Sunday, March 6, 2016

Betrayed and Blamed

6th March (Sunday) -  The event takes place on Saturday.
"Hello doctor. How are you???"
"WHAT THE HELL???? I NEVER HAD CLINIC ON SATURDAYS STARTING FROM THIS MONTH ONWARDS!!!"
I had to hold the receiver away from my ear at that time cause my doctor, who is usually kind, soft and gentle, who usually blasted patient who tried to nonsense with him, it's yelling in the phone. Ahhh, what on earth had just happened? This week is really rotten. First auditing is coming in June, but the higher ups are blasting us for every little problems that gone awry. Small little things that could be settled over some swapping around, but they kept yelling, "Life and death! Life and death!" Oh geez, stop pushing us around like mad dogs. My friend who had been in Saudi Arab and various hospitals for many years before she came here said even when it's close to auditing time, everyone was cheerful, joking even as the day approached near, like any other day. Auditing is auditing, she told me. All you have to do is practice the right thing that you had been doing, and please don't go screwing things up. Sigh... If auditing comes every three months, then we will see people barking like mad dogs, as one of the assistant usually said.
I myself even lost my temper, pushed to a breaking point when the new system is coming out. Somehow, on the previous day, against my will and consent, someone had dragged my name into the  computer learning system. Now wait just a minute, I never submitted my name, and I certainly had never said I mastered the whole computer thingamajingy.
Bloody hell. Oh yes, those words really came out of my mouth. I was so furious, so mad, that I comply at first, and yeah, they couldn't handle all the old fussy doctors' personal assistants, so that I end up taking all the flames. And idiotically enough, I did. All the bloody word came out of my mouth. Bloody idiots, bloody fool, bloody, bloody, bloody, bloody, bloody... The one thing I should've done was take a photo of the schedule because I did not see my bloody name on it. But again, I was an idiot for not doing so, so I ended up letting them get away with it.
Oh she called after 2, after the whole fiasco. She said, "Do you want to teach others how to use the new system?" And I coldly declined, and then she said, "Oh, I thought you were confident, that's why I put your name in the list." Again, in a very cold voice, I said, "You listen to me right now. I had never once said I am confident in the new system, and I certainly never said that I would do it." She kept really silent then and we hung up.
The next day, my friends were teasing me why I'm not taking care of my doctor anymore, and I said, "Oh you know, we are S-E-P-A-R-A-T-E-D." Speak of the devil, the moment I stepped out, our cashier boy went, "You are needed with Doctor So-and-so." Um, okay. So I did, and I already got few patients waiting. Okay, as usual, let's give him a call.
You seen the first two lines between me and my doctor, now let's continue from there. After he blasted me, he demanded, "Did anyone told you that I cancelled clinic on Saturdays and start operating on Saturdays?" And I sighed, "Doctor, no one ever tells me anything." And he muttered something under his breath, then he said, "Give me few minutes, once I'm done with a dressing in the ward, I'll come over." So I give a sigh of relief. Okay, one crisis down.
Oh Christ. Not averted. I thought there's only one patient but ended up there's two, so the chains of disaster were set in motion, one after another. He went, "How come there are two patients now?" There was nothing I could do, because the patients came at 8 and I only just found out. So he accepted and took them over. But once they were gone, he told me to push all of our patients to another doctor., after checking our appointment book. Seven patients, and there's no note nothing that says no more patients for Saturdays. Nothing. He was so furious that he too started swearing bloody idiot like I do (Oh yes, I learnt my swearing from him) then he muttered, "I took Saturdays because everytime when I want to do surgery on Thursdays, they tell me no slot, so I took Saturdays cause nobody wants the slot." Ohhh, so that's why he's around on Thursdays when there's no clinics. I helped him book a lot of surgeries on some Thursdays, Fridays and Saturdays but I never knew. Bless him. In between when he was seeing patients, I called a good friend of mine, a super senior clinic girl about my situation and she went, "Oh my God. Did he informed medical affairs?" I told her that he said he did, and she quickly checked the system for me, but there's nothing there, and I told her so. Then she told me to get my doctor to write a letterhead or memo informing that he has no more clinics on Saturdays, which I informed him, and he said, "I already signed the bloody forms 2 to 3 weeks ago, and I already spoken to the bloody medical affairs officer. How come I still got patients on Saturdays?" Then I meekly asked him, "Did you remember who did you passed it to?" And he said, with venom, ""I certainly remember. It was your good friend, xxxx.  Oh, oh no. Oh God, not her. My God, I can't believe this. What had she been doing?!!! Mother of Mary!!! I apologized like those bobble-head dolls and nearly had to get onto my knees, he looked at me and said, "I'm not blaming you. It's your bloody idiotic colleague who did it. If I ever see her, I'm going to shoot (yell at) her. And do something about the calendar, one of those fools threw it away." Huh? I took a look at my calendar and nearly screamed. The nice calendar that I had, the one which I marked my doctor leaves, public holidays and notes is gone. Thrown into oblivion. Alright, now this means WAR.
I consulted with my friend after he left, and I quickly called the girl who did the assignment, the one who made me pissed, she didn't answer at first. It was her friend, so I quickly relayed the situation to her. She went, "Are you sure?" And I go, "I'm not kidding here, I was yelled by him from 8.30 onwards." She quickly called the girl over and she went, "Are you sure? He had never yelled this bad." And I went, "Well, I've seen him yell like this with nutty patients, but this is the first time he yelled at a staff like this. Did you know that he blocked his clinic on Saturdays to do his surgery?" And she shook her head, saying that there's no messages regarding this, and asked me to talk to the girl who is in charge in fifth floor. So I went to find her at another doctor's clinic, and she too, didn't know anything about it. Great, just great. And because I couldn't stop my patients from coming, I had to run to the doctor that my doctor requested and explained the situation to him. Lucky, he was in a good mood and he said, "Okay, sure. Just get all the folders over here and I'll settle it." Oh, thank you, doctor.
I quickly went to the phone to repair the damage by contacting my patients. Some went into voicemail. Some I was too late, they appeared in front of me, so I had to apologize and said, "I am so sorry. I just came back from a long leave and I had no idea what had happened. My colleague did not leave me a note, and there no updates from her side." My patients of course, go, "She should've updated you." Yes, it's just like what happened to my poor friend form the ground floor. She came back after a month long MC from a major operation, and she get fired by the patients. Now it's my turn. And because the patients know my face, they went, "Why can't you stay with him?" And I said, "I can't. Unless he said so, otherwise I follow my assignment." Terrible, isn't it? He's the only doctor whose nurse kept changing.
So after shifting most of my patients' appointment, I had to do the calendar, the appointments, tidy up the clinic (WHY IS THERE A SPOILED KETTLE UNDER MY TABLE?!!!!), clean up the place, insurance wise I had to settle on Monday when medical affairs is open. And leave notes for the staff who is coming in. Hmm, she's on leave, which means it's me. Oh, clever. Very clever. Looks like I have to do some more damage control. The girl called me and said, "Well, you know his mood, his attitude, his habits, so it's safer to put you in." Gee, more fire to put out. We're starting clinic in the afternoon, hope we get more patients, and please, less drama. That's all I ask. Maybe this week was rotten because I had never prayed to Jesus. Well, I better do it before the day starts... What a mess. Time to go and eat some McDonald's to release the stress. >.>     

