I lie reading a book on the Mayan and Aztec cultures. The culture is amazing but with some very grizzly ideas, but then it’s easy to cast judgment outside of a culture. Aztec law appeared barbaric and theft was dealt with by strangulation. Those found drunk would have their heads shaved on the first occasion and on the second they would have their house knocked down. The punishment on the third occasion rises sharply to death. I lay back thinking that I did not know anything about this culture until I read about it. The outsider of the nursing culture does not know what really goes on in nursing and I bet they would be just as horrified to read what goes on as I was to read about aspects of the Mayan culture.
I dream of what it must have felt like to climb the steps of the great Mayan pyramids knowing that death was to follow through ritual sacrifice. The dread from it all must have been so terrible that I could never imagine. All these people who died needlessly but then their leaders needed to look like they were in control and so their rituals appeared to have significant meaning to the people. Did their people never question why these people had to be put to death? It is so poignant that people accept their fate from what they are told by others and never ever question anything. This behaviour is nothing new as I lie thinking about my glossy filled book which still harboured a smell fresh from the bookshop, which incidentally also sells the most amazing coffee.
A Little Rash
I close my eyes and then the alarm goes off. I am feeling the dread of work and the only analogy I can think of at this time is walking up the steps of that big Mayan pyramid to be put to death. I think about phoning in with various excuses but don’t we all do that? ‘Hello, I’m sorry I can’t make it in today, yes, yes my cat choked on a chicken bone and well I need to take him to the vet.’ Or, ‘I was looking after a little old lady yesterday in the ward and she had a strange rash all over her face and now I have it.’ I doubt they would believe it. Oh well I must get up! I drive up towards the hospital and there are other nurses slowly wandering in. I can always tell the standard issue dark blue trousers with the white tunics hanging below the jacket. They wander in like zombies. They all look miserable and walk slowly from all different directions as though if they walk slow they will miss their shift altogether. As I wait at the lights I gaze across to a field and the dark lush green grass has a wet coating across it crystallised with dew, like a frosty icing on a cake. The trees look dark and eerie with a glimmer of sunrise in the background giving them a silhouette appearance. Green lights set my wheels moving and I turn off my music, my music is my only sanity in all of this, and a day spent without music is a sad day. I watch blue lights flash quickly past me and I see an ambulance bring another sick patient to be cared for. I wander to my ward and quickly get changed. I go to hear my handover and exchange very simple pleasantries but they are not reciprocated.
Maya Head
I try to write quickly but am unable to do so and miss lots of details out. I quickly ask if some details can be restated, I hear a sigh and I pretend I did not hear it. I am not familiar with this ward and many terms are abbreviated and I do not know what they all mean. I am told that I will be caring for beds 16-30 with another nurse and a care assistant. I quickly get started; the other nurse Brenda ignores me as I try to make conversation. I help the care assistant get the patients out of bed while the other nurse decides she is giving out the drugs. The care assistant has been here for many years and also ignores me. She sighs at me as I do things differently to her. I have my justifications and hers are just a way she has built up over many year. Why she does it, who knows, because she has always done it that’s all! She doesn’t ask questions she just does her job. She is an angry looking woman whose appearance has obviously withered in her anger with a face like the large carved head at the Maya city of Copan. She moans at me but I am too nice to speak back although I feel resentment. She never washes her hands and patients are moaned at too, so I am pleased I do not think it is not a personal vendetta against me.
The other nurse Brenda is clinically obese, an all too common sight these days and she wears the dress uniform. She likes to be in charge even although she is band five, the same as me and she has had no managerial skills to be in charge of me. I accept though that I am still unsure of this ward so do not care. She reminds me a patient is getting home for the day, she is having ongoing intravenous antibiotics but has now stopped them and she is due back later in the day to have more. She wanted it that way! As the patient leaves I throw out the intravenous line which is filled with some of the patient’s blood. As I close the lid on the bin Brenda shouts at me across the room filled with patients. She says that this intravenous line was good enough to use again when the patient came back in ten hours time. I think to myself and I examine my actions. I say ‘well it is in the bin now’. Afterwards I thought about this and just for one split moment I thought maybe she could be right and the ward is saving money. When I returned from the world of the insane I was glad I threw it out. How much money does the NHS actually save by reusing intravenous lines, attaching them back to the patient many hours later? What is the point in giving antibiotics for infections when they are pumping old blood but into the patient some ten hours later? Disgusting! If I was the patient I would refuse anyway. What sort of barbaric practice is this? Let’s go back to the old ways of giving the syringe a clean in between patients. What research was carried out to justify reusing these lines?
Mirror Mirror On The Wall Who is the Evilest of Them All?
