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.

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

Nurses Always Seem So Happy (Part 4)

Like every other morning I sit awaiting my handover at 7.30am. I expect to me moved and become the care assistant but I am not. I sit there and hear out handover. I am unsure of some of the patients because I was moved yesterday. It is the usual people today, Sister Poppins, Mrs F Flat another nurse and a care assistant. The care assistant is not from this ward as she works for the bank. My patients are as usual very dependent and some are quite ill. I carry on with my duties and have decided it is best just to avoid Sister Poppins. The other female nurse has been absent for months and has come back but I have never met her. She pulls me aside asking if I am enjoying the ward and I mention how I love working with the patients but I do not think Mary Poppins likes me as she never speaks to me unless she thinks I have done something wrong. The nurse appeared to be a very nice person she had red curly hair and looked like a female version of Gene Wilder the comedian. She told me she was absent because Sister Mary Poppins drove her to a nervous breakdown. She said she could not prove it because once someone is mentally ill they are labelled and truths can be distorted. She told me she had bills to pay and couldn’t face coming back here but she had no choice. I asked her why she didn’t leave. She said Sister Poppins would not give her a fair reference and because she was absent for so long no one would want her. She said she planned on being there for around three months then try to move. She stated that she would now be saving all the facts in a diary as her union had asked her to do. She put on a very straight face as she began to roll out advice like she had saved it up for months to tell others. She said, ‘now my advice to you is move wards, as quickly as you can. While you are here stay away from Sister and her F Grade. The F Grade is her eyes and ears and she comes over as caring but she is not. Oh and if you need anything on no account ask the Sister because she will do nothing for you. One final thing, if you are not in a union get in one now’. Sister turned the corner and we both parted company. I felt a bit scared by what she had told me. I had already had unfair and inaccurate comments added to my personal file. I digested the information while I worked. I always smiled at the patients no matter how I felt. One very frail little elderly lady smiled at me and said, ‘you are a lovely girl dear, always smiling. Nurses always seem so happy.’ I must have hidden a lot of my hurt very well. I made it my duty to never ever take what was happening to me out on the patients.

Patients versus Lockers

When I could hide away from Poppins and F Flat I would be the nurse that could care for the patients ensuring no detail of their care was overlooked. Sometimes it was hard because I would be so busy dealing with the patients that sometimes the ward could get a little bit cluttered. I was just one pair of hands. My priority has always been the patients. Once they are settled then I can tidy up. Sister Mary Poppins would get very annoyed if the ward looked in the slightest of a mess. She came behind the curtain where I was bed bathing a patient with the help of a care assistant and moaned at me for making a mess. She told me to stop what I am doing and clear up the lockers. The patient was naked apart from the towels covering her. I never answered back to Sister but felt this was extreme and this went against my practice. I said to the care assistant that my plan is to carry on with this patient then clean the lockers. I thought about my own rationale and I would never leave a patient naked on a bed to do something as trivial as clean a locker. The care assistant looked worried and said maybe we should do what she says. I said that I would not. As the morning wore on I was left alone with the patients and the care assistant was told that she had to work with the other nurse. I had no help with mobilising patients with severe mobility problems and I needed the help of another, this was moving and handling policy. I could not get organised because I had no help. This meant a couple of patients had to be left in bed and I really struggled. I went through to ask if I could get some help and was abruptly told that I would just have to manage. Sister shouted abruptly at me, ‘just do what you can for now’. So I did and by lunch time those patients still needed help to get out bed. I did all the other things I could and even tidied up.

