Now Ye're Talking - To a Nurse!

I'm A Nurse, AMA · 20-03-2015 12:01PM

Lisha wrote: »

Hi. Serious question I'm not messing.
A friend of mine that works with troubled teens swears that the full moon brings out the crazy in people.
Have you ever thought the same? Or found a&e's to he busier or patients just more difficult to manage at times?

Are essential services like psychiatric service as poorly funded as it seems like? In my experience mental health services are underfunded understaffed and insufficient
Is that upsetting when you know patients are not getting enough care due to lack of funding ?

So, all nurses I know think the full moon brings out the crazy in people, I actually have an app on my phone that I check to see when an actual full moon is, just to reassure myself that the big round moon isn't "quite full". In reality of course its bullplop. There is a lot of superstition in Nursing too, you won't often hear a nurse say what a nice quiet day or night it is, for fear of world war 3 breaking out. I have a load of superstitions which are all a bit OCD (not belittling that condition which full blown is horrendous) but if I don't do these certain things I think I'm going to have a terrible shift. Even if, after doing all these things I still have a terrible shift, I go home thinking, god that was bad, but imagine how bad it would have been if I didn't do my stupid rituals.

Don't work in psychiatry but I know they are struggling as bad as everywhere else, hard out there at the minute.

Absolutely get annoyed about conditions patients are in now because of cutbacks. Few examples. We no longer provide night dresses or pyjamas for patients, we have paper gowns that people who have no one end up in for months on end. We rarely get towels in linen deliveries so we use pillowcases to dry people, we aren't given soap or shampoo in regular stores now, we can get the tiny tubes (like you get in hotels) if you order them, after a couple of days. We don't get talc any more, trivial thing, but a bit of powder is great to help dry someone, especially when you are using your pillowcase to dry them. We don't get shaving foam (we do get razors, if ordered, the worst I have ever used) so end up begging off other patients for a loan.

At the end of a weekend we will have no pads left, or sheets, so a Sunday night will usually see nurses going from ward to ward on the scrounge. Ambulance cutbacks mean if a patients is fit for discharge, you wont get them home until the next day because the ambulance service now need a full 24 advance notice. If a patient has an appointment in another hospital for 9, there is zero, ZERO chance of gettting them there on time, and on occassion the other hospital won't then see them. Theres a few examples of what p*sses me off, and sorry for the rant!

evolving_doors · 20-03-2015 11:26PM

Do you think your immune system is more resilient than any of your non nursing friends/family?

Any 'when kinky luvin goes bad' cases ever cross your path?:pac::pac::pac:... seriously though!

worded · 20-03-2015 11:40PM

I'm A Nurse, AMA wrote: »

So, all nurses I know think the full moon brings out the crazy in people, I actually have an app on my phone that I check to see when an actual full moon is, just to reassure myself that the big round moon isn't "quite full". In reality of course its bullplop. There is a lot of superstition in Nursing too, you won't often hear a nurse say what a nice quiet day or night it is, for fear of world war 3 breaking out. I have a load of superstitions which are all a bit OCD (not belittling that condition which full blown is horrendous) but if I don't do these certain things I think I'm going to have a terrible shift. Even if, after doing all these things I still have a terrible shift, I go home thinking, god that was bad, but imagine how bad it would have been if I didn't do my stupid rituals.
Don't work in psychiatry but I know they are struggling as bad as everywhere else, hard out there at the minute.

Absolutely get annoyed about conditions patients are in now because of cutbacks. Few examples. We no longer provide night dresses or pyjamas for patients, we have paper gowns that people who have no one end up in for months on end. We rarely get towels in linen deliveries so we use pillowcases to dry people, we aren't given soap or shampoo in regular stores now, we can get the tiny tubes (like you get in hotels) if you order them, after a couple of days. We don't get talc any more, trivial thing, but a bit of powder is great to help dry someone, especially when you are using your pillowcase to dry them. We don't get shaving foam (we do get razors, if ordered, the worst I have ever used) so end up begging off other patients for a loan.

