Saturday, March 27, 2010

A week's break

It's my last day of a precious week-long break from work. Especially so, after coming close to burning out.


During the week, I went through my things and started sorting out stuff to be given or sold away, since I plan to migrate. On my first day-off, I framed a Chinese paper cut-out of 九十九個“福”字, symbolizing "everlasting good fortune", and gave it to a colleague SN O who will be departing after her marriage [Note: and also that her 3-year bond will be completed then]. My colleague was happy and surprised by her farewell gift. It makes me happy too, to bring cheer to my colleague who is my senior from the same course and had skills that I respect. My admin colleague was also surprised, she thought that the large framed artwork was very expensive.


I met up with some old friends. Amongst these are 2 dear long-time friends, who are currently running profitable businesses and are still waiting for me to take the plunge and join them in another business venture.

It reminded me of some comments my ward manager made recently about the difficulty of running a business, insinuating that we (her staff) did not have the ability for it, and thus should be grateful to our employer [Note: I do not doubt the benign nature of the founding members of my hospital]. Of course, my ward manager does not know that, prior to nursing, I started-up my own software consultancy firm. And, I had reputable international clients too. I gradually wrapped-up my business because I needed time to pursue a new interest -- nursing.

In short, I honestly think that bosses should not underestimate their staff. Which brings to mind some quotes from a book that I am reading, "Ideaship. How to get ideas flowing in your workplace", written by Jack Foster, illustrated by Larry Corby.
Follow the golden rule. "When we treat a man as he is," Goethe wrote, "we make him worse than he is. When we treat him as if he already were what he potentially could be, we make him what he should be."

Remember that they work WITH you, not for you.
Some of my ex-colleagues are still wondering if and when I would return to my old [IT] career. Afterall, we had fun working together and didn't do badly then either.


I had the time to finish reading some books and magazines. I was particularly impressed with the British "Women & Home" magazine. Its gender-stereotyping title did not catch my attention amongst the various magazines. It was its cover-shot that did it. Unlike most magazines in Singapore with pretty-young-things on its cover, the W&H magazine had a beautiful, dignified, attractive and sexy elderly lady for its cover-shot. I was so attracted by the spirit of the cover-shot that I flipped through its pages. Its empowering articles inspired me, and I thought, why not start a similar niche magazine for the matured Singapore women? I began to list the friends and contacts I could rope-in to start such a magazine. Then at the peak of my excitement, one single thought jammed my brakes -- I'm leaving Singapore, so why bother?


The cable company called to offer me 3 months of free subscription-TV access. They were surprised that despite years of being their broadband customer, I have never made use of their subscription-TV tie-up promotions. I told the promoter, "I'm an internet person, not a TV person." Anyway, the cable guy came to fix up the set-top box and viola, I had more TV channels than I could possibly watch. But then, old habits die-hard. After one day of being TV couch-potato, I returned to my books, magazines and the internet.

Thank you, chatty little girl!

I have not been writing recently because I seemed to be hit suddenly by burnt-out syndrome at work. It started after my 1-day training. The ward was flooded with patients, a mix of adult and paediatric. On an average shift, I had 10-12 patients per shift [Note: More if you count the new cases that come in after the previous ones were discharged], up to 10 IV medications to administer, 8-20 nebulizations to be done, not counting regular medication rounds, assisting with venous cannulations and IV drip replacement, admission assessment and all other nursing duties.

Suddenly on Sunday 14th March, I felt psychologically numb. We had the most adorable group of infants and children, but I could not feel anything more than, "Oh no, another piece of work to be done!"

I was shocked to feel that way, afterall I was less than 9 months into the job/career and logically speaking I recognized that the children would be very adorable under any other circumstances. That's when I thought I might have hit the burnt-out point. I decided to give it a few days, to see how it goes, perhaps it was just a fleeting emotional swing. Unfortunately, both the workload and the numbness lasted. They were exacerbated by a Complaint Queen and my ward manager unreasonable lecturing/demands [Note: Especially over a bloody GE case, and the proof (supporting my nursing assessment) is in the doctor's order after reviewing the blood-stained diaper].

