Thursday, April 10, 2008

Angels, one and all

As we all know, nurses are absolute angels and incapable of any kind of unpleasant behaviour. However, as Creating Tomorrow's Unemployed Nurses Today notes, the attrition rate of student nurses is pretty damn high: Dr Crippen puts it down to the unnecessary amount of theory work, and there's probably something in that.

However, it also doesn't help when senior nurses act like total and utter fucking cunts to their students, as in Faith's case. Now, I'm no workplace lawyer, but I happen to think that comments like the following amount to workplace bullying.
“Well, thats rich coming from you isn’t it? Who are you to judge someone’s appearance? You look dirty and messy Faith but I’m not judging you am I?”
...

“You are an immature and unprofessional bitch to sit there and say all these lies about a porter with a relative. You’ll never get a job on this ward when you qualify. I don’t know what you might say about my nurses.”
...

“I shall be making sure you don’t get a job in this trust when you qualify. People will look to me for references from your placement and I will tell them what you have done.”
...

“You are the worst student I’ve ever had. I honestly can’t believe it. You will never be ready to work as a staff nurse in two years, and I shall be speaking to your link lecturer about it. You should be on a different course. Not the accelerated one. I’ve honestly never had a student as bad as you before. I’m shocked”.

Now, I'm also not a nurse and don't know how one usually goes about attempting to put straight a student nurse on their first placement, but I'm pretty sure that this kind of stuff isn't in the fucking manual.

Do go and read the whole thing (especially my nurse readers: I'd be interested in your opinion); naturally, this was a breach, not of medical significance, but of (potentially) legal protocol and exacerbated by the silo mentality that many people in public service have. After all, it doesn't matter whether the patient's relative was in the right: the NHS doesn't exist for the benefit of its patients, but of the employees.

As people have pointed out in the comments, I highly recommend that asking for a copy of the Trust's Workplace Bullying protocols from their HR department would at least put the wind up 'em: but, then, I guess it's not my career.

As I've mentioned before, I happen to know Faith vaguely; I have no idea about her capability as a nurse (although, since she's been an Aux, I reckon that it's better than many), but I did have to deal with some of the fallout from this incident.

As such, I would like to say to the senior nurse on Faith's current placement ward: stop being such a fucking cunt.

26 comments:

Anonymous said...

Had to deal with nurses recently, including a sister, because my Dad's ill. Argogant, incompetent, condescending, just plain rude frankly. Unfortunately, too many of our dear Angels of Mercy believe their own publicity but fail to put it into practice. Consequently their heads are stuck so far up their own alimentary canals that they barely notice their patients much less their collegues.

But I'm not bitter.

berenike said...

I met folk like this when I was temping.

They can't seem to get their heads round the fact that there are people who really do prefer to ask a question than to do something badly, or to have a bash when it seems that will advance the achievement of the Common Goal (selling cars, cleaning toilets, whatever) and the risk of error is judged acceptable, etc etc.

No, you must be doing it all to show how great you are, and to put them down.

not that they will usually tell you this to your face, or even explain what it is that you are doing wrong (even when you ask for advice)

ARGH!

the A&E Charge Nurse said...

My advice to any nursing student (or qualified nurse on a post-grad course) is to keep your head down, keep your nose clean, and remember there is a long queue of people who know considerably more than you do - so, if you MUST pick a fight, try, as far as possible, to pick one that you have a reasonable chance of winning.

The anecdote highlighted here typifies an entry point for simmering conflict between the various protagonists, in other words the grubby and monsyllabic porter appears to be a mere subplot in the wider scheme of things ?

Porter have managers, and performance issues are usually dealt with by the 'my manager will have a word with your manager' sort of route, rather than summary justice on the shop floor.

Perhaps Faith was genuinely suprised by the unpleassant attack from the ward sister - but I suspect that bad blood might have existed between them long before things took such a turn for the worst ?

As to the general question, are there psycopaths and bullies in nursing, hell yes, just as there are in all other professional spheres (the teaching profession, police, etc, etc).
Was this a battle well chosen ? only Faith knows the answer to that one.

Sadly, skirmishes between students and staff nurses, or between qualified nurses and education providers, not to mention interdisciplinary spats are all too common - in fact they are an inevitable consequence of all large organisations.

Most of the time you can spot them a mile away (ask any of the protangonists watching from the periphery) so as I say, it's (usually) best to keep your head down, or pick your fights with care and forethought.

