It’s time to get up. I hate getting up in the morning probably the same as everyone else who needs to get up for work. The difference is that I have twelve and a half hours ahead of me and I have a bad cold. My legs ache and I keep sneezing. I can’t stay off because Sister Poppins will moan because she expects the sick call the night before. I wished I could go out next week because all my friends are going to the theatre to see a great show and I will be working. I got my off duty just yesterday and as usual it is very late. I can never plan anything as a nurse. My mum and dad have still been trying to phone me and I am thinking that I had better call them or they may think something is wrong and phone the police. They are a bit like that, my mum and dad. My university mates have been in touch and it is great to hear from them. I met some nice people on my course but such a shame, such a change, they are all so different. I feel that they resemble battle wounded soldiers. They have seen so much in such a short time and I am no different but I am now seeing what is happening around me in the NHS! I know I was always destined to help people and that is why I am a nurse. The money has never motivated me but it would be nice to be able to live a reasonable life without debt and just get a little more for the job I do. Will that come to me, who knows? It is time for handover and I am sitting waiting. Everyone comes through to the office and I fix my squint badge with my name on it and I adjust my blond hair so that it is away from my face. I look up to see Sister Poppins and Mrs F Flat. I think I will be taught a bed bath today. Patients are obviously discussed during handover and I try to contribute but I am looked upon like I am the cleaner contributing to patient care. Sister Poppins ignores me. I do not respect her, I resent her and I do not like working here. I need to get out and go to employment where I feel welcome. Who wants a drop out nurse though? I think about possibilities but let’s face it I am stuck, I am in prison. What about my friends from university? The people I am in touch with are having a bad time and wished they had not done nursing. My friends are unable to buy a house and have a normal life; they can just share flats, great! I am told that I need to be a nurse today and not a care assistant. I get on with my job!
Coughs And Sneezes Spread Diseases
A patient is brought in from another ward and is placed in a side room. The relative is outside it speaking to Nurse Ratchet. Nurse Rathchet has a hand on her hip and still wears the nurses dress uniform. I wear a tunic and trousers. The trousers do not fit they are too baggy. I look at some paperwork on the desk and over hear them talking. Nurse Ratchet is not a caring person and the relative does not understand this infection and attempts to ask questions. Relatives and patients are outside our little medical knowledge ring. I think it is still important to realise that the public are far more informed than they used to be. The relative asks what infection her husband has and I hear the nurse avoiding the truth. I know that the infection is Clostridum difficile and the nurse is avoiding telling her. Maybe if nurses could be honest the situation would not be so out of hand. The public know when we are being secretive. It is obviously most annoying for anyone to have this condition but it is common and the only way to beat it is by being up front and honest. Let’s face it, the main cause is antibiotic usage and although people who are already very ill are often the most vulnerable it is antibiotics that are the cause. Why the secrecy? It can obviously spread around a ward fairly quick which is why patients get put into side rooms. Hygiene therefore, also becomes important. Hygiene is a big issue in hospitals especially with a high turnover of patients. In the area Jabba the hutt works, the old part of the hospital, hygiene is really bad. Sister Poppins runs a very tight ship and hygiene is very high on her list but sometimes to the detriment of the patients. The trouble is the design of many hospitals only supplies so many side rooms, so few patients can be isolated at a time. The trouble with poor hygiene too is that everyone uses equipment going from patient to patient. How many nurses go around taking blood pressures and do not bother to clean the cuffs and oxygen saturation probes in between patients? We can’t assume patients are clean. Patients quite regularly have a commode taken to their bedside but never have anything to wipe their hands. Doctors also walk about in their normal clothing going from bedside to bedside with their stethoscopes. I think they must hide somewhere to clean it because I have never seen anyone clean them. Why are doctors allowed to wear their normal clothes while we wear uniforms? Anyway, Nurse Ratchet’s tone goes up as she attempts to convince the relative that it is just a mild infection and it is very common. She avoids the name. It is a bit like the Scottish play that we dare not mention. It is like going back in time, don’t go out in the cold or you will catch a chill? Some nurses are just scared to say what the problem is. It reminds me of the patient that died and the nurse informs the relative, ‘I am sorry but she has gone.’ Before the nurse can explain the relative is shouting, ‘where has she gone how could you let her walk out?’ Nurses also ask patients ‘have you gone today?’ ‘Have you been?’ I remember the funniest I ever heard was with this male patient and the nurse is trying to ask tactfully about his bowels. The patient is not from this country so is confused by what she is saying. The nurse attempts many times with gestures and different ways of saying it. Finally, the patient catches on and with a smile and a glint in his eyes shouts. ‘Are you asking if I have crapped?’ The nurse’s face goes red and I need to leave the room because I am in fits of giggles. Nurse language is really awful and we should just say a thing how it is. Nurses learn to lie very quickly. When a nurse looks at the wound of a patient and there is this smell of rotten flesh with seepage and the patient asks the nurse how the wound looks the nurse screws up her face trying to avoid the smell while saying, ‘actually it is not that bad.’ We could not possibly say to the patient, ‘actually it smells absolutely awful and just looking at it makes me want to throw up.’ So lying to protect patients is common. But we do need to evaluate when lying is the right thing to do. MRSA is the other one that patients fear and so nurses avoid using the term. In this situation the relative raises her anxious voice and rather than reassure the relative, nurse Ratchet shouts back. Relatives are anxious and sometimes it is through this anxiousness that they become angry with nursing staff. So many attacks on nurses could be avoided from the start by the nurse showing patience and care. There are a percentage of patients and relatives though that will just have a tendency to lash out. People are unpredictable. Thankfully, I have never been hurt, so far. The relative gets angrier with nurse Ratchet and demands to see the doctor. Ratchet looks uncontrollably angry. The whole angry scene could have been avoided. Nurses often do not have people skills, sad, but true, there I said it. This same nurse Ratchet thinks I do not possess the skills to give a bed bath as she was discussing this with Mrs F Flat. The relative talks to the doctor stating that she plans to put forward a complaint.
Those That Can Do, Those That Can’t Teach.
I deal with all my patients, helping get them breakfast up, washed and dressed. The buzzers go all morning and I am fetching and carrying and juggling my work. There are many things I need to remember in my head all at once. I feel exhausted because I have the cold. I needed to organise my annual leave but I was scared to go near Sister to ask her anything in case she made trouble for me. She is not approachable at all. I spoke to one of the care assistants who reminded me that I have the right to my annual leave. I decided to write down my request of annual leave a few weeks ago in the manner she requested staff to do it. My request was left untouched while everyone else was getting theirs granted or nullified. At least they got theirs dealt with. I was getting tired and I had been working solidly for months without holidays. I asked for just three days off. Sister Poppins came over to me and very seriously said to me that she could only grant me an afternoon. Her eyes showed hatred towards me and I just could never understand why. I took the afternoon she gave me but was disappointed. There was no long lie in bed! I had looked in the annual leave book and noted that no other nurse was off and there was lots of staff on that day. I could not understand her, I knew she just did not like me and she wanted to make life hard. After all my running about I was called into the side room to watch a bed bath. My brain had trouble staying awake! She made such a meal of it. If I could spend this long over a bed bath none of the patients would be out of bed until afternoon. Nurse Ratchet spoke to me like I was a little naughty girl. I no longer felt like the little naughty girl. I felt like an adult who was being taught by someone who was attempting to keep me down by intimidation tactics. I did not let her bring me down or any of the other nurses and after many months of being treated less than human I was beginning to feel angry. Anger was welling up and it was not sudden, it was over a space of time. I would not show my anger, I kept it locked inside because it was not professional and if my anger gets the better of me then they have won. The trouble with anger is that it has to come out somewhere and just because I did not get angry back did not mean my anger did not come out. When I went home, my moods plummeted. I was not friendly and sociable anymore. My phone would ring and I would ignore it because I felt too unsociable to speak. My friends would still ask me out but I could never get out anyway. I was always given off duty for the weekend. I was cutting myself off from everybody. I was a loner, I really was in prison. From somewhere I gained this surge of energy to fight back and I continue to do so. I have not won yet but that means banning all bullying from work. In nursing there is a culture of nurses who think that being critical in a nasty way is helping develop the skills of the nurse. On the 17th October 2007 The Times Online had a story about the nurse of the year quitting her post as nurse “A “Nurse of the Year” is leaving her job because of the strain of working for the NHS in an atmosphere of “mistrust and fear”, in response to the article a nurse wrote in to state “They send the matrons down to put pressure on the staff which is causing more harm than good considering most of the matrons are in the job for the power trip.” The Sister’s are just as bad in many cases. On the 