3 days later, we had a new admission. A chatty little 3 year-old girl. There is something about this little girl. Her courage when faced with fear. I could see her holding back her tears of fear during IV cannulation, she chatted through the procedure and she even reassured others, "Yes, I am very brave." Her chatty nature cheers up the whole room. Despite my workload, I decided that I would stop for a few minutes to listen to her stories each time I attended to her. I'm glad I did, it was the only bright spark on my overloaded shift and my heart began to lighten up.

In front of the patient, I told her mother, "She's so cheerful and chatty, I'm sure she's very popular with her teachers and classmates."

"Yes, but her non-stop chatting gives me a headache," teased her mother, brimming with pride.

Returning to work on 20th March after my day-off, I was dragging my feet. I had a double shift that day and loafed at facing the load of patients again. A little spark in my heart wondered if the 3 year-old girl had been well-enough to be discharged on my day-off. When I arrived, I found that the chatty little girl was still warded. I had been assigned to the team with the lighter patient load and the little girl was under the care of the other team. Still, I had the chance to pop-by her room to attend to her call-bells and listen to her stories again.

5 days after her admission, the chatty little girl was discharged. By then, my love for the adorable infants and children had returned. Thank you, chatty little girl! You were a patient at my ward, but you've healed the healer.

Wednesday, March 10, 2010

Bookworm next to the library

It's my day-off today. Caught up on sleep for much of the day. In addition, am reading 3 books/magazine borrowed from the library.

As far as I could remember, from age 3+ when my elder brother first borrowed books from his primary school, I was quite a bookworm. We stayed with my grandparents in an extended family. My grandparents doted on my uncle and gave him money to buy many books and an encyclopedia. Besides storybooks, I remember spending time flipping through my uncle's books at random. My favourites were the encyclopedia, the books analysing people and the books that taught one to draw; especially the encyclopedia. I thought then that if someone could have instant access to all that information, it would be so helpful in life. Fast forward some 30+ years, it is now a reality, thanks to Google and Wikipedia.

During my teenage years, when my parents were going through their mid-life and marriage crisis, I took refuge in the town's public library. I spent many afternoons reading murder-mysteries and other fiction, non-fiction works on arts-and-crafts, growing-up, inspirational people, personality analysis, religions and world issues. Back then, such non-fiction English books were mostly from European or American sources. I suspect this early exposure to the western world resulted in my liberal attitude towards personal choices.

A big plus of my current home is that it is next to the library where I had spent much of my youth. Now that I am planning to migrate, one criteria for my future home is "located near a public library". Fortunately, in this internet age, locating public libraries in a distant country is as easy as doing some finger-walking.

Communications training

Attended a one-day training on communications yesterday. Guess it is one of the management's plans to improve nursing communications. This course was deemed important enough that all SNs and above must attend and is conducted by the DON, the ADONs, an NO handling PR, a consultant doctor, and a nurse educator (of course!).

The consultant doctor had a wonderful sense of humour. He made several important points which I felt should be given stronger emphasis.
  1. People generally fall into a bell curve. We meet the extraordinary nice and extraordinary nasty ones, be it patients, doctors and even colleagues. Try not to let the few extraordinary nasty people take over the bulk of our nursing experience/memories.
  2. People are the way they are, most often after years of upbringing. It is pointless to change others who are not interested to change. It is more productive to change ourselves to learn to handle others. [Edit: If this area was explored further, we could delve into the different personality types and how to work in synergy. Hmm, I forgot to add that into the course feedback. Then again, I have already given my 2 cents worth in course feedback as usual.]
At the end of the training, the DON requested us to write what we would do if we were "DON for a day". I wrote down 3 urgent and important ideas. I had more ideas but did not write them down because I quickly filled up a page while others were struggling to write any comment. Anyway, there will be opportunities to bring up further ideas in future.

From the discussions during training, it looks like the management is serious about changing the corporate culture to improve its support for nurses. However, one has to see what actually happens in a crisis/incident, when support is needed most.

Friday, March 05, 2010

Who is rude?

SSN Y subscribes to the philosophy that "when life/work becomes not smooth [i.e. 不順], with incidents cropping up repeatedly, it is a signal that it's time to change [a.k.a. move-on]".

I share the same philosophy too.


Hi [Edited: snipped friend's name],

How are you doing? Are you settling into [Edited: snipped name of Canadian city] life?

Quite a few things are happening at work here and the morale of all the staff is dampened.

