Why I want to give up nursing, Part III

0600hrs - Wake up. Get to work 0645hrs. Fifteen minutes early. Hope to check some personal emails, get some fruit for breakfast.

0645hrs - First patient outside health center. Teenagers never get out of bed early. Must be quite sick. See student straight away. Delay breakfast.

0700hrs - First patient resting in bed. Two more students arrive. Again early. Look miserable.

1715 - Brief window to get breakfast. Spend five minutes in cafetaria. Wandering teaches waltz's by. Teacher complains that kids are waiting to be seen and I'm eating breakfast.

0720 - Ignore teacher. Am used to 5 minute breakfast and am seeing next wave of students.

0750 - First bell has gone. This is supposedly the signal to begin class, but instead 15-20 teenagers flood health center.

0900hrs - Finished with kids. Now have two denist appoinments and three doctor appointments. Colleague takes care of this while I rush to classroom upstairs where student has fainted.

1000hrs - Faint turns out to be vasovagal, nothing to worry about. Called to something more exciting. A chemical splash in students eye. Rush to go there, but no car available. The school has taken then second nurse car away. Has been ongoing problem since school expanded campus to include a building twenty minutes walk away up a mountain, but 3-5 minutes by car.

1020hrs - Finally get car and get to child. Taken to doctor. Fortunately student going to be ok.

1100hrs - Lunch clinic begins, colleague back in time to deal with this. Unfortunately ran out of beds in the health center at some stage and have ten kids scattered around campus in their own rooms. Next hour spent checking up on them.

1200hrs - Try to get lunch, but staff complaing that the health center at the new building is not staffed. Race to get there to see the critically ill students with their nasal congestion.

1330hrs - Finally finish clinic and join colleague at main campus to catch up/swat notes and find out what is going on.

1335hrs - Interupted by phone call. Abusive parents claiming we've neglected their child and left them suffering in their room deathly ill.

1340hrs - Track down deathly ill child. Is in bed with laptop, busy typing away. Claims to be sick, but I already know that a big assingment is due today. Student busy working on this. Student claims to be 'dizzy'. Sick of hearing this. Tell student that 'it's ok. I don't think you'll pass out lying down.'

1400hrs - Back in health center. Check emails. The abusive parent has sent an equally abusive email, even after I'd phoned them from students bedside to let them know their child is fine.

1530hrs - Supposed to finish work. But have four kids to take to doctor. Finish day at 1700hrs.

1700hrs - Home at last. Phone rings. Called to see sprainged ankle.

1730hrs - Phone rings again. Another angry parent.

1730 - 2000hrs - End up seeing multiple kids. Nothing urgent, but when I'm on scence, they make the most of it.

2010hrs - home at last.

0300hrs - Phone rings. Student, not sick, wrong number. Can't get back to sleep.

0600hrs - Get up for another day at work.

No one says please. No one says thank you. No one buys chocolates. Might go work in a hospital again.

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Why I want to give up nursing, Part II

"I'm not going anywhere near someone with swine flu" said a teacher at the back of the room.
"Me neither. I'm a teacher, not a nurse. That's your job" said another.

"Well, we're a boading school. If we get a lot of people with the flu, we're going to need help. Two nurses can't look after everyone."

"I never signed up for this" said the first voice. The voice belonged to Jason, one of the few 'old hands' at our school. "It's not in my contract" he added. The seventy odd teachers assembled there muttered their agreement.

"I'm not asking you all to do medical things. We need help getting them meals. Dropping off medicines. Helping arrange rooms to isolate new cases. We may ask you to check the odd temperature here or there, but we can't do it all."

"I'm not going anywhere near anyone" said Marie, the head of the english department. "Like Jason said, it's not in my contract. It's your job. I'm sorry, but that's the way it is." All heads were nodding in agreement.

'Well, it's not in my contract to look after staff' I felt like saying. 'I don't have to take you to appointments, or arrange appointments. I don't have to give you advice. I don't have to see your children. I don't have to tell you how to deal with that STD. I don't have to do any of the things I am happy to do whenever you come and see me.'

I didn't say this. I tried to be diplomatic. I failed.

In the corridor after the meeting.

"I'm not a nurse. They need to do their job."
"If they don't like it, change jobs."
"They never come and see the kids when we call them. What do they do all day?"

I wasn't supposed to hear this. But I did.

It's not the first time.