Wednesday, March 2, 2016

Bloackage and Pent Up Anger

2nd March (Wednesday) - Last day of February and early March. And things are just going downhill. I had a really bad case of nose blockage, no need mask, but I can't smell or taste anything, I might as well be eating the air for all I know, even the gloriumptious (A Roald Dahl word) pretzel tasted like cardboard. It was so bad til I felt shivering cold and had no appetite. My manager, out of concern, asked me to go to staff health. Really? Go back there? To that awful place? Read on to find out.
I went there for pre-employment check up on 14th February (Year xxxx). Then nurses there are okay, I got nothing against them. The one I really really hate were the MO. Did I ever mention I really don't like MO (Medical Officer)? I had a really bad encounter with one at my old workplace and it's awful. I was already half dead, having difficulty in breathing, and major nose block and looking weak on my legs, she insisted I was fine, with no fever or anything. And you know what she gave me? PANADOL. I insisted it was nose block, not fever, but she said, "You might get a fever, so take this and go."
This one is no different. The first time I come as a patient for pre-employment, I had a previous history of gastric that has been cleared by Prof So-and-So. But the MO isn't impressed. She called my name and went blasting me in front of everyone. "You stupid girl. How can you have gastric when you're so young?!" I mentioned to her that my old workplace was miserable and always busy, which means no time for regular meals, she cut me off. "Don't give me that stupid excuse. You should carry protein bars in your bag." Well, I would like to point out to her that most protein bars contains high amount of sugar and are expensive. I took plain oats mixed with soy-based milk or beetroots, always warm. Again, she's not impressed, telling me that I'm stupid, idiotic, yada yada yada, I'm the doctor and you're the nurse, so SHUT UP. Wisely, I stayed shut, but I was a fool for not going to the customer service and giving her a piece of my mind because I was too naive.
Second time, I decided to give the other MO a try (There's 2). She younger, so in my opinion she should be more sweet.Right? Right?
WRONG!
She is as nasty as that senior MO. Same arrogant attitude, same I'm-a-doctor-so-everything-I-do-is-right-attitude, not much of a help. The medicine she gave me was awful, so bitter til I ended up throwing up a few times when I used it. It's a good thing I kept my old doctor's nasal prescription. 2 years back, but still usable (Expiry date : xxxx), just needed a good swab of alcohol and prime it. It doesn't taste of anything, just like clear water. So much better and relieves my nasal passage. When I tried asking her for a letter for physio due to recurrent ankle sprain, she went, "You stupid idiot! Why didn't you come and see my sooner?!" Well, you answered your own question. A guy came in second before me and went for the elder MO. She didn't close the door, but talked so loudly about his condition that I winced in shame. Ohhh, not again. Poor fellow. This time, I truly, swore I would never step foot there ever again, not til they change their attitudes.
Then, our old friend is back from her long MC. (Hello~~~) Oh dear, the girl before her had made a mess of things that when most of the patients called, we could only go, "I beg your pardon? I had no idea what's going on. Could you please explain to me?"  Then the patient had to go from A to Z about what happened on that day etc etc. The poor girl tried salvaging the mess, but if you haven't done your part, how could we help you? My friend and I were standing by outside, in case she needs our help, and she did not call for us. So we assumed everything is okay. Oh the disaster. The girl then said to me, "Remember the time when it happened to you?" I was a little blur so she prodded me on. "The admission that you did for Dr So-and-So?" Ohhh, I remember. I had prepared my side together with the patient and brought everything over to the admission side, with a note that says PLEASE CALL PATIENT IF ANYTHING ELSE NEEDS TO BE DONE, TQ :) The admission people chucked it somewhere and on the day itself, the patient called and admission said they did not receive anything.
!!!!!!
They yelled at me for not handing anything over. I defended myself, saying I remember I sent the folder clearly with everything filled in by the doctor because I was nearly on my knees going, "Doctor, doctor, doctor, PLEASE fill up the forms. PLEASEEEEEE" And the doctor did it and I stapled everything neatly together. So my friend went over to their side, and lo and behold, there it was. And the worst part was they had pestered the doctor to write another insurance form. So my friend shoved the two papers to them and said, "So my friend did prepared the form. So what are you going to do about it? Send the patient for admission twice?" So they had to admit defeat. Whew, close call. But for this girl, not so lucky. She said, "I'm sorry." Full stop. My friend blasted her by saying, "Don't tell me sorry. The patient got to go for an operation, and she's a professor!!! And she knows you, and she's well-educated!!!! And our doctor is not happy!" Ohhhh, I don't want to be here when the drama breaks.
Then the second girl who works in there said the girl asked her, of all things, where do you put the consent form. For crying out-, the girl was so pissed that she got up, went out and blasted me and my friend, even though we were not the one who did the assignment. Why are getting blasted for no reason??? :(
Frustrated, I told the girl, "You should do what my doctor did."

