THINGS WE DO NOT WANT TO LEARN BUT DO:

One old man I met would not last a minute without swearing. When dining I could hear him yell - bloody bastard, bring me my food. Another time I was walking past he said - Shit, help me please ! Seemingly, his swearing is so routine that words like " F " becomes easy on the ear. 

I looked at the man. He was bent, stiff and helpless. Nevertheless he was never a challenge to manage. In fact he has a degree of humor inside him. One night I went to his room to give his medication.

Nicely I called out his name.John( not his real name ) 

I am here with your medication.

Patient: Bugger off !

I did not feel offended but while he was on his side I went around the bed to put him on his back and raised the head of the bed.

Me: Now let me put you on your back so you can take your pills properly.

Patient: ah shit !

Me: ( sweetly ) okay darling open your bloody mouth so I can  drop these F--

       kin pills

Surprisingly the patient opened his mouth graciously and was never resisting.

I was expecting he would spit out the pill but he was trying to swallow it. I need to give him water to bring it down. 

So I said : good man - now here is some bloody water to take the pills down.

The man drank without much ado. Next I had to apply some eye drops on him. I said, John I need to put some drops on your eyes, can you open it up for me. He replied, oh shit, such a bugger !

I remembered the magic word and again nicely said : darling this wont take long just open that bloody eye so I can apply this f..kin drops and he did. The other nurse could not stop laughing - she just discovered a way of dealing with the man. Then we shared notes. 

My friend was told by her patient, oh I am feeling horny today. My friend did not understand what the word meant and imagining the horn she thought the man had a headache. So she replied, do not worry dear, I will get you some medicine. The patient had a good laugh.

One time at work, I was feeling very frustrated. I caught another staff looking at me with a questioning stare. I said, I am just very stressed at the moment. With a very sympathetic expression on the face she said - oh that is nothing just need more bonking and she went away with an interesting escape. Hey, I called out - what does that word mean ? When she tried to explain we both ended laughing - crazy world!

NOT ALL THAT GLITTER IS GOLD:

In our struggle to cope with life we earn credits by choosing well. We choose a well tailored dress to wear, a fast car to drive,a big house to live, a tasty food to eat and so on and so forth. To ensure a good life we tend to go for better investments like higher earnings, more opportunities , easier market and the like. Even with our surrounding environment - we tend to pick the right friend and a safe neighborhood ... but how good is good?


For us who tried to seek greener pasture in foreign lands, we come to realize that where the field can be abundant it can also be strenuous and hard. Mothers leaving the kids are haunted by concerns relating to the children's welfare and security. In such a scenario we see the benefit being neutralized by the corresponding disadvantage whether real or imagined.


One time, I was confronted by two job opportunities. The first offer I got was for a permanent, part time one. By then I thought, it should be alright while I am looking for better opportunities. The good thing with the offer was, a friend was willing to give me all his part time shifts. With that I was assured of two days work. Another advantage was a staff was going on leave for the next two and a half months which I was expected to fill. In the workplace were old acquaintances who can show me the way around. I felt so comfortable with the place and the rapport between us was so that even before my orientation I was rostered to work for forty hours the following week.


Anyway, before I could start with the job, I got another offer. The second job had a higher pay rate and was a permanent full time one. The management had me rostered for orientation on the same week that I was to do the first job offer. My orientation was to be for two weeks on a weekday. It was then that I had to choose. For once I thought it should not be difficult to decide. Between full-time and part-time it should be wise to pick the former.
Considering the rate surely again it is wise to pick the higher pay rate. Somehow it was not long that the adage "not all that glitter is gold" made sense to me.


On the first day of my orientation, I realized how dodgy the system was. Apparently, I was expected to do as shown. No one was keen to question and things are done seemingly to cope with time constraints.  The sighs from those that came before me seem to measure the weight of unspoken frustrations nursed inside. The phrase - " you will find out in time " sounded like a sinister warning. Yet I told myself, if it be for better outcomes I should manifest the desire for support.


I tried to offer some help which was met with resistance. More the effort attracted a vindictive reaction of concerted politics . Then comes fault-finding to demoralize the spirit and intimidate. I started to think - "is it worth the time and the effort ?'.  As old workers that left started to share the woes they have had I started thinking back to the way I did my choice.


Permanent - Full Time - Highest Rate per Hour; seemingly a better choice but not all that glitter is gold. 

INSECURE POLITICS

Leadership can be a challenging role. A leader is chosen to create an environment conducive to cooperation and productivity. For such a role a leader is to possess qualities to make it relevant. 


An accommodating attitude welcomes people to share their thoughts thereby creating a pool of useful ideas which can be utilized to improve outcomes. Somehow some people rose to ranks for different circumstances and end up messing the working field with ass kissing workforce resulting to frustration and stress.


