulders are our rank. The system is authoritarian and Sister Poppins has an authoritarian personality, concerned with conservative attitudes, submission to and preoccupation with authority, fatalistic and rigid thinking and hostility to humanistic values. Here is a news flash, this is not the army and we are supposed to be human caring people. This type of working structure is outdated and this is why bullying exists. We always hear about working cultures and that we can’t change them overnight. If managers moved away from this authoritarian style to the facilitator role and actively involved their staff perhaps the low morale and demotivated staff culture currently experienced in our wards would lessen, making way for staff that could show better productivity. Why waste time intimidating staff and using petty policies to prove who carries the authority in the ward. It is far more time consuming for a staff member to intimidate me showing me how to do something that I can already do and have been doing for years. Why not show me something new, something I am supposed to know as a nurse. Let me do my job that I am supposed to be trained to do? I finish this shift but have become the philosopher on how to change this rotten system. I look at Sister Poppins and Mrs F Flat as just cogs in a big machine. Their cogs are old and need remodelled. I go out the ward making my way for home deep in thought and pass a couple of newly qualified nurses on the way out. They both look flustered as they go in for their night shift. I ask how they are enjoying nursing. They both moan, it is not what they expected and it is so different to what they thought it would be. No surprise, I have heard this a lot. I wonder how long they will hang in there as I hurry over to my rain soaked car. I need to get some shopping, so I guess I will not get home to nearer ten tonight. I turn on my engine, switch on my lights and wipers and drive off.

From a Mouse To A Swan (part 8)

I am awaiting handover on my ward. The nurse in charge comes to me saying that I need to go to another ward. This is no surprise and in fact I am getting used to it. I arrive into another ward where I have never worked. I will be working with a female nurse who will be in charge once the Sister goes home. Sister is still in her office finishing some work. I sit in on handover and to be honest I am quite unsure what capacity I am here as. Nurse or care assistant? I am informed in handover that there have been many new patients been admitted today and all the paperwork has not been done. I state that I could help out but as soon as I state this I am told abruptly that because I am not from this ward I will not know the paperwork. I get a feeling I will be a care assistant. I should be a nurse not a care assistant. Although, I was asked to be here as a care assistant I am quickly used as just an extra pair of hands. Whatever role. I quickly got on and started dispensing drugs and taking observations. Then I helped get everyone settled for the night. I was fairly exhausted quickly. The heat in the ward was unbelievable. I felt dehydrated really quickly. My mouth became dry and I could barely talk as my tongue stuck to the roof of my mouth. The heat was outrageous! I started to get a headache and looked for a water dispenser. There was nothing to drink! The kitchen was a good bit away. I went in to the changing room to get my bottle of water out my bag and took a big long drink.


There is No Water in the Sahara Desert, it is a Mirage.

It felt like I had walked across the Sahara desert. I felt the life force come back to me as I took a drink from my strawberry flavoured water. I decided to take my water out on to the battle front with me as there was no water dispenser and the heat would no doubt make me thirsty again. I wrote my name on the bottle and placed it in a corner on the nurses’ station. I then heard a voice from the male care assistant who sounded very rough round the edges. His voice was enough to cut down a rainforest. He said ‘Oi can’t leave that there.’ I turned around to see this little guy who behaved like he was my boss. He said ‘we don’t put water bottles on the desk’. I mentioned that I am thirsty and it is too hot to work. He told me that I will need to go to the kitchen, changing rooms or wait until break. I thought a moment about responding and then thought that I do not want to upset the wards rotten apple cart so I went back to put the water back in my bag. I took another drink before putting it back. I carried on working and it was not long before I was thirsty again. I tried to ignore it. The ward was really busy and there was a very ill patient who the doctors were huddled around while discussing their plans for him. They asked me if I was looking after the patient. I said I was tonight. They pleaded with me to ensure I get him eating something, such as jelly or custard, they said they have already spoken to ward staff about this and nothing has been done about it. The patient had a rare condition and if he didn’t eat anything before tomorrow they were planning on taking the patient to ICU. Due to the condition of the patient he could not have a nasogastric feed, which is a tube that is passed down the nasal passages into the stomach. The doctors were quite clear about their decision and they looked a little annoyed. The outlook for the patient was really not great and the patient had lost a lot of weight. I continued with all my work and it was very busy. I had checked this patients oxygen levels and noted that his levels were actually good. I spoke to the doctors to ask if it was worth trying a period without the oxygen as this may be drying up the patients’ mouth and it may encourage the patient to eat and drink. The patient could not have nasal cannulae, which are the little tubes for oxygen to go up the nose; this was also due to the patient’s condition. Instead the patient had a big oxygen mask and he kept pushing it off anyway. The doctors were consultants from ICU and asked me to try him off the oxygen for a few hours to see how he gets on. I kept checking and he was fine.