I can promise Faith that when she is running her own ward, or A&E department, or GP practice, etc she will develop a different perspective on the performance of nursing students (not better, or worse, just different) - the fact that the sister (highlighted in the anecdote) was once a student herself does not seem to have stopped her from developing her into such an insufferable bore.

lost_nurse said...

Wise words A+E C/N.

I took the following as a general rule: do your best - and people will still find a reason to pick a fight. Rise above it.

lost_nurse said...

Rise above it.

ps. that was my self-directed mantra as a student, and in no way intended as a comment to Faith, who has my sympathy.

Dr John Crippen said...

I have a foot in both camps.

First, DK, I think (naturally enough) that the over-emphasis on psychobabel in modern training is destructive. Most people go into nursing thinking that they are going to be trained to look after people in a hands on way. They used to be. Not anymore.

Secondly, I put more weight on Faith's story. Yes, there are pocket hitlers and psychopaths in most walks of life, but the nursing and midwifery hierarchy have the pick of the bunch. I have seen senior nurses behave in this sort of fashion time after time after time. And it is these ridiculous women (usually - the men are better... call me sexist if you like , but its true) who are running the new training courses. Because they themselves do not like doing hands on nursing, they think it is no longer important



John

JuliaM said...

"My advice to any nursing student (or qualified nurse on a post-grad course) is to keep your head down, keep your nose clean, and.....Rise above it."

If this were merely politely worded internecine strife and jockeying for position of the kind found in most workplaces, I'd probably agree.

But the 'people skills' (hate that phrase, tbh..) of this woman, assuming accurately presented, just fucking suck! She might be an angel to her patients, but who wants to bet on it?

Why shouldn't she be confronted, pulled up, made to change her attitude and way of speaking to people, or shown the door if incapable of it?

Your suggestion leaves the way open for this bitch to carry on unchecked, ever more secure in her own omnipotence, to harangue some other student somewhere down the line.

Not sure what I hate more - bullies of the people that do nothing about them.

lost_nurse said...

Not sure what I hate more - bullies of the people that do nothing about them.

Then you entirely mis-understand my point. It's a working environment which - quite frankly - can turn reasonable people into fire-spitting hellcats. Indeed, I've been yelled at by people I consider good friends, even as we crack on. My God, I've even forgiven arrogance in surgeons, provided they've made sound decisions about the rapidly exsanguinating. In short, my average day consists of roughly a million episodes of potential confrontation - it's called "negotiation", and sometimes it requires biting your tongue. And sometimes it requires not biting on the internet - as when it's suggested that I excuse bullying.

I see where you are going, though - nice try.

And it is these ridiculous women...who are running the new training courses.

Hmm - I think Faith's story may have more to do with personality clashes than pedagogy.

the A&E Charge Nurse said...

Yes, an important question, juliam - how to deal with a bully who is safely ensconced in a position of power over co-workers.

But since this a universal and never ending type of relationship that permeates the highest political and corporate offices, not just the nursing profession, how do YOU propose to eradicate it ?

lost_nurse is absolutely correct - the potential for conflict arises everyday.

Sadly, some work place battles are unavoidable, but in most circumstances it is probably worth taking a moment to consider less confrontational (and less stressful) courses of action.

One of the main problems from Faiths perspective is the risk that vested interest (the bitch running a busy ward) will win out in the minds of managers over justice, or a fair hearing.

Faith might be portrayed as a "difficult" student willing to intimidate a hard working member of the hospital staff (the slob porter) - a line that might seem rather appealing to the managers, after all student drop-out rates are pretty high anyway, so what difference does one more or less, make ?

Do I like any of this, no, not one fucking bit, the NHS can't afford to lose a nurse with her integrity but she has to learn early that shit rolls downhill.

And don't be suprised if students grumble about her (when she becomes a sister) because she will be expected to juggle 10 plates at once while trying to address their learning needs at the same time - welcome to the NHS ;o)

JuliaM said...

"...you entirely mis-understand my point. It's a working environment which - quite frankly - can turn reasonable people into fire-spitting hellcats."

Nice evasion of any kind of personal responsibility there - 'Oh, it's no-one's fault, it's just the job..'

"Hmm - I think Faith's story may have more to do with personality clashes..."

Nothing excuses the language used, that she apparantly had an accomplice to this act of threatening harrassment, and the fact that what sparked it appears to have been an 'us against them' attitude.

"...how do YOU propose to eradicate it?"

Follow the HR procedures that are almost certainly in place, challenge it wherever it occurs and whoever does it, and have appropriate and equally-applied penalties understood by all.