First, a leader should understand that when they are entrusted with power, it is not for their own fame but for the gain of those who hired them and more for the sake of the end users of the product made available. A leader is not a leader without a follower therefore they should be able to deal with their subordinates. Ideally leaders are able to promote a supportive and comfortable perspective whereby everyone in the group feels a part in the attainment of the goals and objectives of the organization.


A leader should understand humility. No one is perfect and life is an unending process of learning. Technology is innovating and scientific discoveries are sprouting in every field of endeavor. In our every day struggle to cope with life time may not be enough for us to accomplish everything we aimed for but our shortcomings can be offset by the effort of our team mates. This is one moment in leadership that an emotionally mature leader is to have the grace to accept the need of members' support .


To cover up one's deficiency by reflecting it on the team members, sowing fear by expressing anger and taking vengeance by harassing them for coming out with a better idea takes a leader nowhere. To justify one's mistakes by finding faults in another team member is never a healthy way of organizing a productive team. In fact if a leader is to be good, one should evaluate themselves first before they put the blame on the people under them. After all leaders are to head and guide people in the achievement of an objective.


A leader should also know how to listen. Should learn how to appreciate the efforts and contributions of members. A leader understands the passion burning in the hearts of the team members and will keep it glowing. A leader knows where they stand and is not affected by gossip nor intrigues. A leader respects education and professionalism. A leader sets a good example to follow.

A BLESSED SATURDAY JUST THE SAME :

I was awake from two in the morning till it was time to get up at half past five. My flatmates were not working and I was expecting to walk my way to work. The threat of rain was on the horizon, I was only happy to realized that my other flatmate was actually ready to go for an overtime job and offered to drop me on his way. 


It was forty five minutes before my shift and therefore had the time to sort out my plan for the day. All the staff were quite ready and happy to start working, gathered for change over and we were all on our job.


Till I came to a diabetic man's room at half past eight. He was still in bed.


Good morning Harry, how are you today ?
Lazily, " uh' " .
We need to check your blood sugar - is that alright ?


He slowly pulled his left arm from under his blanket and stretched his hand out. I got a gauze and cleaned a finger and pricked. A small amount of blood sluggishly came out.  I put it on the strip and it read - 12.7 mmol/blood. Your blood sugar reading is 12.7 mmol/blood , are you ready to get up for your insulin ? Lazily he sat on his bed. I dialed the required units of insulin and injected it on him. 


Your breakfast is on your table, how would you like to have them before it gets cold?
Lazily he replied, soon.
By the way Harry you have breakfast pills as well. 
He replied: put in the tray I will take them when I finish eating.


I saw him got up off his bed and moved to the table. Harry's orientation is quite good. He is the kind of resident who keeps his own glucometre and checks his own BSL when you leave. One time I knocked on his door one morning and he yelled - yes come in. In time the resident next door walked to my medication trolley and asked for her pill. While his neighbor was all ready to take her pill, I decided to give her lot. 


In something like two minutes, Harry rang the bell. When I opened his door - he pointed his finger on me:


You, when I call,  you have to come right away.Why you did not come? 
I said, you saw me right through your door Harry and you know I was giving a pill to Robyn.
He said, no you have to come right away. 
I told him - I have no time to argue Harry.
No listen, he insisted - when I call you should come right away. 
I then said - what do you want then? He said - you do my bed and tell your staff to put cream on my leg.
I said, I am medicating Harry and I do not do beds, I will send someone else to come. 
When the caregiver came to his room, he pointed to his bed and floor all messy with stool and urine and said the nurse did it. My staff told him, what do you mean the nurse did it - of course you are the one doing it. Why did you not ring the bell when you need help ? 


Anyway today, forty five minutes after I saw Harry starting to eat his breakfast, a caregiver came to me. Please can you talk to Harry. He is really annoying me said the caregiver. Why what is wrong? I asked. The caregiver explained - he rang the bell and demanded he wanted to see you  right now!  He said - you left the pill on his tray without being told. Oh dear I gasped - no unreasonable arguments please - I still have heaps to do. 


I went to his room - courteously said:


Harry did you call for me ? 
Why you left the pill without tell me ? - pointing his finger to my face.
Calmly I said - Harry you told me you will take your pill after eating. 
Why you said you are busy in the hospital ? I went there nothing happen.
Calmly: Harry there are other residents here in this place and they need as much attention as you do, what is really your problem ? 
Why you come late other staff they come to me first thing in the morning ? Reply: Harry different things can happen on different days but you still had your medication on time.
No, you do not give me Panadol. The other nurses they give - you no.
I replied - Paracetamol is not your regular medication, if you are sore now all you have to do is ask and I can give you. 