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Why I want to give up nursing, Part I

"I want my son to be tested for swine flu" said Mrs Smith.
"Ah, but your son hasn't been ill" I replied.
"He's had a cough, you saw him in the health center earlier in the week" countered Mrs Smith.
"I'm sorry, but he hasn't been back to see us. We did send all parents an email explaining the criteria for isolating students. We also explained we can only test according to government guidelines."
"I want my son tested. Then he can be treated sooner"
"I understand..."
"I don't care what you understand. You're not listening to me. I want my son tested"
"I'm sorry...."
"You're not sorry. You don't care. I'm a mother ten thousand miles away worried about her son."
"I understand...
"You don't understand. You're rude, obnoxious, uncaring..."

I turned the phone off.
I saw her son later that night. He seemed pretty well with his girl friend on one arm and a burning cigarette in the other.

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That extra mile

When do you want to go that extra mile for a patient? Or more accurately I should say 'why' do you go that extra mile?

It's not a big deal, in fact it can be quite small, but doing that bit extra can be as simple as forking out 50 cents for the old fella in room 1 who hasn't got money for his morning paper.

It may involve rounding up four nurses on a busy morning to help one patient to the shower who's been bed sponged for the last month.

It may be phoning up a patients neighbor to make sure their pets get fed.

The list of extra things we do is not always part of the job description, but we do them anyway. We do them because it is not just right, we do them because it feels right.

But there's one thing I've noticed about the people for whom I do the extra things.
They're not demanding. They're often old. They're really nice to the people looking after them. They appreciate what we do for them.

Their only fault is that they sometimes suffer in silence because they don't want to be a burden.

They're not rude, obnoxious, demanding, threatening or abusive.

It pays to be nice. And we appreciate your appreciation. You see, we like to go that extra mile.

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keep your clothes on

She was every man's worst nightmare, at least to work with. She was eighteen years old with wavy blonde hair, blue eyes, a perfect figure, but worst of all, she knew she was a knockout and knew how to use it.

I gotta say something, I can't keep looking at the ceiling. Hell, the low seating sure doesn't help. I'll have to say something. Not sure if it's appropriate, but it's making me uncomfortable.

"Chloe, this is getting ridiculous, please cover yourself" I demanded.

"Why sir? What on earth is wrong" Chloe flicked her hair and beamed a smile at me.

"It seems you've never learned to dress yourself properly. Your blouse is half undone, the top half that is, and everyone can see your chest" I explained.

Chloe made no effort to cover herself "It's awfully hot sir, just getting some fresh air" Chloe's smile was definitely looking predatory.

"Chloe, do I have to call your father and tell him you can't dress properly? I'm sure your assets work well with the rest of mankind, but in my health center you're going to dress properly." Chloe still didn't make an effort to do up her top.

It was time to cruel. Cruel to be kind that is. "And besides Chloe, as a nurse I've seen more breasts than you can imagine, and much more memorable ones."

Chloe quickly buttoned her top up.

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Let's get constuctive, not destructive

In New Zealand some the media are telling us the some Maori like to call the health system racist. They say their needs aren't being met.

Now let's just think about this a moment.

1. Some individual people may be racist, but how can you call a system racist when all it tries to do is help the sick.

2. No system is perfect, and people from all backgrounds probably feel at some stage or another that their local hospital doesn't quite meet their needs.

3. How is calling the system racist help anyone? Think about it a bit. Whether it's meant to or not, all talk like this is going to do is make a lot of good, caring, hard working nurses upset. Nurses take this personally, at least every single nurse I've worked with does.

4. Wouldn't it be more constructive to say "Hey, we've got a big problem with whatever..." be it with drinking, smoking, diet, access to health, heart disease etc. And then say "What can be done to solve these problems?"

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The solution really is simple

One hundred patients through our emergency room door was a very busy day for us. Hell, eighty through our doors was busy enough. I've since moved on from my busy, challenging, exciting little hospital, and I'm relieved I have.

I loved the emergency room. The staff, the challenges, the excitement. But now we easily see 150 plus 4-5 days a week. They've added a new nurse position to help with the extra work load.

It's six years since I last worked there, but I keep in regular contact with the few old friends I've still got there.

95% of the original, experienced staff I worked with have left. The new staff last about 2-3yrs on average.

Total burnout plus fear of screwing up due immense workload = Run for the hills.

The hospital has a budget it can't go over. The government has set aside 13 billion over x number of years for expected legal expenses due to litigation.

