New email: Loumcgee2@gmail.com

Angel of the NHS: New email: Loumcgee2@gmail.com

Angel of the NHS: New email: Loumcgee2@gmail.com

Out With The Old In With The New

It is past midnight and I can hear cheering.I walk up through the close and all my friends who said they would wait for me have gone. I knew they were drunk but not that drunk. I felt lonely and scared, I was all alone. I look up the hill to the big clock and see swarms of people all cheering, arms swaying in the air, staggering in drink induced happiness. I am not happy for I am alone. I walk up the hill towards
the big clock, cars drive by and their tyres are noisy on the cobbled roads and I am splashed as a car’s tyres trundle though a puddle. A man stands in a door way which has kilts in the window; he holds a cigarette and turns to me saying, ‘have you got a light miss?’ I reply by saying, ‘I am sorry but I do not smoke.’ ‘I see you are alone’ he says. I think for a minute and reply,‘no, my friends are up beside the clock.’ ‘You do not want to be alone tonight girl’, he states. I just ignore him and continue walking up the hill. I try to walk through the crowd as some of them try to shake my hand. A few of them jeer me, as I must look unhappy. ‘Cheer up hen, it’s no that bad,' one very straggly looking man states. I push my way through them all and walk down a banana shaped road with row upon row of shops. There are hardly any people in this street. I hear footsteps and look behind me. It is the man that asked me for a light. I am really frightened I just know he is following me.

Out of Breath


I walk faster and I hear his pace pick up too. If I run he will know that I am aware of him. I must run it is my only way to escape. I run down the hill towards a small roundabout and run across the road. I look around and see the man run too. I must find a taxi but there are few and they are all full up tonight. I am now running up a hill and my legs feel heavy. I look up and see a big monument which looks quite eerie and black. I keep on running and get to a big street with people swaying around, they all look drunk. Nobody takes any notice of me. I turn around and the man is gaining on me. My legs have become so heavy and I just can’t run anymore I cough and am out of breath. The man grabs my arm. ‘Where are you going miss?’ he asks. ‘Just let me go,’ I reply. He goes into his pocket and I see something shine in his hand. ‘If you want to be safe you need to come with me, make any noise and you will regret it’ I am so scared I try to shout, I see his face peering over mine in anger. I wake up and do not know where I am, it is very dark. I can’t see the usual streetlights. I lie still wondering where I am. If I am elsewhere I will soon know. I lift out my arm and reach over to find my phone. I grab it tightly as I know I am safe at home. I sigh with relief. I have had another bad dream. I lie back but wonder why there are no lights outside. I get up and turn on my light switch but it does not come on. I search for my torch which I keep on top of a cupboard for such emergencies. I switch on the torch and see the man who was chasing me in the light. I jump up out of bed, as I see the familiar street lights out my window.My nightmares are getting worse. I wander through to my kitchen, open the fridge door and take the milk out and pour it into a glass. I sit at my kitchen table and worry at how bad my nightmares have become. I wonder what they mean. I glance over at the clock, it is now 4am. I am too frightened to go back to sleep in case I get another bad dream. I switch on the radio and read my book while I sit on the couch; the cat sits on my lap. I suddenly wake up with the radio saying that it is 6am. Oh no, I will be late. I jump up and get ready.


Back Shift

I wander through the hospital and I bump into Elias the porter. I ask him where he has been. He says, ‘my back is injured with pushing the trolleys, I have been off sick.’ I feel sorry for him he always looks tired and unwell. Porters are on such poor pay and their work is so hard, they must walk miles every day. Their work is so undervalued. I tell him it is good to see him as we part company. I walk into a ward and I can smell pooh as soon as I enter. I hear a voice shout, ‘you are late, we start earlier in this ward.’ I say that nobody informed me but it falls on deaf ears as the nurse says go through into that room and listen to the taped handover.
I wander into a dusty old room and listen to a tape with many abbreviations and the nurse speaking could not talk any faster if she tried. I keep stopping the tape and rewinding it to try to get the information. I eventually give up. I wander through this very old looking ward. I am told I need to work with another nurse. I introduce myself and the nurse is pleasant back but is very flustered. I feel a bit lost as they are a bit through their morning already. I wander into a room to help a patient eat breakfast. The patient sighs at me as I do not feed her the way she likes to be fed. I quickly apologise and tell her that I am new. I take the patients plate out and place it on the trolley. The care assistant stands there and just stares at me but says nothing. I smile and say hello to her, she says hello back but with a very blank face. I hear that she has been there a long time. She clearly has no time for me and moans at me when I do not do as she instructs me. She said to me, ‘go and do this.’ As I always understood it I am not a care assistants’, assistant but I do not mind working as a team and I understand care assistants can be lovely people too. If she had asked me in a respectful manner I may have helped her out. I see her wander up to a nurse and I hear the nurse shout, ‘aye, is that right, we will see about that!’


Old Acquaintances

The nurse comes up to me and says, ‘Doreen wants your help, why did you refuse?' I feel awkward and do not want to rock the boat and say, ‘alright, I will help her.’ We get patients up and dressed, the care assistant orders me about and I feel very dumb. I feel my brain wanting to close off and I just want to go home. Everything I say is ignored by the care assistant. She wears brown epilates and is clearly very overweight. She orders me as though I am stupid. She rolls her eyes at me and is clearly aggressive. How did I get into this mess I think? Why exactly did I go to university to be ordered around by an overweight fascist with no education and her brown epilates are clearly quite appropriate. She sits at the nurses’ station and munches her way through a whole tin of Roses chocolates while talking about her son’s impending wedding to the other very interested nurses. One nurse is very young and looks at me now and again but tries very hard to be involved in the conversation in order to be accepted. The young nurse moans at me too as I try to find essential nursing resources in the cupboards. I am feeling more and more stupid. How soon they all forget they were once new here too. I am relived as I go for my breaks and I avoid the staff room as I am bored with hearing about Doreen’s son’s wedding. I wander into the canteen and see nurses from the old wards I escaped from. I feel awkward here too. I meet an old university colleague here but we just exchanged simple pleasantries as he seems immersed amongst his colleagues. The last time I saw him was just yesterday, he had moved wards because he hated it after all. I asked him if he was enjoying his new job but he said he hates that too and is looking for something else away from nursing. It reassures me I am not alone but confirms my theory that the current nursing culture is very bad indeed and is in need of an overhaul.


Beauty and the Beast

I watch the nurses as they show lack of care or respect for their patients or relatives let alone new colleagues like me. Nursing was never meant to be like this. Surely there is care and compassion and admittedly they are short staffed and overworked but in this ward at least and it may be true for others the aggressive care assistants are in charge.I, at least will remain true to who I am, remembering back to my dream many weeks ago with the elderly lady at the shore who told me to be myself. In my care at least I do all I can for patients and speak to them not like another patient but like a unique individual with a set of needs. I smile at my patients even although I feel bad in this environment. I make enemies because I am going against the tide of their normal culture and they hate me for it. Doreen does not get my respect or my interest in her son’s wedding. When I go home my mind is on what I could have done better to care for my patients. I listen to a lovely piano solo on my car stereo. In all things ugly there is always beauty. I take out my rubbish bins when I get home and relax reading my book.