I went back to the treatment room and got two tablets of Paracetamol - here is your pill Harry, are you alright now?  
No, at night you give my insulin at eight no good. 
I told him - Harry your other insulin is at bedtime and I can give it at eight. What time do you want your insulin then?
He pointed his finger again - No, no, no - dont ask me? You come and give not me telling you. 
What are you really driving at Harry?  Are you just trying to find fault with me ? 
No, I do not like the way you wok ...
The way I walk ?  - repeating his statement.
Yes ... others they are very good you no good.
Did you say ... the way I walk ? 
Ah no ... I mean wok, trying to work it out with his hand.
Ahhh you mean the way I work. You see Harry, I am not saying that other people are not doing things the right way but I assure you that I know that I am not doing you any harm. If you want things done your way , then you say it and I will see what I can do. 
Why I have to tell you? you should know ... 
Okay, I have no time for arguments Harry, I have things to get done. I turned in desperation and headed for the door.
He shouted - Fuck you Chinese !


I was getting upset but I wanted to laugh. - What Chinese I am Filipino nohh !!!

A STROKE OF ARROGANT IGNORANCE:

One thing I admire  about nursing is the need for one to be versatile and being good at it. I remember how it used to be part of my training  how to maintain composure in the midst of a tight situation. For that we have to deal with monster instructors, stressful examinations and mounting paper works to complete the course.  A good nurse is expected to be able to assess their client properly; plan an effective course of care;  administer health interventions efficiently ; monitor and evaluate outcomes logically  not to mention the task of  documenting relevant  events for recording, reference, reporting and even legal compliance.

The role of nurses is being played practically in each ticking of the time and on everyone. A nurse is a teacher, an advocate, a health provider, a coordinator, a leader yet for all these tasks nurses are to be sensitive, decisive , respectful, patient,  humble and effective.

In the exercise of the nursing task there is always room for improvement. There is also ALWAYS the call for  understanding especially on the attitude and actuation of people we deal with.  Somewhere along the line though is a time when we have to put people in their proper perspective. 

Times when I was giving orientations/ lectures in seminars and trainings. One thing I first think about is my audience - who they are, their background, what they possibly know ( best ).  My main concern was  how to disseminate an information as an added information for my audience to realize its significance and gain cooperation for them to implement desired action. For most of these chances I had to deal with fellow PROFESSIONAL health workers which make the challenge a lot easier if carried correctly otherwise it gets tough when you approach the job the wrong way.

A person of experience would deal with life in  an easy and calm mood. Understandably they  knew a considerable lot about the realities of a field.  Most often it is more about the refinement of ways and improvement of techniques that they have to deal with. More so they have to deal with the changes brought about by the evolution of age and reconciling the experimental skills to bring about better outcomes. Yet the knowledge from history of experience is something that a teacher ( whether they be professional ones, or those acting teachers, or hopeless teachers ) has to respect. 

Once upon a time  I had a chance to be orientated for a job. Coming across a client with swollen legs and looking very drowsy  I gasped, oh no this man is unwell - his legs are all swollen and he is very tired. The person orientating me confidently said - never mind, he has been like that for ages. My heart sunk - for ages ???? . I went through the chart and read something about a recent diagnosis of cellulitis and a recent prescription of antibiotics. I went into the room and tried to talk to the man.  The junior staff started pulling me out of the room - leave him alone, he gets upset when asked. I carry out with our conversation and the man did reply courteously, " yes I know my legs are swollen dear but I will be fine ". The time for his medication came and as a nurse I pulled my spoon and gave the pill right into the patient's mouth yet the junior staff told me - you just leave his pills at bedside otherwise he will get mad. I felt a lump stuck on my throat yet keep quiet.

The next time, a newly registered  nurse asked me to do a patient's dressing for her. She added to say that the dressing has to be done everyday. I asked what is it  about the wound that the dressing has to be done every day? She said, i just think that it has to be done. It was then that I said - I am happy to do wound dressings but as what I have learned dressings are not done daily as it interferes with the healing process unless of course if the oozing has leaked or the present dressing has fallen of. The young charming nurse argued, no there is nothing there to upset I just want it dressed. I gave a chuckle but went to check the wound. There was nothing there to dress, the leg was dry without skin breaks in fact the old dressing has nothing on it. I removed the old dressings, washed the leg and applied cream and without saying anything  I wrote on the wound care plan - dressing removed, no skin break found - leg washed and cleaned - moisturizer applied over dry skin. 

Then the sweet young nurse proceeded to demonstrate the medication procedure. She  confidently arranged  her tray of pills on top of the trolley and showed all the spoons and tumblers inside the drawer. She also explained how to administer the pills with the yogurt she carried with the medication.  With her mortar and pestle handy she readily dropped the pills from the blister pack and started crushing the pills and gave it to some residents. My heart once again felt crushed as I saw the heart-shaped Aspirin crumbled. 