What if six billion of this was spent on adequate staffing. I'm pretty sure you'd save at least as much as you spent.

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Is American Healthcare better than mine?

Again, I've been careless and raising my blood pressure by listening to Fox News. As the debate over government funded healthcare rages, fox news decided to support their ideas by saying the british health system is a disaster as well as the canadian public system. They may as well have attacked my new zealand system because we have a natinal health service.

Naturally they highlighted some individual disasters where people have suffered because of a public system, but it's easy to find examples to suit your argument, both for and against. Do you americans with good health insurance still have bad experiences? Of course you do.

Here in NZ everyone has free hospital healthcare, but if you can afford it you can pay for private healthcare. It seems to work. Whether I work in NZ, Britain, Australia, we all seem to deal with the same problems. We deal with the same people, the nice, the bad, the rich and the dirt poor. We deal with the same conditions, the strokes, the MI's, the trauma. From the american nurses I've worked and shared experiences with, it seems we all end up dealing with exactly the same stuff.

One thing which is interesting is that waiting times in British ER's are substantially less than that in most American systmes? Fox news didn't bother to mention that.

Anyway, I realise there is a lot more to and against this argument, but that damn Fox News is so bloody frustrating. I haven't actually heard any news from them, only one sided, uninformative and insulting comments to support their own agenda.

Tell me what it's like to nurse in America.

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Politics, News and Nursing

I'm a new zealander and I watched fox news for the first time. I was disgusted by how biased and uninformed their reporting was. Here's the scenario, it painted all nurses in a bad light.

14yr old girl rings up an abortion clinic and says she wants an abortion. She lets slip that her partner is 30yrs old. The girl says 'Will you tell my parents'. The nurse on the phone only has a few seconds to help this girl. She says 'no, we won't tell your parents if you don't want us to'. The 14yr old girl is then seen on fox news admitting it wasn't real and she happily joined in the news crew in bashing nurses who deal with sexual health.

It doesn't take a genuis to figure out public reaction. Shock, horror, outrage and disgust at this nurse and all abortion clinics.

Here's what really happens. I now work in a boarding school (male nurse) and deal with sexual health issues all the time.

A girl, (say 15yrs old) is worried she may be pregnant. The first thing she asks me is 'Will you tell my parents?' If I say I will tell her parents, she may not tell me what is wrong. In fact I've had one student who assumed we would tell her parents, and she climbed out of a forth floor window in the middle of the night and scaled down each floor using the balconies on each level. She was accompanied by three friends. If any of those friend had fallen, they would have been killed. They took themselves to a local hospital where it turns out she wasn't pregnant.

What's the point - People, students, kids, adults need to feel they have someone to turn to, someone safe, somewhere safe. They need to know that what they tell us is confidential. Your first concern is the immediate safety and health of the child.

What do I do when someone comes to me for help? I did have a patient who was 15yrs old and pregnant. I told her I wouldn't tell her parents. I did tell her I would talk to my colleagues and the school doctor.This encouraged her to tell me the whole story. After evaluating her situation, including family, boyfriend etc, and discussing with my even more experienced colleagues I encouraged her to tell her parents. She did this and the parents were so supportive. The girl was so relieved as well as surprised. Children are often surprised by how supportive parents can be when in true crisis. The parents came and dealt with the issue.

Back to Fox News Scenario - Fox news jumped on the anti-abortion band-wagon and highlighted how medical people keep parents ignorant.They inflamed the public. This issue isn't about abortion. This issue isn't about the parents (at first). It's about the immediate safety of the child. Hopefully family can and will become involved, although unfortunately not all kids have good parents they can turn to. And by providing a safe environment for the child she can be encouraged to deal with the fact her boyfriend is 30yrs old. Hopefully the guy can be thrown in jail for the rest of his natural life. (I'm a parent as well, I'm not a emotionally immune healtcare giver). Fox news didn't show what really goes on. They didn't show the thoughts behind the medical people dealing with these ethical issues.They showed a nurse in a bad light, trying to make a political point. We all know news is never unbiased.

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Natural Selection

A school night, midnight. Two boys, 16yrs old, in a super enhanced car. The car flew, it literally jumped over a 40cm conrete fence and smashed into the wall ten feet behind it. Booze and blood splattered all over the place.

Two boys dead and one in intensive care.

"Don't label our children as 'boy' racers" read the headlines in the local newspaper.

