jon's blog

Monday, June 18, 2007

project 355: why i cover my ass in the hospital

just as hidden as a set of six-pacs beneath a hunky doctor's scrubs, within the hospital lies an invisible conflict. you could call it a battle of the sexes, or if you would like a Battle Royale of sorts. you might think of it as a struggle for power, or if you're not the literary, metaphoric, 'I-Can-Understand-Shakespeare's-Sonnets' type, i will just simplify it for you and call it a battle. either way, there's is an existence of a pointless struggle between the two most domineering parties in the hospital, namely - the Doctors & the Nurses.

having worked in the hospital for quite a while and seen the clashes on a daily basis, i can't help but relate the whole experience to ninja skirmishes carried out in the dark of the Japanese woods. shurikens are released and poison darts let fly, yet none of the patients or the relatives can comprehend or even see what is really going on beneath their stay in the hospital. it's only those with 'The Eyes' who get the big picture. those who have worked in health-care for an amount of time, those who patronize the hospitals on a regular basis, those from the Allied Health-Care team (eg. radiologists, physiotherapists, medical products sales rep, etc) - they are the ones with 'The Eyes'.

the two teams obviously have their capabilities. team Doctor is filled with people of intellect. people who have studied for so long, immersing themselves in books and one would assume, cadavers. the catch is that the hospital is not filled with cadavers, but rather real, breathing patients who expect a certain amount of bedside manners from them. most of the players in team Doctor are lacking in this aspect. however, this is where the nurses excel. they really do care, they really do give a shit about the patients and their relatives most of the time. but equally so, emotional quotient alone never got anyone anywhere in the first place. truth be told, a majority of the nurses in Singapore lack the intelligence aspect where the doctors are adept at. evidentially, the writer of this post can save a life with great style and etiquette. the catch is that he doesn't know exactly HOW to save a life (insert that song reminiscence of Gray's Anatomy).

this situation would be perfect if the doctors and nurses worked together trying to solve problems and deliver the solutions with great empathy and intellect for the patients. and most of the time they do. however, when it comes to crunch time and the saving of one's own ass, this concept of covering up for each other's incapabilities is practically non-existent.

case in question? about a month ago, a doctor who took morning bloods for two patients with similar names got the names mixed up. patient A's bloods were dispatched with patient's B's blood forms and vice-versa. fortunately, patient A previously had bloods taken before in a group and cross match and her blood was identified to be O+. patient B's bloods that were dispatched under patient A's name were identified to be A+. a huge ruckus was kicked up and an investigation was launched. the official story that came from team doctors was that the nurse didn't assist in the taking of bloods which resulted in the doctor labeling the bloods taken with the wrong patient's identifications. it was a great twist of words and it seems that team Doctors won in the end.

the protocol in the organization would be that the nurses attempt blood-taking on a particular patient twice before requesting the doctor's assistance. also, when the doctors doing their bit of phlebotomy, the nurses (on top of taking care of an average of ten patients and all their shit) are OBLIGED to assist them. but as you know, protocol goes to the dumps when it transits into reality. the routine at the workplace is that none of the nurses are usually free to assist the doctors in blood-taking. in fact, the doctors having understood this concept just help themselves to the equipment they need and take the bloods themselves. all we have to do is dispatch the bloods to the labs for testing.

perhaps in the case mentioned above, the nurses were the ones who did the labeling and they were the ones who got it wrong. from the hospital's well-connected gossip mill however, it seems that the doctor was the one at fault here, having handed the wrong bloods over to the nurses. but it's perhaps a biased point of view given that most of the staff in the hospital's gossip mill interact more with the nurses than the doctors, thus forming a natural kinship with the former.

post-investigation and covering up everyone's asses, a study has been launched to reduce the number of blood-taking errors in the ward setting. for the entirety of this month, the nurses have to chart down the attempts they have taken bloods and inserted intravenous plugs. the also have to chart down the number of times the doctors have done so and the reasons why the doctors were the ones doing it instead of the nurses. not helping is the really bad layout of the charting which is so minuscule that you would need the dispatch the entire survey to the labs and their microscopes just to get the results.

