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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