Only In Dreams in Beautiful Dreams

Mrs F Flat came through and said you should have had all this done by now. I said I would have done if I had help. She told me it was all down to my organisation and I was not very good at it. She said, ‘I see you are still unable to do a bed bath properly.’ Mrs F Flat had no children and did not do a degree. She gained her nursing qualifications through the previous route. On the other hand I had many qualifications and I had children. Studying for a degree while caring for children is very demanding, how dare Mrs F Flat say I had no organisational skills! I was taught bed baths many years ago, so I also did not accept that I did not know how to give a bed bath. Mrs F Flat took over the care of my patients informing me all the time about how poor my practice was, making me feel like a real loser. She said that Mary Poppins needs to have a word with me after lunch. It was time for lunch and I did not have much money but I need to go to the canteen because there is no staff room in this ward to sit and eat sandwiches. Mary Poppins will not allow staff to have a room to sit and relax on breaks. I walk to the canteen and look outside to see that it has been snowing. The ground looks lovely all thick with snow. There are a few patterns of footsteps in different directions. I stop for a few minutes and gaze outside an open door. There was quietness and although it was cold the air was good. I could smell the food from the canteen but I wasn’t hungry. The cold air made my eyes water. I thought about what my footsteps would look like as I walked out towards my car and away home. I thought about sitting at home by the fire with the cat curled up on my knee. Simple life is what dreams are made off and my dreams were locked up in a box and it felt like Sister Mary Poppins held on to the key of that box and would not allow me to have it. This blanket of snow did not stop me from going home the reality of living costs did. I sat down in the canteen to a plate of pasta. I ate a little bit and sipped some tea. I sighed heavily and looked up to see my friend. She came straight over to me with tears in her eyes. ‘What is wrong?’ I asked. She sat down informing me that she will be leaving, that she could not take the bullying anymore. She informed me that her Sister was screaming in her face and that she kept picking on her. She started going though her story and I knew it was bullying. I asked if she had done anything to solve it. She said that she had taken steps but nothing was being done by managers. I asked if she was in a union. She said that she always meant to join but nothing could be done for her as bullying is hard to prove. I wanted to tell her about what I was going through but I couldn’t make her feel worse. This was my friend and I have never seen her like this before. I felt sorry for her but already knew nursing was not the career that it was portrayed. Programmes on television such as Holby and Casualty show nurses working as a team without staff shortages and bullying, I have saw these programmes with staff having the odd exchange of words. To me, a nursing environment like that portrayed in these programmes would be a heavenly place to work. The public have no idea what goes on and we are gagged from saying anything.

The Hogwarts Dunces Cap Goes Too..........

I go back to the ward and straight into a meeting with Mary Poppins. She had again become Professor Umbridge from Harry Potter. Her frog eyes staring at me as though I were a fly that she thought would make a snack. I expected a big long tongue to appear out of her head and I would be swallowed in one. She had been eating her lunch in her office and had obviously just finished, I could smell soup and the crumbs of bread were lying on her desk. I awaited her conversation but she did not speak. She stared at me and then filed through some papers. This was more about her manner; she was not really reading the papers as they were upside down. She kept looking at me up and down but did not speak. She started by saying, ‘I have been hearing your practice is not up to scratch’. She stated that Mrs F Flat had reported me as being unorganised. I explained that this morning there was no-one to help me and I had asked. She put up her hand as though I were not allowed to speak. She went on to state that I was wrong to disobey her when I was told to clean the lockers. She came out with a list and stated that this would also go on my record. I told her that these were wrong and everything else had explanations. She turned to me and said, ‘I do not want to hear it.’ I did not get the opportunity to explain. My side of the story was but a whisper in a crowded room. What was the point of trying to explain? I was obviously stupid and despite my education and prior experience I was sitting here wearing the dunces cap. My stomach ached and I did not know why? I have been getting headaches too but I am sure I am just dehydrated. I went out to the patients and smiled. There was an elderly lady with big bright eyes she was very ill but smiled through all her pain and never complained. We had lovely talks and she had this perfume that always reminds me of her to this day, a perfume called ‘Maybe Baby.’ She would spend all morning putting on makeup and doing her hair it would take her ages but she insisted nobody should help her. Her nails looked lovely and if it was not for the oxygen tubing going into her nostrils it would be hard to believe she was ill. She said that it is her perfume that makes her feel as though she were complete. Today she had turned a corner and became worse. She cried at the thought of leaving her family. I wanted to make this lady better again but I couldn’t. She informed me that I have been wonderful to her. Her family all came in and there was a well of emotion. They asked all sorts of questions of me and I had the doctor speak to them and made them all tea and coffee. They sat by the patient’s bed as she deteriorated. This is the point in nursing when I feel so helpless. After the patient died I cleaned the patient and brushed her hair. When she looked presentable I gave her a little of her perfume, ‘Maybe Baby’. As usual I felt the lump in my throat.

