Nursing Scribbles (http://busynurse.wordpress.com)
This is our own blog covering developments in the nursing world as well as our own random thoughts on nursing, healthcare and whatever else takes our fancy.
Suspicious minds
July 13th, 2007
I am off back into the fold of the NHS for a secondment. I feel excitement, aniticpation and a little fear.
I have worked as a consultant for nearly four years and it has huge benefits but also drawbacks. I love working with someone and not for someone but it can be a lonely and stressful path. In order to win business we often need to work alone and that doesnt suit me at all and never has. Winning business equates to paying essential bills and in the months when clients are scarce or organisations are cutting back and paying late it can be incredibly stressful. There are high prices to be paid for leaving a service which cushions you from some of the pitfalls and stress of managing money which is never certain. I acknowledge that managing budgets and financial pressures are stressful but they cannot be compared to knowing that you are a step away from bankruptcy or from problems putting food in front of your kids and the joy of knowing my salary for the next four months is safe and secure is unbelievable.
On the plus side being a consultant and running a business has taught me a self suficiency which the NHS never could and has enabled me to say and do things which were certainly impossible within the precious fold of the department of health. I have been more honest about the reality facing a service I love and a profession of which I am proud to be a member. I have sat in front of senior people who have listened to me properly because they have paid for my advice and have taken that advice and made improvements to their organisations and to the nurses working in them.
Going back may mean that I am not listened to in the same way and may shed some light on why organisations cannot solve their problems themselves by listening to the clinical voice telling them things which are clear, practical and often simple common sense.
I am looking forward to really getting my teeth into something. A consultant has a severely limited timescale for making judgements and improvements and is under delivery schedules which often are based on money rather than on what would be best. I am excited at the prospect of a full four months in one place and a feeling of belonging somewhere and being part of a team and an organisation.
And my fears? Ahhhh, already the slimey hand of bureaucracy is crying for attention and the noose of conformity is shrieking but the policy says in my ear. Of course those who know me well are looking forward to my expliots and are eagerly awaiting my downfall in the face of these foes but it hasnt happened yet and I have worked in the NHS since 1984 so I am certain four months wont do it now Read more ...
Informaticopia (http://www.rodspace.co.uk/blog/blogger.html)
Eclectic news and views on health informatics and elearning, by Rod Ward & colleagues.
ECDL module for health
The British Computer Society recently announced a new module to be added to the European Computer Driving Licence (ECDL) specifically for healthcare staff, and developed in conjunction with Connecting for Health.
It aims to "provide candidates with an understanding of the key principles and policies relating to healthcare information systems and the practical skills needed by users. As well as enabling users to read, retrieve, update and store patient records accurately, the unit also provides candidates with a thorough understanding of the key issues regarding patient confidentiality and data security."
It has been piloted with 100 staff quite successfully but it will be interesting to see if this is rolled across the NHS and whether it is seen as a high priority for managers and useful for individual staff Read more ...
UK Student Nurse (http://www.studentnurse.me.uk/wordpress)
I am a student nurse at the University of the West of England, Bristol. I have come to nursing later than some, but not as late as others in a dramatic change of career.Pay
Perhaps in the future I might be upset at nurse’s pay, as the recently reported “anger at public sector pay offer”, but right now all I see is a starting salary 25% higher than I was earning in engineering, and 120% higher than my bursary. At least for a couple of years I will feel rich.
Jargon
For some reason I was given some advice in the week to write ‘acopia’ in preference for ‘not coping’, and I really cannot see why - it seems to be simply making up jargon for the sake of it. I can only find a couple of journal articles that appear to be in favour of acopia’s use, Block in Nursing Standard in 2003 quite eloquently explained how adding the prefix a- to a ‘Latinised’ form of cope made a word to fit a situation where “a single, succinct medical word does not exist”, advocating use of ‘Greek’ and ‘Latin’ terms, along with abbreviations and acronyms because they are correct and succinct, whilst I can understand succinct as a reason for many terms, as for being more correct CPR is no more correct than cardiopulmonary resuscitation, nocte is no more correct than night, and really acopia is no more correct, or hardly any more succinct than ‘not coping’, especially if one has to spend time explaining what it means.
As King wrote in a letter to Nursing Standard in 2004 in response to Block “Acopia is the name of a town in Peru and the name of a company, but it is not a scientific term” Read more ....
