Lamenting about the lost art of nursing care:

This is a plastic slipper-pan....mine was papermache...even more lightweight...

I have recently been in hospital, nothing serious but none the less needing/requiring some nursing care: There is nothing like a bit of firsthand experience to relay to nursing and midwifery students the importance of a caring attitude..... I also say that people generally complain about staff that are rude and give the impression of not caring ...that is a distinct difference to the nurse who just doesn’t give a shit.

I do have to say that I find being a patient extremely difficult because I do not want to relinquish any sort of control of my life.....to someone else particularly someone who really doesn’t care. On the whole my care was good..... However it is always the little things that make life all the more difficult..... like your tray being placed out of reach and you can’t move....emmm a little difficult.... and ringing the call bell to use...yes the dreaded bedpan... and it takes 20mins for the nurse to appear....then a further 15mins before you get the slipper pan.... oh no..... you can just feel your bladder is about to burst...and then you have this ridiculous looking slipper pan and you know it’s just not going to happen....at this point I wished I had a penis...it would be so much easier....but alas no we take a deep breath and ask to be left alone to contemplate emptying your bladder lying flat on your back and trying not to be in any pain.... it seems a fate worse than death...trying to pee in these conditions.... remembering you have done this all about 4hours ago and wet the bed in the process...then you have to go through the embarrassment and the changing of the bottom sheet.......anyway about half an hour later I think yes... I’m done.... ring the bell... by now the slipper pan is well and truly stuck to my buttocks... the nurse comes in “are you finished” yes thank you... Ok let’s get it out then.... lift up.... tummy muscles work frantically and lift.... as the nurse manoeuvres the pan out .... oops yes you guessed it.... a spillage...but of course... how can this flimsy product hold several litres of fluid without having a mishap......oh did I mention it is the middle of the night....the nurse says “oh that’s good....it didn’t spill did it?” emm... I lament and say...” I think that the bed is wet”....no says the nurse it’s your perspiration... it will dry very quickly....and slips out the room very quickly carrying her overladen slipper pan.... and me... well she doesn’t know that I am a nurse / midwife educator and am totally blown away by this blatant lack of insight into poor care....now here I am the patient....at this stage a not well patient who has pain, now lying in a wet bed and wondering is it worth the trouble to ring the bell wait another 20mins and complain about my care , have the sheet changed creating more pain or shall I just lay here and hope that I fall asleep as I am still affected from the anaesthetic... to which I do just that (I have to say this only happened once, not all the staff were like this).

I should think it is equally as difficult for a man to pee lying down.....

In the next bed was an elderly frail lady whom I had not met but could hear through the curtains that she had some sort of facial surgery and could only swallow. I came to this conclusion because I could hear her trying to swallow her drinks and her meals came in a bowl, she had hardly any visitors and was very quiet. It is interesting trying to assess someone you have not seen by the care she received from the nursing staff. Some nurses would come in very chirpy “Good morning, I have some pills for you, oh your poor darling, that looks uncomfortable let me crush your pills”....to, hello here are you pills.... Patient “oh I find it hard to swallow can you crush them” nurse – just try; patient; ok..... Cough; splutter; splutter; tears........oh Ok I will be back...... surprisingly it was the younger nurses that showed less caring....this occurred at least 4 times a day all with differing responses.... On the second day when the nurse came in and said “here are your pills and asked her to swallow them after the patient had asked for them to be crushed...... I could not bear to hear the patient again try to swallow....that I yelled through the curtains..if I could have got up without causing myself pain I would off.... why don’t you just crush or give her dissolvable paracetamol......the nurse scurried out the room and came back with dissolvable pills.... I know there is nothing worse than a busy body not minding their own business..... but it just had to be done...later when I got up ...the elderly lady said thank you to me for asking the nurse to crush her pills...and explained she had two sons lived away and it was difficult for them to visit...but they would say something if they knew.... and said I don’t know why some of the nurses won’t crush my pills.....she became teary and wondered whether it was all worthwhile.... I sat with her talking about life and I was saddened that none of the nurses found time to spend any time with this frail lonely woman who has had some remarkable facial surgery and how any nurse could possibly ask someone to attempt to swallow when visibly it was obvious that this was an onerous task for the elderly woman....