Smeagol Will Show You the Way

The care assistant came through and actually shouted at me, saying, ‘we have all had strict instructions to keep this oxygen mask on, you need to put it back?’ I stated that I had spoken to the doctors and they asked me to try him without it. He said, but you don’t know the patients, I have been here for years and I have been told to keep you right’. I couldn’t not be bothered with his manner, he reminded me of Smeagol from Lord of the Rings, so I just walked away dealing with the patients. I picked up some custard from the fridge and took it back to the patient who I had to get eating. I managed to get the patient to eat a few spoonfuls to begin with and I said to the patient that he really needs to eat. I said that I knew it was painful but it will get easier. The patient ate most of the custard but he was obviously in some pain. I went out a bay and had forgotten some notes and walked back into another bay. I could hear the care assistant and the nurse behind the curtains with a patient. They must have thought I was not there. They were discussing how lazy I was; they stated my name and the ward I was from. I thought, ‘did I really hear right?’ I almost spoke the words out loud. I sneaked back in and yes, they were talking about me, he mentioned also how I tried to leave my water on the desk and that I had taken the oxygen mask off when it should be left on. They were as loud as trumpets and as bold as brass.


Intelligent Science Is Not All Rockets

I had not seen much of the nurse but she appeared with a big sized bumble bee in her bonnet. She said that maybe I should help her with her paperwork. I looked through their paperwork and noticed there were quite a few sheets I would not know about. I filled in what I could but there was a lot missed out. I told the nurse I filled out what I could. She started getting angry saying, ‘it is not rocket science.’ You know that phrase, ‘it is not rocket science?’ Well it must be one of my most hated phrases. Nurses use it all the time. Whoever came up with this phrase should be sent away to live alone on a desert island with only boxes of salt and vinegar crisps to survive on to dry up their mouth from stupid phrases. Some of these phrases enter our language by the back door and suddenly everyone thinks it is cool to use them. Just like ‘24/7’, people used it in their droves and now they were using, ‘it is not rocket science’ in an attempt to make others feel less than intelligent, while they stand there smug with folded arms. Here is some news; it is not rocket science to use this phrase. Some of the best scientists of all time were never quite ‘rocket scientists.’ Aristotle’s natural science research includes botany, zoology, physics, chemistry and meteorology, geometry as well as others. Sir Isaac Newton was a physicist, astronomer and philosopher. Galileo was also viewed as the father of science. It is not rocket science to go along with the bleating sheep mentality to use a phrase that everyone is using. The fact is I did not know this paperwork and I admitted that I did not know it because this ward was not my speciality and face it; there was paperwork here there for the sake of paperwork. Talk about complete overlap of information. Who has time to come up with these hair brained ideas? Yes you guessed it, managers! They sit in their office saying, ‘I am bored let me design some more paperwork for the nurses and it will make me look like I am doing my job. I may even get promotion.’ Rubbish, put it in the bin and get out there to help the nurses actually care for the patients! Another thing, these ward cultures come from none other than managers. Managers decide that nurses must become dehydrated because they are not allowed to place a stupid water bottle on a desk. Where are the managers at 8pm after we have done a twelve and a half hour shift? It is also managers that decide how many nurses are required for a ward despite the fact that wards are utterly understaffed. It is us to blame when we do not have enough arms to care for all our patients at the same time. It is us they come to when they wish to find petty faults in our work while they stand there making out they are so perfect. Is it then the managers that have created this bullying culture that seems to be acceptable all over nursing?


Did You Hear Me NHS? It’s Called Bullying!!!!

I go from ward to ward to see a repeat of this behaviour again and again. This is no coincidence that I have just landed in bad wards. I must add, it may be normal to them but I can categorically state that this behaviour is called bullying. What will they do if I take my secret camera in and film it? Who knows maybe I will do just that. Anyway, I carry on with my shift and now start being task driven by the nurse and her sidekick care assistant as though I have no brain. One way to undermine you is to ask in the sugary coated little voice, ‘are you new?’ I have been asked this over and over again by female nurses who should have ‘I am evil' tattooed on their forehead. Their nasty demeanour says it all when their fake personality drops and they moan about their colleagues and patients in front of everyone. Nice people! Women are often in the caring field but this does not automatically make them a caring person, in fact Florence Nightingale once said

“Women have no sympathy and my experience of women is as large as Europe”.

I end up with so many tasks that I can hardly keep up. The buzzers also ring and I answer these too. The nurse is not nice to me after listening to little Smeagol. The nurse turns into wormtongue. I now turn into Théoden and feel weakened. I must also look pale. I am so exhausted and I feel dehydrated. I go into the treatment room and hold on to the worktop as I go dizzy and almost faint. I feel sick! A doctor who is in there asks if I am alright. I tell her I will be in a minute. She said I looked very dehydrated and I should get some water. I go back to the changing room and take my water bottle out and empty the contents. I fill it up again from the water in the kitchen and go back to the desk with it and place it back in the corner. I need to drink; it is as simple as that. I place it in a corner well out of sight and carry on with my work. Twenty minutes later I discover the bottle in the bin. I ask who put my water in the bin. I was told that the policy in the ward is that any water bottles found on the desk are to be put in the bin. They were carrying out their orders. No wonder patients are neglected when wards concern themselves with petty nonsense,

“He who by profession has become a slave of trivial details is the victim of
bureaucracy.”

