Superiorirty Complex

I'll be writing something down here about my work today.

I have a friend, a colleague actually and I've always known her to be a jolly person. I have seen her laugh and giggle all the way through a tough crunch back when we were in the medical ward and I swear to all that is holy that I have never seen her more pissed than she was today.

It started as a usual day, a happy almost perfect day in the pediatric ward. And while we were performing our role as linen staff (one of the jobs rolled into nursing) someone expected but dreadingly uninvited walked in and disrupted our peaceful day in the ward.

He was... someone important and for most guys in the field, who would be important enough to disrupt our routine? Yeah, you probably guessed it. ;D

He started asking questions in a very rude way and before my friend even begun answering his queries, he had another question in mind. Now, I don't know what in the world is wrong with this guy, but for someone in his stature to actually treat a nurse in that manner is just out of the question. I mean, I don't care how many pro bono jobs he did for people but I sure don't like the way he treats nurses.

Now, going back, it seems that our colleagues in the field seemed to have over-stepped their boundaries in the nurse-doctor relationship (oops! did I just drop that?!). Well yes, going back to the topic at hand, It seems to me that some of our beloved doctors have forgotten that they are working with nurses, not nurses working for them. Yes, and I would like to emphasize on the word with.

You see and I am sure most nurses out there will agree that while doctors are team captains, they still need a team to work with; and that team is comprised with lots of nurses. While MDs are obviously more versed than RNs in terms of know-how, it is the RNs who are directly involved with the patient. I mean, and not referring to my current floor, I honestly do not see most of the APs monitoring vital signs every hour, suctioning oral secretions, or changing diapers, no! They don't do that, they figure out whats wrong with the patient and get people, nurses included to work for the improvement of the patient. Yes yes, I understand, they didn't sign-up to do that but hey, nurses also didn't sign up as secretaries and doormats for these doctors as well. We signed up because we wanted to go abroad! (oops! just kidding!) Nurses may not be the one prescribing treatment plans but hey, its not only the MDs whose necks are on the line, RNs have licenses too, and at least by that, we deserve to be treated as professionals not as trash. (photo from Batman, the Dark Knight)

Now, I understand that in advanced countries, the relationship between MDs and RNs did not develop to be this devious. There is a danger presented by the concept of MDs being superiors than RNs and MDs working in a healthy relationship. Author Malcolm Gladwell perfectly illustrates this faulty relationship in his New York Times bestseller book, Outliers: The Story of Success and termed it as "Culture of Honor" where according to his research, the Philippines rank among the top five countries with a strong sense of 'culture of honor'. So what exactly is this culture of honor? To give you the concept in a nutshell, it was exactly what happened to my friend this morning when the not so friendly doctor made his rounds. She (my friend), trying her best not to anger the doctor who she perceived at that time was someone who could have her head served in a platter, talked in a calm and almost submitted manner to the doctor and just took in everything he said, even saying "thank you" when the doctor left. And there you have it, culture of honor. So, how is this relationship detrimental? Well, in a sense, nurses, particularly new ones such as myself are afraid to challenge the orders the doctors are making even if we are sure, something is wrong.

I've been told by one of my supervisors (and God I hope she's not reading this) that I'm growing to be a bit rude by losing the 'mam' and 'sir' titles when I address my colleagues and by calling doctors with their first name. Well, go on and read Outliers and you'll understand the importance of calling people by their first names in effect to working efficiency rather than emphasizing on seniority and title.

Hope you enjoyed my post and God bless,

- Josh

Life as a Pinoy Nurse

During the last NLE (the board exam for nurses in the Philippines), about 90,000 (yes, 90K) BSN graduates braved the local boards hoping to get a foot forward in their plans to work abroad.

In the not-so-distant past, there were less than ten thousand examinees taking the qualifying exam; but for some reason, this BOOM in nursing is attributed to it's considerable demand abroad. All over the Philippines, there had been a significant decrease in the number of enrollees in every nursing school, and there should be for a very good reason.