Life In The NHS (http://lifeinthenhs.wordpress.com/)
Julie is a nurse-turned-manager who is also a forty something wife and mum with too much to do in an average week. Works full time in health care, probably eats and drinks too much but good at weight loss when she puts her mind to it.
Slow blogging week
Slight writers block for me this week. It isn’t that I haven’t been busy, or maybe that is the reason that I have struggled with good ideas to blog about. I have just spent 2 days helping to facilitate a management course which has involved me spending time away from the office and away from my current day job. Because this was a meeting of my previous role and my current one. The facilitating was part of what I used to do, something I am comfortable with, and the delegates for the course were from the new one; they were commissioners. So the discussion was useful and interesting to me, and I could engage in my favourite occupation of recent times; listening, asking questions and storing information for future use. This kind of work, much as going on a course yourself, is incredibly tiring. I am not sure if this is because you have to think so much more about what you are doing, or because it is much more intensive, but at least I have felt I have achieved something.
Today it is back to the day job, but a late start to meet a manager from the hospital local to my house about children’s and maternity services gives me time to blog and have that extra cup of coffee (or two, I must try and cut that down!)
It is with relief that I realise that this is the last friday of the financial year. We can only hope that 2007/8 will be a more pleasant one for those of us who work in the NHS. However, for some of my colleagues, this week will bring their 3 month notice from their employers, because if no suitable alternative employment has been found for them by 30th June they will be redundant. These are not ineffective people who have not previously been of use to the organisation, and they are not sitting around doing nothing, they are doing work no one else either is or can do. What is more they will not be cheap to get rid of, and hopefully they will not be dispensed with in this way.
The people I have met over the last 2 days, most of whom work in other PCTs rather than my own, have all been through the same process as me. Many are now doing new jobs, or variations on their old ones, but all of us (without exception) are carrying battle scars from the very process we have all been through in the last 20 months or so. Luckily for the NHS some good people have been retained, and enthusiasm and hard work is returning, but for others the belief is that the scrap heap beckons, and that scrap heap will be expensive because you can’t get rid of people with 30 years service without paying them off! Read more ...
code blog: tales of a nurse (http://www.codeblog.com/)
This is a weblog specifically for personal medical stories. Many many interesting things happen in hospitals, clinics, schools, hospices, at ball games, recitals, and on planes and trains. Almost everyone that comes into contact with someone in some sort of medical situation has at least one good story, be it an RN, MD, LPN, nurse's aide, unit clerk, unit support, manager, or volunteer. Geena discusses everything from ethical dilemmas to her own pregnancy!Nurses Gone Nice (Story Submission)
I suppose this is a silly spin-off of Kevin MD's "Doctors Gone Wild" category. "Chocoholic" submitted a story about how nurses helped her during a particularly bad time:
Over a year ago, I was admitted to ICU after a suicide attempt. Although I was only there for twelve hours, the saintliness of some of the nurses stick in my mind.
I arrived late at night, tired and confused. The first thing that struck me was the calm and quiet of the place. I always imagined the ICU to be noisy and frantic like in the movies. I think the fact that it was only a small unit in a country area helped. The only sounds were a breathing machine and the occasional beep, and someone making coffee. After the frenetic activity of the emergency department, where I had spent the past few hours, it was bliss, and I immediately fell asleep in the extremely soft, warm bed!
The first thing I found wonderful about the nurses was something simple, yet wonderful to me. While in the emerency department, I had to use a pan, and due to the fact that they had stuck me on a drip, I had to go quite often!! After waking in the night and holding on for as long as possible, I buzzed the ICU nurse and told her I needed the loo. She disconnected the monitors, unplugged the drip and said, "OK, let's go." I was amazed. Something so simple, yet so dignifying. I was suffering no symptoms, and felt completely well in myself and was stable, so she had let me up. The reason I felt like this is that in the emergency department, I felt so vulnerable and like all my dignity had been stripped away using a pan. We chatted about life as we walked, and I complained that the drip was worse to push than a shopping trolley, and she told me I was a card!
The second nurse I had came on around breakfast. After seeing my plate of watery, tasteless scrambled eggs on cold toast, she said, "You can't eat that," and made me some hot peanut butter toast. Later that morning, she sat with me and we talked. I told her about my life, where I was from, what I was studying, about my life living on-campus at the university and the crazy things students get up to. I told her about the emotional hurt I was suffering and how I was frightened of the future, and frightened to go back to university. I told her about a song I had heard on the radiio that morning that had epitomised the way I felt and I told her of my passion for music. After my 18 hours of monitoring was up, she took me and my drip out onto the veranda so I could use my mobile to catch up on things at the university.
