crazy and lovely all under one roof

yes it's that time again folks when the strange one's show themselves on the ward .... and are thankfully counterbalanced by some really brave and amazing people who are also inpatients.

For example a lovely lady who is battling breast cancer, just so impressive in her character and manner. Respectful to staff and an 'easy patient' to like and care for. I don't expect every patient to be 'easy' or a person I can admire.... I have my fair share of tough nuts and some wild dementia patients. Even demanding and whiner-types. But thats life... and I'm pretty much used to that. But then we get the one's like Joe Gut (imaginary name) who are manipulative, dishonest, grotty, lying and have a vague list of symptoms which he seems to expect a nurse has some magical cure for or explanation for... and if not.... your a CRAP nurse.

Joe Gut goes off the ward continually for smokes, then comes back and helps himself to staff area tea and coffee... thinking he is being 'cheeky' and cute and indulged but really is just tolerated because the nurses avoid conflict and conversation with him. He lies from one nurse, and doctor to another regarding his ailments... and tells the opposite team how hopeless and piss poor the other nurses and doctors are in "helping him". He has an egotistical expectation that our whole role and goal in life is to find the source of his illness and find him a cure ???

He has an abrupt manner, invasive of others personal space and innapropriate - I suspect he has some undiagnosed borderline mental health issue but then again, I think he could just be a dickhead. He is an ex (so he says) druggie... he is a know it all.... he is slimy and has a sexual innuendo manner which is totally gross - he is demanding, complaining and needs a swift kick up the arse and out the door dose of medicine.

I know thats sounds so unprofessional, but I have to say... patients like that just make nursing staff shudder. We are only human ourselves.

Last night I told him off twice of his behaviour which was really inappropriate and he hates me of course. But puts on the snake charmer act to get around me and fake apologies and excuses of "I'm so sick I was unable to read the signs that I couldnt go into the room and touch that stuff"... etc

He walks into the drug and treatment room when staff are there to ask for drugs and expects immediate attention. The signs clearly state STAFF only - he invades other patients rooms and sits next to them and asks them personal questions. He leers.....

It's intersting I told him he needs to be discharged. And now he acts all smarmy to me but I am unmoved. I have to be very tough on him as it's easy to see he manipulates or tries to... any one. He's firgured out he can mess with me so is trying to charm me... it's pathetic.

On the other side we have a gentleman who is ill at the moment and insitu a crazy wife lady who sits by his bedside all day and yells at us nurses and tells us off for any percieved lack of care she takes umbrage to. "He's too cold, he's wet, he's in pain" etc and abuses staff for neglecting him and tells us we are "killing" him and he will get double pnumonia from that blanket we are witholding from him.... its all a complete drama played out for her own sense of tradgedy . The man is made perfectly comfortable, dry, well fed and medicated.... she herself may need some medications I don't know. I have had one run in with her this week where she decided to list her litany of how terrible all the nurses and doctors were as usual and I told her "I don't want to listen this time and to be quiet" she retaliated by saying "You all think I'm rude don't you?" I said "yes we do you are very agressive towards staff" and she put her fingers in her ears and closed her eyes like "Not listening Not listening"

what the ?

see what I mean.

Mental

the other nice patient I have is a gentleman Joe who is so much like the Grandpa we all wish we had... a old teddy bear.. kindly and brave. Its nice to sit by his bed while you give IV's and just chew the time..... he is restful and pleasant... and brings balance to the Guts and Crazy wifes just next door....

what I job!

hospital holidays again ...

Can't believe it's almost Easter - well, the shops have been selling hot cross buns since New Years Day but still .... I have put my hand up for working over the four day holiday. Yay.. double time.. and Yay... no physio, dieticians, OT's, Discharge planners, social workers and Medicos anywhere ... er.... not Yay for that.
Over the holidays the only Doctors are those poor Sods who need the money or have lost the lottery in some other way and are rostered on over the break. We are left with usually a junior RMO who has to cover 6 wards and check in with ED .. more often than not a snitty pre menstrual girl doc - who thinks working holidays 'sux', or some pimply 16 yr old boy doc who only has a basic grasp of english and doesn't answer his pager. "Whin deed u payg mih?"

We write "Lists" for our RMO's after hours and sometimes have to tack on another page. Usually they are boring awful lists for Doctors which say things like
Bed 20 BP 190/90 ?GTN
Bed 12 pls chart sleeper and aperients
Bed 16 Pls re chart med chart
Bed 19 Pls inspect rash on arse and prn analgesia
Bed 21 Pls chart valium for ETOH withdrawal
Bed 6 Warfin please
Bed 14 Dose for Gentamicin
Bed 1 Bloods and re cannulate pls
Bed 2 Hypotensive ? withold meds see chart
Bed 30 discharge aSAP !!!!

