Driving on to work I watch the sun come up, it looks brilliant orangey red. It shines off the wet road. There are many stars still twinkling, I still feel cold although I have my heater on in my car. I am tired and I dream about ways of moving out of nursing. I long to work normal hours instead of twelve and a half hour shifts on rotas which means I can never plan anything anymore. My working life is going nowhere and I went to university to become everybody’s skivvy. I was never prepared for this job. I was taught very little at university. So much for training being fifty per cent practice and fifty per cent theory, that is a laugh. I was struggling to get the opportunity to practice as a student nurse and now I am just expected to get on with it. So much for being able to use research based practice. If I try anything different I need to challenge the routine drones who shout, ‘we do it this way here’, but they never question why. How dare I challenge the nurses? Anyway, what nurse has time to look up the internet to check on practice? How many times I have been told off for sitting down at the computer checking up the correct nursing procedures? Did you know it is a sin for a nurse to sit down on a ward? Even the heavily pregnant ones who are due sit down breaks are made to feel bad for sitting down. Universities are so out of touch with the realities of nursing. So for instance if I need to find something out about practice I need to go home and look it up, if I remember after a twelve and a half hour shift. The question is how many nurses actually use the computer at work to educate themselves? Anyway, why are we doing twelve and a half hour shifts if it doesn’t suit us or fit in with family life? Just how safe is this anyway? Would you seriously want a nurse to give you your insulin in the morning after twelve hours of work, if she didn’t sleep much? In all honesty, I wouldn’t as it is dangerous. Let’s face it, we are human and need rest. Some time ago when nurses gave out drugs on a drug round this was all they did; they did not need to answer phones and buzzers at the same time, distracting them from the job in hand. In all honesty wards are unsafe, too many patients with many needs, too few nurses, too much paperwork and tasks to do all at the same time. Distractions are plenty. Let us look at the role of the nurse? What is her/his role?
Tasks are a Plenty
The nurse comes on shift listens to the handover of the patient; this is her bible on the patient for the day with requests and expectations. If you miss something at this stage, you could miss something vital. You need to be alert and listening. When you get on to the ward you will already have some idea of what to expect for the day. The day starts with the drug round if on a safe ward. If not, the night staff would have given out the drugs. Oh dear, how many errors? Anyway, after this or during this the breakfasts arrive. Patient buzzers go at the same time to get help to the toilet. IV fluids come to an end and the pumps beep to remind you. The phones start ringing from relatives asking the nurses how the patients are. Physiotherapists arrive on the ward and have specific demands. Occupational health workers also come in asking specifics about the patients. Meanwhile, after breakfast it is time to get patients up and dressed to sit all day beside the bed. Nurses go into the poorly designed showers to get feet and clothing wet to carry out their duty of cleaning the patients for the many patients that are too ill or physically challenged to manage on their own. Doctors come around and the nurse needs to tag along to hear the progress and share information.
After this, it is time for the measly half hour break to eat something. Sitting with soaking feet and dishevelled hair with a bowl of cereal before combating the next bit. Some patients can go home and this is often a good time depending on the pharmacy order which is often awaited depending on if the nurse gets it in on time. Again the drugs for the patient to go home with are dependent on the nurse. Lunches arrive and the patients also need their drugs. Lunches and drugs are given with little time to ensure patients actually eat. Food charts and fluid balance charts are guessed on and filled in as haphazardly as always. What about wee Jessie in the corner did she eat her lunch before it was whipped away? Nobody knows! She may be starving but can’t communicate. The nurses had been too busy to notice if wee Jessie ate. It is now time for wound redressing if they were not managed this morning. The phones go constantly as relatives, doctors, OT’s, community nurses and blood results phone in. The bleeping of IV fluids goes as a constant reminder to change the bag. Patients who are too ill and are in bed need constant turns to stop bed sores. Patient buzzers go all day to ask for help to the toilet. New patients come in; paperwork needs done for all patients. Don’t forget constant observations, blood pressures, oxygen saturations and temperatures. For those that have slipped downhill the docs need to be made aware. Patients vomit and need injections to stop it. Relatives come in to visit and the whole ward is swarmed in visitors at the same time. They ask all sorts of questions and sometimes get angry because they can’t understand why we are not standing over their mother or father the whole time. The demands are always raised during visiting times. We get another half hour break. After break it is tea time and the patients get the usual routine as lunchtime and breakfast time. Patients often soil themselves, they can’t often help it and it is normal for us to need to clean it up. Sheets, clothing and bedding get covered in it. We always hide this part of nursing but why it is human nature? Someone needs to clean it and both nurses and care assistants deal with it. It is not a nice task but it is the reality of nursing. Can you imagine then the wards that have diarrhoea and vomiting outbreaks? We change bed after bed and the whole ward smells. We go home smelling of pooh with our disgusting uniforms which slip neatly into our washing machines at home, then they wonder about why we end up ill and pass it on to our families. We do not want to take out uniforms home. Scrubs for all laundered in the hospital and kept in the hospital is the answer. We get another half hour and that is if lucky. We are only entitled to one hour unpaid break.