At the end of a weekend we will have no pads left, or sheets, so a Sunday night will usually see nurses going from ward to ward on the scrounge. Ambulance cutbacks mean if a patients is fit for discharge, you wont get them home until the next day because the ambulance service now need a full 24 advance notice. If a patient has an appointment in another hospital for 9, there is zero, ZERO chance of gettting them there on time, and on occassion the other hospital won't then see them. Theres a few examples of what p*sses me off, and sorry for the rant!

It's like a 3rd world country !

I'm A Nurse, AMA · 20-03-2015 11:58PM

Gebgbegb wrote: »

Do you think your immune system is more resilient than any of your non nursing friends/family?

Any 'when kinky luvin goes bad' cases ever cross your path?:pac::pac::pac:... seriously though!

I'm not sure about my immune system, living with kids who are human gem factories any mere adult doesn't stand a chance, regardless of profession.

When kinky luvin goes bad sound like soon to be documentary on tv3. You do get cases, genuinely had a man who had arrived in hospital in full dinner jacket and bow tie , covered in straw. He'd been to local swinger's "get together" and had a vibrator, still on, shoved up his bottom. He was completely unshamed of this, which was surprising but admirable in a way. Had to go to the scope room to get it removed.

You wouldn't have known it was there but for a gentle hum and tiny vibration of his abdomen. Soothing in a children's toy, less so in 50 odd year old man.

There was also a young woman who'd been a bit too rampant with her rabbit and did quite a bit of damage internally, she was in hospital 4 or 5 days as I recall, but thankfully she didn't do permanent damage. She was a good deal more reticent about her predicament which was completely understandable.

You hear loads from the lads in A and E , or ED as they like to call it. The usual things shoved where they wouldn't normally be expected to be shoved. Light bulb, vacuum cleaner, bottle, or when people insert bits of themselves in holes that turn out to be smaller than they first thought. So if you've heard a story along those lines, pretty good chance it's true!

I'm A Nurse, AMA · 21-03-2015 12:03AM

worded wrote: »

It's like a 3rd world country !

It certainly feel's more like that now than it did 4 or 5 years ago. People seem so accepting of it though, particularly about being looked after on a corridor, which gives me mixed emotions. It's great that people are so stoic to put up with it, but also a bit sad there's not revulsion and disgust that it's allowed to happen and people aren't angry enough to complain and shout from the roof tops like they are with households charges or water charges.

lctake2 · 21-03-2015 02:45PM

Have you worked in a hospital where there are medical students being trained and do they bother you or any of your colleagues? I've gotten very mixed reactions from the nursing staff, some have taught me so much and are so helpful and others make you feel like you're only there to get in their way.

I'm A Nurse, AMA · 21-03-2015 03:55PM

lctake2 wrote: »

Have you worked in a hospital where there are medical students being trained and do they bother you or any of your colleagues? I've gotten very mixed reactions from the nursing staff, some have taught me so much and are so helpful and others make you feel like you're only there to get in their way.

Yep we have medical students at the hospital I work in. You can't generalise about what I think of them as you are all different. Some I like and look forward to hopefully seeing them again as excellent doctors and some are obnoxious, self important arseholes who will probably be just the same when they qualify.

When there are 3 or 4 doctors on a ward round, plus 3 or 4 students, then physically you absolutely are in the way. Hard not to be with all those people in a small space crowding round a bed. I don't think that's what you mean though, short of shrinking there is nothing you can do about that situation.

I don't mind having students round the ward, but I do object if they go into my patients without asking me and start questioning them or go through medical notes without asking. This may sound territorial but let me give you one example of why I'm like this.

The sadder the case history, often because of its complexity, the more interesting a case it makes for students so imagine how someone who had been told they have no further treatment options, within 5 minutes is being asked by 2 students all about his illness and how long he's had it and can they prod and poke him. It's happened, I don't doubt they said who they were, or what they wanted, but I do doubt that he was in any shape of mind to take it all in, would you be? If they'd have asked me, I'd have asked them to maybe wait a while, or choose another patient. Not too much to ask.

The same as if they want to look at medical notes that they ask, so I'm not chasing round to look for them so when the physio or OT or SALT or dietician wants to see them they are where they are supposed to be or I know who had them. This isn't just a student thing, but is one thing that gets on my goat with some students.

