Being back in the system is much harder than I thought it would be. Working for an agency is fine - I get to choose where and when I work, which is a big bonus, and the pay is OK, but the work is really really hard. I really don't want to sound like a bleeding heart, but I'm finding it really difficult not to snap at complaining relatives, angry at the time they have had to spend in A&E because the hospital is oversubscribed and understaffed - yes, Brighton people, it's endemic. It's the same everywhere. I want to tell them about the young boy who died in Juba from an asthma attack, because the hospital had run out of oxygen. I want to tell them, when they complain that Dad's medications are 20 minutes late because their nurse simply has too many patients to care for, about the 40 year old man who died from a hypoglycaemic attack (low blood sugar) because he was too far from anywhere that knew what to do . I want to tell them, when they complain that their relative has not been seen that day by the tired, harassed junior doctor , about the young girl with advanced malaria, who was almost certainly going to die because her family did not have the money needed to get her to a hospital that could look after her, or the money needed to pay that hospital even if they did get her there. My tongue is becoming quite raw from all the biting of it I am doing.
Back on the shop floor of nursing, working as a junior staff nurse again after so many years spent being in charge, has reminded me of how bloody hard these nurses work. This is no surprise to anyone, I suppose, but experiencing it first hand again, hour after backbreaking hour is actually making me a bit sad. Sad , that as a junior staff nurse, your main job seems to be ticking boxes on the endless " yes Mr Cameron, I have ticked that box to show I care" reams of paperwork . There are piles and piles of it. Tick a box to say I asked my patient if he was comfortable every hour. Tick a box to say I have looked at his pressure areas every 2 hours. Tick a box to say I've managed his pain every hour. Boxes for food, drink, positioning, happiness....... By the time you've ticked all these boxes for your 8-10 patients you are caring for, it's time to start again. The sad thing is, the health care assistants are actually DOING those things. They are the ones washing your patient, looking at their skin, feeding them, turning them. As a staff nurse you are just the box ticker. There simply is no time to actually carry out the care yourself. You are relying on second hand information, because you are doing the drug round that takes 2 hours, or placating the annoyed relative because your drug round has taken 2 hours and their Dad was at the end of it . I've worked in Care of the Elderly, Orthopaedics, Surgery, and the Acute Assessment Unit so far, and it's the same everywhere. Too many patients per nurse, too much paperwork, and not enough time to actually CARE . Having worked for so long as part of a team of senior nurses, who were all brilliant at their job, I had forgotten what it's like to go home every night wondering if you'd actually signed for that drug that was prescribed to be given 5 minutes before the next shift started, or if you'd remembered to tick all your boxes, or if you'd remembered to tell the next shift all the things you hadn't managed to do ( and hear them sigh with annoyance).
There is a certain amount of relief, not having to keep an eye on everyone else, and make sure they're doing their jobs properly, frankly it's exhausting enough, keeping an eye on myself,and making sure I'm doing my own job properly. And the sad fact of it is, I'm not. Not to my own satisfaction, anyway. I'm experienced, organised, and sensible, and I can't manage to leave work these days feeling that I've done a good job. My heart goes out to the juniors, who must think that this is the way it will be for the rest of their careers. The sad fact of it is, they're probably right. With the advent of the compensation culture and the tide of opinion directed against the public sector by the popular press, the decline in numbers of decent, practical, caring people applying for nursing, is bound to continue to fall. It makes me very sad.
So, happy days ...... hopefully the aviation medical course I am doing in February will open up some avenues into flight repatriation, and I may get the odd contract as a medic at Shepperton Studios if I'm lucky - quite frankly, I can't do this ward work for ever or I will become one of those embittered, uncaring, miserable nurses that exist on every ward. And that was never why I did this job in the first place.
It may not be Juba, but the NHS is a different kind of war-zone.
No comments:
Post a Comment