The survivor, the one in intensive care, told the nurses to 'fuck off' and the doctors to 'get fucked'. His attitude hasn't improved in the following days.

The nurses have begun to lose sympathy, although some never had much in the first place. Some are saying 'natural selection'. Some have become inured to the tragic condition that is part of being human. It happens.

It is horribly tragic.

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I'm not evolved enough

What was I thinking!!! What point is there getting my masters??? One class and I was ready to tell the tutor where to go.
"You haven't learned how to think critically" explained Mrs Crump. "Ah, I'm still not sure what you mean by thinking critically" I explained.

We were dealing with a scenario where I'd been working in an east London hospital on an Agency shift. I'd been left with eight acute patients, no handover, and a nurse assistant who called in sick. I was in the emergency room as well.

I'd complained but like the typical nurse I pulled through the shift for the sake of the patients. I know I didn't do as good a job as the patients deserved, but there was just too much to do.

"You didn't deal with the situation as you should have" explained Mrs Crump. "If you'd been thinking critically, and by that I mean taking control of your thinking and the situation, you would have made better decisions" said Mrs Crump.

I shook my head "So what was the right thing to do? Your explanation still hasn't helped me. I'm sorry, I just don't get it. I use common sense, and just try to do what is right. I did think of walking out but..."

I could have walked out, but as an Agency nurse filling in a random shift, I'd have been in dire straits. The agency nurse always gets the blame and never has any real support when the shit hits the fan.

Mrs Crump is the typical nursing tutor, idealistic but not practical. She's probably never done an Agency shift in a random hospital, they just didn't do it back in her day. I don't think she has thought 'critically'. It hasn't occurred to her that in some situations there is no right way, sometimes you just can't win no matter what you choose.

I didn't go to another masters class. I've been put off, or maybe it was the 4000 word essay that put me off. Oh well, never mind.

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Opposites can't both be right

"I would never operate on this" said Dr X in a firm voice. "Not only would it not be of any benefit, but there is a 30% chance you could permanently lose a quarter of your strength in that arm. Neither the patient or his family looked happy with this verdict.
"Well, ah, just send us the report and we'll speak to our own doctor back home" said the the patient. Home in this case being Germany.

The problem was that the specialist in Germany said that the specialist we went to was wrong and that the patient absolutely must have surgery. "I'd be crazy not to operate" were his words.

The patient is getting surgery soon.

I don't know who is right or wrong, but if the wrong person is right, the patient is going to suffer.

Nothing I can do about it either.

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Common sense is just catching up with me

Ideas I've had which no one thought anything of because when I mentioned them, I was and still am a nobody. It's just frustrating to see that they're being implemented now.

Idea number:

1. Hospitals employing own cleaning staff. Just read the BBC news and Scotland is employing over 600 new hospital employed cleaners, not contractors, to clean out their hospitals. I'm sick of cleaning equipment being locked away from me. I had a cleaner who said she doesn't clean up body fluids (vomit in this case) but wouldn't give me her mop or give me access to the locked cleaning cupboard. I wasn't trained enough.

2. Employing some male staff to work in the Psych ward every shift (I once worked in a place where often I was the only male on shift). I was called sexist. A year after I left they employed a couple of huge men to work as the muscle in the place. This only happened after a female member of staff was placed in a headlock and dragged down the corridor while none of the female staff, all of whom had been trained in restraint, could not stop him.

3. We always had difficulty finding out which patients could do what in the psych ward. ie which patients could leave the ward with supervision, which could not leave at all, and which patients were sectioned under the law. My suggestion was to have on the office whiteboard, next to each patients name, their legal status, their leave status, plus any special requirements if they can leave the ward. I was told this was not very confidential. One year after I left, this was in place and it made life much easier when trying to find out which, especially at short notice, who could leave the ward, especially for excursions for the patients.

I've had more great ideas, the above list is just off the top of my head. One big idea which I feel is critical to saving the NHS is this:

Making it a legal requirement to have at least one registered nurse per 6 patients, with the exception being night shift of course. I've regularly had up to twelve, sometimes 16 patients with a healthcare assistant, all in a busy surgical ward. Patients die because of this, it can't be helped.

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What I'd really like to say

As I opened the mornings emails a groan escaped my lips. There were three emails, two from Russia, one from the States. I knew none of them were going to be pleasant.

The first email - I am disgusted that the school would send my child to a place with third world conditions. My son will see a dermatologist urgently or there will be consequences.