Road To Nowhere

I got on to a big red double decker bus. I couldn’t find a seat and so I sat at the front upstairs. The bus took an unusual route and headed for the country. I turned around to see how many people were left on the bus. I was now alone. I couldn’t get off here because it was very far out of the city. I sat expecting the bus to change route but it didn’t. It turned and drove along the shore. I could see the sea but it wasn’t a calm day. The sea was throwing itself against the rocks turning white and frothy as it did so. The bus kept on going and the road became less than safe. It was narrow and we were driving along the edge, it felt like we could topple over into the sea. I felt frightened. Still the bus kept moving. It turned and creaked over the steep narrow roads. We were really high up over the sea, I kept looking out to see the journey ahead. The bus sped up and now we were going really fast. I saw a bigger bit road ahead and decided I would get off here. The driver looked angry at me as I left the bus. I was at the beach; it was now nice and sunny. To my left was the beach and to my right up the hill was a tennis court. The beach was full of people sunning themselves and children played in the sand. I looked up at the sky and it was changing from daylight to night time. The sun was blocked out by big black clouds. The sea was coming crashing in at a terribly fast rate. Everyone screamed as they tried to pick up their belongings before running away. The sea started to swell up onto the road where I was standing and I was up to my knees in it. I couldn’t move I was scared and even if I wanted to run there was nowhere to run all exists were blocked off. Why did I come this far, I thought?


I'm alright honest!

I jumped out of bed, looked at the clock and I had awoke ten minutes before my alarm. Driving on to work I couldn’t stop thinking about my dream. It was quite warm this morning and I looked up at the sky which still had some stars and was very clear. I wandered into the ward and before I could reach the room to get handover, the sister in charge said she wanted a word with me. She ushered me into a cold room with table and chairs. I sat down wondering what I had done. She had a mug of coffee in a cup with a cat on it. I looked at it as it was the only thing on the table to focus on. She began calmly by asking how I was getting on. I looked up in to her face, youth had deserted her a long time ago but she had a face that could be fixed up but anger had down turned her mouth and it had obviously set. She smelled of strong perfume and she had spilled something down her dark blue overall. Her eyes were a deep blue and she had died her hair a brown colour. Her face was darker than it should be with the tell tale signs of foundation lines around her chin. I said I was alright but then I went on to address some of the issue I had. I said I needed support in the ward to learn a new specialty not isolation. She went on to say that she was annoyed that I had contacted the union. She reminded me that she was my boss and if I have problems then I should address them to her. I said that while this may be true some of the staff is bullying me and I felt I could not speak to her. I said I can’t work in this environment. She got very angry with me and her top set of dentures slipped down as she shouted at me. ‘How dare you involve the union.’she said, ‘who do you, think you are?’ ‘What exactly is it you want’? She said. I told her calmly I just want to get on with my job and to be supported in that. She stood up and walked right over to my face, I could smell the coffee from her breath when she shouted ‘you are making me look like an idiot.’ I asked if that was all and could I go. I was quite scared but I dare not show her. ‘I want you to say everything here is alright, isn’t it?’ I replied, ‘er yes yes.’ I thought if I tell her what she wants to hear she will leave me alone. I reply, ‘well actually things were bad but now they are alright.’ She shouted at me, ‘GOOD!’ I put on a pretend smile and stood up. I walked down the ward feeling really scared. She had just bullied me and I needed to get out of here. In my break I phone the union and tell my steward what happened.

A date has been fixed for me to attend a meeting. I go into the meeting the next day feeling really anxious. I just want a peaceful life, going to work and then getting on with life but this has so far never happened. A woman from human resources and the directorate manager are there along with my steward. I am asked to discuss my issues with them. The directorate manager turned around and said that the sister said you are now alright now, is this true? I replied that I was not alright and I had to say this to get away from her as she was shouting at me. The meeting ends with me being allowed to work elsewhere. I am allowed to go home after the meeting. I am so happy to be away from this unit but through my experiences I do not know if things will be different anywhere else. Nursing has already got a set culture but surely there must be good places to work.


Enough To Raise Your Blood Pressure

I walk away with my back pack over my shoulder. I go into the staff canteen and see one of my old university mates. I ask how she is. She informs me that she is leaving nursing. I ask if she has contact with anyone else. She tells me that there are few of us left and that many have now gave up to do other work. I feel quite sad about it all, we all spent such a lot of time together and very few of us are happy. There must be a reason for this. Nursing is set in a busy environment were mistakes must not be made or we can be struck off. Paperwork is getting deeper and deeper. Our hours are long with very few breaks and we are always short staffed. This is a dangerous culture. It frightens me to think that any slip up could place me in front of the magistrate’s court. If you don’t document a patient’s condition, it didn’t happen; if you did it has to be precise. Omissions are just as bad as poorly written documentation. Damned if you do and damned if you don’t. Every piece of paper we sign our name too is a legal document. I like the way each ward has its own way of writing the notes and everyone blindly copies the same format for example, ‘patient had settled day, non-complaining, all care as planned’. One thing is, who on earth has a settled day in hospital? To write in the notes non-complaining, doesn’t say much about a patient at all. The best one is ‘all care as planned’. To write ‘all care as planned’ is obviously assuming the nurse has carried everything out that is to be carried out for the patient. However, if the nurse gets home and then realises she has forgotten to do something and the patient has an adverse reaction then the record of this has legally implicated her because she has stated that all care was given as planned. However, if the nurse writes nothing then the nurse could be deemed to not have carried out her duties.

There is no fool proof way of recording about patients but at best it pays to be honest. If the patient is complaining about pain, best write that the patient was complaining about pain and what you did as the nurse to alleviate it. As for observations, they are the most important key of how a patient is doing. If blood pressure is low or high and the patient looks well and is up and about, it pays to check back what their normal BP is because it may always be low or high and this could be their normal. New devices though are needed to cut out paperwork.
I walk out into the afternoon sun and go into my car which is boiling. I turn on my music and drive off with a sigh of relief over today. I just hope that my next ward is going to be alright.

Culture of Discontent

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.

Up To Your Neck In It.

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.