New girl : Doctor, the patient had to go for MRI. Does she come back to the clinic or go back home?
Doctor : (Without looking at girl and poker-faced, all serious and strict) The patient is going to do the MRI, then go back to your house. And then I will go there and you will follow me.

The girl, upset, called me by extension. "Senior!!!!!!" I was like, "What? What's going on?"
"Your boss!!!!"
"What did he do now?"  
"He- He- (recalled the whole MRI conversation above)!!!! OMG, what should I do?!!!!"
"What? He did?! Calm down, calm down, he's just joking. Don't take him too seriously."
I pretty much became sarcastic cause of him. Hehehehe. When I asked him few days later, he said, "That's what she get for asking dumb question."
Note to self : DO NOT EVER ASK DOCTOR FUNNY QUESTIONS. You'll end up getting sarcastic remarks in answer.

Friday, February 26, 2016

Unreasonable People

26th February (Friday) - People often say T.G.I.F., but for my case, it's never a good thing when it's Friday. It drives me nuts half of the time. And today especially, it's the worst.
Around 9, we got a patient whose PEG tube is needed to be checked by our doctor, okay, we pushed the patient in, knowing our doctor will come in after he sees his patients. The family, two daughters plus a maid, carried a lot of baggage with them. The moment we brought them into the room, the two daughters demanded my friends and I to remove the dressing. We can't, because the doctor isn't here yet, but busy with his clinic. If we were to remove the dressing, and it takes an hour for the doctor to arrive, it wouldn't be clean.When we explained that to the daughters, they gave us really nasty looks. When you had dealt to many people with these kind of attitudes, you kinda developed a sort of thick skin against patients.
The minutes ticked by rapidly with no pause, and our doctor still haven't arrived yet. The doctor finally came after an hour or so, and he asked us, "Why didn't you all open the dressing yet?" Actually, we were already on standby with our gloves and everything, but the two daughters had to snobbishly go, "We asked them to, but they refused." Well, if that is how you put it... At least the doctor didn't say anything, he just let us get on with our work. After the dressing was revealed, the daughters went on and on about the wound. We got nothing against that, but it's more like they kept thinking they're smarter than the doctor, cause they keep asking really weird questions and kept giving that I'm-such-a-know-it-all  patient so you can't fool me attitude. Our doctor kept a cool expression, but his voice was all firm, going, "I will say it again for the third time, if you do not let me remove the tube, your mother isn't going to get any better. Do you understand?" The three of them bicker back and forth til our next doctor came in. He assessed the lady's situation and tried to loosen the tube, but with no success. In the end, they both agreed to admit the lady, after much negotiation. I took a swab sample from the tube site as per doctor's order, then cleaned around the area. Sounds okay. I wanted to bring the patient out for our next patient, but the daughters said, "We needed to feed her." So we went okay, but after feeding, they wouldn't leave, saying that we must not disturb her cause she's tired.
!!!!!!!!!!!!!
Two hours passed, and the family refused to come out, seriously, they all sat in the room with tea and snacks, locking the door and treating our room like a hotel suite. We can't provoke them, all we could do was wait and hope for an opening. And it came. One of our doctors wanted to use that room, so we told the patient that we are sorry, but our patient needed the room. Unhappy, the family packed everything and murmured under their breath as they walked out. Geez....
Then there was an incident that involved a section of a partition falling on a patient. It was just unlucky. A young patient who was groggy clung to it for support, and accidentally shoved it onto another patient who had just came out from sedation. The poor patient got hit on the head and shoulder from the fallen partition. Naturally, all of us ran to the patient, where we offered our treatment room, but because the patient was from Endoscopy, the girls took her back in to rest. Not even ten minutes later, I heard shouting from around the corner. All of us took a quick peak and saw a lady yelling. Oh, I know that lady. She's the patient's friend, she was sitting next to her when it all happened. She was yelling about getting the cashier girl to pay for her friend's medical bill, claiming that she suffered from concussion. The poor cashier girl suffered the wrath, even though it was just pure unluckiness, to the point where the managers, customer services and building and service people came running to calm the lady down. All of us felt sorry for the girl, because she gotten blamed for something that was out of her hands.  
In the end, they must've offered some sort of compensation because the lady was fuming, but not so much in the end. Super dotty, but we couldn't say anything because we weren't involved. Don't get yourself into trouble for nothing.
On the bright side, we got treated for Subway. Yay, thanks, Y*.