Gramsci, Antonio.


Who’s Bad?

My night is busy without doubt and made more difficult by constant sniping remarks. I choose not to answer back but find myself getting annoyed. The doctors come around to see the ill patient and she is not to go to ICU just yet. I feel pleased for her. Fifteen minutes prior to the end of my terrible shift I am beckoned by Wormtongue, while Smeagol, stands around smirking and looking on, obviously in on what is about to be said to me. I go into the Sisters office, but this is no Sister I am standing in this room with. She asks again how long I have been trained but she already knows. She also knows that I have lots of other qualifications and experience because we have already discussed this. She has given herself a promotion while Sister is at home in bed. She goes on saying that my practice is terrible. I admit inside my head that it would be better if I could be given some actual nurse experience instead of constantly being used as a care assistant and undermined all the time. As a student nurse, I was given the task of care assistant, porter, tea maker and receptionist. Very rarely a nurse! I would ask nurses, ‘can I do that for experience?’ I would either be ignored or told to do something else. I eventually got my book signed but with the very minimum input from other nurses. What incentives did nurses have to help students anyway? Being a nursing student is a very fine balancing act on a very thin line. If I did not do what the nurses asked, my book would not be signed. As a bottom rung band 5 nurse, Agenda for Change does not recognise all my skills, I am a uniform doing the job, not a human being with skills and qualities. I could also do without sniping comments and have some positive feedback for a change. Positive feedback is not around in the NHS. When the positive feedback courses were handed out, the NHS were not around because they were too busy in meetings handing over the public’s hospitals to private companies. Nurses on the bottom rung of this two rung ladder are constantly told how bad we are, so perhaps it is a self fulfilling prophecy. I must be bad!


I Am A Swan!

Wormtongue was grinding me down. Inside me the pressure was building, just like the balloon that has been blown up too much and is in danger of popping, I too thought I would pop. It was time to let out some air before I did and it appeared from nowhere. Like the lioness who snaps at the hand of anyone touching her cubs, it was very quick and I surprised myself. I said, ‘how dare you condemn my practice and if you have any complaints then you need to get your boss to speak to mine.’ I told her that I was not perfect but I worked very hard while feeling ill with dehydration. I asked if this was the end of my shift and she replied that it was. I turned around and snapped, ‘GOOD’. I saw her face look startled and I walked out the door, leaving her standing there motionless, like someone had just poured quick drying cement on her. I saw Smeagol standing rubbing his slimy little hands, awaiting the outcome. I smiled a grin but not at him, I was going home, I was free once more. I had several days off and I was going to live life to the full. No more dwelling on this, no more little timid mouse, I was changing into a swan. I have many mores steep mountains to climb. I walk out feeling like a soldier going to battle on the bullies. For once, I feel, confident, I feel like me.
I turn my music up in the car. I listen to a song called Into a Swan
What in the world is happening?
What in the world could this be?
I'm on the verge of an awakening
A new kind of strength for me
I feel a force I've never felt before
I don't want to fight it anymore
Feelings so strong can't be ignored
I burst out - I'm transformed
Rising up, shaking it off
The yesterday dreary
Graceful and strong, No more forlorn
Today's a jubilee
Don't be surprised
This change is my design
I feel a force I've never felt before
I don’t want to fight it anymore
Feelings so strong can't be ignored
I burst out - I'm transformed
I feel a force I've never felt before
I can't hold it down I've just got to soar
And laugh in the face that is vulture law
I burst out, I'm transformed
I feel a force I've never felt before
I don't want to fight it anymore
Feelings so strong can't be ignored
I burst out - I'm transformed
I feel a force I've never felt before
I can't hold it down I've just got to soar
And laugh in the face that is vulture law
I burst out - I'm transformed
I burst right out - Into a swan
I burst out into a swan
by Siouxsie

One Flew Over The Cuckoo's Nest (part 7)

I suppose I had better get up for my night shift, I thought, as I lay thinking about the prospect of another night. I had very little sleep because I have road works outside my house and I couldn’t sleep through it. I have had problems with my childcare again because childcare just does not go past 6pm. On a day shift I work from 7.30am until 8pm and nights are 7.30pm until 8am. I often wonder how other women cope with it; it always seems so unfair to work such long hours with children. Surely, in this day and age they could allow women with children to work more flexible hours. Sister does the off duty just a couple of weeks ahead, so I always have last minute planning to find childcare. I had some toast and sipped some tea while watching the Evening News on television. I keep glancing at the time and as it gets closer to leaving I just fill with dread. I just have to get through this shift. I put on my red coat and step out into the rain and into my car.