You Should Have Joined The AA

I give my handover to the night staff who listen intently as I inform them off the patients. Only one staff member is from this ward the rest are bank staff. The nurse says she is leaving to go to another hospital as the absence rate is getting high and everyone is leaving. She smiles saying that she never works daytimes here because of Sister Poppins and Mrs F Flat. She said she caught sight of Mary Poppins today stuck in her car on a slip road with her hazards on. The nurse said it looked like she had broken down. She said that all the other cars were beeping their horns at her. I leave the hospital at the end of my shift with my car keys in hand ready to make my getaway. The snow was deeper now and as I was driving home I could see all the snowmen lined up in gardens like sentries. Everything looked bright and it made me smile to be going home to my fire.

Angel of the NHS - What a Calamity! (part 1)

What a Calamity!

Thank goodness this is my last shift of four. Its 5.30 am it’s freezing outside and my legs ache from the last three, twelve and a half hour shifts in a row. My uniforms had to be hand washed last night because my washing machine broke down yesterday. I still can’t get that tomato soup stain out and I hope the patients don’t think its blood. I have got no food left in my cupboards because I haven’t been able to get to the shops, so I will need to go the staff canteen today. It’s now 7.20 am and I am supposed to be getting changed now but as usual there is a queue for the car park. There are no parking spaces and I will need to wait until the night shift staff comes out. Well, 7.45 am and I finally get in the car park and I know sister will go nuts at me. I arrive for handover out of breath to hear the last five minutes. Sister wants to have a word with me as she is none too happy with me being late.

From A to B

I am taking team A, a total of 12 patients and the other nurse is taking team B and she also has 12 patients. There is another nurse who is floating, an F Grade and a care assistant. There is also a student on our ward and I always hear how she is not included in the numbers as we go through the staff rota every morning. I have never understood this because she does the job of a care assistant. This ward is quite heavy and the patients need mostly all care just now. Three patients are being discharged today and two of them are mine. Sister catches up with me and corners me in the treatment room as I prepare for the drug round. Sister tells me she is really sorry but because I was twenty five minutes late I will need to have this deducted from my annual leave. She looks at me as though I am a naughty child. I often wonder how she manages to be so perfect. Sister Mary Poppins, practically perfect in every way! I start my drug round and the breakfast trolley arrives. The care assistant, the F Grade, and the student put out the breakfasts.

Pooh Bare

I dispense the drugs to the patients and have the usual chatter while observing their conditions. Some patients are lovely and the ones that moan at me I make excuses for because they may be in pain or have worries, so I smile. I walk in to one room to find the patient is in the bathroom. I hear a shout “my god”, the man said, “someone has put pooh all over the bathroom”. I walk in to find the man covered in pooh. “Who could have done this to me he asks?” I smile reassuringly then ask him if he wants a shower! The patient is staying in a single room! Looks like a normal day in the ward. After the drug round I help get all the patients up and dressed. All the patients up, cleaned and dressed sitting by their freshly made beds by 10am! Sister likes them all out of bed. One up all up! For those that are unable to get up alone they must be hoisted up to sit in the chair. One patient refuses to get up, this is normal. The patient says she never gets up until 11am each day and just because she is in hospital why should she change this? The other nurse hears this and comes thundering through shouting at the patient to get up. The excuse given is that she must get up because the bed needs made! The nurse turns to look at the patient’s locker which is covered in cards and flowers and moans about there being too much clutter. She turns to me informing me that if all the lockers are not cleaned then the Sister will moan. So I finish helping everyone, start all my observations, while running back and forward to the phone to inform relatives how the patients are and have many conversations while going back and forward with Doctors, Speech and Language Therapists and physiotherapists. I am also arranging all my discharges.