You get it !

It's the drudge kind of Doctoring which is very unexciting for medico's but yes needs to be attended to. We do get phone orders of course but often on weekends and holidays wait hours for someone to show up and take our list in hand. And we often bombard them with a few extra chores once they turn up... ! hee

But for the most part our docs are awesome and we have a lot of laffs with them. They are pretty much all down to earth and very concientious and good at their job.. but we occasionally get some strange ones being a teaching hospital.

But they don't really like out of hours shifts without their mates around them and the team to call on. They lose a bit of the swagger and cheek. And often run around stressed or pressured. And I get that... and I find myself being pretty gentle with them and giving them room. Most of our list isn't urgent.

Holiday shifts are times when the phones settle a bit, the vibe is more relaxed as none of the bosses and hierarchy work holidays but leave the skeleton bosses who are usually a bit more laid back. Don't get me wrong, we are just as serious in our job, and responsibilities, but we can usually laugh a bit more and kid around... even the patients often comment on weekend and holiday vibes. Seems alot more relaxed and less 'frenetic'.

That is unless their is an emergency then its all Go Go.

I like working Sundays, and Public holidays. Not just the money but the vibe. And its a time when I can often chat to patients, and their families... co workers and the drive home is quiet.
I did have chrissy off this year so I don't mind working easter. I will have my days off after and besides every one knows it rains every Easter. The ocean gets too cool to swim and the roads are crazie

I know Easter isn't about chocolate or bunnies for me anyways... and God is an awesome God who knows we needs caring nurses on the wards every single day...
Nurses with lists.

alcoholics keep me in a job....

Things are going along fairly well.... the ward is its usual busy, crazy and thriving work place which keeps me occupied for usually 8 hrs a day. One good thing is with this economic crisis my JOB is SAFE ---
we are never going to run out of sick people !!

Speaking of which, our ward is usually Medical, with chronic medical patients but more often than not lately most of our 20 bed ward are long term ETOH with liver and renal complications, alcoholics, obese, druggies, heavy smokers and poor managment of diabetes or long term medical problems which take a back seat to the primary addictions.

It's seems amazing to me that at least 1/3 of our public funded health system is full of people who refuse to manage their health ... and put addictions first despite diabetes, lung problems, liver problems and renal health .... and - continue to drink, drug, smoke and neglect insulin and diet in favour of pushing their already compromised health into radical acute sickness and end up on our ward... constantly. The thousands and thousands we spend on these people. Some of them so far gone - and yet they end up in ICU, our ward, rehab .... only to skip out on their rested livers and head straight to the bottle-O, usually with money from Centrelink government funded sick pensions we Aussie hard workers give with our hard earned tax money.... yeah. It's a weird, weird, world.


Don't get me wrong, I see these patients as people first. And for the most part they are nice people, a true cast of characters and I'm the first one to have a joke with them, be tender and caring towards them... I even try with the rude bastards who make up a small percentage of the 'unkepts'.... (joke!) I think the thing which makes me so surprised is that despite KNOWING they are killing themselves prematurely, and really understanding they are abusing themselves they continue to drink, smoke, eat crap and not excersise their bodies or one bit of self control. And they keep re-presenting and syphoning up health care dollars, hospital beds, and get propped up for another jaunt back into the world of beer, wine , drugs and poor personal management.


I do believe in free health care, and I do believe in supporting those in our communities who are too unwell to work. but I find it hard to support free health for those who knowingly and purposefully continue in self abuse at the tax payers expense. And usually these same people are on a tax payer funded pension or benefit. So we pay for the drugs, the junk food, the alcohol and the hospital treatment. It's NUTS


I often wonder if these same people lived in third world or second world economies just how they could support this life style? It would be impossible. And yet alot of them don't seem to make the connection that everyone around them is paying for every aspect of their lives and they are themselves NOT contributing a thing to the world or society. Just draining it, and killing themselves off pretty slowly, but prematurely. When they complain about the nursing, or medical attention they are recieving I find myself internally indignant. The bloody cheek !!?? We are all using our hard earned credentials to make them better, our hard earned money to provide food, shelter and care for them but they have the HIDE to whinge and whine about their pain meds not being exactly delivered at 0800 hrs! Doh!

I think if I thought about this all too much I'd get very disillusioned. I know every nurse and doctor working in government hospitals in Australia sees the same issue everyday and yet, continues to get up each day and treats these self abusers.