22nd of October there was an article titled ‘Pay a nurse peanuts and what do you get?’The discussion is about the columnist sitting vigil in ICU. From the outset ICU is so different from the wards and it is a very specialist type of nurse who is trained to work in ICU. It is also compulsory for a high nurse to patient ratio, which is also why funding ICU is so costly. ICU can never be compared to the wards. It is a little like comparing theatres to the wards as the skills needed can be so different. In both theatres and ICU much of the time patients are very heavily sedated so patients generally are not up and walking about. Theatre staff can be very good in anaesthetic rooms with very frightened patients going for operations. They are also very good in recovery. A lot of what happens in theatres is often hidden away and so poor theatre staff can be forgotten by patients. Still, in response to this article a nurse wrote, “I am tired of hearing about the poor under paid nurses, the angels. In many cases I have found nurses on general wards very uncaring and bad tempered. We are told they are too busy to help patients with their food and take them to the toilet.” In my response to this, if I was working night shift, I could share some thirty two patients with just one other nurse and a care assistant. I would love to ensure that all patients’ needs rightly are cared for but I have no control over staffing levels. If it is any consolation I think it is a disgrace that anyone is left in their own urine or pooh! It is true that many nurses are uncaring and it is a shame that the bad ones ruin it for all of us. If the owner of this comment had to run around all night for twelve and a half hours with just two half hour breaks, clearing up pooh, sick and all other bodily fluids with lack of staff I am sure she would also be bad tempered. Some nurses are lazy and some take their frustration out on the patients, these people are the rotten apples. I am physically and mentally exhausted after each shift. Why should NHS management sit on their big fat salaries with no real insight into what we put up with? When it all goes pear shaped, I know lets blame the nurses. Someone also wrote “Nursing leadership and example at ward level are absent with professional advice, correction and challenge, if it's ever given, regarded as 'bullying'. This could only come from a Sister. When the pressure mounts, the Sister is standing well behind the battle lines at her desk with her nice civilised day time hours, being allowed to go home at four in the afternoon. She can also choose when she goes on holiday. This comment is exactly the management style I mentioned earlier. It is outdated and in need of repair. I am glad she mentioned bullying because in other occupations it is clearly recognised as that. It is one thing giving correction and challenge but when I am doing my work, I do not want someone coming up to me while I am with my patients giving me random maths tests out the blue. I also do not want correction in front of patients which is utterly demoralising. I also do not want to be shown skills that I can clearly do. I do not only want spoken to too when I am deemed to have done something wrong. What is also wrong with praise when I am doing my job right? I never get that! In the older days nursing did not have the high level of academia that it does now. I have served my time at university which the Nursing and Midwifery Council are happy with and this proves I can carry out my job, while extra courses keep my skills up to date. There is nothing in any written documentation stating that I must constantly be given maths tests or be shown basic care over and over when I clearly have the skills. I am an adult not a child. I am the registered nurse who is accountable for my own practice. I need to know my limits and if I mess up it is me that loses my registration. If these Sisters or any other senior member of staff demonstrate the wrong way to do things and I follow this practice, if they are wrong, is it any defence in court to say I was just copying the Sisters practice. They would then ask, ‘if you saw someone jump from a bridge would you copy it?’ Would the Sister stand happily beside me supporting me all the way? I doubt it; I would be on my own, in a boat, without a paddle heading into the direction of Lonesville. I need to know my own limits and my nursing parameters. If I don’t know I will ask. In the older days of nursing, Sisters may have used this challenge approach to gauge what level nurses where at. Many of these outdated Sisters do not have academic qualifications themselves. I now challenge them to gain a degree qualification on a minimum nursing bursary. Let’s face it, how many times do Sisters make mistakes. I see them making mistakes all the time. Who corrects and challenges them at ward level? The point I am making is we are all human and humans by our very nature make mistakes. What we do not want is costly mistakes, which is why I never carry procedures that I am not trained to carry out. If I make a small mistake in the ward, I do not expect to get my head blown off for it and screamed at. What I would like is for someone to take me aside and say to me that I made a mistake and show me what I did wrong. I can take it, I am an adult and do not need shouted at in front of patients like the naughty child. It is all about the manner in which it is delivered. Better management skills are required please? Sisters need to go back to school!
