Saturday, October 10, 2009

Nursing is making me racist

Just so pissed off with another FON mother early this afternoon.

Her child was admitted last night at 10+pm for vomiting. Her child regurgitated 3 times after feeds yesterday, each time a small amount of undigested feeds. However, the mother insisted that the child was vomiting and insisted that the night staff charted it as vomiting. Since the mother insisted that the child vomited, the doctor's order is to stop feeds and rest the GIT. The night staff had a difficult time with this mother and noted to us in the handover report.

This morning, only her maid was around when the specialist reviewed her child at 9+, almost 10am. Both parents were not around for the child. The mother called around 1020am and asked for updates about her child. Since I was the staff nurse taking care of her child, the admin staff passed me the phone. I informed her of doctor's instructions that her child can start feeding and other updates. She requested that we provide her child the milk and bottles since they did not bring any on admission. I explained that we could only provide 1 milk bottle and the complimentary milk powder if we have stock. She agreed. We happened to have the milk powder, so I brought 1 tin and a milk bottle into the room. I informed the maid that she could make milk for the child using the hot and cold water provided in the room. The maid nodded her head. I further stepped into the room several times during my shift. Each time the child was still sleeping.

The mother came around 1+pm. First thing she did was to ring the call bell and kick a fuss to my colleague HCA M asking why her child was not fed this morning. As my colleague HCA M informed me, I went into the room to clarify the matter.

"Are you the child's mother?"

"Yes, I am. Why nobody told my maid that my child could be fed this morning?"

"Remember? You called this morning. I was the staff nurse who spoke with you and I explained to you that your child could take milk? I provided the milk and a bottle as you've requested..." [Note: I was interrupted by the mother.]

The mother widened her eyes and raised her voice, "Yes, it's only logical that if the milk and bottle are provided, that the child can drink. But, my maid is from the village. These village people wouldn't know anything."

"When I brought in the milk and bottle, I informed your maid that she could make the milk for the baby. I even pointed to the water flasks and explained that she could use the water for making milk. She nodded her head to indicate that she understood. If she claims that no one told her that your child could take milk, then I'm sorry, I have nothing to say."

"The doctor didn't tell my maid that the child could drink."

"Normally the doctor will explain to the parents if they are around." [Note: Both parents were not around that morning. This particular doctor prefers to do his rounds alone, so there was no witness on whether the doctor did explain to the maid or otherwise.]

Now switching to next line of tackle, mother said "Well you're nurses right? Why no one checked if my child has taken any milk since then? You know, my child has gone hungry since 1030pm last night. How can you let a child go hungry for so long?"

"I came into the room several times this morning. Each time your child was sleeping..."

Mother interrupted again, "Well the maid may not know that she has to feed the child once the child wakes up. Why didn't anyone check if my child has been fed? It's not just about my child. In any hospital, you would have to ensure that the child is fed, right?"

"I came into the room several times this morning. Your child has been sleeping the whole morning." [Note: In fact, the child was still sleeping at the time we were speaking. Anyone knows of a hungry child that sleeps soundly?]

The mother ran out of line-of-attack and changed topic to how much to feed her child. I replied accordingly.

I moved on to serve other patients. At around 230pm, HCA M informed me that the mother complained to her that no one informed her maid that the child could be fed and as a result the child was not fed in the morning. This after I have already explained to her? I was pissed. SSN R who was in-charge this morning asked me what happened, I updated her and SN J who was in-charge in the afternoon. SN L heard my update. She had dealt with the parents yesterday. She informed me that the father has arrived and he is more reasonable. Then I went into the room and spoke to the mother again. As noted by SN L, the child's father was also present by then.

"My colleague told me that you complained to her that no one informed your maid that the child could be fed. I already explained to you what happened this morning, right?"

Mother now switched to getting-sympathy mode, "Well, I am not feeling well myself. I feel like vomiting. I am very worried about my child. All she had was this. What's this? Does this have glucose?" Mother holding the IV drip bag, trying to read what was administered to her child.

"Yes, it's a combination of glucose and salt solution. Your child probably didn't feel hungry because she has the drip. You don't need to worry about her hydration. Anything else that you would like to clarify?" [This is me asking with a fake smile because I was really pissed off by the mother's attitude by then.]

"No, I don't have any further questions now. I am really feeling not well..." and she went on complaining about her condition.

Since she had mentioned that she was nauseous, I gave her some plastic bags for puking.


This is the second mother from the same ethnic group to raise ruckus unreasonably recently. Add to that an FON adult female patient of the same ethnic group earlier this week. The adult patient was incidentally under the care of SN J's team and of the same ethnicity as SN J, but she ignored the call bells of her "difficult patient" on the morning of her discharge.

As much as I'd like to be nice and treat everyone fairly, it seems to me that those of this ethnic group think that being polite makes one a small fry to be trampled upon. Well, thank goodness my colleague HCA M who is from the same ethnic group behaves differently from the lot.


[Postscript on Sunday 11th Oct, 2009]

While taking report this morning, SN J informed that during the afternoon shift on Saturday 10th Oct, she noticed the mother sleeping on an adult bed in their 2-bedded room. Since SN J was in-charge, she went into the room and informed the mother that she cannot sleep on the bed as it was meant for another patient to be warded subsequently. The mother then verbalized to SN J that a staff nurse told her that she can sleep on the adult bed and had arranged some staff to give her that bed. SN J was surprised by the matter and thus reported it this morning.

It turns out that the mother is twisting her words again. When she told me that she was feeling nauseous, she asked if I could give her some medication for it. I explained to her that our hospital policy is that we cannot dispense medication without a doctor's order. I recommended that she visit our A&E dept for a consultation. Then if our A&E doctor assesses that she needs to be warded, we can arrange for her to be assigned to the same room on the bed next to her child since he is in a 2-bedded room. The mother then verbalized with a slight mocking tone that she planned to go KKH (the restructured hospital for treating women and children). Subsequently, the runners needed a cot bed for a new admission, so they swapped out the cot-bed next to her child and replaced it with an adult bed. At no point did any staff offered her a patient's bed for free!

I was glad that SN J brought the matter up. It showed the mother's behavioural pattern clearly.

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