Brainwashed

My mum is so old fashioned with views that could sink a battle ship. I go to visit her on my day off but I have more battles with her. She kept telling me that I need to settle down and have a husband look after me. She said I should not be working at all. She was blaming me for being outspoken. ‘Women should know when to keep their mouths closed’, she would say. I could feel the annoyance as I sat staring at her perfect little world obscured by society’s realities. Oh, to pull off her rose tinted glasses and put ‘my world’ specs on to her glazed over eyes. I told her that she should be proud of me, for here I am independent and with a view of my own. I pitied her, for I know she was a mere servant to my father and times did not allow her to live. They did what they were told by society and society was telling her how to keep her daughter in line. Socialisation breeds herds of sheep and my own parents trotted along with flock. My mother told me that if I had not been outspoken my first relationship would not have broke down. It was my fault because I must have said too much back and I am not content to be the housewife. I am outspoken, that is me. Thank you mother, you taught me not to be like you. However, I am not yet outspoken enough to deal with the bullies in nursing, I would go to work and do what I was told, like a good little girl. Just because I did not speak out openly did not stop my brain from speaking out. Alarms bells rang in every ward about how wrong the culture of nursing is, except for the few exceptional nurses of course.
I would lie awake every night wondering what I could do to make things right. This night was no exception and I lay in bed dreaming. The big black crow appeared again as it so often did, looking down waiting to swoop. The crow was about justice for all the wrong doings. At first I was looking up but then I became the crow looking down. I am eyes and ears and I see and hear everything but how do I tell everyone what goes on? I have no voice. I watch the breakfasts dished up to the patients, who is ensuring those who are weakest are fed? Heavy duty painkillers and antibiotics, dehydration with little food is enough to floor the strongest let alone the weakest. ‘Come on Mrs Brown you need to eat and I have no time to stand here and feed you because after lunch I need to hand out your tablets, there is only one of me to fifteen patients right now, how do I manage this workload?’ The nurse looked stressed and worn and was doing her best but her best was not good enough, she was understaffed. She would give out the drugs but was so distracted by the millions of jobs in between she would forget to sign for drugs and leave drugs lying around. She heard a moan from the corner of the ward and realised that the patient had soiled herself again. She looked at the distressed patient and it was up the patient’s back. Nobody was around to help her clean the patient up and she was in the middle of the drug round. What could she do, the patient is too heavy to lift alone? Relatives walk in and find their mother covered in faeces. Sister comes out her office to discover the angry relatives. Instead of being understanding Sister blames the nurse. Finally after months of this, the nurse snaps and gets angry, patients and colleagues suffer, so long as the jobs are done, who cares about being nice, being nice has no place in nursing. As for smiling, that is well wiped off the nurse’s face. Who is this nurse? The nurse is the seventy per cent of nurses. To get the job done they learn to bully because they do not want Sister breathing down their neck. Sister is the evil dark blue Troll who lives in the office and only comes out to belittle the nurses. They feed the culture of bullying. They are at the top of the bullying hierarchy. I fear becoming one of that seventy per cent that it haunts me in my sleep. I wake up from the alarm on my phone. I go through my usual routine to get to work. I work beside an angry elderly nurse who bosses me around. Patients get a bed bath at 5am in this ward. I stare up at the cracks in all the paintwork and the tiles in the ceiling are loose. The sinks have seen better days and it is impossible to get near them due to the patients beds. Many nurses in this ward ignore washing their hands just because it is part of the culture. This ward is an exception; it is not like other wards. It is the quintessence of evil wards. I would like this ward condemned along with the heartless mean staff that run it. Run in and save all the patients then cover it up for all eternity in dirt. It holds up to its well known reputation. Nobody wants to work here and there are always vacancies. Everyone knows about their bullying. What does HR do about it? They do nothing, for they know what goes on here but choose to ignore it. One nurse after another leaves and some odd nurses stay to join the ranks of the bullies. The bullies have become one big gigantic ego driven organism feeding off any new staff coming in. Dr Who writers could never dream up such a disgusting nausea filled monster. HR does not have the guts to fight that type of monster and so it eternally lurks in the old part of the hospital waiting to pounce on new recruits. Join nursing if you dare for you may be sent here. I never knew that women could be so hostile and so brash with patients. If I disobey them, I will suffer. How do I escape this ward? I consider giving up nursing for good and quickly go home after work to apply for jobs. Supermarkets are beginning to have some appeal to work in. How did nursing get so bad? Working in Sister Poppins ward was heaven compared to here. How do I get out? I sit in my car staring out at the setting sun which I missed again today, wondering, how people have become such sheep and how they say nothing but follow everyone else. I am no follower but I am alone. I have a long hard road ahead of me and I can see nothing new on the horizon.
"Every Day Is Exactly The Same"

I believe I can see the future
Cause I repeat the same routine
I think I used to have a purpose
But then again
That might have been a dream
I think I used to have a voice
Now I never make a sound
I just do what I've been told
I really don't want them to come around

Oh, no

Every day is exactly the same
Every day is exactly the same
There is no love here and there is no pain
Every day is exactly the same

I can feel their eyes are watching
In case I lose myself again
Sometimes I think I'm happy here
Sometimes, yet I still pretend
I can't remember how this got started
But I can tell you exactly how it will end

I'm writing on a little piece of paper
I'm hoping someday you might find
Well I'll hide it behind something
They won't look behind
I'm still inside here
A little bit comes bleeding through
I wish this could have been any other way
But I just don't know, I don't know what else I can do
Written by NIN

Night Shift

It is 15.30 and I need to get up for my night shift. I stare over at the flashing red lights on my alarm clock wishing I could lie here just extra few hours more. I haven’t slept well, I was on day shift just a day ago and my body clock has not adjusted at all. I will need to try to have something to eat before work and I find it hard to eat through the night. It seems so abnormal. I eat some pasta and throw some fruit into my bag. I drive through the dark city as it all winds down for another night. It is cold and I turn up the heating in my car. I have my music to wake me up but I am tired and wonder how I will get through tonight. I stare up at a shining star that looks so lonely I also feel quite alone here but I know deep inside I am gaining strength to fight on. I get to the car park entrance and notice that spaces are few. I wander up the stairs feeling the dread build up with each step. I go into the ward but it is quiet and the smell of finished cooked food hits my nostrils. I see relatives sitting around beds like they were sitting around a camp fire gaining warmth, realising how precious these people in beds really are. A relative looks up at me and smiles saying goodbye to me as he walks gingerly out the door. I do not know this man but I am a nurse and my duty is to be happy and polite even though sometimes I feel miserable. I say goodbye to this relative I may not know him but I do not know his pain either and for that reason I have to be polite.
I sit in handover listening to this god awful tape with blurry sounds and no way of understanding spellings and pronunciations. I hope nobody sees my handover sheet. I beg anyone to listen to a tape of anyone speaking and try to copy down what is being said. Let’s face it, we are a multi-cultural society and I do not know spellings of names from many other cultures by someone attempting to pronounce it on a blurry tape. Print outs are better and accurate. I go out on to the ward; I need to look after eighteen patients with another nurse and a care assistant which seems not too bad. One patient is quite ill though and may not get through the night and another patient has just been diagnosed with cancer. I get the patients settled for the night and the male patient who was diagnosed with cancer sits staring blankly into the air. My instinct wants to walk away from him because it means confronting the situation and I know that his situation will hurt me inside too because I guess I am very empathic. My nature however, tells me it is my duty to speak to him and spend time with him. You know when someone gets a diagnosis like this it is always the small little things that make life for the patients hard. I list many support groups but I sit on the chair by the bed understanding the patient and what he is going through. He does not have children but always wanted them and so many things in his life are left unfulfilled. I can’t make everything right but I can be there and that’s all that matters. I know I have other patients to attend but I need to give this patient my attention too. He does not look ill but inside his head is swirling like a tornado and I need to put some calm in there to be able to help him think rationally. We are nurses, taught to care for the physical ailments of pain but of the psychological pain many nurses do not know how, but it is our duty to be there.
The patient breaks down in tears and I wish I could wave a wand and make it all better but I can’t and so I am filled with his pain in this same room. I am sharing his pain, it rips me apart. I give so much more of me than what I get in my pay. I should cut off from the hurt of people’s pain but I am definitely human and I have a duty. I sigh with a heavy heart as I walk slowly out his room; he is only thirty years old, and why is life so cruel?