like i said before, when it comes to crunch time everybody uses both hands to cover their asses. unless you've got really big palms or an extra appendage, no sane person who values his career would spare you a hand to cover yours. the only people who would prolly do this would be the gay men. or at least me. i would spare my non-dominant hand to cover a hot ass anytime.

jokes aside, this 'cover your own ass only' mentality is the reason why i'm perhaps so particular about writing every single detail of what i have done for the patients in my reports. it also helps that i'm adept in all things literary. certain words can be used to mean 'A', but for the sake of my own safety, can be turned around to mean 'ABCDE' complete with a very thick smokescreen. the only catch is that it's extremely time-consuming to write elaborate reports. i always end up having to stay back twenty to thirty minutes after shift hours to finish up the bits and pieces that i have not completed. but at least i get my ass-covered and people get to enjoy my excellent penmanship (i have very messily neat hand-writing). so my advice to all the nurses-to-be out there, attempt report-writing as if your life depended on it. but your career and perhaps your life even, really does depend on it.

and my advice to all the doctors-to-be out there?
well, my non-dominant hand is rather free if you need some ass action.

posted at 7:13 pm by the nurse | Permalink |

24 Comments:

From another male nurse, you are right on the money. I too write down everything I do and have since becoming a nurse 16 years ago. Some things do not change over time. Enjoy your blog.
By Anonymous, at 8:06 pm

Office potitics' everywhere...
By NIL NIL, at 8:18 pm

i am so curious!. which ward u r from~!
By Anonymous, at 9:22 pm

It's always about covering your own ass, keeping evidence of what you've done or have not done in case ppl try to find fault. Such is the world we live in. Hahaha

- Wyl
By Anonymous, at 11:19 pm

two things common in an office/organisation:

1. cover (and wipe) your own ass
2. kiss your boss' hairy ass

- steve
By Anonymous, at 11:42 pm

C'est la vie, Jon! =)
By Veeen, at 12:16 am

la'encier: definitely the 'potitics' are everywhere. hur hur.

Wyl: what to do? we live in a fucking selfish world who sue at every possible opportunity. no choice lah.

steve - i'll be kissing my boss' saggy ass then, because she's a post-menopausal woman.

veen - tres true.
By the nurse, at 9:59 am

well, as people say:

'our gahman paid $1 million to train our elite doctors through med school..

whereas our gahman spend thousands to import nurses...

so, where do the blame goes to eventually?? who's expandable?

Nurses!! (TKO hands down!!)

l am so smart l should have been a minister!!
By Bone_collector, at 10:13 am

As the case in every hospital, accusations fly in the form of shurikens and poison darts whens something goes wrong. And everyone has to write an explanation letter.

Well I rarely throw shurikens if I can help it - and my nurses love me, that has to count for Team Doctor right? :)
By savante, at 11:49 am

jon, there're always conflict in every job.

eg. the office i'm currently in. four "aunties" heading the office and one great boss. the place is dominantly women (i know it's sad...) and a lot of backstabbing involved. *wails in profusing pain*

so like wad la'encier says:
office potitics everywhere...

and dun kiss your boss's ass, pls. OMG. you'll get infected with "saggititis". X_O
By a collaborative thinker, at 12:09 pm

Tai Zhi at the workplace. Feel Qi flow...
By William, at 2:36 pm

i'll cover your ass and you cover mine! how about that? :p
By Purring Tiger, at 8:48 pm

to veeen:well im a senior from your school.

Sorry jon for using your blog like a chatting session lol. anyway just like students and teachers. The teachers AlwaYS seems to win don't they?

~ C R i X ~
By Anonymous, at 9:36 pm

This comment has been removed by the author.
By Veeen, at 11:20 pm

And anyway Jon, been wondering how you achieve that nice tan of yours. Been tanning all these while and seems like theres no much result.
By Veeen, at 12:24 am

is the butt in fridae yours too???