* Name is kept confidential to respect privacy

Wednesday, February 24, 2016

Stung Once, Twice Bitten, Thrice-

24th February - Yesterday we were all alright with dressings, but today is a market. Everyone keeps on coming, nobody bothers taking queue numbers, nobody bothers sitting, nobody made an appointment, they just kept on coming in like an overflown dam. There were some patients whom are really nasty, the types that shout here and there. Ugh... Of all days... I was right about dancing up and down that today's my half day, but I'm guilty for leaving my friend alone, but she said, "It's okay, just go back home. If I need help, I'll let you know as soon as possible."
All of our doctors are fighting for the treatment rooms, ohhhh, dang it. And one of our doctors got two PRPs and is hogging the room. And one doctor, poor doctor, he's always in a hurry and have no room for his injection. His poor patient ended up in the clinic for a long time, and because I just needed to apply one copper sulphate, my friend took over just as he said, "You're free?" And I answered, "Just." And he said, "Okay, get me a dressing set, local anesthesia, shincort and iodine." Well, my friend did say it's just a normal injection, so I grabbed what's needed, a pair of gloves for precaution and run into his room where the patient is waiting. He was looking up down for his gloves, and I said, "Here, I got these as spares." Whew, he took it and I start preparing the equipment on his table. I didn't had a choice, there's no trolley, and his counter surface is the only place where it's clear. So I got him all his stuff and he jab...at TWO places. Oh Mother of God, please don't let him explode. Well, he didn't. He let me place the gauze there while I run like crazy for a second plaster. Thank God, thank God he wasn't fuming, he just tossed the needle and syringe into my kidney dish and said, "Watch your hands. I put the needle in there." The moment I stepped out, he started shouting at the clinic girl about why there's so many patients without appointments. Uh-oh. I hightail it out of there, refusing to get involved in the drama.
Everybody's sick too. Poor them. The only ones who are not sick were us Three Musketeers and a few clinic girls. Well, the weather is awful, and working in a hospital is a place where you'll most likely get sick, hence why we need annual medical checkups plus good immune system. If you think that's bad, many patients with masks are also piling in. My doctor didn't wear his mask, but he still had sore throat. Poor doctor. I didn't had time to see him cause I was super busy, and for the love of God, both legs of mine are really in pain now. Thank goodness for Voltaren gel, but if this keeps going on, I'm going to have to see him for prescriptions of Acustop plasters. Please no more X-Rays, @.@
I just about had it with a doctor. For goodness sake, he's still going on about the cotton balls. Geez, it's not just our hospital, it's worldwide. Everyone stopped using those fuzzy cotton balls because it sticks onto patient's wounds, and it hurts. Don't believe me, try it. I had seen patients screaming like hell when we pulled those fuzzy cotton from their wound. Outside pharmacy still sell them, so why not try there? Knowing that he had lost the battle, he started taking out all of his stress on me. Okay, enough is enough. From the first time I solo-ed with him, he kept saying I'm slow, no matter how much I prepare smoothly, it's always I'M SLOW. Once upon a time, I might have broken down and refused to assist him, but you know what? Sod it. I'll assist you in your cases and do it right, but not for you, for the patient. Say whatever you want, I'm tired of arguing with people who always think they're right.
This pretty much sums up today.


Monday, February 22, 2016

Haunted by Past

22th February (Monday) - You think, that today being Chap Goh Mei will be a happy day. But oh no, this is MY life we're talking about, and it's anything but normal.
Things started off innocently enough, then there's an incident on Saturday, yes, I did not manage to post it up back then cause I was beaned. I was returning the appointment book to the respective department when the two senior girls asked whether I'm happy working in an outpatient department. Is that a trick question? "Of course I do, the place here is wonderful, I get to meet doctors, some really nice ones, and I have wonderful supportive friends who had helped me." Then, comes the bombshell.
"Do you want to go back to your old department?"
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"Are you okay? Your face is really white, like someone had sucked out all your blood..."
I swear, my heart seemed to have dropped all the way into my stomach.
Go...back...there?
"We're not forcing you or anything, but it's just that there were some...incidents going on, that's why we are asking you whether you want to go back there."
Oh... Going back to the place where I worked at means staying with one doctor, and handling the few little cases, but is it worth it? I suffered depression from there, attempted self-harm and self-loathing, and very nearly gave up on being a nurse. I was shifted from here and there, absolutely lost til I went to the place where I am now. Where the people there had brought me back on track, the doctors, especially a few, supported me. My friends at that department, supported each other, got each other's back, like that song :

Our paths, they did cross,
Though I cannot say just why,
We met, we laughed, we held on fast,
And then we say goodbye.
And who'll hear the echoes of stories never told?
Let them ring out till they unfold.

