Sunday, July 5, 2009

Funny Complaints: The Nurses Cannot Win. EVER

So I am back. I think we finally have a fully functional PC now. Fingers crossed. We had built one recently and had problems with that so finally we bought one.

To be honest I have also been having a bit of blogger block. I think have about 30 half finished posts.

I don't have a lot of time today but I thought I would check in anyway. A couple of work related incidents have made me laugh out loud this week.

A large medical ward such as mine takes a large number of elderly patients at any give me time. This means that we often take patients who have hearing loss. It also means we have a large number of extremely grumpy and self centered people. I don't care if that last sentence sounds offensive. It's true. You and I will more than likely be self centered, miserable and easily stressed over nothing when we are elderly as well. Reality. Deal with it. I don't do politically correct on this blog. The fact of the matter is that old age sucks and that it will come to most of us someday.

Let's start with the hearing loss. We obviously have more than a few patients with some type of hearing impairment. Their hearing aids are usually lost somewhere between Casualty and the medical express units. By the time they get to the ward we have a serious barrier to communication. Whiteboards and notebooks don't always work out too well due to additional problems with eyesight, crippling arthritis etc. Most of these patients have only suffered from hearing loss recently and do not use sign language. If the hearing aid is awol we will try and get audiology to sort it out. If we are lucky they will come and the see the patient about 800 years after the initial referral. That's deemed quick.

So my patient cannot hear me. I am going a mile a minute and can usually only spend 10 seconds with any patient at any given time. This is bad. The patient has no understanding of what I have on my shoulders and thinks that I am running in and out of the room without taking the time to explain things because I am an inconsiderate bitch. Yes, we know that this is what you think. I do try to explain things in the few seconds I have between dealing with the transfusion reaction in bed 4 and the fall in bed 28. Sometimes I will fly into your room to give you a much needed pain killer when I am in the middle of an emergency elsewhere. I shouldn't leave the emergencies to give a pain killer. Not ever. But if I don't use the 2 seconds I have right now to do it, before the bleeder really starts to crash, then you may not see me again for 2 hours.

Multiply this situation by about 12. Realise that often the nurses are in this situation almost at all times. due to short staffing. Then you will see why we fly in and out of the rooms to fast. We are not trying to be rude or inconsiderate. If you think I can control how long I spend with a patient your are completely crazy.

Often we are trying to communicate with our hearing impaired patients by just talking loudly and trying to help them to lip read. Sometimes it works. Sometimes I just cannot work it all out due to time constraints. Most of the time the patients in near beds will complain about the nurses "talking to loudly and disturbing them". This is especially a problem at night.

Example: Patient with hearing impairment rings bell because they have started having pain. Nurse has to ask questions. If things like notebooks etc are out of the question ...then the nurse has to speak loudly and clearly. It's not a good solution but what else can your do at 3 AM if all other options are out of the question. The rest of the patients on the ward go ballistic and threaten to "strangle that deaf bitch and the nurse". We are often trying to communicate with patients who have difficulty hearing during the night. Unfortunately you are not all in private rooms. This is not a situation that was created by the Nurse so fuck off.

On the other hand, and often at the exact same time...we get complaints about the nursing staff from hearing impaired patients. The nurses offended them by "talking too softly and quickly when she knew I was deaf" and "not taking all the time that was needed etc". The former occurs because we have multiple other patients on the ward who complain about the lack of quiet on the wards. The latter occurs because we are always rushed due to factors out of our control.

Patients in general: We are not talking loudly to piss you off. Patients with hearing impairments: we know that there are mega barriers to communication and we are really doing the best we can with the resources and time that we have. We are not being "insensitive" the the fact that you have hearing loss. Nor are we insensitive to the fact that patients really need peace and quiet. We do get that. Yes, really.

But sometimes there is just going to be a lot of noise.

I'll never forget the night that my colleague found a young patient in full respiratory arrest (but with a pulse) during her rounds at about 2 AM. I was the only other nurse and was on the complete other side of the ward. ANNNNNNNNNNNE!!!!!! The way my junior colleague screamed my name made me go cold. It was an unexpected arrest and a young patient. Then there was the chaos of the cardiac arrest, the senior docs and ITU team shouting orders. The patient survived. The next day multiple other patients complained all day long to anyone who would listen about the horrendous noise they were subjected to at 2 AM. They complained about how much they suffered and how dreadful the nurses were for disturbing them like that.

Why is there always this bad attitude and towards the nurses? Why all the assumptions that all these bad things happen because the nurses are being cruel, insensitive, inconsiderate, thick etc. The answers to those questions can be found if one studies the history of the nursing profession and the subconscious images that people have of nurses. I'll get around to finishing that post.

My children were promised a day out today. I'll try and add to this in another post later.

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