The son happened to be on a school camping trip. He'd been bitten rather badly by either the mosquitoes or the sleeping bag he had used was full of bed bugs. The problem had resolved, the bites fading. Nothing a dermatologist could do.

The second email - I am writing to you because of the substandard care my daughter received. My daughter now needs surgery because you didn't bother to x-ray her. She has a fractured tail bone...

The daughter had self discharged from hospital, she said she wasn't in pain. And who the hell operates on a broken tail bone anyway?

The third email - I want to know how you can let children leave campus and get so drunk they end up in hospital...

The boy was celebrating his 18th birthday and his parents had given permission for him to leave campus and go to the city. They said he would be staying with his uncle. The hospital never called the uncle. They called me. I never saw the uncle because he never bloody existed.


What I wished I could say

The first email, the bedbugs - Dear Parents, do not threaten me or tell me what to do, ever. Your son got bitten by some bugs. This is what happens when you go camping. The bugs could have come from his sleeping bag, which you bought for him, or from some rather voracious mosquitoes. The bites have healed fine. A dermatologist would be of no benefit, other than to make you look desperate to blame someone for something that really is nobody's fault.

The second email - Dear Parents, Have you forgotten that it was your daughter that discharged herself from hospital because she was sick of waiting for an x-ray. Have you also forgotten that I recommended she stay, but she insisted she was fine and in no pain. I have never seen someone who actually has broken their tail bone be pain free and sitting fine in an upright position. I have also never seen someone have an operation for a broken tail bone, but this would not be the first time I've heard of absurd treatments from Russian doctors, although I am aware that with $20 US dollars you can get a doctor to write what you want from over there.

On another note, I hope the behavior witnessed by myself and the other nursing staff in the emergency room where your daughter was admitted was not typical. She was rude, abusive, obnoxious and generally appeared to be a spoilt, selfish, nasty little minx. I wonder where she gets this from

The third email - Dear parents, How can we expect to be held responsible when you say they are staying with relatives and take them away from campus. And since I haven't seen any sign of this uncle who was supposed to be looking after your son, and since it was I that got out of bed at 2 o'clock on sunday morning to drive two hours to the city to see your son, you should be on your knees thanking me. But you're probably feeling guilty for lying about this uncle, and I know you're lying because your son has admitted there never was an uncle. And now you're looking for someone to blame. Well take a look in the mirror.

Oh and this is not the first time your son has been in trouble for drinking, although it certainly is the worst. He says he's been drinking at home since the age of fourteen. I don't want to judge, but feel I must say that this is illegal.

I won't bother telling what I really wrote as that is too boring, too damn politically correct and cover your ass.

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Missed Fractures

"Don't you question the doctor?" asked Bryce. I took several slow breaths before replying as I was becoming more agitated with every word Bryce said. "No Bryce, we never advocate for the patients. We let the doctor do as he wants" I replied. "You what?" Bryce exclaimed. Caught off guard by my comment Bryce seemed to miss the sarcasm in my voice. Bryce is the head of the complaints department. I don't know how he got the position, especially as he is not a doctor or a nurse, although he did once work as an assistant in a lawyer's office.

"Bryce, we always advocate for our patients, but if the doctor says the x-ray is fine, then I tend to take his word for it. I'm not an x-ray specialist" I said.
"Well, the family are complaining because they say Miss Putin now needs surgery because the doctor missed the fracture on the x-ray. You were right there, you saw the x-ray" Bryce said.
"Are you saying it's my fault then? That I should have seen the fracture that even the most senior doctor on duty didn't pick up?" Bryce shook his head, "No, no, that's not what I mean" Bryce said almost apologetically.

"Bryce, why am I even here? This is between you and the doctor who saw the x-ray" I said. "But you were there, you saw everything. This was your patient" he said. "Well, if you want my opinion, well, here's how I see it. First, the patient apparently has a tiny break in the tail bone. She wasn't in that much pain. She wanted to go home. You don't do surgery for a broken tail bone. Oh, and this happened six months ago and we don't have the x-ray to confirm that there really is fracture that has been missed" I paused for breath. "When you put this whole thing together, this sounds like a load of shit."

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I"m to dumb to understand that diagnosis

"Fuck off" said Peter. I moved suddenly, catching Peter off guard. I grabbed the front of his shirt and slammed him against the wall. "Don't ever speak to me like that again Peter, or you'll be real sorry" I snarled. "You can't do that to me. I'm a patient. You're fucked" he managed to gasp. I replied by slamming his head against the wall, "Let's find out if you're right, eh."