Even when we were busy, get yelled at by rude patients, we still stick together. I dubbed us the Three Musketeers since there are three of us (nurses, I mean), which they accepted as an endearing term. And to be really frank, even if I were to go back, what can I achieve? I know my condition, I got nothing against the people, but it's more like the environment is not right for me. I can try, and try til I break, but I'll never be able to fit in there. Yes, it's a small place that focuses only on certain procedures, but I'll be miserable. I won't be able to be with my friends and my doctors. I'm not willing to give it all up. My department is big, true, with all sorts of doctors to handle, and all sorts of funny procedures, but I was happy. Truly happy to find a place where I belonged. They knew that I wrote novels as a second job and they were proud of me, even giving me inputs on some ideas. I had to go for my psychiatrist's appointment when the time comes, and they were accepting of me, instead of shunning me as though I am a pariah. Especially the surgeon whom I assisted, he had seen me going for my appointment and he had been supportive, always telling me not to stress, not to get upset, but to let him know if I'm having difficulty. If I had been there, I would've never met him, or any other doctors, of all types.  
When I got back after a long while, they asked me where had I been. Never one to hide anything from them, I told them the issue. They were actually outraged, for me. "Who do they think they are? When she was depressed, they had to throw her out. Now that we had mold her back to normal,. they think they can just waltz in and take her back just because of their incidents?" I nearly burst into tears, because they had accepted me as part of them from the time I joined in, even when there were rumors of me going around, about how I am insane. Outraged that they said if they dared to come, they will set the few doctors that I am closed with on them. I assured them that they didn't have to do that, because I had politely told the senior girls that I refused the offer, not that I still hold hatred against my old department, but because there are just some places where I just don't belong to, no matter how much I tried. Like that old saying that goes: If the shoes fits, something like that, I really can't remember how it goes.
I learned a really weird procedure today.


 Nope, you did not read it wrong. It does read Buddy Splint. God knows, the doctor yelled at me because of the cotton balls. He wanted the old ones, the fuzzy kind, not the gauze type. No matter how much I told him that we've been using it from last year and most of our doctors love it, he was like, "Get me the freaking cotton balls NOW!!!" Fortunately, my patient was a CI for the hospital and she said, "Doctor, there really is no more of those kinds." And he kept looking at me as though it's my fault. Ahhhhh, please don't eat me. In the end, he shoved the cotton balls into my hand, fixed the splint, and walked off. Whew. The CI confirmed with me that there's no more of those cotton balls and I apologized non-stop, and said perhaps outside are still selling the old types, which she thanked me and assured to splint her toes.
I asked my friend why is it called a buddy splint, and she showed me by putting two fingers together, side by side. "Two together, right? BFF, That's why they are buddies."
Oh.... OH....
I drew the toes together like she mentioned. And yes, you can apply it for your toes and fingers, as long as you have a pair.
Over and out. With more to come.