I know we all use the excuse that we as nurses and midwives are overworked, but please, caring and compassion is what we are about... it is a basic human need.....everyone is so busy with the task that there was absolutely no caring or compassion ......

My dilemma as an academic is how we teach our students to be caring and compassionate in a world that demands tasks to be completed in unrealistic timeframes.... and why are we producing young nurses that do not have a caring philosophy.....

Tip to nurses.... you never really know who the person you are looking after.... therefore be kind, caring and professional to all.... treat your patients like you would like to be treated yourself... and if you are having a bad day stay home..... don't inflict it on your patients.....

Back to my roots Africa:

We have been in Africa Tanzania for a week now…. I will be blogging about the clinical experiences soon but just had to share this wonderful weekend with my friends and the world. Despite all the hardships that can clearly be seen in parts of Africa the country and its wildlife are absolutely magnificent….Africa is rich with warm friendly people, diverse cultures and stunning wildlife. I began to feel as if my soul had returned home once I got off the aeroplane. The steamy airport….. crowds of people a disorganized chaos was all reminiscence of my times spent in Zimbabwe.



Our weekend was spent at Mikumi National Park: the park is in Morogoro Region, in the southern tourist circuit of Tanzania. This is the nearest park to the commercial capital of Tanzania, Dar Es Salam. It is about 288 km west of the city and takes about 5 hrs by car. We travelled in convoy in land cruiser troopies 8 to each vehicle that includes the driver (who is a local). The road is bitumenised all the way to the park. The park gets its name from the spindle – shaped borassus palm trees which are typical of the area. Mikumi National Park with an area of 3230sq.km is the fifth largest park. It lies between the villages of Doma and Mikumi on the Dar Es Salaam-Tunduma road. The Mkata River-flood plain, with its hardpan, ridges, swamps and black-clay grassland, the miombo woodlands on the hill to the east and west, and the rivers with their fringe of tall trees and dense thickets. Often it looked like it was going to rain…. Thankfully it didn’t; the short rains usually fall during November and December. Long rains are from March to May.



Everyone relaxed and really enjoyed the weekend, it was just not long enough…..being with the students all week, it was great to see them relax as well as us (the supervisors). We were warned that the animals wander around the grounds and to walk together and be watchful. As we sat drinking; me with a gin and tonic and as we had lunch we watched the animals arrive at the waterhole; zebra, warthog (pumba) and her babies and a small family of elephants…. It was brilliant to watch the elephants drinking and having a mud bath…..the giraffe were ambling in the background grazing on the leaves ….. what a wonderful world we live in….it was a time to reflect, re-energize and rejuvenate.



We stayed in small lodges made from mud….self contained double rooms. The windows were open spaces covered by a wired mesh similar to fly wire. We were all sharing; I was sharing with two other fantastic women…. We chose our beds unpacked our bags then out for our first adventure in the land cruisers. The usual application of sunscreen and insect repellent…. Excitement in the air…..a beautiful sunny day….the African air. It was not long before we came across our first elephants, then impala, lots of impala they are almost like our kangaroo’s…. we were all glued to the scenery trying to spot the next animal…when I called out “there’s a Kangaroo” ……on our way back to the village we came across a group of Giraffe, they are so spectacular to watch…. elegant and graceful. Alas still no Lions: The African sunset was spectacular as expected….. got back to the village…. Had a double gin and fanta as there was no tonic….tasted great… a fabulous dinner….beef stew and veg whilst watching animals at the waterhole….. later that evening the lions came to visit…some of the students were disturbed and frightened, the park employees escorted everyone back to their rooms….. it was a hot night…the electricity went off at 11pm so no more fans….. we slept under mosquito nets…it was a hot sticky night….as for me I had tooth ache so took a bucket load of pills and could feel my tooth throbbing…..but did manage to get to sleep…..



