Failed management…the ugly truth

Management expects you to be like a dead fish in a river and go along with the flow.

Globally, nurses face discrimination and victimization in the workplace.

In Saint Lucia, nurses encounter injustice daily and are called “insubordinate” if they do not comply with management. These “insubordinate nurses” are targeted and blacklisted.

There are many issues plaguing nurses in Saint Lucia.

Nurses remain silent and nothing is being done to alleviate the issues due to poor representation and lack of respect from the relevant bodies.

Nurse managers

A manager is supposed to be someone you could report issues to without fear or backlash and with hopes of anonymity and confidentiality.

Imagine being unable to openly speak to your manager because you know the outcome.

The manager will go back to report the exact thing you said to the exact person you made the complaint against.

Backward mentality

Managers make way for their friends with or without the qualifications, experience and years of service.

Basically, the nurses who support management become managers or positions are created to place them.

Nursing has not evolved in Saint Lucia because of the same culture and mindset.

One set of nurses run the show and are stuck in the same “long time ago mentality and era.”

Management feels like whatever happened to them in the past should continue and happen to the oncoming nurses.

No one tries to be different. Surprisingly, the one who is different or at least attempts to be, is not liked.

Rivals and division

Managers are against managers, managers are against nurses, nurses are against managers and nurses are against nurses.

Nurses carry tales on each other and there is a “never-ending reporting.”

No disciplinary action is taken if a nurse report one of the manager’s favorite nurses.

If the manager likes you then you might be defended.

However, if the manager does not like you then you might be “pulled up” and taken to higher authority.

Unfairness or heartlessness

Gifts and tokens of appreciation received from high-end establishments are not evenly distributed.

The deserving nurses who take the brunt of the manual labor receive nothing whereas management keep the perks to themselves.

Many times, nurses “drown” as they work alone or with skeleton staff.

Nurses battle to provide quality care given the high nurse to patient ratio, workload and the patient’s acuity and category.

Management would not lift a finger or raise a leg to assist.

Yes, the nurse suffers but the patient suffers more.

A therapeutic nurse to patient relationship is not developed. A thorough physical assessment is not done and quality care is not rendered to the best of the nurse’s ability.

Favoritism

Managers give their favorite nurses preferential treatment and do not care how visible it is.  

Managers openly say all nurses are free to leave the establishment and seek employment elsewhere.

Yet, they try everything to prevent nurses from leaving when the opportunity presents itself.

Management and “liked and unliked nurses”

The “liked” nurses are pampered and thoroughly trained for certain positions even without knowledge, qualifications and experience. These nurses bypass everyone who started working before them.

The “liked” nurses get a day owning when they do not report to work. Whereas the “disliked” nurses get NOD- not on duty and are scolded.

The “liked” nurses get whatever request they want. The “disliked” nurses must beg for their request and sometimes do not get it.

The “liked” nurses get weekends and holidays off even without requesting whereas the “disliked” nurses would not.

The “liked” nurses know every detail about scholarships whereas the “disliked” nurses are told close to the deadline.

The “liked” nurses get opportunities to learn new skills, go to workshops and get available sessions. The “disliked” nurses do not share the same fate.

Overtime, the “liked” nurses are promoted and the “disliked” nurses are transferred to another ward as a form of punishment.

Frustrated nurses

Minus their nurse peers and family, nurses have nobody to express their concerns to.

When nurses air their views to management, they are said to be complainers and get bad appraisals.

There are multiple managers and everybody wants to be in charge so there lacks structure and unity.

Rules are bent for some nurses and not all.

Management plays a significant role in the reasons nurses migrate. There is no one to manage management.

Then again. Who cares, right?

Reems Sonson

Our Tropical Living

Come live and love island life

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This is not a paid or sponsored blog post but based on discussion with a few nurses.

A NOT so typical day as a nurse

That thing called “Nursing”

Nursing has been one of the most challenging things I have done! Nursing can affect you physically, emotionally, mentally, socially and spiritually. You experience many different feelings and events on a daily basis and some are extremely traumatizing.

To the persons who want to become a nurse, please ensure that you prepare yourself mentally and physically. Every day is different and you do not know what you will encounter on the job.

Nursing is a very unpredictable, overwhelming, stressful, tiring but rewarding career. My favourite part of the job is seeing a patient recover fully from a life threatening condition and leave the hospital cheerful and thankful when they are discharged to their home.

Witnessing this makes me feel proud of myself. I tell myself “wow, I helped do this. I helped bring someone back to a state of good health and wellbeing!” It feels amazing!