I watch this nurse all day after this and examine her practice. She also never washes her hands and doesn’t even try to speak to the patients. If I was a patient and she came near me I would get out the bed and run as fast as my legs could carry me. She converses with the care assistant with the stone cold Mayan head but looks at me as though I where the mother of all evil. I check my appearance in the mirror as I go for my break to eat my cereal. I look at myself in the mirror feeling sorry for myself, beginning to wonder if I am emitting evil from somewhere unsuspecting. Perhaps I need to smile more I think, I try to smile in the mirror but just look stupid and just feel sad. It is hard spending each day at work without anyone to speak too. I don’t belong in nursing, I am not like them I think. Maybe they have something I do not. I comb my hair and walk towards the door when it is flung open. In walks a nurse that I saw from afar today in the other part of the ward. She looks up at me and says ‘I hate nursing, this is just my third month and I regret every bit of it’. ‘Maybe you will get used to it’, I say. She said that she was looking for another job already. She speaks to me about her experiences and bursts out crying. She is now getting counselling to cope with the bullies in her job until she can get another one. I understand what she is going through but I don’t want to tell her my experiences because I may make her feel worse. I go into the staff room to eat my cereal and I listen to a conversation about a poor young eighteen year old girl who has a severe illness and has no longer got the ability to do anything for herself. They discuss her very condescendingly because the patient was refusing to have anyone wipe her bottom after the toilet. How dare she be the spanner in the works of their cosy routine? One nurse pipes up, ‘she will just have to get used to it because that is her life from now on’ another nurse sarcastically laughs saying, ‘she says she will be going back to the gym, she is so out of touch with what is really going on.’ I felt so sorry for this young girl all her mobility cut off so young and I just couldn’t stand the way they were dissecting her life as though it were just another episode of Eastenders. What eighteen year old girl would gladly succumb to having all her dignity ripped away from her like that? Imagine having Mayan head lady come up to you saying, ‘I’ve come to wipe your butt’. Scary thought! The young girl may not be facing up to her realities yet because if she did then it would sink her as it would anyone. A big part of her life was going to the gym and why shouldn’t she dream of getting back there. Ripping away someone’s dreams is the cruellest thing any nurse could do! Hope is something that we all need! Nurses all need to be taught counselling skills.
Hope For Us All
I go back to the ward one patient is just thirty and she is so happy that she will be getting home at the end of the week. I didn’t get to know her but we had great conversations on everything and laughed together. Her face was very yellow and her eyes were sunken. She informed me she was getting married and she was so full of joy about it I could feel her happiness. She was diagnosed with cancer and was given three months to live. She shook me by the hand as she left the hospital at the end of the week and said you have been a great tonic. I looked into her sunken eyes as she left and I wanted to make her well but knew only a miracle would save her. It is hope that kept her going. The Mayan headed care assistant now thinks she is in charge and attempts to boss me around while the other nurse look smug. She informs me of so called ‘unit errors’, which are all trivial and are done by way of culture rather than any rationale. I ignore her and make some excuse for myself but then feel bad for not challenging her. She makes my life a misery. A little elderly man comes in and has traveled far, saying he is unsure of the visiting time. He asks if he can briefly see his wife as he has not come in before now. His wife is very unwell and the little man looks so upset. I open my mouth but before any sound comes out Mayan head lady shouts harshly, ‘you will need to wait until visiting time’. She expected the man to wait until mid afternoon. His car in the car park would be clocking up cash. I turn to the other nurse who agrees with the care assistant. So I am overruled. This upset me as I watched the little elderly man walk away slowly with his little brown leather holdall. I know we need to be strict but this is surely excessive. I accompanied his wife to have a procedure done and we came back for lunchtime. She started to deteriorate and became less responsive. Brenda checked the lady’s oxygen saturations and moaned that the equipment was faulty and just sighed and walked away. When she left the room I placed the oxygen probe on to the lady and noticed her oxygen levels were sitting at 82% and she was already on high flow oxygen. This was a bad sign. I immediately went to the doctor. The doctor said that the woman will not survive the next few hours. I went to the woman’s notes to find her next of kin contact, this was her husband. I tried to phone him but he had obviously been in. I contacted the patient’s daughter who came rushing in. The little elderly lady died and the daughter did not get the chance to say goodbye. Sadly, neither did the husband. I felt so cruel and heartless. Why did I not say something, I thought to myself?
We Are Just Obeying Orders!
I watched the elderly man hug his wife for the last time as I closed the curtains on them to be together. Mayan head lady said ‘well it’s not our fault we have rules to adhere too.’ This reminded me of an experiment carried out by Stanley Miligram whereby he showed that people adhere to authority figures. In this case an actor was receiving electric shocks for getting his answers wrong. In a social psychology article Stanley Milgram summarised his experiment in his 1974 article, "The Perils of Obedience" writing: I set up a simple experiment at Yale University to test how much pain an ordinary citizen would inflict on another person simply because he was ordered to by an experimental scientist (an authority figure). Ordinary people carrying out their jobs and without any particular hostility on their part can become agents in a terrible destructive process. Additionally, even when the destructive effects of their work become patently clear and they are asked to carry out actions incompatible with fundamental standards of morality, relatively few people have the resources needed to resist authority. In this case the care assistant and the nurse had caused pain to adhere to orders. I myself had to go along with this because I did not have the authority to overrule the situation.
The Incredible Hulk
Later on I saw Brenda walking about in a plastic apron on top of her uniform. She had sweat running down her face. Mayan head lady asked her why she didn’t take her apron off. She turned around saying that she has burst the zip and doesn’t have another one to change into. Nobody in the ward was her size. She was to swelter under plastic for the rest of her shift. Plastic suited her because she was a plastic nurse with no feelings or care for others. She was the opposite of the plastic Barbie doll. Brenda the bull I thought. I discovered later that Mayan head lady was angry that I was filling the post her friend wanted. I being there ruined her cosy little set up. Oh dear, how sad, never mind. I open up my car and sit down reflecting on today. I do not know how long I will last in this ward but I have no choice right now. I felt like David Banner searching for a cure for the Incredible Hulk, the Incredible Hulk is the beast that is the culture of nursing. I drive home with wiper blades sweeping away the rain as it hits the car with great force. There is something peaceful about the rain and I do not play music as the rain plays its own song.