Sleeping Salvation

All the patients are asleep now or at least I think so. I wander back and forward in the night looking at the patients. It is time for my hour break at 3.00am and I go to the staff room. I set my alarm on my phone and sit on the chair and accidentally nod off. Abruptly, a big nurse walks in shouting that there is to be no sleeping in the staff room. I awake suddenly, to see an overweight nurse shouting at me about sleeping. Hang on I think, this is my hour, I am not being paid for it and I am not on duty. I ask her what I have done wrong. She said that if I was needed in a hurry I would not be fit. I said that I am not being paid and did not need to go back to work until the end of my break. I said that if this was day shift I could be in the staff canteen for an hour and no-one could get me there. I also said that I did not sleep well in the day time which is quite common for those on night shift. The nurse mumbled something back at me but to be honest I did not care.

Breaks are For Resting!

Night shifts are strange because nobody admits to needing a sleep but everyone is tired and nobody admits to sleeping on their breaks in case they get into trouble but many nurses do it. Oh dear, I have given away a little secret. It is obviously more productive to have nurses that power nap on their break because they will be more refreshed. It has been scientifically proven that power naps work and are more productive. I mean, many nurses still need to give out drugs in the early morning after a twelve and a half hour shift. I know if I was to get drugs from a nurse who had been awake all night I would rather it was from the one that had the power nap.
I go back to the ward feeling better for my nap and see that there is a patient who is not too well. The other nurse was not aware. I tell her that the patient looks ill and I check observations. Observations say it all; the patient is not to be resuscitated as he would not make it anyway. I hold his hand and stroke his forehead as he passes away very peacefully. The relatives are on their way already. We deal with the patient in the usual manner and get him ready for visitors. Other patients sleep through the night oblivious to the events. The other nurse yawns as she shoves in crisps to her mouth like a steam train needing coal for fuel. As for me, I have slept and am wide awake and have made do with fruit all night. We dish out drugs in the morning and check patient observations. We ensure that our fluid balance charts are done and that patients are comfortable. After handover, I walk along the ward and each patient thanks me for my care. The patient with cancer speaks to me and shows hurt in his face. He taps me on my arm awkwardly saying thanks for my kindness. He has tears in his eyes and I know I must go. I wander down the stairs and pick up a newspaper as I leave. It is cold outside but it is sunny again and it hurts my eyes but it feels good.

Changes

Am I Dreaming?

I go to sleep feeling unwell. I am sore and my head hurts. I think about work, it is always on my mind, there is no escape. I am soon wandering through a forest in the dark. I hear noises and I think I am lost. I meet an owl, but no ordinary owl. He tells me that I am in control but I need to find my feet. He tells me I have powers that I am unaware off and so I am trying to find out what these are. I walk further and I feel scared. I run very fast, hearing footsteps behind me. I start to soar above the trees, I am in control, and I can fly. When I can’t control it I soar too high and I look down at the sheer drop below me. How am I doing this? I start to drop and I sink, my legs feel heavy and I try to run but I can’t anymore. It feels like I know longer know how to run. I look down at the grass and it is dying as I tread on it. The grass emits an odour, I feel sick. I need to eat but there is no food. I try to eat an apple but as soon as I take a bite I feel it sticking in my throat, I awake feeling ill. I am still sore and my throat hurts. I should have phoned in sick but I didn’t. I need to phone, I do not feel well. I phone in sick and I lie back down feeling the dread build up inside me, thinking about how much more trouble I have caused for myself. My crime was to become unwell I will soon suffer. Two more days go by and I still feel ill. I have developed a bad cold. I should not be absent, but if I go in to work, not only will I be giving my germs to patients but I could become a liability. I justify my reasons to myself at the same time knowing the NHS are not so understanding and they would sooner I came back ill to save costs. I have a meeting with my bosses about my work and my union steward will be there.

Margaret Thatcher , who is she?

I sit awaiting my verdict like a prisoner on trial while there is discussion about me. It is agreed that I will try out a new area. I am to leave Mary Poppins behind it feels so good. I am released from her grasp. It feels like I can breathe again as fingers one by one are peeled back from choking me. I could not have done it without my union. In this day and age people think unions are a thing of the past and that they all ran away from the iron fist of a certain previous Conservative leader called Margaret Thatcher; let me assure you that unions are a thing of now and of our future. If it were not for our unions, our working conditions would be equal to slavery. You would have no rights; it is the unions that have battled for your conditions and your pay. I urge you all to join. You out there who benefits from your colleagues subscriptions, it is time to join your union. It does not cost you much.I am not used to dealing with respiratory patients but I soon get to work learning all I can. The thought of collecting sputum has always turned my stomach, I guess even us nurses have our limits. I meet my new boss; she seems alright with me but she is not friendly. This is normal in terms of charge nurses, I have come to learn. I start to enjoy learning new skills and gradually settle in over a couple of weeks. Some of the nurses are nice but they still will not show me much. I try to learn from books and the internet. As nurses we are supposed to keep up to date anyway. I go into the staff room for my break one Tuesday night shift and get speaking to a really nice nurse who shares her experiences with me.
I ask her how I have not seen her before to which she says that she is a pool nurse. I never knew what the nurse pool was. She said that it was the same as me but she could work anywhere. She was a really experienced nurse and her skills are clearly remarkable. She said she only works nights because she has children and she had to leave her previous area because she could not get childcare for the long shifts. Nurse shifts are normally twelve and a half hours and usually start at 7.30 until 20.00. Then night shift starts at 1930 until 0800. We get an official one hour unpaid break, usually two half hours. I did not have children but planned to have them one day. I could not imagine how I would manage with childcare. This must be the most bizarre of employment that does not support women with children and yet the majority of nurses are women. Surely it is discrimination because as I think I understand it, there are no childcare facilities beyond 6pm and before 8am. Yet we have nurses with children expected to work these long hours. If this same scenario was applied to disabled people, that there is no disability rights beyond 6pm then they would rightfully be campaigning to change it. Why should women with children rights to employment in the NHS be lessened due to the expectations of long working hours? If I had children would I need to leave my job because I could not get childcare beyond 6pm? Why is it in the first place that women, with children are expected to work beyond the normal childcare facilities times? Surely those with children should be allowed to work during daytimes? Should there not be automatic rights to flexible working hours? Perhaps this would help retain more nursing staff. I wonder if there has ever been a survey done on the levels of nurses leaving due to childcare restrictions. Surely it would be cheaper in the long run to keep nurses that are trained. I know that there are some wards that are very flexible with working hours for those with children but largely it is still quite rigid. Off duty is done by those in charge and if you can’t do the hours allocated you could get a hard time. Could this also lead to bullying, I wonder? It’s alright for those in charge with their nice daytime hours but for the rest of us, we have these long hours that do not suit us all. It surely is time to take nursing into the contemporary era that we now live instead of constantly looking back. Sure we can learn from previous years but society has changed and it is always changing.