The phone began ringing. I woke from my daydream. I reached over and answered the phone.

We do have a patient called Peter. The doctor thinks he has a Personality Disorder. I don't understand this diagnosis. To me he's the bastard who got caught drug dealing in the paediatric ward just after his wife had given birth. He's also the only patient who does tell me to "Fuck off" on a regular basis.

He's never been admitted to a psychiatric ward before, but after being caught by the Police he tried to kill himself. Ten paracetamol is not enough to kill, but his liver has got to be suffering. I'm sure he knew it wouldn't kill, but he probably didn't know he'd damage his liver.

Maybe I'm insensitive. Maybe unprofessional. But I'm allowed to dream.

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Defibrillator Battles

One heart attack down, another dozen to go I reckon.
Everyone smokes here, the maintainence guys are mostly over 50, or even 60 year old. They smoke about 30 cigarettes a day, and have a pretty decent amount of alcohol. Hell when I arrive at work in the morning to open the health center, the hall is full of the smell of cigarette smoke drifting up from the basement workshop.

The head of business has told me he's not keen on spending money on some defibrillators. "Well, there's legal issues involved" he said and "It's not just as simple as going out and buying a defibrillator." I shook my head at this "It is that simple. We buy it, then I show the staff how to use it. They're desgined so that even young children can use them. You switch it on and follow the instructions, which usually are "Push the button"

Anyway, to be thorough, I offered to have the school send me on a course to officially train others ie lay people like the teachers and maintainence guys, on how to work the damn thing.

Too much money apparently.

I wonder what happens when the next staff member drops dead. We had our first heart attack last week. Fortunately he survived, but no thanks to the health center.

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You don't really want the truth!!!

Is our curiosity insatiable? It would seem so. We relish the gory details. Whether on TV, in the newspaper, or in the bookstore, stories which tell the good, the bad and the ugly always sell... at least I thought so until now.

People love hearing the truth about what goes on in your average restaurant, the gross stories which show the horrible things which happen to your food. People love reading about the lies, cheating and debauchery of literally anything. But do people want to know what really goes on in your local hospital?

I think not. Again, the book I'm trying to get published, an honest look at nursing, told from a male perspective has been turned down. The publisher said it was written well, even said I had some writing talent, but they don't think books about hospitals and nurses will sell.

What makes it even harder is my book is not a cheap, nasty tell all book. It's an honest book which shows how amazing nurses are, what horrible conditions we sometimes work in, but also show some of the horror of what can happen. Why show the horror?

By showing the bad, we can see what happens when hospitals are chronically understaffed and managers cut staff. Maybe this way positive changes can happen.

By showing the bad we can see what it takes to be a great nurse or doctor, and show how easily it is to be a bad nurse or doctor.

The publisher enjoyed my work, but doesn't think the public want to know, as well as think the public can't handle it.

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Religion vs Nursing

A nurse in Britain was recently suspended for offering to pray with/for a patient. The patient said no. The nurse said 'Ok, no problem' and never offered again.

Has the world gone mad? Hell, nursing and caring for the sick has always been tied up with Christianity. There is no big deal about what this nurse did. She was professional.

If people find it offensive if being asked whether they would like to pray, then soceity is even more pathetic than i imagined.

Oh no, I got asked if wanted to pray, I need counselling. It's soooo offensive. Hell, I'll sue the insensitive religious buggers, that's what I'll do.

Simply put, we can't be too afraid to ask.

It doesn't matter what profession we are in. Everyone's so bloody worried about offending someone. Well, I'm offended that I can't ask. Hell, if the patient gets offended, too bad. Say 'Sorry, I won't ask again. I didn't mean to offend'.

Patients have rights as well. They have the right to appreciate what we do for them, and not take offense when none is intended.
Hell, any patient who decides to take offense is probably looking for an excuse to stir.

Patients need to show a little common sense and tolerance as well.
No one should ever be 'deeply offended' if asked in a non forceful or persisting, nagging way.

Get a grip you politico correcto's. A nurse should be able to offer if they feel it appopriate.

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Sick of Management

Aim of management - To get something for nothing

Aim of nursing staff - To give the best with nothing

From my first days as a new graduate nurse to many years later, all I've ever seen is senior management making life miserable for those that do the caring.