Up on Sunday morning at 0600hrs out to go for the morning safari drive; wonderful morning… a bit cloudy…weather great…cool; spotting animals… we came across a herd of elephants…. Unbelievable…the female leads the herd and the rest follow there were two calves in the herd… we spent quite a while admiring them it was so quiet you could hear them walking, they came very close to us…. Fantastic pictures…..we drove for an hour watching…. I was standing feeling the wind on my face…….feeling very much at home in one with the land…..the driver got a phone call and then began driving very fast…., we knew there was something to be seen…. We finally caught up with the other group to find a pride of lions who had very recently killed a buffalo, it was disemboweled…. There was a lioness close by well camouflaged, we all were excited and scrambled to get pictures…the safari was complete now that we had seen lions in the day….it was back for breakfast then the homeward journey back to the hotel (5hrs).



It was fantastic to see large herds of buffalo, wandering groups of elephant, wildebeast, zebra, impala, baboon, warthog, jackal and giraffe. Most spectacular was the sight of a fresh kill of a Buffalo by a pride of lions…… wow… just amazing.
Giraffes are the tallest of all living land mammals. The animal’s typical gait is rather slow, deliberate and remarkably graceful, almost as if the actions were filmed in slow motion.

Elephants have a gestation of 24months and live to about 60yrs, they weigh 3-4 tons and they eat 375kg of food….wow

I have to mention that the traffic (in Dar Es Salam) and the cars / buses are just diabolical – they are crazy drivers; how there are not more accidents I do not know…. We cringed more than a few times on our journey….. overtaking… causing the oncoming traffic to take responsibility to move out the way…..our drivers were excellent: There was a small gift shop on sight which I bought some material for the girls (Kanga) a traditional piece of cloth used for clothes: Now it is back to reality we have another week left….

spot the lion: sitting watching her kill...the pride was further back under a tree too far to take pictures:




I have written this blog on the homeward journey on the bus, as we are often stuck in traffic and hopefully I can upload it when I get back to the hotel, if the wireless is working....Watch this space for further tails and I have many…… photos will be coming soon.. it has taken me over an hour to upload these few.....it is back to work tomorrow...

Being a student again: a humbling experience:

As a lecturer myself I consider that I am a considerate fair and equitable person when I am dealing with students, in fact it applies to all aspects of my life ; one thing I really don’t appreciate is being taken for a ride.... in other words when students “take the piss” then I come down like a ton of bricks;
As some of you are aware I have commenced another course reaching for new heights..... My aim is still woman and birthing focused..... equality, autonomy and right to refuse treatment; the right for women to choose where to birth and with a midwife.
Being a student in a completely new discipline has been daunting....going from experienced to something completely different, a whole new style and way of thinking....it really is letting go and learning new ways of being....I still have not mastered this... I guess it will take some time; patience is the lesson I need to master;
As I reach the end of the semester (13 weeks) and start to cram for exams, which incidentally I think is the worst way to learn anything.....I really appreciate the way that I interact with the students whom I have been privileged to teach. Most of the lecturers I have encountered over the past 13 weeks have all been inspiring, articulate and passionate, exactly how it should be; however there is always one.....that is challenging. This one is a male.... he takes a tutorial group... he walked into the class.... or I should say he strutted in and said “hello I am Fred and I Fucking swear.... and if you fucking don’t like, there is the fucking door” well I was flabbergasted my jaw hit the floor.... there were students squirming in their seats...myself included. Here is a man who is presumably highly intelligent.... or so I thought, holds down a very important job and I am sure he would not swear in a court room...so I wonder why he would do so in class.....Our assignment was a case study that we would work on and discuss in a tutorial group, this is nothing new similar way of teaching that I have adopted.... I did notice that I used to say to my students “now this is easy, just follow the model as I go through it” of course it seemed so easy to me, as I teach it week in and week out.... with enthusiasm I might add.....when my tutor went through the case study at 100 miles an hour, telling me how easy it was..... the penny dropped for me.... this is exactly what I said to my students.... “I felt like saying of course its “Fucking” easy you teach it week in and week out and you know it, but alas I did not, I sat quietly and decided I would never tell my students how easy something was.... because it’s not me doing it” lesson learned;
The other valuable lesson I have learned is how vulnerable you can feel as a student: I mean I know that this is possible but as a student you want to pass, so therefore you do not want to be to argumentative as marking is so subjective a terrible way to feel and you don’t want a personality clash; if your tutor does not like you, would it affect your mark, theoretically no.... I felt several times when I questioned the tutor’s methods I was quickly reminded who was the student and who was the teacher....how could I forget this? I decided it would be best to grin and bear it.... until the unit was over... then I could have my say! Now we are at week 14 he has become nicer....more considerate for the first year students.... even thoughtful.... it must be the semester is nearly over..... and all I can say is thank God for both of us; this experience has made me reflect more on my own teaching methods and I am ensuring that I am always fair and equitable.