Matron Your Time is up.

Nurses no longer live in residence with the Matron deciding what time her staff can go to bed at night and if it is alright for her staff to get married. This authoritarian type of matron should be dead and buried along with the previous useless nurses hats that served no purpose other than get in the way. We are always told that in our modern age in the UK that we do not live in a totalitarian society. Why does this exist in nursing when politics have changed around it? Political leaders attempting to score more points talk about the past NHS as something good to go back too. The only good thing was that there were more beds for patients and patients were not thrown out of them before they were well enough to go home. Oh how good the old days were with no MRSA and other HAI’s! Let’s go back there for a little reflection. Even 50 years ago the average life span was a lot less. We still had Nightingale wards. Death rates from respiratory conditions were common as we had no vaccines to flu or pneumonia and it was common for women and children to die in childbirth. The sophisticated operating procedures that we now take for granted did not exist and during an operation instead of keyhole techniques there would have been massive incisions with greater blood loss. We would not have had the greatness of screening procedures that we take for granted in preventative medicine. So let us stop looking back to the good old days they are in the past. We have now advanced in medicine let us now advance in working practice. Bye bye Matron it’s time for retirement, we need to work as a team now, we do not need your authority or bullying tactics, our job is difficult enough. It is up to us all to manage to keep our hospitals clean not a Matron; if we do not know how to clean our hands then we should not be working there in the first place. So give us some credit that we know how to wash our hands and let you all be assured that we do wash our hands. We do not need some matriarchal figure watch us wash our hands. With the greatness of modern medicine more patients can be seen in a year.

However, the high turnover of patients in today’s era means that per year on average we are seeing an increase of patients using the same ward and the same beds. So potentially a ward could have different patients within hours. For example a patient admitted into a bed for a non emergency gall bladder removal could be replaced the next day with another patient. It is common now for this operation to be done as an inpatient day case as are many other procedures. If this operation was done on a daily basis on a five day working week, in that same bed in just one month there could have been 20 patients using it. That could potentially be 100 patients just in five months with all variances of additional diseases that the patients have. A four bedded area in a ward in just five months could have on average 400 patients sharing the bathroom facilities and then we wonder why there are HAI’s. The answer to HAI’s is complex but there should not be any patients sharing rooms. All single rooms with en suite facilities are the only way to go and if a patient can go home, home is the best place to be. I hear the horror of those reading this wondering about the cost of redesigning hospitals, better that than the cost of the NHS being sued for unnecessary deaths due to HAI’s. One death is one death too many. So, I finish my break and get back to work.

A Meer Trifle

When I get back on to the ward the crash team are all swarming over a patient. The patient is saved but will not last long and is taken to High Dependency. I look in on my patients and they are all asking what the commotion was. We are not allowed to discuss patients with other patients so it sometimes makes it difficult when other patients ask about each other. ‘It alright,’ I inform them, ‘a patient is just unwell’. There are some aspects of this job I still do not know about, so I ask a nurse who reminds me of a meerkat if I can try to apply humidified oxygen as I have not done that yet. I ask if she will show me but she looks at me as though I am someone to be despised, the mother or wife of a killer or worse a killer myself. What have I done to deserve this? I only asked! She turns around staring at me with utter contempt and says, ‘it’s alright I will do it’. Her neck is long and she is always looking around her. Her name coincidentally is katherine and everyone calls her Kat.

True enough, she has never spoken to me. She blanks me in the corridor and I always say hello. So, there is always one! Surely, things will get better. The Sister calls me in, and asks how I am getting on. I reply that I feel happy here and that I will soon settle in. She looks at me and does not smile. Her face takes on the resemblance of Hattie Jacques from the film Carry on Matron and she looks quite strict. ‘Well’, I think, ‘at least things will not be so bad because Mary Poppins would be worse.’ She shows me my record. ‘This record is not very good, you have a lot to learn’, she says. ‘I do not mind learning,’ I answer. ‘You need to go back to basics again,’ she says. ‘You are not a good nurse as I have heard a lot from your previous boss.’’ Well,’ she would say that because she bullied me,’ I say. She turns around with her face dark red and shouts, ‘how dare you speak to me about my colleague. ‘I do not want to hear any more about this.’ I go out the room in complete disbelief. This is not what I thought it would be like. I ask a nicer member of staff what this sister is like. 'She is a big bully,' I am told. ‘Stay away from her and you should be alright.’ I find out her history and it turns out she previously worked with Mary Poppins and they are best friends. I can hardly believe it, I took on another post to get away from her but it seems I am not so free. I feel the shackles go back around my throat. Battle axe Hattie is on to me and things may be worse. She stands watching me, I feel on edge as I try hard to fit in. I am bumped into and pushed aside by Kat and told to go and take observations on other patients after I shout for help as a patient collapses with a cardiac arrest. I did the right thing as we get the crash team in to help us. I guess I will always remain at the bottom and they will always ensure I stay that way. Kat goes in front of me to the changing room. She must only be in her early twenties. She checks her face and hair in the mirror; she likes to keep brushing her hair and always has loads of lipstick on. Her perfume is overpowering and it is difficult to breathe when she sprays it. She coughs really hard as it affects her too but as she coughs something falls out her mouth. Her teeth land on the carpeted floor. She sees that I notice them and she looks embarrassed. I smile inwardly but dare not let her see me. What goes around comes around I always say. I walk away but heavy hearted, this may not be what I thought. Is nursing for me? I sit down in my car and turn on the radio. I look out at the sky and see the moon shining bright with all the stars twinkling. I look down at my steering wheel and stare at my car logo in the centre. I imagine life before nursing. I feel flat.I listen to the music that beats out...
"Butterflies And Hurricanes, Muse"
change,
everything you are
and everything you were
your number has been called
fights, battles have begun
revenge will surely come
your hard times are ahead

best,
you've got to be the best
you've got to change the world
and you use this chance to be heard
your time is now

change,
everything you are
and everything you were
your number has been called
fights and battles have begun
revenge will surely come
your hard times are ahead

best,
you've got to be the best
you've got to change the world
and you use this chance to be heard
your time is now

don't,
let yourself down
don't let yourself go
your last chance has arrived

best,
you've got to be the best
you've got to change the world
and you use this chance to be heard
your time is now