This one man I have nursed this week is only in his 40's, his liver is wrecked, he eats absolute junk all day, smokes like a chimney, and now needs dialysis. He complains about wound dressings, his urine bottle not being in reach (he CAN walk) and other minor inconveniences and expects the nursing staff to run and get him pain relief whenever he buzzes. Oh wow... it's incredible. But we continue to nurse.... well, I do and I try not to think about this type of person too much because its really depressing. I don't "get" them... I mean, I used to smoke but I ended up hating it and hating feeling like a slave to it. I was worried about health implications. I know addiction is hard to conquer but it's like these people have veils over their eyes and just will NOT see that they are at risk. Or will NOT.. they prefer to succumb to their own urges and desires despite the cost, to them and to the australian public purse. Still... the sick keep coming in the doors and I keep my job and life goes on and on.

Hurricane Crazy lady

Life has its ups and downs but generally I am satisfied - had some real "characters" of patients lately - one lady, who has what I call the "CrazyLady" Syndrome was on the ward for a week or three driving everyone nuts. She was one of the most manipulative persons I've met - and yet it was interesting seeing how someone with a borderline half diagnosed mental illness has the capacity to mess with those around her...


She is of course, ill - but not dying. YET. however in the meantime she is like a careening car driving full tilt motorised by fear, panic and indiscriminate crashing into whomever is in her path.
Crying, tears, yelling, quiet pleading and begging... each turn of the personality wheel every fifteen minutes with the only respite from the narcotics she continually wheedled anyone with a credential to bring her. If the tea ladies were able to... she would have had them 'on side'.

The narcotics settled her periodically, heavy duty meds which one would wonder after a while just how 'off her head' does she need to be? But if it kept her quiet well....
Her crying was not the type to evoke alot of pity.... once people got to 'get her vibe' the pity evaporated and the tears were no more empathy inducing than a pair of slipper she wore. Was just an 'add on'.

Her blotchy face, her puffy eyes and leaking nose were part of her performance for attention, drugs and personal connection with whomever got dragged into her bedside soiree of whiny pleading and story telling.

This went on day by day and it was amazing to witness her fresh meat, the staffers who'd had days off and had no previous experience at her bedside, the allied health workers who got lured in by request and sucked into the vortex of her drama and came stumbling out of her room dazed and annoyed. These 'newbies' got snavelled up by her as soon possible, her antennae looking for a new ear.... a soul to be attached to her misery for a while.

I was also impressed by those who picked up on her 'craziness' as soon as they saw her and did not let it even come close to them. Seasoned staff who'd seen her ilk times before and social workers who were completley unfazed by 'Crazy lady syndrome'. Even her main Doctor and his associates held her in distant disregard and water off the ducks back didn't come close to impressing them. The waltzed in and out of her room when needs must and continued down the patient list as if they hadn't just consulted with the teary, whiny, pleading, drama queen who shook and yelled and said crazy stuff 'bout herself, and us and life and them ...

The volunteer ladies were scared of her - and went into her room with trepidation ... the minister got sucked into a long winded session with her and came out asking us if we were aware she was talking about 'killing herself' (for the tenth time that hour)...???
Eventually she had to be discharged but promised to kill someone if she didnt go home with a bagful of narcotics. As u do.
She had nobody at home, unfortunatley but an errant son who would look in on her. We had arranged home nursing for her every day but it still wasn't good enough and she left us with a snarl and whinge....

Wow... hurricane crazy lady was a very unusual patient and I must admit... very educational for me.

MY dumb stuff latley

It's ages since I posted - what can I say .. Life gets crazy busy - The life of the ward is up and down, some weeks, or shifts so good, others a freakin' nightmare - (Try two patients continually having diahorrea and vomiting in two rooms side by side for 8 hours!)..... hard too was each was on precautions and so I'd have to don gloves, gown, mask and get new bedding each time, bowls of washing water, towels, pads, and change of anything that wasn't nailed down. I also had a few other less needy patients to take care of along with these two, who were sadly neglected. STRESS! oh I just crawled home, into the shower and felt like never going back to work again!!

Other shifts just breeze by with a feeling of accomplishment and enjoying the tasks each day or evening... interesting patients, fun co-workers... ahh... wish that happened more often. Some of the new staff on our New ward can be pretty tiresome... a couple in particular are slow, not team players and difficult to share a patient load with. I get soooo frustrated.