Escape from Alcatraz

I do finally get on my break at 10.45!

I then realise I have no food with me. I get to the canteen and sit down to eat at 11am. I am exhausted already! I hear a voice and it’s my friend from another ward! We share stories of happier times before nursing like a couple of prisoners talking about their past lives before interment. We also talk about our escape and ways of tunnelling out nursing. We know we are both trapped; we exhausted our funding from Student Awards. We are like two prisoners who accepted their sentence of being guilty. We both love caring for the patients but we cannot get our heads around the other nurses who put up with this working environment. It is as though they too have accepted their fate and do nothing about these awful conditions. We discuss our views on nurse bullying and wonder if these nurses realise they are doing it? I get back to the ward for 11.15 and sister makes her way up to me, I fill with dread thinking about what I have done wrong now. She tells me another ward is down a staff member and I will need to go to help out. “Great!” I thought. What an idiot I am, from the frying pan into the fire. I went over to another Sister Mary Poppins in this different ward. She smiled at me with great effort, the strain was showing. She informed me what to do with an air of authority that could turn back a tidal wave.

I’m only human, but are they?

I, of course, did not know this ward. I worked hard and tried with great effort to speak to the staff. Maybe I had done something wrong to offend them but they would not speak to me. I pinched myself to see if I was still alive. Ghosts, sometimes think they are still alive. One nurse did finally speak to me but she spoke with hostility. Still, this proved I was still alive. I worked hard and before I knew it time had flown by. I held the hand and spoke gently to a lovely little elderly lady as she passed away. She had the most beautiful eyes. I felt sad that she had no relatives and I always get a lump in my throat when a patient dies.
This lump in my throat is what makes me human and I know that I care. If I stop getting that lump in my throat I will leave nursing for good!

Dead men tell no tales

I go into the treatment room to gather some supplies and I watch the other nurse make up the intravenous antibiotics. She is very quick and talks with confidence but talks to me as though my brain had stopped producing cells at the age of three. I ask general questions still just trying to make conversation. She has only been a nurse for a few months, yet I had the impression she had been there for fifty years. I asked about her antibiotics course because I realised she must have been quick to do this. She informs me she doesn’t need to do this course as she knows what to do with antibiotics. I questioned her on her accountability should a patient have an adverse reaction. She explains her rationale which appeared very convincing but only to her, in her place, in her mind, the equivalent of a gold mining camp back in the 1870’s called Deadwood in South Dakota, America where no laws existed. She said that should a patient die because they did not get their antibiotics she would be in the wrong. Was she the nursing equivalent of Calamity Jane who helped nurse Deadwood’s population during the smallpox outbreak? This is not the 1870’s and those that care for the sick no longer use barbaric practices and patients are protected by laws. This means us nurses are not deemed competent until we pass these courses, this protects our patients. As I am not from this ward I asked Calamity Jane about a specific procedure pertaining to the ward but was told I need to work it out myself and it is not rocket science.

You can do it, if you B&Q it

I was not aware of DIY nursing procedures. I quickly apologised and explained that I wouldn’t be carrying out this procedure as I was not trained. Ah well! I had lost the only one who would speak to me. It was cold stone silence for the rest of the shift. I wasn’t asking for more gruel like Oliver Twist. I wouldn’t do the procedure! I heard the nurses talk about how stupid I was as they huddled together. “It's easy”, I heard one nurse say. I understood if I got it wrong and do not have the training I become Calamity Jane too. At the end of my shift at 8.00pm, I throw off my uniform complete with tomato soup stain and become me again. My whole body aches as I walk into the fresh crisp winter air but I can ignore the pain as freedom feels good. I have two days off before I do this all again. What more in store? Will Sister Mary Poppins be nice to me and let me keep my 25 minutes for my annual leave? Will Calamity Jane take her courses before she is struck off? Will I have a whole shift where I have an uneventful day? Will the tomato soup stain come out? Tune in next time to find out what happens next to Angel of the NHS?