Snakes and Ladders

It’s not long before I am in my ward. One of the nurses informs me that I am to go to another ward as a care assistant; I have been instructed to ‘constant care’ a patient, which just means sit with them all night. I stroll up through the long corridors, past Accident and Emergency and the little row of shops which are all closed with shutters down. I see a nurse that I have worked with many times but she never speaks to me, she looks the other way as I say hello very loudly to ensure she hears me. I always say hello but she always looks the other way. She reminds me of a snake the way she looks so sneaky. I would love to ignore her but then that would make me as bad as her. I thought when I was a student that some nurses did not always speak to me because I was just a student. When I became a nurse I thought they would communicate with me but that was not to be. Some do speak to me but they are the nurses that slip around on the bottom rung of the ladder trying to get their balance like me or they are just decent nurses who have a strong footing and there are few of them now.

How many Nurses Does It Take To change a Light bulb?

I go up the stairs and into the ward. There is the usual scurrying about getting patients settled for the night. I just go up to a nurse and ask who I need to care for. I go into a single room where a male patient is asleep. I read through his notes and gather information about him. He is just at risk of falling out of bed as he is very confused and had attempted several times to climb over the rail sides. I sit next to him and read his notes while observing him. A nurse comes through and says to me, ‘what are doing sitting about, can you do observations on the other patients and help out?’ I said that I thought I was to sit with this patient. She said, ‘yes but the patient is asleep right now and you could help.’ I told her that if I go out to help will she take the responsibility for the patient should he wake up and fall out of bed. She looks annoyed with me and then another nurse comes through to have another go at me. I inform her also that I do not mind helping but someone needs to sit with this patient while I do, as that is why I have been asked to this ward in the first place. They both look angry. Then a night sister comes to see me and I tell her that this is my nursing registration on the line. If I was employed as a care assistant I could not lose my registration if something went wrong but the fact is I am a nurse doing a care assistants job. So the Sister pauses a minute and then sees the sense in what I am saying.

Rotten To The Core

I sat down and the patient woke up. Just as well I held my ground. The trouble is because I did make a fuss about it I was outcast by the rest of the nurses apart from one care assistant who was from Poland. She kept coming through to speak to me when she had a minute. She said she was leaving this ward because the nurses were so horrible to her. She said in Poland the nurses treated each other with respect. The door was left open and I sat near the door. I could hear the nurses talking about the Polish girl. I felt really sickened to hear what I did. Not only was it racist but they were laughing at her. I am clarifying here; the trained nurses were being racist and laughing at a Polish girl. It got right up my nose! The girl was really very nice and I couldn’t understand why the nurses had to be that way. I felt ashamed and embarrassed to be a nurse in this country. I had wished these rotten nurses could be exiled to another country and experience racism. They were rotten apples. While I sat there all night I was terribly bored. No other nurse came to see if I was alright with the patient apart from the Polish girl who was sneaking in to speak to me.

Your Numbers Do Not Add Up Nurse.

The patient was quite restless most of the night, so I had to stay awake beside him. I read a book in between dealing with the patient. I also had my writers’ magazine, I always wished I could write articles but never got the opportunity to do it and always thought I may be no good. My confidence in anything at the moment was very low. I often doubted my ability as a nurse now. I thought to myself that maybe Sister always gets me to be a care assistant because I am a bad nurse. I sat thinking about another nurse on my ward that was like Nurse Ratchet from ‘One Flew over the Cuckoo’s Nest’. She was so hostile and her eyes were also cold. I have seen more emotion from Data, the robot in Star Trek Generations. When I first started in the ward, she would come up to me and ask random questions about nursing. I often thought she had prepared them advance, so she could look good in Sisters eyes. She wanted promotion and she didn’t care how she got it. She once asked me to do random maths questions on a paper towel on the side of a patient’s locker, in front of the patient. It caught me off guard and like a mug I rose to the challenge only to be ridiculed when I got it wrong. I had a degree in Economics and had an exam on drug calculations and passed it with flying colours. So, why did this nurse think it her duty to give me random math tests in front of patients? Was this to intimidate me because it certainly felt that way? She would write down a sum then go away and say, ‘now bring it to me when you come up with the answer?’ The patients would all be staring at me.
One day I was feeling very low, Sister had left me out of their Christmas preparations and I had to work on their night out. They all had to buy each other a present and I was not asked to be part of it. So when they all opened presents and spoke of their night out I was left out. I couldn’t have afforded to buy a present anyway but it would have been nice to feel included.