I didn't say it was easy, but the defeatist, self-regarding attitudes shown by you and lost_nurse above are why it continues to happen and why is is regarded as 'normal in the line of work we do'. It really, really isn't.

"...the NHS can't afford to lose a nurse with her integrity but she has to learn early that shit rolls downhill."

Amazing viewpoint! Why didn't you just say 'She should shut up and take it'. Same concept, fewer words to type. An attitude that encourages these kinds of behaviour and will result in no change whatsoever and pretty much guarentee the perpetuation of such behaviour.

So, how do you feel about racism, homophobia, attitudes to mental illness? 'Shit happens, what do you do, just ignore it'...?.

lost_nurse said...

It really, really isn't.

What line of work are you in? Please do elaborate.

Nice evasion of any kind of personal responsibility there

Bore off, JuliaM. I have been involved in the minefield that is disciplinary hearings - they are not matters for second-guessing on the internet. I've had to make some horrible, horrible decisions about care priorities - and gritting one's teeth is emphatically not the same as apathetic indifference. Quit trolling.

As I recall (on this site), you wanted to start World war III with Iran - simply because Arthur Bachelor's salary comes out of your taxes. I care very little for the professed disgust of armchair generals.

lost_nurse said...

ps. Nothing excuses the language used

Did you care to note that I expressed my sympathy for Faith? There appears to be a substantial backstory to the tale of one grubby porter - I'd suggest Faith uses it as an object lesson in what not to aspire to, when she herself is a senior nurse.

I knew a ward sister, whose patient care was exemplary, but whose tyrant-like behaviour to the staff eventually did for her (sacked after an internal enquiry). Contemptible as her behaviour was, I'd still want her looking after me post-op.

Funny, eh? How things can be so, y'know, complex?

Devil's Kitchen said...

lost_nurse,

From what I can glean, yes, there is a personality clash here.

However, what really sticks in my craw is this senior nurse accusing Faith of being unprofessional and yet using such absolutely unprofessional tone and language.

As you and A&E will know, I do ave some experience of this field and I know how stressful it is: however, this was not a medical problem that could have caused someone death, for instance, but one of protocol.

Further, Faith is there to learn: one would expect a student to make mistakes, especially this type of mistake. Shouting and being offensively personal is not the way in which to remedy a protocol breach.

DK

lost_nurse said...

Further, Faith is there to learn: one would expect a student to make mistakes, especially this type of mistake...

I agree entirely - much of being a student nurse involves learning the hard way, and what one might term "freedom to fail" is a valuable element. I'm glad to see that she does atleast seem to have that kind of rapport with her "lovely" mentor.

Unprofessional - I've seen this kind of spat happen infront of patients, which is utterly unforgivable, imo, especially when it arises from some trivial misunderstanding.

If there are issues that Faith needs to take forward, then there are established procedures (and union reps!). But I hope she will forgive me for not wading in over the internet, except to raise a clenched fist in support. Contra JuliaM, telling somebody to keep their chin up is not the same as casual indifference. Faith should focus on finishing the course - she's clearly made of the right stuff, and it is worth it in the end. :)

JuliaM said...

"I've had to make some horrible, horrible decisions about care priorities - and gritting one's teeth is emphatically not the same as apathetic indifference."

Oh, cry me a ****** river! That's what you are PAID to do - what bearing does it have on this?

"Quit trolling."

Get a dictionary. Having an opinion that doesn't concur with yours isn't 'trolling'.

"As I recall (on this site), you wanted to start World war III with Iran - simply because Arthur Bachelor's salary comes out of your taxes."

I'm pretty sure that isn't even a charitable misinterpretation of what I might have said on the Iranian sailor fiasco, but I can see how you might want to argue things your opponents say in your own head, rather than the ones they actually type in comment boxes...

"I care very little for the professed disgust of armchair generals."

Woohoo! The 'chickenhawk' argument rears its head again. Good thing you went into nursing, you would have had your clock cleaned in Debate Camp!

"Faith should focus on finishing the course.."

Yup. And let the bullying power-tripping nurse supervisor free to do it again to the next intake. That's the way to build a first class health service...

JuliaM said...

"I knew a ward sister, whose patient care was exemplary, but whose tyrant-like behaviour to the staff eventually did for her (sacked after an internal enquiry). Contemptible as her behaviour was, I'd still want her looking after me post-op."

I wouldn't. If she has no respect for one group, it doesn't excuse her to fall over backward to be nice to another. Also, it 'normalises' that behaviour in the eyes of others and perpetuates it.