You have horrible people in all walks of life, including nursing, so if you show a nurse some common courtesy and they are still horrible, and make you feel like you're in the way, ignore them, you've done your best and rest assured, their fellow nurses probaby think they are nasty pieces of work too.

God luck with rest of your training too by the way.

NotCominBack · 21-03-2015 06:28PM

Is working in a hospital really like Scrubs?

I'm A Nurse, AMA · 21-03-2015 06:55PM

NotCominBack wrote: »

Is working in a hospital really like Scrubs?

Never worked in the US so who knows what those zany dudes and dudettes get up to, but I'll guess no.:D Maybe they have a lot more time on their hands though.

I know one comedy that pretty much nails healthcare here and the UK, it was called Getting On. Very funny, was on BBC 4 for a couple of series, shows up the ridiculousness of healthcare and hospitals beautifully!

There are a lot of funny people in nursing (in all senses) though, definitely good to have a laugh to release some of the stress.

sunbeam · 21-03-2015 06:58PM

Do you think there is a lot of bullying and/or backstabbing among colleagues in your profession?

Have you ever seen a colleague treat a patient or patent's family member in a bullying/aggressive/demeaning way? If so did you intervene?

Do you think that there are any major difference in terms of expertise or attitudes between younger nurses with their four year degree level training and older nurses who would mostly have gone through the more traditional hospital based training?

Call Me Jimmy · 21-03-2015 07:08PM

What's your opinion on the attitude of the patient towards their illness and how it influences their recovery? Obviously a good attitude alone won't cure cancer, but have you seen anything notable in this regard?

I'm A Nurse, AMA · 21-03-2015 07:52PM

sunbeam wrote: »

Do you think there is a lot of bullying and/or backstabbing among colleagues in your profession?

Have you ever seen a colleague treat a patient or patent's family member in a bullying/aggressive/demeaning way? If so did you intervene?

Do you think that there are any major difference in terms of expertise or attitudes between younger nurses with their four year degree level training and older nurses who would mostly have gone through the more traditional hospital based training?

Do I think there is bullying? Yes, there probably is, senior managers bully newly qualified in my opinion in to doing horrible shift patterns, (in fact there is no discernable pattern) as I've discussed before. Backstabbing? There are people who don't get on with each other and won't be glowing when discussing them. No worse than any other work place I've worked in and I try not to get involved. I had 7 years working before I ended up in nursing and the politics of a ward are the same as an office or a building site or factory floor.

I have seen inappropriate behaviour toward a patient, it was reported and got as far as the nursing board who made their decision after about 8 months! (anyone can see their rulings actually if your interested, on their website). I know of a couple of care assistants sacked and one nurse who was struck off. Any nurse who wants to keep their registration should report abuses, otherwise your culpable in that abuse.

It's not uncommon for raised voices to occur, from all sides. I try very hard not to, because, being honest, it's easier to be non confrontational and even if you feel you are in the right, shouting loses you any credibility. I have mentioned what I consider to be not great nursing (lazy or rude etc rather than abuse etc) to my ward sister, but I'm not a charge nurse, nor do I want to be, so it's up to them what action they take.

The training one is interesting, I have a diploma in higher education which I got over 3 years of project 2000 in the UK so not the old school you're probably talking about. Old school enough though! I have no intention of getting a degree either. Most of my colleagues have their degree, mostly achieved later on their career.

The confidence of the students coming through now is very different even from my day in the 90s. There is a feeling amongst my colleagues that they are trying to run before they walk and sometimes the confidence falls into over confidence. There should be an expectation that their knowledge and particularly practical skills, might not be as good as someone in the job for years. Some newly qualified or students nearly qualified don't seem to see this. Alarm bells ring when they go through a whole day without asking a question about something because the rest of us are still asking questions of each other ALL THE TIME. The other thing I see, most students are looking at what specialist area they want to get into, and plotting how they'll get off the ward before they are even on them. Ward nursing is seen as last choice.

I think, maybe I'm wrong, that the degree course is making an increasing minority of wannabe Junior doctors as much as it is good nurses, they can talk a good game but personal care, or talking with the patient is pretty much the last thing they want to do.

You do get nurses at the other end of their career who have no interest in learning new techniques or ideas and they are probably just as bad. I like learning new stuff on the ward but I'd rather pull out my own teeth than use up my free time writing essays or doing research.

