Monday, 22 October 2007

The Authoritarian Cogs (part 9)



The Future is Orange

It was great; I had the best few days off for weeks because I just did not dwell on work. One major change in me is that I have been taking active steps to protect myself from bullies at work. Over the last few days I have been asking other nurses if they are members of a union. It is so hard to believe that hardly any nurses are members. It is amazing though how many of them sit there complaining. They moan about their pay and conditions but they do nothing about it. No wonder our pay is so low if they will not do anything to help. It is as bad as citizens that do not vote in elections. They moan then say that they are not interested in politics. Pericles said
“Just because you do not take an interest in politics doesn't mean politics won't take an interest in you.”
Politics affects everyone! What is so frustrating is that women fought hard to get equal rights for other women to vote and take part in politics and these people can’t be bothered to vote. One of the lamest excuses for not voting I have heard is, ‘I need to go out and do some shopping for my night out’. That is of course from a nurse that wouldn’t speak to me; I am just on the bottom rung of the ladder, so I guess she is following the culture of bad nurses that do not speak to those beneath them. Anti-social I call it! The nurse comes back into the ward to show others of her own genre and of the higher ranks, what she had bought with her incredibly large nursing salary, after seeing the night out as more important than voting. She was so proud of herself buying foundation make up for her face but the bombshell was that it cost over fifty pounds.One of the nurses asked if she was already wearing the foundation on her face. She replied that she was. You know I am very good at composing myself when I should not be laughing but when something is that funny, it is terrible trying to not to laugh. I looked at the nurse’s face and although she was making every effort to try to look good while pretending she had a high salary to fund these expenditures, nature has a way of showing these types of people for who they are. She had not voted and made such an issue about not voting, so this was her punishment. For the crime of not voting you are to be sentenced to have an orange face. She looked like an Oomaph Loompah with her new makeup. She enjoyed having everyone around her while she showed off her big expenditures at the nurses’ station but if she had not bothered to come back to work to impress her colleagues, she may have taken more care on what colour of makeup she chose and she would have had time to vote.


There Is Cake On Your Curriculum Vitae


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

Fawlty Towers

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

Join the Nursing Army

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