Crazy? Hectic? Morning shift?

Morning change of shift report

The morning report usually occurs from 7 a.m. to 7:30 a.m. The nurses from the night shift give the oncoming nurses a rundown of what transpired from the last morning shift up until the end of the night shift at 7 a.m.

After the morning report, the nurses station is cleaned, the crash trolley assessed and the nurses are assigned to the patients they will care for for the shift.

Receiving your patients is like having a whole new family every day.

Meet the family

You proceed to assess your patients by performing a head to toe physical assessment and rate their independence level and ability to perform activities of daily living.

This is the first physical encounter with the patient so you use your nursing judgement to develop an individualized plan of care centered around the patient’s needs and diagnosis.

This is generally an introductory stage and where you develop a one on one and therapeutic nurse-patient relationship. It is the “breaking the ice” stage for me.

Rundown of the surgical morning shift

Depending on the day of the week then the ward requisition is done. This entails thoroughly assessing inventory on the ward to see what is low in supply and what is necessary to order.

Requisition has to be done accurately to ensure that the ward has supplies so that the nurses and doctors can perform their duties efficiently and effectively. 

The morning shift tend to be the busiest and most hectic!

Reasons for the busy mornings

Doctor’s rounds

Various doctors perform doctor’s rounds at varying times. This includes surgical doctors, medical doctors, the orthopaedics team, the neurologists, nephrologists, psychiatrists and dermatologists.

If it is a female unit then the gynaecologist too would make rounds. Sometimes patients are managed by multiple doctors depending on their condition so rounds can become overwhelming for them.

Nurses follow rounds and assist doctors where necessary during rounds. Doctor’s rounds serve as a time to receive the updated management for the patient, discuss the patient’s condition and improvement in the patient’s status.

Doctor’s rounds merely revolve around the patient, serve as an educational tool and ensure that everyone is informed of the treatment plan and are on the same page. The plan of care is re-evaluated and adjustments are made or it continues.

Patients

Most times nurses have to prepare multiple patients for procedures and surgery and then receive these patients from surgery. Nurses handle discharges and admissions, do wound dressings, remove drains, set up intravenous (vein) fluids and parenteral nutrition (nutrition given intravenously).  

Vital signs including blood sugar get assessed and medication has to be given at various times.

Patients have to be cleaned multiple times especially when their condition do not permit catheterization.

Depending on the patients status, nurses have to accompany patients to the radiology department for ultrasound, chest Xray, Doppler ultrasound and any other procedure that has to be done.

Patients have to be propped up in bed to eat and to be fed. Plus nurses have to sometimes suction patients, reposition patients and perform pressure area care.

Nurses have to perform the doctor’s orders and any stat orders given (right now, immediately). The stat orders could include catherization, administration of new medication, insertion of nasogastric tubes, administer blood transfusions and giving enemas.

Visitors and relatives

The morning shift is packed with responding to visitors questions and concerns, directing persons who walk in as an elective case and assisting family members trying to locate a relative.

Nurses have to attend to all other visitors who come in for assistance and advice. Plus there is visiting time! Nurses often are asked by relatives to update them on a patient’s current state and educate them on the patient’s needs.

The morning shift is filled with educating patients and relatives, allaying fears and concerns and providing support and reassurance.

Phone

Multiple phone calls are received and made! Calls range from other health care workers seeking information, calling doctors for patient issues and calling various units for resources.

Patients frequently ask nurses to call relatives on their behalf and relatives also call to inquire about patients.

“In betweens”

Nurses assist patients and doctors where necessary and staff from other units coming in for supplies.

 Attend to patients who call and need assistance at their bedside to empty commodes including urinals or bed pans.

Nurses have to document, lots of paper work!

This is only the beginning of what we do and we are not even half way!

There is no such thing as a typical day in the life of a nurse. A patient can be laughing with you now and a second later going into cardiac arrest. The shift quickly goes from nonemergency to emergency.

Sometimes I say nurses should be given roller skates because of the quick paste at which they have to work and move on the ward.

By the end of the day, nurses are mostly hungry, thirsty, body sore and aching, feet tired and really just want to get home to their family, bed, television or pet.

Thank you nurses for having lots of patience whilst caring for the patients.

I leave the rest to you…feel free to answer and share your experiences as a nurse.

What do you love about your job? When does it get hectic?

Reems Sonson

Our Tropical Living

Come live and love island life

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Doing this for my passion for sharing my stories and love for writing. This is not a paid nor sponsored blog post.