I'm A Nurse, AMA · 21-03-2015 08:21PM

Call Me Jimmy wrote: »

What's your opinion on the attitude of the patient towards their illness and how it influences their recovery? Obviously a good attitude alone won't cure cancer, but have you seen anything notable in this regard?

I think a positive attitude helps in recovery, but I completely understand how cancer or terminal illness can sap positivity and sometimes it does the soul good to wallow a bit. It should be completely allowable to feel sorry for yourself, at least for a while. Because cancer is a f*cker and there is no good way of getting over it, you see just how much it can ravage a human over the years they come to the ward and sadly you see the end of their fight at times too.

Age isn't a guide to how well someone is going to get over something either, there is just as many old patients who do well post an operation or infection as there are young patients. There's a nursing mantra that "pain is what the patient says it is", basically everyone has different pain thresholds, and can cope better or worse with setbacks. You see sprightly 90 plus year olds with all their faculties walking out the ward after big surgery and that always give you hope, and they aren't all tee-total, non smokers, we had a lady who still smoked 10 a day, and had her sherry every night but was fit as a fiddle well into her nineties (don't advise you smoke though, it is bad for you, it says so on the packet) and was coping with a stoma bag with no problems which was fantastic.

Incidentally I think the "pain is what ...... etc" can be quite hard to believe at times, particularly when a patient is sat there chatting to a visitor and you ask them for a pain score, 0 being no pain, 10 the worst you've ever had, and they'll say, ooh, about a 9, and what's for tea? :rolleyes: (<--- I use this very expression from time to time at work too)

Lisha · 21-03-2015 08:28PM

Do you agree that hospital food is simy horrendous and brutal from a nutrition point of view ?

I'm A Nurse, AMA · 21-03-2015 08:43PM

Lisha wrote: »

Do you agree that hospital food is simy horrendous and brutal from a nutrition point of view ?

I think its very hit and miss, and probably more miss than hit. I don't think the type of meal we order for patients (like a high calorie meal which in theory comes with extra butter and glass of milk) looks any different to a "normal" meal. There is a disconnect between what we ask for, and what the patient gets.

A cup of tea and biscuit they used to get in the evening is gone since the cutbacks, more often than not, even simple things like replacing the water jugs aren't done, so as we do the drug round we are in the kitchen as much as the ward getting water or glass of milk or extra butter. The girls in the kitchen have a set time allotted to each ward, then they're gone, so we do the supposed "extras" like giving them a drink!
Supplement drinks increasingly get added by dieticians because calorie intake targets are being missed, often by miles.

I trained in North London, and here's a top tip if you find yourself in an ethnically diverse part of the world, and eat meat, order the Kosher or Halal dinners, they are usually shipped in from outside catering and always looked and smelt delicious!

Gaspode · 22-03-2015 02:28AM

After this long at your career, would you recommend nursing to a young person or tell them to look elsewhere?

I'm A Nurse, AMA · 22-03-2015 10:47AM

Gaspode wrote: »

After this long at your career, would you recommend nursing to a young person or tell them to look elsewhere?

It's a tricky one, it hasn't always been this bad, so being positive I have to think it will improve again, I have 25 plus years to retirement so it had better!

It can still be a fulfilling career, and if you're any good at it, you'll make a positive impact on people's lives who are otherwise in a bad place.

If conditions were to continue as they are now I could never, in good faith, recommend nursing as a career.

sunbeam · 22-03-2015 10:06PM

What did you find were the greatest differences between working in the UK health system versus the Irish one?

I'm A Nurse, AMA · 22-03-2015 10:31PM

sunbeam wrote: »

What did you find were the greatest differences between working in the UK health system versus the Irish one?

I never dealt with any private patients in the NHS, that's one difference, no "he can get an MRI tomorrow and he has to wait a week" because of who has insurance and who doesn't. That is really jarring.

The healthcare assistant to nurse ratio is also very different. Ward of 32 in UK had 3 nurses, here it's 5, 6 in the morning. Healthcare assistants in UK did a lot more, minor dressings, removing sutures, removing catheters etc. Had doubts about that level of Care they were allowed to do myself since they had no registration to worry about.

