MGS RADAR

Today I finished my last day on an internal medicine ward. Five Weeks of hard work behind me and I must say I was bored, really bored.

Everyday I sense the scent of pampers diapers, shit,wet wipes and Baby cream before I even enter the ward, I see the patient bells ringing and the moaning of sick patients who spent the night on the floor because they are completely desoriented. I enter the kitchen, where the night shift handover is going on, I see the tired and meaningless faces of my co-workers, facing a massive army of highly dependend and very sick patients, some of them nearer to death than life. They are all tired, many of them went into sickness because they are so burned out and came back just to end up in a frustrating circle of a endless flow of patients. No moment to step back, if a bed is empty it’s filled within a shift and if you sent a sick one home, you are partly afraid of the unknown patient coming in.

With coincidence, a very fit patient will see a nurse on the morning round, on breakfast, on lunch and maybe two times in between to measure some things or do some necessary things.

A few ammount of patients is going home “healed” or “better” from there. Most of them are just stable, some of them are unstable, they come back in 24 hours because some nursing home is under-staffed and give their patients some laxatives to sent them to hospital because of diarrhea. They know for sure, that they are gone for at least 3-5 days, maybe 50. One less patient to deal with.
One patient was (and currently is) on this ward for 150 days. He was admitted because of unkown decrease of general condition, then he had a heart attack, then he had a pneumonia, then he refused to eat. He is a little bit desoriented, but he does his job very well. He is still in hospital because…yeah nobody really knows the reason!

The work is not quite enjoying, but one thing I learnt is that your co-workers can improve something, if you are part of the team. But I wasn’t even if I thought I was.

I refused to be a part of a team which left me alone and didn’t help me. I refused to be part of the team which isn’t really a team because they are backbiting each other.

I know really good teamwork, I had it in our project and I loved it it was such a great experience. I know the difference. But in this case, I said fuck about the team let’s focus on my patients and they improved very well , but they were to sick to tell me that they took some enjoyment out of it and felt “cared”.

But it’s the last time I worked on a ward like this, it’s the last time I was “forced” the next time I choose what I do.

Stephan

["If liberty means anything at all it means the right to tell people what they do not want to hear!"]

Here are fifteen basic rules that I established during my student nurse fellowship and I think these rules apply to everything you do as a nurse.

1. Learn and stay to the basics (Anatomy,Physiology,Basic nursing care)
2. Try not the get addicted to prestige from the wrong persons (attending physicians, physicians, charge nurses), set your mind in the “on” position and try to think in efficiency and not in how much prestige you are gonna get.
3. Try to train yourself and put yourself in a position where you can say no matter where I work , I can do it unrelated to the subject. If you specialize too early you blend out certain disciplines that you probably might enjoy later.
4. Don’t think you are the tributary of your employer,charge nurse or training nurse. You are in a training position but you don’t have to give up the other part of your life!
5. Learn to draw the line from frustration, anger and depression and hang it on the hook at the end of the shift - You can’t  change all the things that bother you and especially not at home in your mind.
6. Look for a mentor or advisor , preferably someone from the older staff with years of experience who will show you how shit works!
7. Be an advocate for your patients, stand up for them and try to protect them from bad decisions doctors do SOMETIMES - This means you can stand up to the doctors which means you have to beat them at their level which means: know everything
8. (I hate this rule, but it’s simple) You can’t be a very good nurse without experience, no matter how good you are in school and no matter how good you think you are in practice, you need years of frequent doing.
9. Don’t kill your patients (Which means, be safe about medications, injections…anything)
10. Try to assess the patients or critical situations by half your knowlege and half your gut’s feelings - That’s your job
11. Never under-estimate the importance of a good breakfast or meal!
12. Try to maximize the bedside - time and minimize the writing - time without forgetting either subject
13. Document often, Document early!
14. Prioritize your work, sometimes things that seem important are not important and can wait!
15. Seek help often and early in case you are not capable of doing it alone! + Seek for reflection of your work!
16. (Introduce yourself to everyone from the cleaning lady up to the chief resident physician, especially to people whom you work close with, and if you go by a ward which is unknown to you, introduce yourself to everyone around. Beeing known is the key for getting help at night shifts where you are alone and need help)

Stephan

["If liberty means anything at all it means the right to tell people what they do not want to hear!"]