Nursing Graduating Class of 2010

Brian the Master of Ceremonies and organiser:

 

The end of semester signals many things....from a lecturers point of view it is a busy time with winding up the semester, making sure the students have handed in all their work and then there's the marking, a mountain of marking...this is where you find out if the students have applied what you have taught them...getting all the marks in for the Board of Examiners..there is a quick turn around before the next semester.... then of course there are those students who have come to the end of their course...for nursing it is a the culmination of three and half years....this group of students is a particularly special group for me... as I have seen them over several semesters throughout the last two years...which can be rewarding because you see them grow and gain more confidence and you began to feel the excitement as they are coming to the end of their course.....I don't always teach in the last semester of the nursing unit, however I have done it a couple of times now and really enjoy seeing the students go out into there 10 week clinical practice and blossom over the weeks. There are off course the trials and tribulations that go with clinical practice.... the good and the bad of the nursing professions preceptors, bullying, the usual coping with being a student and time management.

Which one of these nurses will become a "midwife"?

 

As a lecture you also have the ability to see which students are going to succeed and those that will struggle...I am proud to say we have a large number of very gifted students in the class of 2010 and I would love to see where they are in 5 years time.

 

This celebration was organised by one of the students Brian a talented man who will be a brilliant nurse...there were about 90 people...students, partners and academics.. it was really nice to see the partners there supportive and proud.... and rightly so....it was like the red carpet at the logies.... the girls were gorgeous and the guys handsome...I have to say there were some great shoes and dresses around....there was a buffet dinner again brilliant and off course desert was great.... drinking and dancing was had by all and I had a fantastic time...

 

Now at every celebration there are the traditional speeches: yes the academics as they like to hear there own voice... had something to say... Brenton whom I greatly admire (now retired) gave a heartfelt impromptu speech...and as expected it was brilliant, great words of wisdom....Lorraine wrote a poem "Ode to the new Curtin Grads"...which was excellent... Fiona...stunning wooed the audience and again thanked Brian for the enormous job he had done...and off course I had a few words to say....
The students had there own set of awards which was brilliant: "the nurse best not to upset because she has access to a variety of theatre instruments"
"The nurse most recognisable from far away"
"the nurse most likely to achieve her PhD"
"the nurse with the quietest voice and softest touch"
"the nurse most likely to hear there voice talking over the chaos in ED"
"the nurse who organised the best Xmas party"
there were a couple more that I can not remember.......

 

There are a large number of male nurses in this group...in which area will they be in 5 years?