I also have had my own health worries the last couple of months but all resolving. Every little thing I have it seems , scares me. I guess I see so much cancer and awful health problems which affect everyday kind of people that I internalize my own symptoms into to real 'fears'.... my own GP has told me to 'settle down'. As I have mistook lumps on my face for skin cancer (solar keratosis ? Not even!) I've thought my bloated tummy is Ovarian Cancer - I've thought my hemorrhoid was Colon Cancer and went and had a Colonoscopy to prove otherwise... Yuk, that was a nightmare. Of course I'm fine, nothing wrong with me except altering my diet a little and using some new face cream. (And arse cream!) - I have minor issues and yet I've blown them out of all proportion .... I'm fortunate to have a great GP who understands my anxiety and has made me see myself in this new light recently of how I internalize my job stress and allow it to manifest itself in these kinds of fears... about illness, health and loss of control. Anxiety and control - these words are both apt for me, and he knows it!

So this year I will turn back into that carefree person I used to be who didn't scrutinize every bodily function and blip and make it terminal - I want to live without that kind of crazy fear.

I did have an awful experience with the prep for the colonoscopy ! UGH - The prep for it is both Pico and Glyco Prep fizzy mixture drinks which smelt and tasted like I imagine Goats piss to - just swallowing that stuff made me gag and I had to glug down litres and litres of the mix, as well as drinking a truck load of H20 along side it... I was like the proverbial belly balloon just filling up and filling up and not draining out quick enough.... I thought I would burst! My stomach was stretched beyond itself and was paining something awful - Nausea, aches and a massive 9/10 headache for several hours overnight made this PREP experience a living HELL. And I still had to repeat the dosing at 5am the next morning... I only ended up having half the mix the next morning and chugged it back while having to remain upright for a few hours so I wouldn't lie or sit down and have it spill out of my gullet... I could hardly keep it in. I was rather tearful by now and as far as the bowel movement, it wasn't happening enough for me... took ages for that to even start ... ! My GP reckons I must have a slow gut .... slow emptying and reabsorbtion etc etc and I would tend to agree. I was feeling like I needed a big pin in the belly to let it all out... YUK!! I finally got to the surgery with about a 70% result of what I believed was necessary - but it was enough for them to do the scope OK- the Scope itself was a cakewalk - just a needle, sleep and wake up and its all over.... yay!! Diagnosis ? Hemorrhoid - ha ha and it cost me $500 bucks to find that out.

Mental Still, I must admit that shocking experience has opened my eyes to how many times we get our patients prepped for various tests and don't take much notice of how difficult it can be for them to drink awful drinks, have barium meals etc etc - the nausea and discomfort of it all - And I certainly appreciated how NICE and KIND some of my nurses were at the Scope Theatre - their kindness just helps us along... I vowed to take my experience back into the work place and really be more sensitive to my prepping patients. Those who are scared and uncomfortable. So in some ways it was well worth it.... better dash anyway.

And I know 2009 will be a good year for me despite the financial state of the world - the bushfires, floods and terrible news of the world and my country - I still TRUST God and I know all things work together for good to those who love him and are called to his purposes. Even crazy ol Me

Co-workers - the Nursing team

As our Ward is new, so are the staff. We have about 10 Permanent's now along with a few casuals who regularly work on NewWard.

At any given day of course I find myself with 3 -4 other Nursing staff I'm about to spend and 8hr shift with and the next day it might be a different 4 and so on and so on. With a rotating roster, there is a nice variety... however I already have my favorites and alot more fun with some more than others. It's human nature... we are drawn to those we 'click' with more easily and thus create 'Cliques'.

But in a nursing environment, these can often be negative so its best to be mindful of excluding others. I have tried to come into this ward with an open mind. Take people as they are.
Be welcoming to new staff.
Be friends with everyone as is possible
enjoy the diversity of different personalities don't expect too much.

So far all is going good, I'm having laughs with most people, forming friendly attachments and am able to really connect with a few. But it's funny how, after several weeks there are the stirrings of division and gossip.. mostly centered around one part timer who isn't a very friendly lady.
She is in her mid 50's, loud and opinionated, likes to rebuke others and is a prickly sort of person. She rarely cracks a smile and will not usually even say hello when you greet her. However, she has the boss's ear and can be spotted engaging him in rowdy and friendly conversations, speaks on his behalf when he is not around, and generally acts like a suck up to him and now of course, alot of the other co-workers hate her. Doesn't take long.

How people set themselves up for being hated seems quite obvious to me. Act cool, aloof, cold but show your friendly side to the boss only, or other selected people who suit. I came on to the ward with an open mind and have been friendly to her, from day 1. She has been cool towards me as well as many others for no apparent reason.

