feeling sorry

I would imagine that many blogs are born out of a bad day. The desire to rant anonymously into the ether, particularly when the author is feeling oppressed and disempowered by an unwieldy system larger than, and seemingly oblivious to, oneself. One which demands a service which it simultaneously renders impossible.

Today was a bad day.

To begin with I should briefly explain...I'm a nurse working with older people in an NHS hospital setting. I feel very strongly and passionately about promoting dignity and quality of care for older people in heathcare, and particularly for people suffering from dementia, who are especially vulnerable. I love my job but find it very stressful, and there are components of it that I'm completely rubbish at (time-management, for example).

I have been qualified now for one year. Over the first 6 months I spent a good portion of my time sobbing in the sluice/toilet/linen cupboard. This, I gather, is fairly normal behaviour for a newly qualified nurse (for reasons that may become clear over the course of my ranting and apologising). The following 3 months or so were more enjoyable. I began to feel confident, competent, and to feel that elusive sense of elated job-satisfaction that comes with the feeling of a job well done, with a high quality of care delivery and a pride in one's profession. Then ensued staffing cuts, re-organinisation, slashing of resources and supplies, and a general waning of morale, teamwork, and safe and dignified patient care. An over-simplified summary but it hopefully serves to set the scene.

Ostensibly nothing momentous occured today. None of my patients died. None issued a formal written complaint. There was no catastrophic drug error, no 'incident form' to complete.

I arrived on duty promptly at 7.30am, and received calmly and stoicly the news that 3 staff members were off sick and that I would be responsible for a caseload of 10 heavily dependent patients (this is not, after all, an unusual occurence). I presented a resilient cheerfulness towards my colleagues, metaphorically rolled up my sleeves, and set about my work as busily and efficiently as I knew how.

After a long and arduous drug round I set about 'helping' a confused and immobile patient with a shave and bed-bath. He shouted out, and shouted at me, throughout; protesting against my wet soapy flannel and the back-breaking pushing and shoving required to manoever him into shirt and trousers and onto clean sheets. Immediately post qualifying the tennet of gaining informed consent for all nursing interventions was sacrosanct to me, I would not have dreamed of overriding someone's wishes so brusquely, least of all a vulnerable confused patient. Today however, with the nagging thought of 9 other patients to wash and care for, and no time for negotiation tactics, I ploughed relentlessly on, trying to pacify him throughout (in calming and reassuring tones) with platitudes and a patronising spiel I have come to learn from my colleagues.

The patient, reluctantly scrubbed, shaved, dressed and repositioned to look presentable to his relatives, eyed me accusingly, desisted from shouting "help," and began to repeat the words "you're horrible. You used to be nice but now you're horrible. You used to be good but now you're evil."

His words broke my heart. I shut myself in the linen cupboard and wept.