From The Heart

Inevitability

I am dreading going to work today. My boss may know I have said something now and I am worried she takes it out on me. I wander slowly into the ward looking down at the highly polished floor. A cheery smiling Polish cleaner all dressed in green smiles at me and says ‘cheer up miss, it surely is not that bad.’ I smile back knowing that this cleaner is always smiling. I wished I could be so happy in my work. I say hello to him and say that 'I am sure I will be alright.' I always speak to the cleaners, they provide a great service in the hospital and they often get such bad media attention for our hospitals being dirty. Their salary too is terrible. If your hospital is dirty don’t blame the cleaners they are an easy target, it is down to poor staffing and the nurses extended roles. We are supposed to clean up body fluids, mattresses, beds the lot. It is often difficult to clean everything when there is lack of staff. My priorities are the patients and you may argue that cleaning does affect patient health. It does, but if I have a dying patient while at the same time I need to clean a patient locker. My choice is always the patient. If we do not have enough staff then we must always prioritise. It annoys me that they say also that we never wash our hands. Of course we do and who the hell has time to record our frequency of hand washing with statistics, please get a life! Spend the money on getting us some staff please? Oh and one more thing while we are on this subject, I bet those that design hospitals never regularly burn their hands on the hot taps, most of the wards I am in do not have mixer taps and the water is too hot. Come on those doing the research, let me watch you put your hands under a scalding tap. If you do research you need to account for all your intervening variables like scalding hot taps. Oh, well, I have reached the report room and I walk in. I almost sit down when Sister Poppins walks through the door very harshly. She stares at me in a very frightening way. She does not speak, and just keeps staring at me. I feel on edge and so I just stand looking back like the rabbit staring at the headlights. I observe the red blotches around her nose, she must have been blowing it again she always does that. I also see the pink coloured lipstick that has missed her mouth and strayed into the creases up above her lips. Her hair looks neat today but her eyes are filled with rage. I could almost swear she has the rage virus out of the film 28 Weeks but she is doing her best to hide it. There is a whole lot of psychology going on between us. I feel like we are two angry cats sizing each other up. My anger is through being tortured. I feel hate towards her for what she is putting me through and I am filling up with emotion and I want to shout at her. I just want her to treat me like a normal human being. I would love to write here in words what went through my head but somehow this does not come easy and perhaps only those who have been bullied would understand that. We both gently backed away like two cats, not daring to show our backs.

Rebel with a Cause

She walked out the room. Everyone who was sitting down asked each other what that was about. I looked down at the grey carpet and shrugged my shoulders. I was not part of their team because I was ostracised anyway, she had made sure of that. I was always sent away. Today was no different; I walked away along the corridor to a ward I had not been in. I walk in and it is quiet. I am just in time to hear their report. So perfectly put, with good handover sheets and the nurses verbalising the patients’ conditions. I discuss with the nurse who I am working with, our plans for the general organisation of our shift. She comes over as being really nice. She tells me she is from Africa and she has a lovely manner with the patients. I can tell she really enjoys her job; she is a real nursing gem. We coordinate our work well. One thing, I do notice is that this ward shares facilities with the ward next door. A patient asks me for a drink of water and I go to the shared kitchen. I search everywhere for glasses and jugs. There are none other than a tray with many glasses and jugs on a trolley with a big white sheet of paper on top, with writing clearly marked in red pen, “Everything on this trolley is for the use of patients in ward 14 only” So, rather than annoy anyone, I went back to the other nurse and asked what we do for jugs and glasses. She said, that we just need to search around and that the staff on the other ward gets annoyed if we use their equipment. I search everywhere and I go to the main kitchen. All I see are tea cups. This is insane, I am searching everywhere for a container to get a glass of water and there is a trolley with jugs on it. Do we not share the same hospital? So, my patient should become dehydrated and do without water? Not on my duty they won’t. I go back to the kitchen and take a jug and glass from the trolley, feeling like a real rebel. Oh and if they complained when they counted their glasses and jugs I left them a little note to say, ‘I am sorry but I took the glass and jug because I thought we all work for the same NHS and patients come first.’ This insanity is rife in our hospitals. This equipment belongs to our ward and you can’t use it. Let us thrash this nonsense out, so we have a pot of money that goes to the NHS and it obviously gets shared out between services. So, wards have their own budgets and they want to keep what they have bought for their own patients. So, there is perhaps some logic in what they are trying to achieve but it has created room for nonsense and utter misery when trying to care for patients. How about we have a central store in a hospital and if we need equipment we go and get it, that’s more logical. Why are we short of anything in the first place? It’s crazy that we have nurses hoarding sheets, towels and other items to stop it being used by any other wards. Stop this insanity now!

What’s your Poison?

I spend the majority of my shift taking disorientated patients safely back to bed as they go for a wander. Many of them are at risk of falling and are so fragile that if they do fall they will break a bone. I give an elderly patient her medication, she is very confused. She asks me if I am a poisoning her. I smile and pat her gently on the shoulder and say ‘of course not but I am sure it will taste like poison.’ She looks up at my face which is very close to mine as I am leaning over smiling at her. She says, ‘I know you wouldn’t poison me dear, you have a very nice caring face.’ This fills me with warmth. I go through and speak to a male patient who has written some questions for me on a piece of paper. He asks why he is not a candidate for an operation as he has been told by consultants that he will not be fit enough for it. I look at his history and note he has a very bad heart condition. I say that I do not quite know the specifics of what the consultant said but my guess could be due to his heart problems. He informed me of languages he spoke and mentioned his big academic background. I looked at him and could see that he was now very frail. He seemed very proud of his academia. I showed an interest and asked about his languages. I got him to teach me some words and he smiled at his opportunity to use it. He told me I was a real tonic and that nobody in here speaks to him. Sometimes we can be so busy that we just deal with the physical ailments of a person that we ignore the whole person. The man smiled and I wished I could speak longer but had to deal with other patients. It was just nice to see him smile. Smiling is a good healer. It is a pity I could not do more for another patient. The lady was too ill to be resuscitated and would not make it if the doctors made any attempt. This side of nursing can be sad. We need to comfort these patients until their heartbeats are no more. This lady had terminal cancer and there was nothing more that could be done. The other nurse and I noticed how she was deteriorating. I quickly phoned her husband to say that his wife was very poorly and he must come quickly. While awaiting the husband, the patient slowly slipped away while we both held her frail soft hands. There is always an air of serenity and death always emits the same odour but it is not a foul odour, it is just death. We quickly tidied the patient up and changed her clothes to make her presentable. I brushed her hair and gently closed her wide open mouth. Music plays..."Thoughts Of A Dying Atheist, Muse"

