Good times, bad times, and fitting in

The ward census was not high since last Sunday. As a result the adjoining ward was closed, and their staff deployed either to my ward or other wards. In addition, my ward was opened for admission of adult patients.

Generally my past few days were pleasant other than this afternoon's FON mother and an FON adult female patient discharged 2 days ago. In a way, I am fitting into the ward.

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However, the same cannot be said of the staff from the adjoining ward who were deployed to join my ward. For example, SN SB told me her grouses yesterday morning at several brief intervals.

Sometime mid-morning, ADON G came to our ward. As several of the staff were at the staff room, ADON G saw SN SB at the ward area and asked her, "You know about the incident, right?"

The night staff had passed to us several issues, the most important of which was that a patient's uncle had complained of a water jug with an odd smell. SN SB replied, "Yes, you mean room XYZ who complained of the water jug with a smell?"

The ADON looked surprised and raised her voice asking aloud why no one told her about that incident.

SSN Y was in-charge that morning. According to SN SB, SSN Y was upset that SN SB leaked the cat out of the bag. SN SB was upset by the ADON's and SSN Y's reactions, especially since her information to the ADON was unintentional. Thus she shared her grouses with me. She told me that she plans to leave the hospital soon.

Then later at around 130pm, SN SB asked if I had taken lunch. I told her that I did not pack lunch from the staff canteen today because I intend to eat only after work. SN SB told me that she has not packed her lunch yet. I was surprised. I told her that our ward's housekeepers went around offering to pack lunch for us, which is the ward's norm. It could be that the housekeeper missed out SN SB because they were not familiar with her. SN SB then told me that she felt excluded because the other nurses knew that she was around and yet did not inform her about the arrangement nor did they tell the housekeeper to ask her. That added to her grouses.

I feel sad that SN SB didn't feel like she fitted into the ward and plans to leave the hospital. She is an experienced staff nurse and a wonderful teaching SN when I was a student nurse at her original assigned ward. She was subsequently transferred to the adjoining ward and now "kicked" (to use her own words) into my ward.

Another thought I had was that many of the nurse mangers and my ADON G need leadership training. Their common habit is to raise ruckus whenever they hear of any incident, instead of keeping calm and gathering the facts. Their behaviour may get one much attention and, hopefully, fast response. However, such a habit of making mountain out of every incident, regardless of it being a Mount Everest issue or a molehill, encourages staff to be on the defensive and thus impeding and/or defeating the problem solving process. In this regard, my NO is an excellent example to follow. Sadly, as I understand from my ex-nursing lecturer who previously worked in the hospital's sister organization, leadership training is sorely lacking at my hospital.

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After our shift ended yesterday afternoon, I sensed that SEN L was waiting around to speak to me confidentially. Finally after the other staff had left the staff room, SEN L asked me if I was interested in joining her at some events. It turns out that she joined an MLM company as she was interested in their beauty courses. At one point, SEN L said, “人此職的原因只有兩個，對工做沒興趣或者沒有前途。“ [Employees resign from their jobs over 2 reasons. Either not interested in their job, or there is no future in the job.]

I understood where SEN L was coming from. The school for registered nursing turning down her application for training to be an RN has had a big impact on her hopes. However, as I've mentioned to her on another occasion before, her nursing future is not limited to being trained and practising in Singapore. Thus I responded teasingly, “前途是自己創造的嗎！” [The future is in one's hands.]

To which she replied, “不只是“前途”。我講的還有“錢途”。” [Not "future", but "monetary rewards". Note: Both are homophones in Chinese Mandarin.]

I understand what SEN L was talking about. Nursing pay in Singapore is not high (click here and search for "nurse"). Even at managerial levels of NO, one can only expect around SGD4-5K/month gross pay. The highest paid are those trained and practising in highly specialized areas like OT and CCU nursing where SGD 7K-9K is a possibility after many years of experience, with overtime thrown-in. This is miserable compared to the pay of other "professional" fields where specialized training is a pre-requisite. There isn't a single nursing-based job listed on Singapore's top 100 best-paying jobs across all industries in 2009. Thus, nursing while labelled as a noble job, is not seen as a rewarding job by the Singapore society in general.

To quote one patient's grandfather words to me yesterday morning with regards to nursing, “這種工做，吃力又不挑好。” [This type of job, takes so much effort and yet is unrewarding.]

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Nursing is like that. With good times, bad times, problems with fitting-in, (hopefully) eventually fitting-in, handling one's ups and downs at work, and ultimately ownership of one's own work behaviour and career expectations.