 

For me I am passionate about teaching, I just love it.... and my message is to always trust yourself and your gut feeling...have integrity, honesty and cover yourself... that means always documenting everything despite time constraints.....you are armed with all the skills it is now time for you to fly..... fly high and be passionate about your work...when you have passion...success follows; and think about doing a postgraduate course after your graduate year.....Well done and good luck......

Virtual Homebirth Rally

By now everyone is aware of the new legislation threatening Homebirth in Australia. Next month there is a rally in Canberra to support Homebirth and hopefully influence the parliamentarians to reconsider there current position of not providing indemnity insurance for independent midwives / private midwives. Unfortunately I am unable to attend the rally in person however I am excited at the prospect of being represented through a virtual rally, thank goodness for technology. I have designed my banner for the Homebirth rally and uploaded my picture.

In my time I have attended several rallies, some political and some pay issues within my nursing / midwifery career. I found them exhilarating, especially when you are fighting for a cause; of course the other issue is the rebel within me has a chance to be expressed. There have been several that I recall as monumental, one of those was when I worked at RPH and we all walked off the job to protest at Parliament House about workloads and pay. More recently was the march on Parliament House with the Maternity Coalition which was successful relating to maternity choices, again it was the consumer that made the difference.

One of my funniest protests was quite by accident when my girlfriend (Christine) and I were living in Hemel Hempstead UK about 10 years ago. We decided to go into London for the day, it was a Sunday, and it was a beautiful sunny day. Yes I know that can be unusual for the UK; we caught the train then the tube and got off at Piccadilly Circus. As we came up from the tube station, we thought the city of London looked particularly busy for a Sunday, some strange people everywhere, we looked closer as we were walking through the crowds towards Trafalgar Square and noticed that many people were carrying placards with a green leaf on them and there was a strange smell in the air. As we approached the centre we realised it was a socialist protest to ‘legalise it’ a green plant I guess it was “Marijuana” at least that’s what the plant looked like. We had a good laugh and wondered what our children would think if they saw us now, in the middle of a protest march for which we new nothing about. That’s how you get caught inadvertently in a protest march.

The power of the consumer is very important and people power can change legislation, so I urge you all to try and attend the rally and if not then please do become a virtual count, make your voice heard so that the politicians can see women are serious about being able to have autonomy over their own bodies. Women have the right to choose where to birth their babies without being dictated to by politicians or the medical model.

It is about, trust, integrity, fairness, honour and empowerment. Women know how to birth and where to birth – allow them the right to choose where to do it and to have a named midwife during pregnancy, birth and in the postnatal period.

Teaching in Singapore:

It is always good to go away, but to experience teaching overseas is an exceptional experience. I am happy and grateful to have this experience and share the cultural diversity in which we live. I love my job and am passionate about teaching and doing my part to ensure that women are given informed information to make informed choices.



Life works in strange ways, let me give you an example: anyone who knows me knows I love books, I enjoy walking around bookshops and will visit bookshops where ever I am. I don’t always have a book in mind, however if a cover jumps off the shelf at me, I have to have it. Let me rephrase that, I will read the back cover and then make a decision, 90% of the time I pick the book. Now airports are a great place to walk around the bookshops or newsagents, for some reason they seem to have a different selection of books and I always find one that I like, what a surprise that is! Last trip it was Three Cups of Tea by Greg Mortenson, & David O. Relin, it was an exceptional story, if you get the chance read the story.

This trip it was The Hospital by the River by Dr Catherine Hamlin & John Little. It is a story about an incredible couple; both Dr’s in Obstetrics & Gynaecology who worked in Ethiopia dedicating their lives to women suffering the catastrophic effects of obstructed labour and the awful injuries as a result, that is, fistulas. These women are often from the age of 14 upwards. I have not finished reading the book, but it is both heart wrenching and compassionate. It has opened my eyes in many ways and I am grateful there are people in the world like the ‘Hamlin’s. The story is based in Ethiopia in the early 50’s. It was interesting to read that Sylvia Pankhurst the daughter of the famous Emmeline Pankhurst (the English suffragette) and she set up the Addis Ababa Fistula Hospital which is now world renowned for its incredible life saving work. It is a small world, it makes you think are you born to do great things?