Saturday, February 20, 2016

Many Faces

20th February (Saturday) - Hello, I'm back folks. And my last post was dated back in January. The Chinese New Year festivities had everything in a rush, visiting relatives and old friends and whatnot. Being in a new working environment made things tough to take leave, but a week of R & R is good enough.
Let's see, I came back and things were the same as usual, but had a few ups and down, inside and outside of work. Before Chinese New Year, there was this patient who seemed okay enough, but the sister, the younger sister, is quite frankly, awful. There are many ways to describe her, but I'm  sticking to the one that is nicer compared to the one we're thinking of her. I'm sure you know this better than anyone, but when it comes to hospital stuff, you are not allowed to take photos or video recording. Well, when I do my usual standard of dressing, she stopped me and started talking in a really, really arrogant tone. "What the hell do you think you are doing?" I was a little confused, because I didn't know what she's talking about. Then she slammed her hands on my trolley and said, "This is a sterile procedure. Why are you not using sterile gloves?!" What the-
She said WHAT?!
I looked at her brother's wound, it's no bigger than a ten cents piece, a centimeter deep. You can clean it without batting an eyelid. You don't need sterile gloves for this, just clean hands and your principal of sterility will do. Well, she basically called me a lot of names, and not satisfied, shouted, "My brother had an appendicitis!!!" (So....) I wonder what is she so worked up about. In my department, all general and gastro surgery such as appendicitis (appendix), lap cholecystectomy (gall bladders), colectomy (colon), hemorrhoids, and many other fracture bones cases surgical wounds like the knee, back, shoulder, legs and more are something that I see nearly every single day. And so far all of our patients are okay except for her. Not enough to berate me, she whipped out her phone and started recording me, demanding me to start from hand washing til the end. If I don't comply, she will take me to customer service. What could I do? My mind on auto-pilot, I complied and ignored the fact that there's a camera recording my every move. The brother kept silent, only answering when I ask him if he feel any pain. The sister made sure to keep me in her sights.
You can imagine the relief once I finally placed the dressing in place and let the patient out. The moment the brother went out, she looked at me and said coldly, "If I ever catch you doing that idiotic thing again, I will drag you to customer service." Dispirited, I sat down in a corner with my face in my hands, not crying but thinking what went wrong. My friend, pittied me, comforted me, saying that I should just ignore the crazy patient's sister. Since the sister had me in her, um, blacklist, she took the case over while I handle the other various cases. My friend(s), both of them,  are the no-nonsense type. So the sister couldn't talk to them like how she did to me. Turns out the sister is a staff nurse in the National Heart Institute.
!!!!!!!!
Now hold on a minute. The Heart Institute deals with heart cases, and, of course you need to be sterile because the heart is a vital organ. One slip and you will cause death. The brother has appendicitis. Now I'm not saying that it's not a big deal, but common sense here, if your patient has a dry incision wound, don't tell me you are going to open a dressing set, one large bottle of saline, sterile gloves, all for the sake of a dry wound, where you can actually just wear normal gloves for protection and use one swipe of the alcohol swab to clean the dried blood. Believe me, when I first started down here, a doctor was going on and on about how opening a dressing set to clean a small dry wound is a total waste of money. Since then, I always looked at the severity of the wound first before deciding on the dressing set or not. And to be frank, being a nurse in the Heart Institute is nothing to be braggy about. I been to banks many times and had to fill in the occupation part, when I put down my position and company name, most people go, "Oh, a 5 star hospital, so good." But I always smile and shake my head, saying it's just like any other hospital. When I was a patient undergoing surgery, I had never sued my position to bully other nurses, I just act like a patient, because the moment you are sick, and you come for help, you are a patient. Of course I've had student nurses taking my vital signs and whatnot, but I had never once antagonize them by pointing out their flaws, I just smiled softly, but did give them advices and tips instead of yelling at them like some maniac. The doctor asked me about the patient and he said that the brother and sister duo had caused dramas in the ward as well. Hm, if only the world is such a nice place.
Yesterday I encountered a family of three under one of our department surgeon. The mother was the speaker for the family, she came up and rapped the counter and said, in a very rude and arrogant tone, "My son had daily dressing under Dr. So-and-So. Do I go to the ward for dressing or here?" With a bright smile plastered on my face, even though my heart is writhing at her tone, I answered, in a really bright tone, that all dressings will be done in our treatment rooms. She took a look at the room and gave a huff. Then, rapping the counter again, she said, in that tone of hers. "I want to know how much is the cost for a dressing." Again, I told her politely that I can't name her a price, because each and every patients are different. Then she snapped, "You are a nurse. Surely you had seen all sorts of dressings, I want you to give me a fixed amount! Don't tell me you don't know how much a dressing costs if I told you my son dressing is about this big! (She puts her thumb and index finger together.)"
Oh..... I know these types. These types of patients are the one who asked you a price, then they come for the procedure. Even if it's a few dollars expensive than the one you stated, they will go to customer service, start making dramas, and then, the usual statement, "The nurse told me so!!!" Sorry, I had my fair amount of handling these types, so I told her, quite firmly, that I don't know the exact price, and if she has any inquiries, to please go back to her son's primary doctor. Naturally, she took my word, then went to cause a big drama for the doctor as well. Ahhh, I guess there's no reasoning with some patients.
After work, I went out shopping with dad for a blanket-pillow for traveling necessities, so we found a nice empty space at the parking lot and parked there. No sooner had we taken more than a few paces, this elegantly dressed lady in red came out, and said in very rude way, to please move our car. We didn't get it because she parked in her space, and so did we. But no, she was making a big fuss that our car will bang hers. So we took a good look at her car. A really old, faded green Proton Saga with rusted tires. For the love of - IT'S NOT EVEN A PROPERLY MAINTAINED CAR OR SOMETHING FANCY LIKE A MERCEDES, yet she kept demanding us to move. When we put the car in reverse, she didn't walked away, but watch us with those hawk eye gaze of hers. Fuming, my dad ordered me to get in the car and we drove another round for a parking spot. We passed that lady's car again, and surprise, surprise, no one parked beside her. I took a quick sneak peek and saw the lady sitting at a window table of a coffeehouse, staring out at her car. Geez, no wonder why nobody wanted to park next to her. Of course Dad went ranting about how unbelievable some people are and I told him to calm down, to not lose himself, and someday, karma will come back to her. It's the Circle of Life.
On an extra note, I was beaned by an orange during a lion dance. *K.O.ed*

Sunday, January 17, 2016

The Darkside of Nursing

17th January (Sunday)- A post I ran across while doing research. I don't know who the author is, but her Facebook name says Do Not Resuscitate 
 