As we moved from room to room she  opens the blister pack and asked me to deliver the pills to the resident ... I could laugh in the inside acting like a courier.  Most of the medication she said I should leave at bedside for the family or the patient to take to make it to a certain time. I started to  feel  uncomfortable that at the middle of the rounds I said - okay, I got the technique, but just let me  read the medication profile first - match the medication list with the pack and I can read the names on the doors or ask the other staff for those that I cannot locate. I urged her to leave me to manage by myself but the young nurse refused to leave and zealously guarded HER MEDICATION TROLLEY. Funny for this thing to happen between two licensed professionals but it did.

Back to the medication cupboard, she put out another set of breakfast  pills which was to be controlled drugs. I looked at the time - it was around 10:30 - I realized they were all pain management one. I then asked could it be better if we  give these drugs early with the breakfast  for the patient to have some relief before they are moved for morning cares? She said - well that is how we do it because we do not have the time. I could not help but wonder - what time is she talking about ??????

Finally I was given the chance to bring my own trolley, I put all my pills inside the drawer. I put the spoon and cups on top. I emptied my trolley from stuff that are not used during the rounds and set off to do things my way. Then a junior staff approached me - she asked, please this is only between you and me , may I know why you are not doing things as told ? I said it is not you nor anyone my dear, it is just how my own mind works considering safety and reading the policy. On the first page of the medication chart is the copy of the said policy and you can read it afterwards when you have time. 

Then another junior staff yelled at me to say - look here, when you do your medication you should start from this wing and check the windows, and close them. I said, really ? I then look her straight  in the eye and said, if you need help what you need to do is say it nicely ... you are paid your rate and should be doing the tasks expected of you. I am paid a much higher rate for greater duties and when I am assessing the well-being of the residents do not tell me to close the curtains because my license is not issued to do that ; when I am timing my medications do not tell me when to start and when to finish because you are not responsible for me on these matters. If everyone is too busy to close the curtains in the lounge - it is common sense to draw them just as you close the windows of your room at night. I do not need an instructor for that. 

Oh this attitude of trying to be ALL KNOWING and too perfect in the midst of our human frailty.  ARROGANCE in the face of IGNORANCE.

New Zealand a Haven for Filipino Nurses ?

In 2005, an Aged Care Education program gave some Filipino nurses and other health professionals a chance to come New Zealand to work as health care assistant. Much as it was regarded by various groups with two opposing views personally I have seen and could say how most Filipino families benefitted and enjoyed the opportunity.

Before anything else I want to point out the reality of seeing New Zealand as a young nation with its own aspirations. It has a government that is trying its best to manage its own people, the aspiring settlers they have allowed within their borders and the visitors exploring the beauty of this land down under. There is no room for perfection in this world and all that is possible is the best that one can have.

In 2006 when I came,  aged care facilities were happy to sponsor Filipino Nurses working as health care assistants in polishing their English and make it to the requirement for Nursing Registration. With the sponsorship was a pay off period which some considered more of a restrictive bond rather than an opportunity. Successful nurses are wanting to work in the acute setting at the DHBs and are happy to be free from any sense of a debt of gratitude.

Five years later the scene had changed. The greatest factor could be the economic recession and the earthquakes in Christchurch. With many locals made redundant in their workplace Immigration is prompted to look into its own people. It may be true to say that the locals are not happy to do caregiving ( if they have a choice ) but at this time of economic crisis it is not wrong for Immigration to give the job opportunity to their own people for them to earn rather than depend on government benefits.

It is for a fact that graduating from a nursing degree plus experience in specialized areas make any Nurse over qualified for health care assistant job. Who knows where the mistake occured or who is at fault - I could only hope that Filipino nurses who came to New Zealand via Aged Care Education had done their part. At present the challenge of finding a job as nurses is quite stiff. With an increasing supply of nurses from different places both New Zealand ally nations and non- ally ones - even getting an offer for a place to study become tedious. Aspirants should be aware that if a school with at least 20 students could not accommodate applicants on a 7-week term how much more for a hospital who would need only one or two nurses per area probably all thru its existence.

Another factor for consideration is how most big facilities had sponsored potential nurses, some facilities even have their own CAP courses and should prioritize their beneficiaries in the hiring of new staff. With the increasing supply of nurses surely health facilities have a choice of hiring those who can present a more superior skill. Not to mention the facilities' preference for applicants with New Zealand experience , those with current work visa or those with residency and citizenship.

With the recent earthquake in Christchurch, a number of health facilities have closed. With its closure is the resulting loss of jobs for many who are now looking for a place to work. The Nursing Council have always warned its applicants and that is even in 2006 when I started opening the site not to come to New Zealand without the Nursing Council approval of your application. With the current economic situation aspirants should think about the challenge and think weather New Zealand is a Haven for Filipino Nurses. I am not discouraging anyone from coming - just being honest to say that things are not as easy as one could imagine.