I entered nursing school in 2004, I was under the impression that if I passed the NLE, I'd take the NCLEX and fly away as soon as its over. Those were the days when we had about 10 sections comprising of no less than 35 students each. GREAT! But hey, before any of you readers out there think of saying to your newly out of high school friends "mag nursing ka nalang", better stay a while and read through what nursing is really all about and let me give you a quick list.

1. Nursing is not for the poverty-stricken public.

I know, you've seen the dramatic tele-novelas of a pretty young girl abused and she took up nursing, graduated, became a nurse, met the love of her life, went abroad and became thick rich! Well, thats not the case, in nursing, you will be spending a great deal of money just to make it to graduation and unless you come from a family that could help you with that, might as well look for another field.

2. Nursing is not a pass-port out of the country.

Again my friends, do not be fooled! In the not so once-upon-a-time years, nursing was a sure hit to get employers on your heels and to get a passport to other countries offering more opportunities for nurses but hey, it's 2010, the world is in crisis and good luck to you in finding an employer who's willing to pay for your ticket. EVEN if you do possess a visa to the US, it's not a working visa, so think again.

3. Nurses are trained to save lives and kiss asses.

Yes my dear friends, kiss asses, your eyes aren't fooling you and between the two, saving lives and kissing arse, you're more likely to end up with the latter. Although I must admit, there is a priceless reward when you contribute to saving someone's life.

4. Nurses undergo a lot of training.

Most hospitals have a list of requirements for nurses before being accepted into TRAINING. Basic Life Support, and Intravenous Therapy is just for starters and I would recommend just getting the two of these. There will be a lot of other courses out there but they will just be a decoration for your portfolio. BLS + IVT, thats about 3,000 pesos off your pockets and if you're a fresh nurse from the local boards, thats a lot of money. Oh and the PNA membership, another 500 pesos.

5. It's not a lucrative job.

Whoops! Are you a bread-winner hoping for a better life as a nurse? Well, you won't be getting it any time soon. Unless you have someone to back you up in a hospital, you'll be climbing up the ladder slowly. Training, Volunteering, N1 or floaterhood, probationary, and finally! To be a staff! Training costs a lot of money, in my case about 5,000 pesos (100+ USD), for a chance to experience being exposed to different areas in the hospital. 5,000 pesos and you get to go to the hospital without pay; it's like attending school again. Hmmm what else? Oh, thats about 8K now plus IVT and BLS. What about the period of volunteering? Well, you get to work for free. And floaterhood? You get to work 5 days per cut-off with the minimum wage. Probationary? You get full schedule minus the benefits. And staff? Well, you get less than 15K per salary. YES! All that trouble for LESS than 15K! And agencies will ask for no less than 150K during your applications.

6. It's a time killer.

Wanna grow old? This is the job for you. Well, in my case, I spend no less than 10 hours every day in the hospital stressing myself out. I learn yes, but when I think about it, why did I do this again?

7. It's an expensive choice for a chance to go aborad.

Other than the afore-mentioned expenses, you of course, want to work abroad and the land of opportunity, the United States is a very tempting option but before you say yes to the enduring profession in which I hope to have opened your eyes to by now, I would do you a favor of telling you about the expenses you will be having when you decide to go for the US.

1. The NCLEX, application, exam proper, etc. It's a very expensive examination for a Juan dela Cruz nurse who will be taking it. It cost me about 600USD in total, apart from the review.

2. IELTS/TOEFL IBT. This costs about 150 to 200 USD.

3. VISA SCREENING. About 500USD.

Hey! What about other countries? well, get experience first. About 2 years is the minimum, IF, you can endure the schedule and salary that is.

So, whats it like to be a nurse here? I'd say I sacrificed about a year of my life now, and I still will be doing so for more years to come.

Listen buddy, if the list I mentioned above earlier wouldn't cut for you, don't go into it. If you're a highschool kid looking for a career in the future, I'd advise you to look elsewhere. Nursing requires a heart for service, something I had to look for during the 1 year period I have been working as one and I still haven't convinced myself that this is my life, the life that I chose, the life that I will be living. So, if your parents are telling you to go into nursing and you don't have a clue, now you do. You might want to discuss this with them

God bless,

- Josh