They were right to sack her, even if she was the reincarnation of Flo Nightingale herself.

lost_nurse said...

Oh, cry me a ****** river! That's what you are PAID to do - what bearing does it have on this?

Because, sunshine, those kind of situations can be somewhat terse. And the vocabulary and body language employed thereof can be rather...abrupt - leastways, to those who are delicate of ear and eye. I'm sorry if this doesn't chime with your happy-happy vision of the world. What do you do, btw? I'm curious.

Get a dictionary: you troll in an angling manner. It's some jump to suggest that either A+E C/N or myself excuse bullying, but that doesn't stop you trying.

I can see how you might want to argue things your opponents say in your own head

I remember the Iran exchange well enough. And, yes, "chickenhawk" is entirely appropriate for your kind of safely quartered outrage.

If she has no respect for one group, it doesn't excuse her to fall over backward to be nice to another.

But generally, you'd welcome a bit more iron discipline for us lazy nurses, right?

JuliaM said...

"Because, sunshine, those kind of situations can be somewhat terse. And the vocabulary and body language employed thereof can be rather...abrupt - leastways, to those who are delicate of ear and eye."

'These situations' including being called onto the carpet afterwards in a private staffroom? Not exactly frontline with the bullets flying... And the delicate little flower should just suck it up if she wants to run with the big boys, eh..?

Congrats, you've sparked my inner feminist. Didn't realise it existed until now...

"you troll in an angling manner"

Oooh, sporting references, eh? Well, sonny, you just broke cover and I'm shouldering my gun now, how's it feel to be in the sights?

""chickenhawk" is entirely appropriate for your kind"

Well, I suppose it's no excuse for a well reasoned, calm debate with the facts, but I guess you have to go to blog commenting with the arguments you have, not the ones you'd like...

"generally, you'd welcome a bit more iron discipline for us lazy nurses,"

I really can't say, have you included some bizarre personal fantasy in this..? I suspect Max Mosely is your go-to guy for that...

Now, do you want to argue the premise that excusing unprofessional bullying behaviour likely to cause disrepute to the NHS HR management is a bad thing, or do you want to randomly type a few more insults in the hope of hitting an imaginary target...?

lost_nurse said...

And the delicate little flower should just suck it up if she wants to run with the big boys, eh..?

FFS, my comment was not directed at Faith (who, you might recall, has my every sympathy). It was directed at you - given that you seem to imagine that all conversations under pressure are carried out in oh-so-polite Queen's English. That does not include being humiliated in front of other staff. It means, for example, accepting that a nurse in the middle of a sudden ITU transfer might well snap at you - and living with it. Difficult as it is to judge this kind of thing over tinternet, I would imagine Faith has what it takes to survive. So good on her.

As for somehow implying that I am sexist (the sporting references and nazi fetish stuff I don't quite follow)... speaking as one of the few males (and as a very low-ranking RN - the lowest, infact) in the profession - I really can't be bothered to reply, even given the supreme irony.

have you included some bizarre personal fantasy in this..?

Nope. Said (sacked) Sister was a "matron" in the purest, most fear-inducing sense of the word. In other words, exactly the kind of figure the Daily Mail believes can vanquish MRSA just by looking at it. That (and carbolic soap) is all we need, eh?

As to NHS HR, what bit of "If there are issues that Faith needs to take forward, then there are established procedures" did you not understand? For sure, the senior nurse's language was unacceptable. But Faith doesn't need me to pronounce third-hand judgement on it. Meanwhile, A&E C/N gives good advice, of the kind that served me well as a student nurse. And you pour scorn on the notion that there is an Art to de-escalation - in a work environment that you (I'm just guessing) have no experience of. Tell me what you do - please? Because I want to make ill-informed assumptions about it.

As to Iran - it's one thing to suggest that the sailors made fools of themselves, once back on Uk terra firma (which they did). Quite another to take a "disgusted-of" letter writing tone about being surrounded by a superior force. I'd so dearly like to see you run that past an RSM.

the A&E Charge Nurse said...

Ahh, juliam, the court of perfection.

Yes, we should ALL be fighting negative attitudes toward homophobia, racism, mental illness, child abuse, war, poverty, third world debt, corrupt political states, and of course bullying in the workplace, otherwise one is simply left open to accusations of defeatism, or even worse (as you illustrate with such joie de vive).

Incidentally what did you do today to ameliorate any of these problems ?

JuliaM said...