A classic example: Happened in my first ten months working. The ward was very short staffed and bed numbers increased from 25 to 30 beds. The charge nurse wanted to recruit this student nurse who had been working her electives there for the past four weeks. She was a great student who worked well and the staff liked. When the charge nurse wanted to employ her, the big bosses said no. The charge nurse (best I've ever worked under) quit as she was sick of not being able to do what was not just right, but safe, for the ward staffing level.

Within one month of her resigning, the student nurse (now a graduate nurse) was getting work on a 'on call' basis, all the time. This happened because the understaffed and overworked nurses in the ward kept calling in sick. The big management types realised that the extra workload with those five extra beds was too much for the already overworked nurses. They eventually employed the newly qualified nurse that the now resigned charge nurse wanted to.

Result - One great charge nurse lost. More anger/frustration at management.

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A Thakless Job

"Give me" said Darren, pointing at the medicine cabinet. I could hear Darren sniffling and blowing constantly into a tissue, but he wasn't going to get any sympathy from me. In fact very very of the teenagers in the health center waiting room would get sympathy for me.

"Ah Darren, what's your problem?" I asked, my voice deceptively calm. "I'm sick. Just give me some medicine" he said again, completely oblivious. "I know you're sick, but there's something wrong with your eyesight. Didn't you see the twenty other children in the waiting room who got here before you" I said as I placed my hand on his shoulder and gently turned him back towards the waiting room.

"But I'm sick. It will only take a minute. You can't do this. I'm sick" protested Darren. "I know, but you're not the only one here Darren. You're blocked nose is not an emergency. You'll have to wait just like the others" I explained. Darren's face went red, but not with embarrassment. "My parents pay your wages" he exploded as he pulled out his cell phone and hit the redial button. Thirty second later and he thrusts the phone to me "My parents want to speak to you." I shook my head and walked away. "You'll have to wait your turn just like everyone else. I'm not talking to them right now."

Sure enough I received a scathing email about how terrible the health staff are, how we don't care for the kids, how their child has been suffering terribly for the last month. It's normal. I expect it. It's a shame when you learn to expect this sort of behavior.

Oh, and if you're thinking I brought this on myself by not speaking to the parents, trust me, if I'd got on the phone things would only have been worse. It seems no matter how kind, how reassuring, how professional I am, phone calls usually go awry.

Oh well, maybe I'll get a job in anaesthetics.

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Broken bones & Bullshit

The kids at our school are privaleged to live in a ski resort, and even more privaleged to get two half days a school week to ski. It's just a shame so many break their bones. Two broken wrists on the first day. Both kids were jumping. I keep telling them to take it easy, but they never listen. Even so, I still feel some sympahty for these victims of their own over-confidence.

But there is a group I don't have sympathy for. In fact there's a group of students that make me want to bring back corporal punishment (caning).

Bang, bang, thump, thump, slam. I looked over at Stacey, my fellow nurse, "Ah, do you want to get that" I tentatively offered.

"You got to be bloody joking, you go out there" Stacey replied.

"I'll go out there then, but it won't be pretty" I offered.

The problem was that the health center was besieged by a horde of teenagers claiming they were either too ill or injured to ski.

One look outside at picture perfect day, the brilliant blue sky and glistening snow covered peaks made me angry enough to open the door.

"Why's the door locked? I'm sick. I can't go skiing"
"My knee's playing up, I can't go skiing"
"My mum said I'm too sick to ski, so I'm not going"

I motioned everyone to quienten down while blocking the door and physically restraining kids who tried to push past. "We're closed. You had your chance to come to clinic this morning at breakfast clinic. If you don't to your activity, you'll be marked as absent. Goodbye."

I began to close the door but someone's foot was in the way. I looked up at the owner of the foot. "Ah, olga, you need to move your foot, it might get hurt" I said, the soul of innocence.

"It's your job to help me. You're the nurse. My parents pay for you to help me, so do your job. I'll call my dad. You don't want me to call my dad." It was interesting to note the change in Olga's tone from just plain obnoxious to sinister. Olga's parents are Russian and as far as I can tell they've never earned an honest rouble in their life. Mafia, Russian Mafia, that about sums up Olga's family.

I took a moment to gather my thoughts. Should I make her cry. Should I tear her to pieces in front of her friends. Nah, she's not worth it. I know how to make her more angry.

I forced the door shut, completely ignoring Olga.

I am a caring nurse, but I don't care for bullshit.

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