When you went for a job in UK, you were interviewed by ward manager so they chose nurses they thought they could work with. Here they get zero say who is employed on their ward, you get interviewed for the hospital (actually think its whole area now) and have joy of relief for months on end.

Diversity of patients was different, and had more dealings with different religions over there but patients tend to be similar wherever you see them.

sullivlo · 22-03-2015 11:44PM

Do you get grossed out by any of it? Like the bodily fluids and cleaning of them?

I was having a colonoscopy recently and the nurse said "don't worry, we've seen it all" - have ye really?

Do you ever become attached to patients?

What's the most annoying family member / visitor you have encountered?

Zippie84 · 22-03-2015 11:46PM

What type of a nurse are you e.g. general / psychiatric etc?

I'm A Nurse, AMA · 22-03-2015 11:52PM

Zippie84 wrote: »

What type of a nurse are you e.g. general / psychiatric etc?

General, as a student I did a placement with psychiatry and all the other specialities.

Zippie84 · 22-03-2015 11:55PM

I'm A Nurse, AMA wrote: »

General, as a student I did a placement with psychiatry and all the other specialities.

Do you find mental health still a big part of your job as a general health nurse?

I'm A Nurse, AMA · 23-03-2015 12:15AM

sullivlo wrote: »

Do you get grossed out by any of it? Like the bodily fluids and cleaning of them?

I was having a colonoscopy recently and the nurse said "don't worry, we've seen it all" - have ye really?

Do you ever become attached to patients?

What's the most annoying family member / visitor you have encountered?

We genuinely have seen pretty much everything, had a poor man who's abdominal wound has broken down, would opens and the poor man is walking towards me with his intestine hanging out of the wound. That was an interesting end to a night shift.

Occasionally things might make you gag a little bit, having to take poo samples you use a little tiny plastic spoon to dig a bit out! It's important if you are dealing with anything unpleasant next to or with a patient you try your very best not to make them feel any more embarrassed or uncomfortable than they already are.

My kryptonite is sputum specimen's or trying to put an nasogastric tube down, or take one out. So snot and sputum is pretty gack.

Definitely become attached to patients, you really remember the lovely ones and you remember the head wreckers. You often reminisce about both kinds with staff, don't cry very often, but we had one patient die and I actually couldn't deal with it and my colleagues had to get the patient ready if you know what I mean. It was a selfish response because all the suffering the man had been through he deserved the release from it but I missed talking to him, just listening to him, we had him on the ward on and off for years and he always saw the best in people and his situation. His family consoled me ffs, that's how nice they were as well, their lovely dad has died and they are hugging me. That was nearly 10 years ago and I'm here welling up.

You get lots of visitors and relations who are very intense, they have loved ones they care about and I understand it but every complaint about everything from catering to doctors not being on ward round to the smell on the ward to the lack of showers to visiting times to parking charges to wait for blood results, think you probably get the idea comes to the nurse. We are the one who take the complaints about EVERYTHING. The visitors I have the most issue with are the ones that think a nurse should solve all these problems and still have time to give the patient the care they deserve. Or the that they'll discharge their loved one because something isn't to their liking. I'm not sure who they think they are punishing if they go through with that threat because it sure as hell isn't the nurse.

I'm A Nurse, AMA · 23-03-2015 12:27AM

Zippie84 wrote: »

Do you find mental health still a big part of your job as a general health nurse?

Massive. Anyone who takes an overdose but also has alcohol in their system won't be accepted to psychiatric services immediately so we look after those patients. If someone has committed deliberate self harm with wounds that need daily attention we look after those patients, long term psychiatric patients from the community who come in with medical/surgical issues we care for those people. People with Alzheimer's or dementia, we care for those people, people with eating disorders are cared for on the general side where I work. People who live "normal" lives at home often have numerous psychiatric issues that play a part in organising what care they are given. Drug addicts if they are being treated for a medical or surgical issue get treated by us, alcoholics get detoxification with us.

Even people with no supposed mental health problems should be seen as a whole not just whatever ailment they have (I'd include relations and loved ones of patients in that to). People can be badly affected by trauma or altered body image or loss and we should do out best to help them. Trying to avoid another nursing buzz word but I can't, it's called Holistic Nursing.