One other co-worker in particular, Nicky, a bright vivacious twenty something has decided that this grumpy lady (I'll name Dora) is a right pain in the arse and has subsequently told all of us to just 'ignore Dora', or take no notice, and I guess this is how divisions begin. I can see it all unfolding down the track, conflict resolution, arguments, and a build up over the coming weeks.

Another co-worker, Danny, has been put off side by Dora's scathing comments on his work performance. 1. Not her place and 2. Provocative. This story has done the rounds and Dora is now greeted with eyes rolling behind her back and nasty smirks after report. This is where it all begins.

I am guilty of listening to others unload about her, comment on her and I too have agreed she isn't the nicest woman I've met. But I don't want to get involved in a stand off - I can see that it's all going to blow up - the boss seems to like Dora alot, and why not, he sees a very nice side to her... So it will be interesting to see how it all unfolds. why can't all nurses be friends? Its interesting because everyone else does seem to be bonding and connecting very well.

Hi ho, Hi ho, it's off to work we go!

How many people drive to work full content they are in the job they know is right for them? Or go to work knowing its not all fun, easy or always enjoyable but know its still the right fit? I feel so fortunate...
I've had jobs in my life I've HATED, been bored out of my mind or just withstood for the sake of making money. I was a secretary for a while in the church I went to for a long time, and I liked that job because I was working with my friends and mucking about on Publisher... but it wasn't like a real job. My boss was a good friend, we all had long chatty lunches. I only worked two days a week. It was a Hobby job. I had had part time jobs as a young mum. Really stupid ones likes handing out samples in a supermarket. So monotonous and completley brainless. Wearing a fake smile, listening to people rave about a dumb product which I'd never buy myself. "Here try this new chicken paste its amazing!" (hee)

I decided to go more along the Admin side of the career ladder and got a job at a busy Medical Centre as a receptionist. It was 20hrs a week, I was single mum by then, and needed the money. I'd had enough computer experience by then and had done a Medical Reception course. It was good experience for me, but my immediate boss was a right little power broker who gained alot of pleasure out of making all the receptionists bark to her orders and decided degrading criticism was the key to good staff management. I was inexperienced enough not to stand up to her but smart enough to know the job would eventually wear me out. I worked hard and learnt alot but I lived in fear of her tirades and nasty comments.

She was shocked when I handed in my resignation, getting another job behind her back was tantamount to crossing enemy lines and I left in the wake of her snarly disgust. I used to run into her at the mall and hide from her, until quite recently when I saw her at the butchers and informed her I was now a qualified Nurse while asking her politely what she was up to, ....'oh still in Admin, your a personal secretary? oh how nice....' (ho hum)
It gave me alot of perverse satisfaction seeing her eyes widen that I had a professional career in spite of her humiliating me time and time again. Some people should never be bosses.

(more on that another time)

I had another Medical Reception job after leaving the tyrant, but it was a smaller practice with a husband and wife team. They were good to me, and I stayed for about 4 years. Learnt alot there but after a few years bored mindless. I could do everything by rote, could do it all in my sleep and was hungry for new challenges. Also at times this husband and wife team would argue and it affected the whole tone of the office. They would be cold to each other and the vibe would permeate the practice and it was like working in a deep freeze. But over all it was a good learning curve. I was so bored at times when it was quiet I read mags, and went out the back and smoked. Texted on my mobile and chatted on the phone. Fun for a while but not a great way to fill lifes dreams. I was drifting and feeling redundant to the human race. Watching paint dry was on par... the days meshed into this bland life like porridge without milk or sugar. I was listless.

Then I decided enough was enough - and went for a job at a Hospital doing Surgical Admin and was looking forward to not having to add up wages, cash and bill patients, or listen to my bosses marital fracas. It turned out to be a good move and got me into the nursing atmosphere. I worked for 3 years there on the surgical Unit which was fascinating and full on work, until I took the plunge for nursing. I was just so tired of office Admin, paperwork, computers, files and lists..... of course I still do a bit of paperwork in my job... but everything has changed. I do feel proud of my working career as I really plugged in and just plodded on through some boring and challenging times. I've worked with grumpy arses, sulkers, lazy co-workers, gossipers, and power mongers but also lovely funny and good people and thats good life experience.

No doubt I will still have awful times at work, be bored, or dissatisfied at times.... but I am finally driving to work feeling like I am where I'm meant to be. I think I can take all my past experiences into this job and not be bullied, gossiped to, and manage lazy co-workers without it being a major catastrophe. Mostly I'm in a job where I'm not sitting in front of computers, phones and have the autonomy to manage my time and interact with so many types of people.. and my biggest goal to give my patients a good day.. to have a NICE nurse on shift. Thats the hardest ....