McDonalds Has Come to Nursing
I watched this bed bath and learned nothing new. I would have been of far more use helping patients get to the toilet. Nurse Ratchet looked smug as she went over to speak to Sister Poppins while rubbing alcohol gel on her hands. She could not make it clearer she wants that vacancy. The interviews for the job are to be held in a few weeks. What more misery will she cause until she gets the job? I go to lunch to meet up with another friend who is leaving nursing. If the ‘Nurse of the Year’ leaves nursing and all my university friends are leaving there must be some size of a turnover in nursing. Maybe we have the same staff turnover as McDonalds. Scientific management views society as moving towards the fast food restaurant by efficiency, the optimal method for accomplishing a task. Calculability, objective should be quantifiable (i.e. sales) rather than subjective (i.e. taste), Predictability, standardized and uniform services, Control, standardized and uniform employees, replacement of human by non-human technologies. Nursing staff are easily replaceable, we are drones. Agenda for Change has devised the roles. The job description is standardized and the human qualities do not matter anymore. So, for example a nurse who comes along with years of experience who has gone through years of university needs to start alongside those other nurses who have the minimum qualifications. It is no longer about the individual qualities. Anyone with a brain who is treated like a drone from day one will not last long in nursing because it is the equivalent of sitting at the checkout at Tescos. So, what happens is they leave and gain employment in an area where their skills and qualifications are matched. Management does not care if we do not like the job or we fail at what we do because it is like pulling off another bin bag from the roll. We are easily replaceable. The sad side to this is that it is patients that pay the costs. How much does it cost to train each nursing student and then when the wards are left short staffed when the nurses can no longer cope, it takes time to get someone new in. New staff are not always efficient because they have not been given adequate support due to the bad training on placements in the hospitals but when they make a mistake it is their fault, they are blamed and they are struck off. How about doing something to keep existing staff? How about ensuring students are supported properly and not in the current bullying manner that goes on which teaches students that to ask questions is dumb.
The Spider Fights The NHS
After my evening break I sit down and fill out my notes while all the relatives ask me questions and the phone rings incessantly. Relatives who are used to being fobbed off come in with an attitude from the start. Many of them see I am not like some of these other nurses who are hostile and cold. I build a rapport with them; I get given lovely cards and get many a thank you when I try my best. I am open and honest with them all. I am there for the patients but I am a wave going in a slightly different direction from many others. I will fight for my patients but I also need to fight this horrible old nursing culture. I have two swords to cut through all of this but I am just one woman on the bottom rung of a two rung ladder. I am willing to fight, how many others will side with me? The NHS is worth fighting for and if all these good people leave we will be left with a poorer service than ever. When I look through the charts I notice that other nurses have forgotten to fill out certain parts. I do not blame them, I understand that patients must come first but try telling that to the Sister. It is nearly time for the end of my shift. I have spent a long day with my patients and I also think it is good courtesy just to say good night to them. They are not all the perfect patients and I am not the perfect nurse. I will never be Sister Poppins. I am me, I am human. On the way out I bump into relatives who want to chat and who want my knowledge of directions. I see relatives when I am out and about on my days off and they remember my name. I see a few care assistants I know as I leave. They are puffing away on cigarettes before they go in to do their night shift. We smile and wave at each other. I am now not far from my car. I am now feeling hungry and I take a tissue out my bag to wipe my nose. My cold still feels bad. I keep worrying that my mum and dad will wonder what is wrong with me. I take my mobile out my bag and dial their number, my mum answers and I say, ‘Hi mum it is me, I am alright, I am off in a couple of days and will come along to see you both.’ I wind down the window in the car to wipe away the rain from my mirror. I notice a spider making a web in the rain while being bombarded with water. It slips several times but does not give up. Is that what Robert the Bruce saw? If it was good enough for him, it is certainly good enough for me. ‘If at first you don’t succeed, try try and try again.’ Bullying is a fight we need to be in together. We all need to be in it to win it.