 The surgeon is doing a tonsillectomy on a 4 year old boy. Dr. Jones drops an instrument on the floor of the OR. The instrument is now contaminated and has to be sterilized by a special machine called an autoclave. This was a small hospital, so they did not have a large inventory of duplicate surgical instruments. So the circulating nurse put the instrument into the autoclave. As this machine locked in with a special timer, they had to wait for the sterilization process to be completed.
It was 2 minutes, then 3 minutes. The surgeon screamed at the nurse saying it was taking too long. Dr. Jones stood up, having his sterile surgical gown and sterile gloves on, and he picked up the steel stool he was sitting on and threw the stool across the room and it crashed against the wall, as he screamed obscenities. No one was hurt... physically, but it was a verbal and a physical threat. This violent act or gesture was reported to administration. All of the nurses knew the surgeon would get away with it. He would never be reprimanded or put on probation. It all was swept under that proverbial rug. Like nothing happened.
Or... The circulating nurse placed an incorrect instrument onto the surgeon's sterile table during surgery. The surgeon was so angry, that he picked up his scalpel and threw it at the male circulating nurse. This scalpel, this razor, missed the nurses face by 1/2 of an inch. The nurse pressed charges. Eventually, the charges were dropped for insufficient evidence.
Administration did not blink an eye.
Cathy was a timid nurse, but was the kindest nurse you'd ever want to take care of you.
She was very busy, as is the case in the Intensive Care Units. She was new to this hospital. Her other hospital did not have many patients on ventilators. This night was a heavy assignment. She had many IV drips running. Levophed, Vasopressin, Ativan, fentanyl and a pavulon drip. The patient had to be chemically paralyzed due to his asynchronous breathing with the ventilator. Cathy could have looked up this drug: Pavulon, but she saw 3 experienced nurses and so she asked them what were the indications of Pavulon.
First they ignored her as the 3 nurses 'huddled' together laughing. They didn't answer her.
So Cathy asked her question again. And outside of her patient's room, the three nurses started to laugh and talk about her. She heard them say out loud that she was stupid and how ridiculous it was for her to ask that question. That maybe she should take remedial nursing 101.
Cathy stayed in her patient's room, looked up the info on the computer , as a few tears slowly trickled down her face. She now knew that working in this most strategic, dynamic ICU, that she was on her own. Dangerously on her own.
A month passed, where she was shunned and ignored. She heard the nurses talk about upcoming weddings and baby showers and birthday parties of fellow staff members. She knew she wasn't invited... To anything. They basically treated her like she was invisible.
Cathy felt degraded, isolated, lonely and depressed. She felt that the group of nurses were so negative and aggressive, that she didn't have a chance to change the lateral violence in that unit.
Cathy transferred out of the ICU hoping she could find a place that was friendly and kind and encouraged team work.
Patty was a traveler nurse. And she loved it. She was able to travel to different cities and states and practice her Emergency Department Nursing specialty.
This ER was gigantic, and everything came through this door. Gun shot wounds, near suicides, heart attacks, any trauma, it was a smorgasbord for all ailments throughout this big city and beyond.
But Patty noticed that this ER lacked team work. The nurses basically shunned her and immediately she felt like an outsider instead of being an experienced nurse here to help them out.
She started to receive the worst assignments. The nurse- patient ratio was one nurse to four patients. Patty was given six patients at a time. All of the time.
When she called out for help, no one was there. When she needed help pulling up a 400 pound patient, no one was there. When she needed an RN to witness her mixing a vasopressin drip stat.... No one was there.
Patty could normally handle any situation, but now she felt overwhelmed.
She overheard a staff nurse say to the charge nurse: 'Well she makes all of that money. She can do it herself. Give her the worst'.
So where are the bullies?
They are everywhere. In the nursing workforce, they are in the OR , in the Emergency Dept, in ICU's, in floor nursing, in nursing homes and assisted living centers.
Who are bullies?
Bullies are older nurses who can be cruel to the younger nurses.
They are managers and directors that turn their backs on the nurses that plead for help.
They are physicians that belittle the nurses and put them down and are condescending to them.
They are younger nurses who feel like they have a special entitlement granted unto them, who have minimal experience but dictate to the older nurses that they are now old and 'in the way'.
They are the 'know-it- all' nurses who know everything and everyone else is stupid or 'special' . The list goes on and on. The situations and circumstances unfortunately are endless. And in the land of nurses being loving and caring and saving lives and being unselfish in all that they do, there is a percentage nationwide, universally that is destroying the core of what good nursing is all about.
What is the make-up of a bully?
Someone who may have low self-esteem, that it subconsciously makes them feel better to tear someone else down.
Someone who has narcissistic tendencies. They consider themselves infallible, above all others, including physicians.
Someone who has lived in a home environment and has learned to mimic
negativities such as harassment, shunning, ignoring, and laughing at others.
This behavior affects the entire unit. It reduces morale and the chain of comradery is broken.
60-80% of nurses nationwide have reported that at some time in their nursing career, they have been bullied. Many leave that workplace, some nurses leave their profession.
Nurses that are victims become detached, they second guess their skills, they become depressed and withdrawn...
Who can help?
Besides confronting that person, management would be the next in command. If management is ineffective, human resources would be next. But there is always a fear of retaliation.
Some institutions have a 'Zero tolerance' . This behavior is not accepted. EAP (Employee Assistance Program) is recommended for the victim and for the bully. EAP is a counseling service offered by many hospitals to their employees.
A probation period may be recommended for the bully.
Hospitals that implement Zero tolerance, have seen a 50 % change in the 'climate' of the unit, for the better.
If more institutions would implement 'Zero Tolerance' we could all get back to caring and practicing what we love. And that is nursing.
Let's put a flashlight on the bullies. Make this end. Turn your units around, nationwide and get back to empowering each other, educating each other, coming together and learning from each other and helping one another with physical tasks, and emotional tasks. We are only good if we work together. For the sake of the unit, the nurses, the physicians, the technicians and most important: for the sake of the patients, let's come together and make nursing the greatest profession nationwide.
Educate, team work, empower...that's what makes a good nursing unit.
On behalf of the majority of positive nurses, managers, physicians, EMT's paramedics and technicians, I salute you all for relentlessly doing some of the hardest tasks a job could have. This medical profession is emotionally and physically challenging. We have to constantly stay updated on medical terminology and protocols. Every day, every minute is a new challenge. Saving lives is not an easy job. All due respect for these medical professionals.
 
