Both sides of the Bedpan: a Nurse's experience as a patient.

I spend a lot of time wondering about my patient's perspectives and experiences. I feel it's the hall mark of a good health care provider to ensure that my patients feel comfortable with me and the processes they are involved in to the best of my ability.

My dedication comes from several sources. One, I have wanted to be in the health care field since I was a child. Two, I have friends/family who are heavily involved in the patient side of  health care and I get to hear their perspectives, worry and frustrations. I vow that my patients will never experience with me the things I have seen these people go through. Three I am customer service trained from my days in high end resorts where I was empowered by the management to find and fix guest issues.

The biggest view shaping though has come from my own experiences.

It has been said that the most effective doctors / nurses are those who have been sick, very sick at sometime in their lives. Now, I would never wish anyone ill but I have to say that I agree with this philosophy. I know what being ill has done for my practise.

I know very very well what it's like to know something is wrong with your body and not be able to get the people in charge of your health to take you seriously. I know the frustration, the exhaustion, the fear and the worry.

I know what it's like to be in an ER at three AM having been dragged there by a well meaning friend who was beside herself with worry only to be metaphorically handed my hat and shown the door.

I know that feeling despite being a 10 year veteran of the health care field. Despite my personal health record keeping, my ability to use the lingo and my very clear and concise and consistent reporting of my concerns.

I know the stunned rage of having a physician stand with unmitigated gall  and tell me they "empathise with my pain" and my diagnosis is their "best guess" while consistently avoiding giving  me the definitive diagnostics I ask for or the dignity of talking to me in a meaningful way about my future.

I know what it's like to start to wonder if I'm crazy because if the doctors and the nurses and the diagnostics say I'm fine, the pain I'm experiencing must be psychosomatic. That is a terrifying moment.

I also know that moment when somebody, in a hospital not in my home town looks me in the face and asks me what my expectations are. That moment when I am told that indeed, I'm not crazy. There's a problem here and we're going to get to the bottom of it.

That sun came out from behind the clouds moment when I have in front of me a  person who listens to me, takes me seriously and says "here's the plan, here's the time line, here's what I expect to find and here's what we're going to do about it if we find it."

That is the moment when I cried.

It took me three years to get that moment.

Three years of using my professional knowledge to record and report my issues. Three years of talking the lingo, asking the questions, self advocating and trying to partner.

The point of this story is this.....if it takes ME three years of talking and asking and hoping and waiting while in pain with all my clinical knowledge and skills WHAT is happening to patients without these skills and knowledge?

What is happening to patients who are cowed by the health care system? Who think that doctors and nurses are the be all and end all?

How badly are we failing people by not giving them the tools to partner in their own care? How many cracks are there to fall through?

What would happen if we asked every SINGLE patient what their expectations are? If we gave them the plan, and told them the expected outcomes? What if we ended every patient interaction with the phrase I was taught in resort industry: "do you have any questions, comments or concerns? Have we covered everything you needed covered today?"

One simple phrase, backed by a change in the basic philosophy of care can, if not alter outcomes significantly alter experiences.

Don't nobody look good on surgery day....but I was happy as all get out to finally have the procedure.

Well, THAT'S embarrassing.

 It seems there is a current trend in politics for people in power to come across as power hungry, win at all costs types.
There is certain level of disdain for the rules and the public trust.

The current theme seems to be "I'm in charge and I'm right and I don't have to answer to anyone"

Now, I've got a problem with this on several levels. Obviously I resent a public figure who thinks they are not accountable to the public. In my view, we hired you. You work for us.

I have a problem with  public figures who disdain the rules. The rule of law, and the rule of parliamentary procedure are not negotiable. They are not to be applied selectively. That is the definition of tyranny.

The biggest problem I'm having at this moment, however is embarrassment.

Why am I embarrassed you ask? Well, Internet. I'll tell you.

I'm embarrassed for my country. As if our leader's decisions to pull out of Kyoto and the Anti-drought convention wasn't bad enough,currently we have the audacity to claim we have the moral authority to be in third world countries "helping them toward democracy" as Peace Keepers and as Elections Canada Officials.

But the reality is that we are living under a government that got it's mandate through fraud and voter suppression. Whether Justice Mosley has ruled that the fraud he found altered the outcome of the 2011 election or not is moot.

The point is that there was Election Fraud. In Canada.

Let that sink in for a moment.



We look foolish on the world stage.
Our hard won reputation for fairness, integrity, and honesty is swirling the drain.

The question is:
What are we going to do about it?

The Nursing Home Issue.

There is a disturbing video making the rounds of the Internet and news. It shows  hidden camera footage from a nursing home.

In the video a woman with advanced dementia is subjected to abuse by a staff member, she has a facecloth with her own feces on it shoved in her face and she is roughly handled during a bed bath. In other scenes two employees nuzzle each other suggestively while in this woman's room with her in the bed.
In yet a third scene another resident wanders past a barrier and into her room and sorts through her belongings.