I got another ridiculous hit today. A parent angry over the renovations noise took her anger out on the afternoon staff. The patient was upgraded from a 4-bedded room to a 2-bedded room after the mother's complaints over the renovation noise this morning. When we took over the shift this afternoon, the patient's mother pushed my HCA to prevent her from taking temperature. [Edit: The renovation manager was escalated to speak to the mother. He informed us that the mother wanted the renovations to be stopped while her child is hospitalized, but the best that he could offer was to stop the renovations for a short while and to resume later in the afternoon. I asked him if the mother was ok with it, he just shrugged his shoulders and gave a "bo pian" i.e. "can't do anything about it" smile]. Since I heard of this difficult parent, and the child's medication was due, I quickly headed to the room with the child's medications.

When I was in the room, I saw that the IV drip was finishing and thus I left the room and returned quickly with the IV replacement. Then the mother called her husband on the hospital phone and complained loudly about her unhappiness over the noise, hospital service and threatened to leave for [Edited: snipped a restructured hospital's name] tonight. At one point, her words were, "Give us free, we also don't want to stay". I just kept quiet and waited for her to finish her call. After giving the oral medication, I had to wait for her to feed her fretful child a bottle of water to calm the child down [Edit: which took about 5 minutes]. Then I started the nebulizer. She snatched the nebulizer mask from me while it was on-going. Later, she accused me of being rude in that I left the room [Edit: after a few minutes of the nebulizer] instead of watching over the entire nebulization process.

We get such nonsense from time to time, so I would have easily ignored the matter. The worse part was when the NO on-duty (who addresses PR issues) blamed me for starting another problem. From my perspective, the parent was angry over the renovation noise and was just finding excuses to vent her anger. Thus, I told the NO in her face that her accusation is bullshit, and that in any other restructured hospital, nurses are NOT treated as such. I told her I would quit the job if the blame is pushed to me. The issue of the angry parent was escalated further to the ADON G, who emphasised that everyone should keep calm and solve the problem together. She did not mention any blame on the staff since I vented my side of the story and my workload of the overflow of adult medical/surgical patients. [It's a paediatric ward, but I had 5 paeds and 5 adult medical/surgical patients under my care at the start of my shift.] Finally, the ADON spoke to the mother and came out with the command to the staff to "do not bring up the noise issue again". When evening came, I just pretended that all was normal and served her child's medication after having to check on them a few rounds for the child to be ready.

Back to migration issue. I am still waiting for [Edited: snipped name of Canadian province] nursing board's reply. I think I will probably bring forward my plans to leave. Instead of waiting to pass the nursing exams, I may go once I get a job when the temporary nursing license is approved. Afterall, more than half of the trained day-shift nursing staff at my ward have plans to leave within this year. Those with plans to leave: SSN 1 of 2, SN 3 of 5 (including me), SEN 2 of 3.

Please share your experiences at [Edited: snipped name of Canadian city]. Would love to hear about them.

Best Regards


p.s. SSN R asked me during dinner if I regretted joining nursing. I told her honestly, "The nursing part is ok, it's the other nonsense that's..."

p.p.s. Not all patients and NOK [next-of-kins] are difficult, of course. We also have many thankful ones. E.g. Recently, we had an elderly female patient whose children are already themselves in the "golden age". One of them remarked to me when he found that I was a local nurse [i.e. born-and-bred local].

"It's a tough job, nursing", he said appreciatively. "Not many want to be in it."

"Yes, it has its challenges", I replied.

"There are few local nurses. But we need more given our ageing population. I, myself, am an example."

"That's why we need so many foreign nurses. At the rate our population is ageing, we will be needing more." [Note: I discreetly omitted that the rate at which we are losing our local nurses is also a major factor.]


[Addendum: 10-March-2010]

The day after on Sunday 7-March-2010, my NO spoke to me to get my side of the story. Thereafter, she remarked must "sayang" [Malay word for "shower with love"] us for what we had gone through, especially me. Perhaps the admin staff noted on Monday 8-March-2010 that I was not quite back to my usual bubbly self yet, and so my NO spoke to me again. She shared about her experience with the other NO (the NO on-duty that day). I agreed with her that the other NO probably had a slip of tongue, and that she didn't mean to blame me. From my past observation, the other NO is actually one of those that I respect. She is very responsible and is usually supportive of the nurses.