As a child I always remember my father saying he left Italy after the war and went to live Ethiopia & when he was ‘kicked’ out of Ethiopia he moved down to Rhodesia (Zimbabwe)where he met my mother and I eventually came along. I didn’t realise that Mussolini invaded & occupied ETHIOPIA (and thats why my father was there) in 1935 until 1941. I don't like to admit it but my father was one of those fascist, unfortuntaley he was a Mussolini man, well, each to their own. You live and learn.



Now back to teaching – Singapore is a beautiful city however the humidity is more than I can bear at times – I often feel like I am constantly in a sauna, but there is no plunge pool to cool off in. I spend an intensive 12 hour teaching over 3 days. This is usually split into formal lectures, workshops and group interaction. The group are multi - ethnic made of Singaporeans, Chinese, Malay, Indian and others. The religious make up is Buddhist, Muslim, Christian, Hindu, Sikh, Taoist, Confucianism and apologies for the ones I have left out.



The students are always respectful and courteous, family is very important and there is great respect for the elderly in the community. Most people are softly spoken and calm, at times it is very difficult for me to get the students to engage in open discussion, and therefore it is important for me to observe body language before nominating students to answer questions. Sometimes we have long periods of silence whilst I am waiting for the discussion to begin – my next trip I think I will introduce a prize a token gift for those who engage in discussions, and see if this makes a difference. Everyone likes a gift.

I have to ask the question whether it is a good idea to have the Nurses Board in the Ministry of Health, Medical Profession Building under the umbrella of the Medical Profession as in doctors. The building is OK but maybe in a separate office to acknowledge the profession of nursing as a separate entity.
On entering this building the security is evident, you need to show ID and have a pass to enter. In Singapore the Nurses Board, Dentist Council and Medical Council are all in the same building in fact it looks as if it is all in the same office. Under the Nurses and Midwives Act Singapore The Nurses Board consists of two Doctors and 14 other people (nurses). When it comes to disciplinary matters for nurses the doctors assess the fitness of the nurse to work. I wonder if the medical board has nurses on it, and if the nurses have a say as to whether the doctors are fit for work. I think not.
The other difference I saw was that there are midwives in Singapore however the Board or the Act does not reflect the 'term midwife' in it. It is not surprising to hear that the nursing union is not strong in Singapore and that the nurses feel underpaid and would like to be more political, however the cultural differences are noticeable when it comes to being political. I have heard the term 'controlled' Democracy when people have been discussing the politics of Singapore, I now know what that means.



I took some time out to visit the Botanical Gardens, and it was time well spent relaxing, walking soaking up the beautiful scenery and flowers. Shopping is always wonderful in Singapore so much to choose from and the sales were at there peak and the credit card took a bit of a hit – I came home with four pairs of new shoes – shhhh I didn’t tell my husband, I just hope he doesn’t notice –but they were such a bargain I did buy him, a golfing book. The diet also took a pounding as the food is so good it was hard to say no. But I’m home now and back on track with the diet and exercise and the shoes look great. Until the next time, Ciao.

Soooo busy marking papers! no time for blogging!

I am so busy marking papers I can not see the forest for the trees. I am dreaming case studies, law and ethics. Marking is fun when your students are getting it right - however marking is so much harder when they get it wrong, there has got to be a better way of testing knowledge. The biggest issue I am facing is incorrect referencing, paraphrasing or incorrect paraphrasing and PLAGIARISM, role on next semester when I will use a computer system that detects plagiarism for you. I am sure that will make both the students life and mine easier. I found this great site that helps you understand referencing, paraphrasing and plagiarism - have a look and pass it on to others who may be interested it is called The Owl at Purdue:
Must go, marking calls, the joys of lecturing/teaching.....................