"..my comment was not directed at Faith...It was directed at you - given that you seem to imagine that all conversations under pressure are carried out in oh-so-polite Queen's English"

Really..? Where exactly did I say that, and please note that the conversation Faith refers to was carried out after the incident with the porter and in a private room...

Not exactly the white-hot heat of battle, hmm?

"...exactly the kind of figure the Daily Mail believes can vanquish MRSA..."

Well, I don't read the 'Daily Mail', so I'll bow to your obvious experience with this one, no doubt they ran an article that could be summarised as 'We don't care if matron is a bitch to traineee staff as long as the MRSA rate stays low'. Could we have a link to that, if it exists anywhere other than your imagination?

"A&E C/N gives good advice, of the kind that served me well as a student nurse."

The 'suck it up until you can dish it out in turn' advice...? Well, it's advice for sure, but whether it is 'good' is a value judgement I'm sure not willing to make...

"Quite another to take a "disgusted-of" letter writing tone about being surrounded by a superior force."

Yeah, those 'superior forces'. A pig, aren't they. A bit like bullies. Let's just surrender, save ourselves the hassle.

At least you are consistent.

"Ahh, juliam, the court of perfection."

No, I've never claimed that, but since you can (without fail) be found defending anyone against anything if it involves the NHS, I think someone can't see the wood for the trees...

"Incidentally what did you do today to ameliorate any of these problems ?"

Ah, you got me there. Nothing today. I mean, the opportunity never came up. But still, perhaps I should have created an incident, so I could denounce myself? Would that help?

I wonder where people get the impression that some NHS workers are chippy, argumentative, defensive malcontents?

lost_nurse said...

a value judgement I'm sure not willing to make...

Is there - infact - anything you do? Other than oh-so-fierce internet patrols?

JuliaM said...

"Is there - infact - anything you do? Other than oh-so-fierce internet patrols?"

Actually, I don't comment that much, compared to some people. I do have the benefit of the Internet at work as well as at home though; perhasps that's confused you?

Not sure I'd regarding as a 'patrol' - that sounds a little military for my taste. It's just that when I see an unfounded statement or ill-thought-out suggestion, I feel I should refute it, or offer a better suggestion. I think it's what the internet was made for.

Rather like, oh, say....not allowing bullying and unprofessional behaviour to go unchecked?

YMMV, ofc...

the a&e charge nurse said...

'nothing today', juliam - you suprise me given your uwavering beliefs in this particular sphere.

I can only conclude that you either inhabit a world that is so completely devoid of homophobia, racism, workplace bullying, etc, etc, etc, that you (personally) don't have to do anything about it, or (and I'm just guessing here) you don't, but prefer to do nothing yourself ?

Surely nobody has to manufactur anything for you since this phenomena is around us every day (if you care to look) - so if yesterday was a bad hair day, what are you planning to do today ?

I'm coming to the conclusion that your (lack) of action might otherwise be construed as a tad, er defeatist ?

Then again maybe you are just as secretive about your good deeds as to what it is you actually do ?

JuliaM said...

"...you don't, but prefer to do nothing yourself ?"

There you go again, operating under that false premise once more.

I never said I'd done nothing in the past. I have, both verbally on the spot and through official channels, earning someone an official letter of concern once, and having staff-managing privileges removed from another (permanently - she left soon after).

"..this phenomena is around us every day.."

Exaggerating just a touch there..? Or do nursing supervisors talk to students in that fashion all the time, everywhere? If so, perhaps you might wish to consider why. Maybe because it's shrugged off as 'part of the job'..?

"I'm coming to the conclusion that your (lack) of action might otherwise be construed as a tad, er defeatist ?"

Except of course, it isn't a lack of action, as I have indeed challenged that kind of bullying behaviour by word and deed in the past. Those false premises, eh? Catch you out all the time...

"...maybe you are just as secretive about your good deeds.."

I offered my seat to a pregnant woman on the Tube last week, and went shopping for my disabled neighbour; didn't really feel the need to shout it from the rooftops, but there you go. Perhaps some people feel it isn't enough to do something for someone unless you can earn brownie points for doing it?

Sad life, but each to his own..

nhsstudentnurse said...

"the conversation Faith refers to was carried out after the incident with the porter and in a private room..."

In a private room, yes- but in front of another student, a Healthcare Assistant (whose business is was not!), a deputy sister and a sister.

I have no issue with being told off for what I said. I have issue with the way it was said. My link tutor has been informed and didn't believe me at first. It'll be dealt with- when i've left.