When she delivered me, fully dressed and freshened and neat (the way I always like to dress and feel), to the Psych ward that afternoon, she stopped and took my hand.
"You are an inspiration," she told me, "You are a beautiful, sensitive determined person. I just hope now you can get the help you need, and I wish you luck in finishing your degree, which I know you will."
When she finished, she started to tear up. I hope she knows that I am finishing my degree, and loving every minute of it, and I remain greatful to this day of all the nurses - in Emergency, ICU and Psych-and their compassion, humanity and sensitivity.
That was sweet, huh? It's nice to know that we've really helped someone out, even if they don't or can't tell us at the time. Read more ...
about a nurse (http://www.aboutanurse.com)
May, RN. in California. finding sense or humor in life and in a medical-surgical telemetry unit. if it is nonsensical, it should at least be humorous. or vice versa. if it is neither, what's the point?dry walls
just when i thought it can’t get worse, it did. i’m talking about our staffing condition.
the change that was implemented last week caught us by surprise, but we are flexible, so yeah, we are still alive. now, if our patient census is 17 and below, we do not have a resource RN, no PCA (patient care assistant), no unit secretary. “what doesn’t kill you only makes you stronger”, right?
i won’t bore you with the details of how i find this new staffing guideline extremely revolting and unbelievably inconsiderate (both to the staff and the patients) but when i say this sucks BIG TIME, you better take my word for it and just believe me.
the other night, i was going to take my patient off the bedpan when i saw G, the other patient in bed 1, naked. she was calling out different names of people who i assume are important people in her life. confused and incontinent of urine, her soaked diaper was left open, a new set of linen, diaper and gown were at her feet. lying in bed diagonally, she was trying to get out, but was too weak to succeed. it looked like somebody started cleaning her up, but was unable to finish the task.
like a real pro in staffing shortage issues, i did the smartest thing to do in situations like these: i looked the other way. ”i have MY own patients, and i need to take care of MY patients first”, i rationalized. you know, to sugar coat the guilt. i went straight to the restroom to wet the washcloths…and what did i see?
an awkward, uncomfortable sight.
G’s nurse, (let’s call her Anna) was standing on the corner of the shower area, crying her lungs out. she covered her face with the washcloths, not much out of an attempt to conceal her identity, but to save her face from the implied humiliation.
i didn’t have to ask her what was wrong, because i already knew. i only asked because i didn’t know what else to say. since my supposed concern made her more tearful, it made me feel bad. i tapped her shoulder a couple of times and told her to wait till i’m done, and i will help her. now, helping another nurse is not in the “how to survive stupid staffing rules handbook”, but there is something about a fellow wounded soldier that strikes a chord.
while we were cleaning G, Anna was fighting back tears. “please don’t tell anyone that i cried, or i mean, that i’m crying… it’s just that…and i don’t want others to make a big deal out of it…”
i nodded. i know, it was not a big deal. G being over 200 pounds, Anna being under 100 pounds. honestly, cleaning a patient twice your weight is not a big deal. the real big deal is: you need help and there was NO ONE who can help! taking care of four total care patients is no big deal. the real big deal is: there are no extra hands and feet when you can’t lift and run in four places all at once. “promise me you’re not telling anyone…”
i told her i’m pretty sure no one will notice it. everybody was just selfishly concerned about their OWN patients. anyway, “it wouldn’t hurt if you wash your face with cold water” i said. while she was drying her eyes, i assured her she was not alone, that like her, everybody else was overwhelmed. images of myself and nurses on the verge of breaking down, and some eventually crying in the middle of countless responsibilities, flashed in front of me. all of a sudden i realized how this whole thing doesn’t make any sense.
this whole situation doesn’t make a lot of sense. it probably doesn’t make sense to others, and it certainly doesn’t make sense to me. it doesn’t make sense to me that a lot of good and caring nurses feel inadequate and drained. it doesn’t make sense to me that many genuinely helpful nurses do not feel rewarded and fulfilled in helping the sick anymore.
it doesn’t make sense to me that a number of usually composed and confident nurses who think straight even under tremendous amount of pressures are found crying inside patients’ restrooms, frustrated and overwhelmed, helpless and embarassed.
it doesn’t make sense.
but it doesn’t mean it’s not happening. Read more ...