Eerie whispers
trapped beneath my pillow
won't let me sleep
your memories

and I know you're in this room
I'm sure I heard you sigh
Floating in between
where our worlds collide

scares the hell out of me
and the end is all I can see
and it scares the hell out of me
and the end is all I can see

and I know the moment's near
and there's nothing you can do
look through a faithless eye
are you afraid to die?

it scares the hell out of me
and the end is all I can see
and it scares the hell out of me
and the end is all I can see

It scares the hell out of me
and the end is all I can see
and it scares the hell out of me
and the end is all I can see
Love Hurts

Birth and death bring opposite emotions but are both inevitable in life. We need to present death to the relatives with great care as it has lasting closure on an individual’s life. When the husband appeared I knew the patient was already dead and so I calmly asked him to come with me to the relatives’ room, knowing I had to tell him the bad news. It is always such a long walk. The silence to the relatives’ room is always so difficult. I imagined their long life together and how difficult it would be for this man left without his wife. I sat him down in the room and I sat close to him. He stared at me searching my face in desperation. I went through the sequence of events and told him with great care. I sat for a little while just listening to him talk while the news digested inside him unfolding like a flower in spring opening up for the first time. Tears rolled from his eyes and I knew my words came like boulders hitting him deep in the heart but I could not lessen them. I could feel my own emotion as usual and the knot in my stomach as I felt my own brown eyes glass over. I put my arm on his shoulder. I said that his wife is waiting on him if he would like to say goodbye. His family joined him as they came rushing up the corridor to hear the bad news. They all broke down in tears. I escorted them to the patient. I put down chairs for them and told them they can spend as long as they like. This was now their time, I patted the husband on the shoulder gently showing I care and left the room. I wanted to wrap my wings around them all and make their hurt go away but love hurts.

I pick up my rucksack and throw it over my shoulder. My shift is finished, my shift was difficult but I worked with a nice nurse. My meeting with my bosses and my union is next week. I wonder what to have for my tea, I have not eaten much today and my mouth is dehydrated as usual, we had no water dispenser let alone a cup to drink out today. I drive off, thinking of the relatives I left behind and how they will be left to cope. I turn on music by Incubus and the song is Love Hurts.

Tonight we drink to youth
And holding fast to truth
don't want to lose what I had as a boy
My heart still has a beat
But love is now a feat
(as common as a cold day in LA)

Sometimes when I'm alone I wonder
Is there a spell that I am under
Keeping me from seeing the real thing

Love hurts.....
But sometimes it's a good hurt
And it feels like I'm alive
Love sings
When it transcends the bad things
Have a heart and try me
'Cause without love I won't survive.

I'm fettered and abused
Stand naked and accused
Should I surface this one man submarine
I only want the truth
So tonight we drink to youth
I'll never lose what I had as a boy

Sometimes when I'm alone, I wonder
Is there a spell that I am under
Keeping me from seeing the real thing


Love hurts
But sometimes it's a good hurt
And it feels like I'm alive
Love sings
When it transcends the bad things
Have a heart and try me
'Cause without love I won't survive

Love hurts
But sometimes it's a good hurt
And it feels like I'm alive
Love sings
When it transcends the bad things
Have a heart and try me
'Cause without love I won't survive

Love hurts, oh
Love hurts
Without love I won't survive
Love hurts, oh
Love hurts
Without love I won't survive

A Birds Perspective

Today, I have a meeting with my union steward. I have reached the pinnacle of what I can endure. I am up here on my own, looking down and seeing what goes on and like history that can’t be changed so too does my outlook. It is cold up here and I know no one cares so long as I fit in to the cogs of the big machine which operate in the wrong direction to that of the caring conscious. This act which I have learned so well, does not fit me like a glove, but is like the mask that was designed for another face and it keeps slipping down on me. This mask is the mask with the big black tear and black painted smile. I am sitting on a rock and I cannot fly away and so I wait until the time when I can come down from here. I sit and mull over my regret. I go along a section of corridor which has many different offices and a row of little shops as though I am in a shopping mall. The shops are in the wrong location, they have no place here. This hospital is all about making money from the sick, the company that owns the car park wants as much money as possible. It is all sewn up and it is endorsed with yellow double lines all around the outside of the hospital, just in case any of the bleating sheep stray from the flock and try to escape the payment. The sick and their families are herded in to make the payment to the company that sits on a wealth that is stolen on opportunistic illness and disease. Gaining profit from the sick could only be dreamed up and acted upon by people who have no conscious and it is the quintessence of all evil. I knock on the door of the Union office and am ushered in. I tell my steward everything but the words are hard to find and I feel it comes over, like gobbledygook. I am trying to say that I am being bullied but instead I pick out example after example. I feel confused and my emotions run high. I have not been eating properly and my sugar levels will be low. I see that the steward knows what I am saying and listens intently. My steward reminds me of a wise owl and has a wealth of information. I am in the situation whereby I must fight or flight. I feel I do not have the energy to fight and my body is warning me that I must run away. Still, I know in my head that I must fight back. I know my fight is against an army and not just one person. I talk until I can talk no more which is something quite unusual for me. Conversation is a commodity we all take for granted and we can iron out the most minuscule of detail with it.

Let The Battle Commence

I go back home and pour coffee into my cup and consider my fight. I do feel apprehensive like a soldier getting ready for battle. I need to meet my bosses and we need to talk this out. I evaluate what I need to say and it goes round and round in my head like a tornado about to hit a little village. Until then I need to stay calm, the calm before the storm.

Was That You Henry?