Top of The Morning

Anyway, on this day when I was really low Nurse Ratchet came over to me with her sums as usual written on a paper towel. I stood there for a few minutes, I couldn’t concentrate on her stupid sum, and I was very low. I walked to the dressing room and considered walking out the door. I went into the toilet and burst into tears. I eventually made an excuse that I had a sore head and asked Nurse Ratchet if we left the sums for today. Nurse Ratchet looked smug as though she had a point to make and she had made it. After that, every time she came up with sums I would say I was too busy. It was obvious Sister Poppins was her role model.
I check on the patient and he is now asleep. The sun is coming up and I was let away a few hours ago for my break by the Polish girl. The nurses who work nights here do the early morning drug rounds. I think this is very dangerous, especially as many insulin injections are given first thing in the morning by these tired nurses. I stand up and I change a bag of saline when the pump starts beeping and I mark it on his charts. I fill out his fluid balance chart. I have always thought fluid balance charts are the most inaccurate measures of a patient’s fluid intake. These charts are often forgotten about and when they are remembered the nursing staff, guess the amount the patient has had. There must be an easier way of recording fluid intake but until then we are forced to use them. Sister Poppins moans at me all the time to ensure I fill these charts out. Even though I do fill them out she accuses me that I have not, I can’t win. She moans at me over trivial things too. One day I dropped a towel on the floor by accident and she moaned at me. I began to think that maybe people just do not like me but then I know that my friend is also going through a bad time and many of my friends have left nursing. I have another female friend who is going to counselling because the nursing staff on her ward are so hostile to her. She spoke to her Sister and the Sister said it was just a clash of personalities and not to take it personally. I handover this patient to a student nurse who is taking over from me sitting by this patients bed. I am pleased to be walking away from this shift. I always see it as a sense of achievement when I reach the end of a shift. I often now envy people in other jobs and wonder if they are being treated like me. I have another shift tonight and hope that I get through it whatever their plans for me. I listen to The Manic Street Preachers on the way home.

If You Tolerate This then Your Children Will Be Next.

The future teaches you to be alone

The present to be afraid and cold

So if I can shoot rabbits

Then I can shoot fascists

Bullets for your brain today

But we'll forget it all again

Monuments put from pen to paper

Turns me into a gutless wonder

And if you tolerate this Then your children will be next

And if you tolerate this Then your children will be next

Will be next Will be next Will be next

Gravity keeps my head down

Or is it maybe shame

At being so young and being so vain

Holes in your head today

But I'm a pacifist I've walked La Ramblas

But not with real intent

And if you tolerate this Then your children will be next

And if you tolerate this Then your children will be next

Will be next Will be next Will be next Will be next

And on the street tonight an old man plays

With newspaper cuttings of his glory days

And if you tolerate this

Then your children will be next

And if you tolerate this

Then your children will be next

Will be next Will be next Will be next

Lanterns of Hope (part 6)

I still ache all over but I suppose I had better do my night shift later. I had a great rest yesterday but I still can’t eat properly. My mum and dad keep phoning me because they have not heard from me. I just do not want to tell them I am unhappy at work because they were so proud of me becoming a nurse. My mum told me she always wanted me to become a nurse. Parents always know when something is not right and I wouldn’t be able to lie to them so avoiding them is easier. Every time I see them they ask how my job is and look at me so proudly. When I became a nurse they gave themselves a big phone bill discussing it with all the relatives. If I inform them just what it is like to work for the NHS I would shatter their illusions. I miss my mum and dad. I pick up my belongings to go to work and walk out into the cold dark night. The stars are already visible and there is a lovely grey moon in the sky. I zip my jacket up tighter as the cold bites in. I jump into my car and put on a cd and I listen to the lyrics of a song called Lanterns and it goes, “and if it all fell through tomorrow put my bag on my back”. This was always my motto when things were so bad just to walk away. In my carefree days gone by I could just walk away but now I couldn’t. I arrive to the ward to find a note with my name on it. Dread fills me once more. The letter was from Sister who always leaves at 4pm, it was now 8pm. I pause and think about what the letter could be about. I slowly tear it open and rip off the bit tape stuck to it. I read the letter several times and Sister said she needed to speak to me about my absence. She wrote that I should have phoned the night before I called in sick. She also wrote that I need to go to another ward tonight. I have not been in this ward and it is way across the other side of the hospital. The building reminds me of a big haunted old building and I am filled with apprehension as I go in to the ward. I walk up to the nurse station and there are a few nurses sat there and also a student. They all turn and look at me. I say that I am here for the night shift. An outspoken nurse turns to me and nudges the nurse sat next to her smiling falsely, saying, “Tell that to someone who gives a shit”. My jaw dropped and landed on the floor and I did not know how to react. I felt like a computer that is given all the wrong programming, it sent me reeling; I became aware of a buzzing noise in my head. I could not walk away I had to stick this out.