Luke92 · 23-03-2015 12:28AM

I'm A Nurse, AMA wrote: »

having to take poo samples you use a little tiny plastic spoon to dig a bit out!

I had Leukaemia and my ward was all private rooms with a room to wash hands and glove and apron up before coming into me.

I had to use that little spoon myself! Bloody awkward things to use! But it was my own so not too bad! Except when its diarrhoea!

Anyway, ward I was on it was nurses who done everything (healthcare only changed bed clothes and occasionally answered bells and stuff). Nurses done everything to do with my treatment, well, once the doctors told them what they were doing.

All in all I have great respect for nurses! All I have met were very caring and highly skilled. Never put a foot wrong.

Thanks for all you do!

Zippie84 · 23-03-2015 12:31AM

I'm A Nurse, AMA wrote: »

Massive. Anyone who takes an overdose but also has alcohol in their system won't be accepted to psychiatric services immediately so we look after those patients. If someone has committed deliberate self harm with wounds that need daily attention we look after those patients, long term psychiatric patients from the community who come in with medical/surgical issues we care for those people. People with Alzheimer's or dementia, we care for those people, people with eating disorders are cared for on the general side where I work. People who live "normal" lives at home often have numerous psychiatric issues that play a part in organising what care they are given. Drug addicts if they are being treated for a medical or surgical issue get treated by us, alcoholics get detoxification with us.

Even people with no supposed mental health problems should be seen as a whole not just whatever ailment they have (I'd include relations and loved ones of patients in that to). People can be badly affected by trauma or altered body image or loss and we should do out best to help them. Trying to avoid another nursing buzz word but I can't, it's called Holistic Nursing.

Sounds like a very well-rounded response.

I both have / had mental health problems, and deliver mental health training, and it's a subject very close to my heart.

Glad to hear of the 'even people with no supposed mental health problems' especially since it's not just about having a diagnosis, but ultimately about how we feel within ourselves, and we can struggle with that at times, particularly due to life circumstances, and especially due to things like trauma, loss etc, like you mention.

I was not surprised at all to hear that it's a massive part of your job, think people are often surprised by this, but there's such an overlap between physical and mental health, and usually we just can't seperate them at all.

I'm A Nurse, AMA · 23-03-2015 12:35AM

Luke92 wrote: »

I had Leukaemia and my ward was all private rooms with a room to wash hands and glove and apron up before coming into me.

I had to use that little spoon myself! Bloody awkward things to use! But it was my own so not too bad! Except when its diarrhoea!

Anyway, ward I was on it was nurses who done everything (healthcare only changed bed clothes and occasionally answered bells and stuff). Nurses done everything to do with my treatment, well, once the doctors told them what they were doing.

All in all I have great respect for nurses! All I have met were very caring and highly skilled. Never put a foot wrong.

Thanks for all you do!

Definitely a knack for diarrhoea samples alright!

Hopefully you're done with bad luck now, stay healthy and avoid hospitals for a very long time. Thanks for the thanks!

I'm A Nurse, AMA · 23-03-2015 12:43AM

Zippie84 wrote: »

Sounds like a very well-rounded response.

I both have / had mental health problems, and deliver mental health training, and it's a subject very close to my heart.

Glad to hear of the 'even people with no supposed mental health problems' especially since it's not just about having a diagnosis, but ultimately about how we feel within ourselves, and we can struggle with that at times, particularly due to life circumstances, and especially due to things like trauma, loss etc, like you mention.

I was not surprised at all to hear that it's a massive part of your job, think people are often surprised by this, but there's such an overlap between physical and mental health, and usually we just can't seperate them at all.

It's important to at least try to do your best for everyone, we are all human beings after all.

Zippie84 · 23-03-2015 12:48AM

I'm A Nurse, AMA wrote: »

It's important to at least try to do your best for everyone, we are all on the same team after all.

Especially when the aliens come like they did in independence day.

how do you mean, re on same team? I kinda look at it as in general = general in all senses, including mental, so there isn't or shouldn't be a division... that you're there just as much for mental as physical stuff.

and sorry whatever you mean about aliens and independence day has gone over my head

Now Ye're Talking - To a Nurse!

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