Reading this reminds me of my previous workplace. No pointing out names here, but I was a junior in a ward, very new at that time. Working life was a whole new world to me because I had never taken part time jobs at McDonald's or other restaurants, so I had zero experience of working life. Look back to my previous blogs of 2014 and you can see some of the ups and downs. I tried to refrain the bad part because I don't want people to think nursing is an awful job, but there are some. 
Even till now, when I go outside and people ask me, "What's your profession?" And I trot out my standard answer, "SRN/ RN/ Staff Nurse." People give me that look. That look that says, "Uh...". Some just shake their head and go, "I never want to take up nursing. Always running after patients..." Or they just nod politely and take zero interest in your work. Of course everyone thinks it's an easy job, but I had encountered some of the nasty side of nursing, but I try not to let them hit me down. 
After moving from my previous workplace, I was still unable to adjust due to the trauma. Eventually I got help from kind Sisters and was shifted to a new department, where people often isolate our department side. But being isolated doesn't mean it's a bad thing, our little department were like a family. We support each other, and surprise, surprise, the surgeons here are all super understanding type. Yes, I'm not joking. There's one who is a super grumpy type, and he tends to shout, but his heart is in the right place. You just have to look past his unsmiling, strict face.
On a day after 2016 ushered in, my two colleagues are on leave due to personal issues, so I had to run the department alone. All of our surgeons just came back, so you can imagine, with all of the patients pouring in too. And there was just me. My colleague had called for help before she went on leave and you know what they say, "Oh, we're short on staff. Sorry, you guys will have to work out on your own." !!!!! Now, I said our surgeons are understanding, but imagine if you have three surgeons who are all fighting for the treatment room, and there's only one of you. You got six patient stickers waiting, each of a different doctor and procedure. The only solution is for me to go two by two at a time, with different doctors. An example would be like this:
 
(Names are all not real to respect privacy and confidentiality of others) 

1. Alex - Dr. Anderson
2. Harry - Dr. Skyler
3. Penny - Dr. Cho
4. Celia - Dr. Anderson
5. Elliot - Dr. Skyler
6. Guy - Dr. Cho

Instead of pushing all of the same doctors' patients in, you have to alternate. Like Dr Anderson in Room 1, Dr Skyler in Room 2. Once Dr Anderson is done, you push Dr Cho's patient into Room 1. And Dr Anderson to Room 2 once Dr Skyler is done and vice versa. That way you won't get stuck into any conflicts and you won't have the surgeons breathing fire down your throats. At that time, you can imagine I was running back and forth like the Mad Hatter. In between, when there's no procedures, I helped my cashier boy register patients. Because when he's busy taking payments and processing insurance letters, who is going to attend to the patients who are all impatiently waiting for their numbers to be called? And it was nearly half way through of my morning hour when they finally sent someone down, and that was after they changed the assigned person 3 times. Apparently they said a surgeon of ours is scary.
Now hold it right there. Remember I came down to this department last year, first as a temp, then to a full time staff. Never had I seen this surgeon yell or complain. No, when I wasn't sure of how to spray a certain solution to preserve the specimen, he gently took the canister from me and showed me how to spray correctly without damaging it. And few days ago when he was about to administer two injections, my friend and I were struggling with drawing Lignocaine because the syringe that we need to fill was the tuberculin syringe. The little ones that you usually use to administer insulin. The needle is so small, and the Lignocaine bottle is big. The surgeon laughed (not in a mean way) and instructed us to give the bottle a squeeze so that when you draw it actually goes into the syringe. See, that's why he's the doctor ^^
The surgeon that I often assisted, many people refused to assist him because they say he's strict, doesn't talk and smile. That's not true, I had worked with him for more than five months now, and he's a kind, sweet guy. When I sprained my ankle and overstrained my shoulder muscle, he nagged at me like a father to a daughter, instructing me that I should be more careful and gave me those anti-inflammation plaster patches and cream. Give him a chance, and you'll find that you can't get a better supportive doctor than him.
Okay, I think I ranted enough for this round. I need to rest my shoulder now, due to folding many red packets ornaments for the upcoming Chinese New Year. Can't wait. Yay...