- steve
By Anonymous, at 12:45 am

How drama! This could be so Grey's Anatomy. :P
By Sam, at 3:19 am

WRITING REPORTS!!! Urrrgghhhh...still remember those hospital dayz! Can't get a single nurse to do anything when they are writing or passing report! I was once called for resuss but there was only one really junior foreign nurse attending to the dying patient cos the rest of the honcho nursing team were "passing report"! Same things never change, I guess! Wahahahaha...
By Anonymous, at 10:45 am

Even though the mere mention of the term, "Nursing Care Plan," makes my colleagues and I cringe, it really does help when it comes to "CYA" (Cover Your Ass).

During my very first clinical, a seasoned nurse provided the sage words of wisdom: "DOCUMENT EVERYTHING! If it's not documented, it didn't happen."

I've seen the conflicts between doctors and nurses, even though it's really supposed to be we're all theoretically a team to do what's best for the patient. The one thing that I've found odd though is the different treatment male and female nurses receive from doctors.

If I confront a doctor questioning his/her orders, it always seems to be a tad more "tolerated" than if my female colleagues approach a doctor. I still don't know what that's about. I remember there was this one doctor who all of my female colleagues had absolutely zero luck in speaking with, but when I spoke with him about 'possibly' changing his orders, it was done in minutes... like my penis somehow whacked him in the head and had mind-control abilities.

Then there are the first-year resident MD's who you can NEVER leave unattended with your assigned Pt.'s. I stood across from one as he attempted to start an IV line, and he kept looking up at me almost asking, "Here?... Here?... Here?" I couldn't help but think what he was like in bed...

However, it's been my experience that doctors get sued by the patients whereas the nurses get it from hospital administrators... I still don't know which one is worse.
By DChizzle, at 4:45 pm

When I was in secondary school, my 1 blue pen could use up to a year. Now in Nursing, my pen could be used up in Just two weeks. We did more documentations and paperwork then we could do bedside patient nursing care.
By NeoNeo, at 3:06 am

but but but...
you've given the doctor's syringe a BIGGER 19G needle, whereas you've put on just as 21G green needle on the nurses syringe.

Ahn Chua?
By Anonymous, at 12:35 pm

bone_collector: i've never thought of it as that way. but yeah... it does make sense. good thing is that we're training a lot more nurses these days. hopefully the situation eases up in the near future. i would vote for you btw if you ever ran for minister.

savante: well i would love you too if you were my doctor, working with me.

fiexx: i'm not the type to resort to bootlicking lah. but neither am i the type to jeopardize my relationship with my boss. so for now, i'm play along without having to carry any balls or breasts.

william: i have this air-condition vent where i always park my trolley filled with patients' case notes. i call it my 'feng shui' spot. i get a lot of wind there. plus, i think it brings good luck. nobody has died on my shift so far. cross my fingers though.

kon kon: to put it in the words of another famous gay anthem, i'll lick your ice-cream, and you can lick my lollipop.

crix: SEEM. that's the keyword i noticed. not all the time lah. small little pleasures that is invisible to the eye.

veeen: my skin tends to retain tans for a very long time. i haven't tanned in like years, but my butt tanline is still there. i'm truly blessed with a colorful ass i guess.

steve: yeap. mine. nice?

sam: yah i know. if only there was someone scripting the whole thing down at work.

dchizzle: i would rather get it from the hospital administrators actually. better than getting caught up with all the legal action. i guess that's the good about being the nurse. a little sacrifice in terms of privileges and pride never did hurt anyone.

neoneo: i spend more time talking to my case notes rather than my patients. which isn't the reason why i signed up for nursing in the first place. i've been cheated!

cedric: you could look at it that way. OR you could see it as a difference in rank, but a battle that's still being fought. because like it or not, doctors are still given more autonomy than nurses. btw, are you the cedric i know at work? and what's ahn chua anyways?
By the nurse, at 1:31 am

Unfortunately for doctors, nurses are a pain till proven otherwise...something to do with being deluged with oftentimes silly questions and requests. However for competent & efficient nurses, you'l realise that doctors will bend over backwards to accomodate them.

you're alright I guess, didn't bug me very much when i was a HO in GS ;)
By Anonymous, at 10:31 pm

Ahahahahaha
No.
Not that Cedric, tho i know who u refer to
If we lucky, we'll see each other in the ward

and Ahn Chua is my lame-ass attempt at Hokkien (meant to say 'How?')

keke
By Anonymous, at 11:20 pm