Ok, so I have a 100 year old grandmother. I have been a nurse for 10 years. Naturally my knee jerk response was to lose my nut.

But then I got to thinking. I'm a thinker, Internet. I think alot. Sometimes when I ought to be sleeping.

When I set aside my outrage at the treatment this woman endured and I view the events through a clinical lens, I see different things.

I see process failure, for one thing. Why was this careworker left alone to do the personal care on an elderly woman with dementia? This almost never goes easily. Its a two person job. Done properly its one person doing the care and the other person running distraction. This is not to excuse the care worker's behaviour. This is to point out places where changes can and should be made.

Work with dementia and some behaviourally challenged patients should be done in pairs. It's safer for the health worker and safer for the client.
This may translate to an increased staffing cost, but I think its worth it.

The romantic couple is another situation all together. There is never a place for this behaviour in  a work setting. Let alone in  patient's room with them present.
This disturbs me on many levels. Certainly the lack of professionalism is a problem but I have to wonder if this is an isolated incident. It look pretty familiar to me.
I worry that this reflects badly on male health care workers in particular. I have to say that male nurses and PSW's endure their share of prejudice. I hope that people see this for what it is....two individuals acting poorly.

The wandering patient also looks like  process failure to me. Now, it's difficult to judge without knowing the wandering patient's history but again this behaviour doesn't look hesitant to me. It looks practised. Clearly the yellow no wander barrier is not working. Which would indicate a need for a different intervention.


http://www.chextv.com/News/LN/13-05-16/Hidden_Camera_Reveals_Shocking_Abuse_at_Long_Term_Care_Home.aspx

In heath care, especially when working with vulnerable patients we must be ever mindfull of our actions. This video casts us all in a potentially poor light. I, for one resent the hell out of these workers.

There are thousands of heath care staff in this province working hard on a daily basis to be worthy of the trust the public puts in us when they leave thier loved ones in our hands. That work has been diminished by the behaviour of these three people.

We need to look at how we are delivering our care both personally and systemically. We have to be worthy of the public's trust.

Brothering and Sistering. This is how you do it.

April 11th was national Sibling day.
This would have escaped my notice entirely if not for my sister and Facebook.

My sister's status on that day read:

"In honor of National Sibling Day I'd like to send out a big salute to the worlds best brother and sister, Chris Nunn and Jennifer Nunn. You're not just around when it's convenient, but when it's a real pain in the ass too. I love you."

So, naturally I got a bit teary. You can never hear too much that people love you. Especially people who have known you your whole life. Parents are one thing, they kind of have to love you. They made you.


Siblings are a WHOLE different thing. I mean you kinda have a history with them so you love em...but you aint gotta like em. In fact I can tell you stories of what I like to call horror siblings. Brothering and Sistering gone so horribly wrong it would make your hair curl.


But those jerks aren't my brother and sister. Thank God for that.

So in honor of my brother and sister, here's an outline of how brothering and sistering should go. These are based on my brother and sister and there's plenty of people who could learn a thing or two from them.


Brothering.

My brother is the show-up-ingest dude I know.
I got a problem, I call my brother. He hangs windows and paints walls and hauls furniture. He will gladly speak to anyone who disrespects  our sister or I.
He's the first guy to show up and the last guy to leave.
When our sister was in ICU he cut her grass and did her gardens so she didn't have to worry and her husband didn't have to think about it. We paced the halls together for two days that week.

I take my 12 year old nephew with me to his house to show him how men should act. He accepts my boy even if he's not our blood. He talks to him, and plays with him and praises him. My nephew's dad is a great guy, but you can never have too many good examples.

This is how brothering should go. Brothers are supposed to be your example of how a man should treat you. Their job is to go first into the world to make sure everybody knows you have backup.

They're supposed to eyeball the guy you are dating and tell you from a man perspective if he's a loser or not.


Sistering

My sister is the got-your-back-ingest girl I know. You sure as hell don't want to be overheard talking trash about me near my sister. No sir. That's trouble.
She's the first one to tell me if I'm being a jerk and the first one to tell anybody else who suggests it where they can go.

She'd never let me leave the house looking bad.
She shops with me to make sure I look good.

When Mom is away we split "Dad duty". We make sure there is food in the fridge and the house is reasonably clean.

I take her with me and my ex sister in law when we go out. My ex sister in law doesn't have a sister and that's a damned shame. So I share mine with her.

She reminds me that I'm worthy of what ever I want in this life. She gets upset if I don't believe her.

This is how sistering should go. Sisters are supposed to prop you up when you're down. They're supposed to make sure you and everybody else remembers that you're a rock star.

Their job is to tell you if your friends are really frienemies.


This is the barest outline of Brothering and Sistering. There is a whole depth of support and acceptance that I cannot put into words but am eternally grateful for. I feel a lot of empathy for people who don't have siblings, or have siblings who don't know how to do the job.

If you are one such person, feel free to share this blog with your siblings. We'll show 'em how it's supposed to be done.



That's us....WAY back in the day. No, my sister didn't let me leave the house in that shirt.