Health carers’ stress

Very recently heard the news, one of our consultant doctors had decided to end her life by jumping from her apartment. Although I knew as much about her as a junior nurse would of a senior Doctor, almost nothing, but she exuberated confidence and often greeted colleagues and patients with a smile whenever she made her senior rounds. She will be missed.

As a small potato, I have no insight nor can I make any comment on medical professions stressors, but this news really made me think of nursing professions, things that my colleagues often whine about, and the extent of damage it can cause.

1) Workload
The most obvious source of stress comes from patients. Their life is in your hands and any responsible nurse tries to provide excellent care for all her patients. And yes, it’s a pleural, because unfortunately local nurses often carry a patient load of 10~12 (instead of WHO standards of 4-6). There is no notion of change because management not only doesn’t feel it’s a problem, any errors that occur are explained as carelessness or inexperience on part of the junior nurse. Seniors often feel they had an even larger patient load “back then” and the junior who can’t handle is incompetent. They also have no further incentive to schedule an extra staff because it’s worked till now, why change. As an admission ward, is it safe to assume workload will remain the same a month in advance? (Which is when duties are schedule)

If the ward is downstaffed, it’s also a reason to bargain for not needing to “call” (admit new patients from Emerg) so obviously what good can it be to schedule an extra staff, when the next ward gets to have extra day off and the ones on duty get it easy? Hm, simple math really. So wards compete to have as minimal staff as possible, and patients are the ones taking the risk. So when you have to concurrently manage a dozen patients, each with their own ailments, do you think safe care can be provided?

2) Hierarchy
This is probably more prominent in Asia than Western countries. Seniors expect to be respected, but don’t feel the need to respect their subordinates. They were trained as such, and they continue training others in the same way. Evidence based nursing is a term thrown around, but practice is based on word of mouth, and anyone who questions them is deemed disrespectful, does not listen, difficult employee. And when they are ridiculed, dismissed, or reprimanded, how are these barely 20 year olds expected to respond?

3) Complaint culture
When this society is run on who can complain the loudest, those who are simply quietly trying to do the right thing is drowned out. Patients expect to complain, just to get respected or get what they want, and in turn, management tries to fulfill those who complain. The quiet little patient is pushed to a corner, neglected. Or this VIP culture, where if you know who-and-who, you can expect to bypass so-and-so, or get this-and-that, well why not eh? And it doesn’t help that media feels a need to make everything a catastrophe, and label everything from normal waiting time, complication of treatment, or adverse affect as a “medical malpractice”. And because no one wants to see their paper bag covered face plastered on some gossip paper headlines, everybody resorts to finger pointing, and scapegoat hunting, and nit picking. So how is anything expected to get done when the focus is all wrong?


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