The End is Nigh
Anyway, it is time for patients who are not in bed to go to bed and prepare to give the nursing handover to the night staff. It is always a worry that enough information is handed over. Oh and do not forget to hand over the drug keys from the uniform pocket this may mean a drive back to the ward.
Above is the broken down version of the nurse’s role, there are many more little jobs, like fetching and carrying and accompanying patients places. When the patient becomes really ill then we also need to deal with this. Can you imagine this for thirty patients with two or three nurses and a care assistant? Remember we always run short when nurses go on break? If three members of staff get one and a half hours each for break that is four and a half hours we run short of staff. Do any of us really have time to train students?
Chocolate Break
I have worked hard today in this rotten ward with no support or friendliness from any of my colleagues. I am isolated. This ward is full of cliques and I am situated in the old part of the hospital. Jabba the Hutt the obese nurse works here and she loves to eat chocolate Hob Nobs while I run about doing her work. I worry about the state of her health and fear she will have a cardiac arrest as she sweats profusely with the thought of work. It is hardly surprising she has no energy and she is not promoting good health to the patients. We live in a society that has to be politically correct and we are no longer able to manage our overweight issues which affect health. It is not being un-politically correct to state that on a regular basis we as nurses hurt our backs attempting to slide obese patients up the bed. Because we are understaffed we do not have the manpower and it is common for two small female nurses to pull a heavy obese patient up the bed. Slide sheet or not, it is hard work. I recognise obesity is a problem in this day and age and even recognise that it is difficult to keep the weight off but we could at least manage the work load if we had more nurses on the ward. Nurses who are overweight in the NHS should be given priority to a free gym pass. In fact, give us all one and build a gym in the hospitals for us. We are on the front line of promoting health and we should be good specimens within sensible reason and how dare any nurse who is grossly overweight from overeating with no exercise tell a patient who is overweight how to lose weight. Those in glass houses and all that! There is always the exception and that is those that have medical conditions which cause a weight increase. Those of you that fit this category can relax; I am not including you in this. There is another way to look at this, working twelve and a half hour shifts promotes poor health in an unhealthy environment. Can we really be promoting good health working like this? Who are we kidding?
SHRITE Sister Your personality is Showing
I am under the rule of a new sister blue office troll. I can only call her Sister Elizabeth and she is on HRT. HRT stands for Hellish Righteous Toad. Sister Hellish Righteous Toad Elizabeth is her name. Abbreviated is SHRTE. Sounds like...... anyway, she is no nice woman and watches me carefully. She knows I have gone to my union and she wants to dispell any rumours about her ward. She speaks to me as though I have slid off her shoe when nobody noticed. I am not favoured by her at all. She wants to speak to me but not today. I am to see her tomorrow. I go home looking at the setting sun and listening to the radio which informs me ‘Scottish NHS bullying running at 50%
5 November 2001: a confidential survey by Grampian University Hospitals Trust reported in The Scotsman reveals that nearly 50% of staff working for a leading hospitals trust have been bullied at work. "Undue pressure to produce work" was the largest single cause of bullying. This figure of 1 in 2 echoes Charlotte Rayner's seminal survey from Staffordshire University Business School in June 1994.’
The Beginning of the End.....
This is now 2008 and my story is just beginning.