Be your shelf
It’s raining! The big wet drips hit the ocean like bombs. I stand at the shore looking out. Each drip has a sound of its own making the rain noisy but like a song. A man comes up to me and asks what I am doing. To be honest I do not know. I watch the sea swirl and the wind blows through my blond hair which is getting long now and blows across my face into my mouth. I look out and see someone on a boat, they are being thrown about and the sea is very stormy. An elderly lady comes up to me in a red waterproof anorak and asks me the time. I look for my watch but it is gone. ‘I do not know the time,’ I say. I look into her face and it is a patient that I cared for but she had died. I look into her eyes and they are big and blue. The lady looks very well. I ask her what happened to her. She says, ‘don’t worry dear, I am alright, you helped me come here and my family are with me but I am concerned about you.’ I said, ‘oh I am alright too.’ The lady said, it’s ok dear I know how it is don’t be scared, I am not one of them, you can be yourself, it’s so important to be yourself.’ I can’t be myself,’ I said, if I do I am doomed.’ The voice grew deeper saying, ‘be who you are.’ Me, how could I be me? I awoke and my mum was shouting at me. ‘Mum what are you doing?’ I shouted. ‘I stupidly stayed with you last night and your shelf has fallen down on your bed.’ My mum said. ‘You are lucky it did not land on your head.’ My shelf, myself, I think! I lie there for a few seconds thinking about my dream. I have books lying on top of me and one falls to the floor as I turn around. I hear my mum pottering about, what a bad idea having her over because my house will be rearranged again. ‘Forks on the left, knives to the right in the cutlery drawer.’ she always says. ‘You need to go in there and you need to tell these people what for.’ ‘Yeah, what does that mean exactly?’ I say, as I switch the television on. ‘Tell them that you are not taking the bullying anymore.’ Who exactly do I say this too?’ ‘Your boss, or her boss,’ she replied. She just does not understand, if only it was that easy. The fact is my boss is bullying me, how can I say? Bullying is normal in nursing. How wrong, how sad, that in a caring field it is normal to be bullied. My mum has ironed my uniform and it feels like cardboard as I get changed for my shift. My mind wanders back to my dream. I know I can’t be myself in nursing because they will bully me all the more. I need to appear like them. I wander through the corridors of the hospital and I bump into Elias the porter. He asks how I have been and I smile in my usual way. I tell him I am alright and he asks how Sister Poppins is treating me. He has a cunning smile as he asks about her, he says he has been in her ward a few times recently and she was moaning at him about taking so long. Elias never says a bad word about anyone; he wears typical porter clothes for the NHS, blue trousers and light blue top. He always looks tired. He shrugs his shoulders and says that he hopes I have a good day. We part in opposite directions. I make my way to the ward and as I walk in, there is the usual smell which is quite distinctive to my ward but there is also an overpowering smell of coffee. I go past the nurses’ station and Sister Poppins looks up at me, I still smile and feel stupid for doing so but let my smile fade away under a cloud. She does not say anything to me, nor does she smile back. She still stares at me as though she were about to tell me something bad but she doesn’t. She watches me walk past her. My gaze turns from her to the office door which I open with a heavy heart.
“Don’t be Horrid Henry.”
As I open the door, I see a familiar nurse auxiliary. I am so pleased to see a face I know, it can make my day better. He has a little mischievous grin and is often up to childish jokes but he is not nasty. He reminds me of the children’s cartoon character Horrid Henry. After handover he works with me with my patients. We get the patients up and make the patients beds. He talks incessantly joking the whole time. He is laughing saying that he needs to pull a prank on Sister Poppins. He laughs calling her scary Mary. He said the last time he was here she was shouting at him for leaving the toilet light on. She has signs on all the lights that they must be switched off. In fact she has signs everywhere, on cupboards and walls. One sign reads that tea and coffee is for patient use only, meaning staff need to take in their own. Another sign reads big lists of duties that staff must carry out on night duty which is stuck on every available wall. On the desk there is a sign that staff must not place any drinks there. We get on with our work and it is nice to have a laugh. The patients smile too, they really cheer up when there is someone who is very friendly. I hear this voice shouting, yoo hoo over here dear. I go over to a patient and she says, ‘I do not want to cause a fuss with my hotel bill but I think they have overcharged me.’ I smile and say do not worry your stay in hospital here is free.’ She says that I must take something and she will have her secretary write me up a cheque. Then she turns and asks what is on the hotel menu and will she need to dress for dinner. I look at her face and she has been eating chocolate after chocolate and it is all over her face. I ask if she would like a shower this morning. She keeps going on that the service in this hotel is wonderful. I just smile and know that she is confused but at least she is happy. She has various pictures beside her of her family. I look at the pictures and wonder how her life once was before she became ill.
More Water Please!
We organise many patients and the heat in the ward builds up. I am so dehydrated. I feel a little faint and stop what I am doing. Horrid Henry says he will get me a drink of water. He comes back a few minutes later saying that if I want water I will need to walk to the kitchen. Mary Poppins would not allow him to bring me some water. I go to the kitchen feeling light headed. I always wished we had a water dispenser on the ward; it’s such a basic need. I drink lots of water until I feel myself return to normal. I take my lip balm out my pocket and put it on. Because I have been so dehydrated and it is so hot I need to carry lip balm around to stop my mouth becoming dry. It is known as one of the basic essentials of nursing by many nurses. I go back to my patients but Sister Poppins stops me. She tells me that I should never walk away from my patients. I inform her that I was dehydrated and Horrid Henry tried to bring me some water. She said that there is no eating or drinking on duty in ward areas. She said that in future if I require a drink then I must ask permission to leave the ward. I know she is just picking on me and I look up at her and want to say something but know I can’t. I go back to my patients. Sister Poppins keeps coming through to check on me and keeps telling me off for little silly things. I really can’t take this ward anymore. Horrid Henry says, ‘don’t worry about her, I will get her back.’ ‘What do you have in mind?’ I say. He just laughs, he is an enigma. The day passes over with all patients doing well and a few will be going home in the morning, which is good. It’s always the nicer side of nursing.
Honest it wasn’t me.
Before my tea I need to go to an office to collect my pay slip, Horrid Henry is already on his break and another nurse will be covering for me. Sister Poppins has just left. I realise I am walking behind her in the corridor but she is still a little distance away. I then hear shouting, ‘Sister Scary Mary, Sister Scary Mary.’ It’s a non-descript voice and I look around but nobody is there. In fact, nobody is now in the corridor other than Sister Poppins and me. The voice gets bigger, ‘Sister Scary Mary!’ Sister Poppins turns around and sees me walking behind her. ‘Oh no’ I thought, she thinks that was me shouting. Sister Poppins stands for a second looking horribly at me and then walks away. This is not funny. I go back to the ward and Horrid Henry has finished early, so I don’t know if that was him shouting.
And they’re off
Sister has introduced taped handovers on the ward. They have become the new ‘in thing’. I really hate taping my voice and allowing others to hear it. Why tapes? Sister said that it is a breach of confidentiality having handover sheets. These are sheets of paper given to each nurse on duty prior to going on the ward to work. It informs the nurses about the patients and has basic information on it to ensure continuity of care. Handover sheets when done correctly fit nicely into the pocket and are a little bible to keep nurses right throughout the day; we can tick things off and add to them as the day goes on. The crazy thing is that everyone listens to a handover on a tape and takes notes, creating their own improvised handover sheet anyway. The situation is worse on tape and information can be lost. Nurses wanting to get home as quickly as possible speak as quickly as they can. It is like listening to commentary for a horse race as the nurse gets quicker and quicker. ‘And they are coming up to the finishing post and little Mrs Smith has developed a leg ulcer.’ It’s often hard to hear anything and taking down basic names and much information can be lost or misinterpreted. Nurses from other countries say that they hate the tapes because often English is not their first language and they are self conscious about their voice on tape and often they find it hard to understand the fast handover. I just want the handover sheets back with any updates vocalised personally to the nurses taking over. If it works don’t fix it, as they say. I go home into my car, its cold, its dark and I am exhausted. I hate my job. I need to look for something else. I think about what other opportunities I could have. I think about a nice little desk job or even just working in a shop. Anything has to be better than this. I start to think about the little elderly lady in my dream. She said that I need to be myself. I love caring for people but I just can’t do it because of the bullying. I need to hide the real me in my job. The real me is the caring person who is the real nurse. I am a nurse hiding behind the wall I have built to protect me. When the bullying can be stopped I will knock my wall down and the Angel of the NHS will be revealed.