Jabba The Hutt With The Voice Of Chewbacca

I am ordered to do certain jobs and the nurses on nights look after all the patients so we do not have teams. I am just ordered about all over the place. A patient I remembered from another ward is sitting looking anxious. I ask her if she is alright. She is very young and shows me a bit paper with her diagnosis she has had today. I am not surprised she was anxious but I try not to appear shocked. She turns to me filled with tears. I stop what I am doing; she turns and curls up on the bed. I put my arm around her and kneel down to her level. I say to her that this is very new information to her and it will take some time to digest. I say that it is alright and very normal to cry and it is all part of the process. She has her boyfriend with her who looks awkward and worried. I tell her that I will be here all night and when I get time we can have a chat. The patient looks up at me with wet blood shot eyes and says, ‘thank you.’ She starts to speak to me but another nurse puts her head in looking angry at me. She shouts ‘there is no time for social chats, the work needs done’. I apologise to the patient and walk out the room. Gradually, all the patients are settled and I go to the nurses’ station beside all the other nurses. One nurse has got knitting out and one is eating while reading magazines. The care assistant sits looking up holidays on the internet; the pictures look like typical holiday resorts, cheap holidays aimed at the working class masses, crammed hotels like high rise tower blocks in housing schemes, sand, sunburn and discos thumping out music which is all fuelled with too much alcohol. I sit down and the nurse who is eating turns to me and says, 'have you finished everything, are you sure?' She asks, ‘can you ensure all the charts are up to date?’ I look at her; she is clinically obese as could be measured by the BMI scale. She sits stuffing chocolate biscuits into her mouth, one by one, practically swallowing them whole. She looks very angry and I do not know why. I have never met her before. She has short messy hair and her age range could be anything from, twenty five to fifty. I instantly get a picture in my head of the character from Star Wars, Jabba the Hutt. The nurse turns to me again and says, ‘well, what are you waiting for?’

Everything Stops For Tea

I walk away looking at them all enjoying themselves. Each time I finished one duty I would go back to the nurses’ station to be given another by Jabba the Hutt. The staff never moved for hours. Each time a buzzer would go they would ask me to get it. I was exhausted looking after all the patients. I was given no credit and if anything was done a different way I would be criticised for it. I attempted to try to find common ground with the staff but I was looked at as if I had just asked them to give me their salaries for their jobs I was doing. I learned that they did not wish to speak to me and that I was a good skivvy while they sat there. When I finally did get my break I was cold and tired. I had no cardigan and the building was cold and draughty. I sat in the staff room with my jacket on as it was even colder. I couldn’t eat, so I tried to cat nap but I couldn’t. I sipped tea, the only comfort I had. I stood up and looked out into the cold night sky. Everything was peaceful apart from me. I felt so alone. I sat thinking about ways out again. Why is it that no matter where I go there are these horrible people, who are supposed to be caring? I go back to work and walk up and down the ward all night caring for patients while they sit there round Jabba the Hutt. My consolation is that if I keep active I will not end up obese. Nurses are great at telling patients how to live healthily but some ignore their own advice.

Is That Egg on Your Chin or Chocolate?

I walk up and down then I hear a whisper, 'can you come here please?' I go over to the door of this room and there is a nurse sat in there. She is very small but has a kind caring face. I had not seen her when I came in. I go over and ask if everything is alright. She says, I have been trying to attract attention but no one bothers. She says she is caring for one patient who is at high risk of falling and she has been there for hours and needs the loo. I look in to see a chair with a little torch still lying on top of the magazine she was reading. I sit and look after her patient while she goes to the loo. I work out that she has sat there for four hours. She comes back and says she is really bored and is finding it hard to stay awake. I offer to swap with her if she wishes. She says, ‘no thanks I would rather sit here than be out there with that lot.’ I ask if she knows them all. She says they are horrible here and all bullies, she says she just works bank shifts. I tell her what I have been doing and that I can’t wait until the morning when I go home. We share jokes with each other to cheer ourselves up. I say that I will come back to speak to her but I had better keep an eye on the patients because no one else was. I go to the nurses’ station to hear Jabba moaning. She is complaining about a job she is bitter about because she doesn’t think she will get it. There are two other candidates going for it who have lots of academic qualifications. She goes on and on and on. I look at her face and notice chocolate above her lip and a bit on her chin. It is 5am and Jabba shouts at me in a moan that sounds like the voice of Chewbacca from Star Wars, ‘give that patient in the side room a bed bath?’ To me this seemed barbaric. So I had a student help me as she was ordered by Jabba. The student was a bit of a worry. It was as though she had learned coping skills by behaving like them, she tried to order me around. I organised the bed bath. We undressed the patient; the patient had severe disabilities and was not in a position to rebel. Her eyes did not look happy. The student said that she forgot the towels, so left the room. I quickly covered the patient’s naked body with her sheets. The student came back in and said in a really arrogant voice, ‘hey what are you doing, I only went to get her towels, why are you covering her up again?’ This is the only time I nearly lost my temper. I turned to her and said, ‘if you were this patient how would you like to be left freezing, naked on a bed, is she not entitled to her dignity?’ The student went quiet and we dealt with her bath. After I had climbed the mountain of work on the ward I left with the bank nurse. We swapped stories on the way to the car park. I bump into her all the time in the hospital. She is one of the gems in the sea of discontent. As I drive the one hour drive home very tired, I put my cd back on and play it loudly to keep me awake. I go to bed dwelling on my night shift but laugh at the thought of Jabba the Hutt with chocolate all over her face.

Sick (part 5)

This morning I awake at 5.30 am and I feel like I have not slept at all. My legs are sore and I just kept waking up all night. I worry that I have missed out something on the ward and Sister will give me another dressing down. I am feeling so tired just now and I am just unable to face going in. I do not know what is wrong with me but I just do not have any appetite and I constantly have headaches. I must be coming down with something. I pick up my mobile phone and phone my ward to say I am not coming in today. I just say that I think I have flu because I just do not know what is wrong with me. I may go to see my GP, but for now I just need to pull my duvet up over my head and forget about my ward today.

Ban Bullying At Work : Supporters and Links

Ban Bullying At Work : Supporters and Links

Nurses Always Seem So Happy (Part 4)

Like every other morning I sit awaiting my handover at 7.30am. I expect to me moved and become the care assistant but I am not. I sit there and hear out handover. I am unsure of some of the patients because I was moved yesterday. It is the usual people today, Sister Poppins, Mrs F Flat another nurse and a care assistant. The care assistant is not from this ward as she works for the bank. My patients are as usual very dependent and some are quite ill. I carry on with my duties and have decided it is best just to avoid Sister Poppins. The other female nurse has been absent for months and has come back but I have never met her. She pulls me aside asking if I am enjoying the ward and I mention how I love working with the patients but I do not think Mary Poppins likes me as she never speaks to me unless she thinks I have done something wrong. The nurse appeared to be a very nice person she had red curly hair and looked like a female version of Gene Wilder the comedian. She told me she was absent because Sister Mary Poppins drove her to a nervous breakdown. She said she could not prove it because once someone is mentally ill they are labelled and truths can be distorted. She told me she had bills to pay and couldn’t face coming back here but she had no choice. I asked her why she didn’t leave. She said Sister Poppins would not give her a fair reference and because she was absent for so long no one would want her. She said she planned on being there for around three months then try to move. She stated that she would now be saving all the facts in a diary as her union had asked her to do. She put on a very straight face as she began to roll out advice like she had saved it up for months to tell others. She said, ‘now my advice to you is move wards, as quickly as you can. While you are here stay away from Sister and her F Grade. The F Grade is her eyes and ears and she comes over as caring but she is not. Oh and if you need anything on no account ask the Sister because she will do nothing for you. One final thing, if you are not in a union get in one now’. Sister turned the corner and we both parted company. I felt a bit scared by what she had told me. I had already had unfair and inaccurate comments added to my personal file. I digested the information while I worked. I always smiled at the patients no matter how I felt. One very frail little elderly lady smiled at me and said, ‘you are a lovely girl dear, always smiling. Nurses always seem so happy.’ I must have hidden a lot of my hurt very well. I made it my duty to never ever take what was happening to me out on the patients.

Patients versus Lockers

When I could hide away from Poppins and F Flat I would be the nurse that could care for the patients ensuring no detail of their care was overlooked. Sometimes it was hard because I would be so busy dealing with the patients that sometimes the ward could get a little bit cluttered. I was just one pair of hands. My priority has always been the patients. Once they are settled then I can tidy up. Sister Mary Poppins would get very annoyed if the ward looked in the slightest of a mess. She came behind the curtain where I was bed bathing a patient with the help of a care assistant and moaned at me for making a mess. She told me to stop what I am doing and clear up the lockers. The patient was naked apart from the towels covering her. I never answered back to Sister but felt this was extreme and this went against my practice. I said to the care assistant that my plan is to carry on with this patient then clean the lockers. I thought about my own rationale and I would never leave a patient naked on a bed to do something as trivial as clean a locker. The care assistant looked worried and said maybe we should do what she says. I said that I would not. As the morning wore on I was left alone with the patients and the care assistant was told that she had to work with the other nurse. I had no help with mobilising patients with severe mobility problems and I needed the help of another, this was moving and handling policy. I could not get organised because I had no help. This meant a couple of patients had to be left in bed and I really struggled. I went through to ask if I could get some help and was abruptly told that I would just have to manage. Sister shouted abruptly at me, ‘just do what you can for now’. So I did and by lunch time those patients still needed help to get out bed. I did all the other things I could and even tidied up.

Only In Dreams in Beautiful Dreams

Mrs F Flat came through and said you should have had all this done by now. I said I would have done if I had help. She told me it was all down to my organisation and I was not very good at it. She said, ‘I see you are still unable to do a bed bath properly.’ Mrs F Flat had no children and did not do a degree. She gained her nursing qualifications through the previous route. On the other hand I had many qualifications and I had children. Studying for a degree while caring for children is very demanding, how dare Mrs F Flat say I had no organisational skills! I was taught bed baths many years ago, so I also did not accept that I did not know how to give a bed bath. Mrs F Flat took over the care of my patients informing me all the time about how poor my practice was, making me feel like a real loser. She said that Mary Poppins needs to have a word with me after lunch. It was time for lunch and I did not have much money but I need to go to the canteen because there is no staff room in this ward to sit and eat sandwiches. Mary Poppins will not allow staff to have a room to sit and relax on breaks. I walk to the canteen and look outside to see that it has been snowing. The ground looks lovely all thick with snow. There are a few patterns of footsteps in different directions. I stop for a few minutes and gaze outside an open door. There was quietness and although it was cold the air was good. I could smell the food from the canteen but I wasn’t hungry. The cold air made my eyes water. I thought about what my footsteps would look like as I walked out towards my car and away home. I thought about sitting at home by the fire with the cat curled up on my knee. Simple life is what dreams are made off and my dreams were locked up in a box and it felt like Sister Mary Poppins held on to the key of that box and would not allow me to have it. This blanket of snow did not stop me from going home the reality of living costs did. I sat down in the canteen to a plate of pasta. I ate a little bit and sipped some tea. I sighed heavily and looked up to see my friend. She came straight over to me with tears in her eyes. ‘What is wrong?’ I asked. She sat down informing me that she will be leaving, that she could not take the bullying anymore. She informed me that her Sister was screaming in her face and that she kept picking on her. She started going though her story and I knew it was bullying. I asked if she had done anything to solve it. She said that she had taken steps but nothing was being done by managers. I asked if she was in a union. She said that she always meant to join but nothing could be done for her as bullying is hard to prove. I wanted to tell her about what I was going through but I couldn’t make her feel worse. This was my friend and I have never seen her like this before. I felt sorry for her but already knew nursing was not the career that it was portrayed. Programmes on television such as Holby and Casualty show nurses working as a team without staff shortages and bullying, I have saw these programmes with staff having the odd exchange of words. To me, a nursing environment like that portrayed in these programmes would be a heavenly place to work. The public have no idea what goes on and we are gagged from saying anything.

The Hogwarts Dunces Cap Goes Too..........

I go back to the ward and straight into a meeting with Mary Poppins. She had again become Professor Umbridge from Harry Potter. Her frog eyes staring at me as though I were a fly that she thought would make a snack. I expected a big long tongue to appear out of her head and I would be swallowed in one. She had been eating her lunch in her office and had obviously just finished, I could smell soup and the crumbs of bread were lying on her desk. I awaited her conversation but she did not speak. She stared at me and then filed through some papers. This was more about her manner; she was not really reading the papers as they were upside down. She kept looking at me up and down but did not speak. She started by saying, ‘I have been hearing your practice is not up to scratch’. She stated that Mrs F Flat had reported me as being unorganised. I explained that this morning there was no-one to help me and I had asked. She put up her hand as though I were not allowed to speak. She went on to state that I was wrong to disobey her when I was told to clean the lockers. She came out with a list and stated that this would also go on my record. I told her that these were wrong and everything else had explanations. She turned to me and said, ‘I do not want to hear it.’ I did not get the opportunity to explain. My side of the story was but a whisper in a crowded room. What was the point of trying to explain? I was obviously stupid and despite my education and prior experience I was sitting here wearing the dunces cap. My stomach ached and I did not know why? I have been getting headaches too but I am sure I am just dehydrated. I went out to the patients and smiled. There was an elderly lady with big bright eyes she was very ill but smiled through all her pain and never complained. We had lovely talks and she had this perfume that always reminds me of her to this day, a perfume called ‘Maybe Baby.’ She would spend all morning putting on makeup and doing her hair it would take her ages but she insisted nobody should help her. Her nails looked lovely and if it was not for the oxygen tubing going into her nostrils it would be hard to believe she was ill. She said that it is her perfume that makes her feel as though she were complete. Today she had turned a corner and became worse. She cried at the thought of leaving her family. I wanted to make this lady better again but I couldn’t. She informed me that I have been wonderful to her. Her family all came in and there was a well of emotion. They asked all sorts of questions of me and I had the doctor speak to them and made them all tea and coffee. They sat by the patient’s bed as she deteriorated. This is the point in nursing when I feel so helpless. After the patient died I cleaned the patient and brushed her hair. When she looked presentable I gave her a little of her perfume, ‘Maybe Baby’. As usual I felt the lump in my throat.

You Should Have Joined The AA

I give my handover to the night staff who listen intently as I inform them off the patients. Only one staff member is from this ward the rest are bank staff. The nurse says she is leaving to go to another hospital as the absence rate is getting high and everyone is leaving. She smiles saying that she never works daytimes here because of Sister Poppins and Mrs F Flat. She said she caught sight of Mary Poppins today stuck in her car on a slip road with her hazards on. The nurse said it looked like she had broken down. She said that all the other cars were beeping their horns at her. I leave the hospital at the end of my shift with my car keys in hand ready to make my getaway. The snow was deeper now and as I was driving home I could see all the snowmen lined up in gardens like sentries. Everything looked bright and it made me smile to be going home to my fire.