The System Lets Us Down

I am blessed by having a daughter who is doing what she loves, a Children’s Nurse, working in Paediatric A&E. 

It is a special relationship because I get to speak to her most days. During these times she often shares what life is like during one of her twelve hours shifts. In the department where she works there are usually only two Nurses, sometime three, if they are lucky.  She may have quiet days but mainly her days are full on, and I mean full on. 

She is able to share some of the highs and lows, the excitement, the challenges, and of course those sad moments. We have a relationship where she can share whatever she likes, however dark or difficult, which includes some choice language at times. Even more so during my recent chat with her, where the system lets her down, as you will read below.

As she is primarily ‘in charge’ of the Children’s A&E department, she is juggling priorities all the time, (there is no point in her writing them down, as they will have changed before she has finished writing), triaging the children that present to the department, deciding if their condition is an emergency and needs to be seen by a Doctor to start immediate treatment or if they can wait in time order to be seen, just been informed that there is a sick child being brought in by Ambulance and due here in five minutes, (note to self, is there a bed available in the Resus area?), what about the child that has been here over three hours, if they require further investigations, then they may breach (means going over a four hour limit and the Trust may get fined), need to call the Bed Manager to inform them there could be a potential breach, where is the Doctor I asked for to about ten minutes ago, a parent is getting cross at me, questioning me as to when their child will be seen by a Doctor as she has been waiting for nearly an hour , offer apologies and explain that the Doctors and Nurses are working as fast as they can and her child will be seen soon, this prompts another child’s parent to come up to the desk and ask the very same question, my Nursing colleague who happens to be a new Nurse, (joined the department recently, having just qualified), needs me to do a minor procedure, (which she is not yet trained or qualified to do), goodness the Ambulance will be here in one minute, I have to document all that is happening, each call, each interaction, each conversation whoever they are from, have now been asked by a different Doctor to do something that I do not feel is right for a child, (it is right for an adult), and he is more senior than me, gulp, but I have to tell him, “I do not feel what you are suggesting for the child is correct”, does not go down well, but he understands, although he was arguing with me loudly and in a place where many people could hear, I have to run, the child has arrived in Resus, oh my, this is a really poorly child, she had drowned in a swimming pool, they did mouth to mouth at the pool and in the Ambulance on the way to A&E, she looks lifeless, but we have to try and save her life, the child has been stabilised and transferred to a Specialist Hospital, quick tidy up and restock of equipment that has been used, back in the Department, triaging a new patient, dealing with an upset parent, trying to convince the Doctor they are needed and needed now, and maybe, just maybe, if lucky, a chance for a drink and maybe to use the bathroom.

A brief snapshot of life as a Children's Nurse in A&E, and this goes on and on throughout the shift, and the next shift. 

There are times when she has experienced a child who passes away on the shift, (which is understandably hard on everyone, Nurse and Doctors included, who have been desperately trying to save that life for some time), followed by a set of procedures that need to be carried out, alongside being compassionately there for the parents and family members, who need her support. 

All of this goes on in a small, airless, windowless area, a large waiting room, a few small assessment/treatment rooms and a small open central nursing station where the computers/telephones are located, where parents can come up to and ask questions. The noise when it is busy is constant, frantic, dramatic, never ending. So stepping out into the fresh air and almost silence is truly like a breath of fresh air.

Most days the Nurses get used to it, for many, the drive or ride home has the events of the shift laying on their minds, did I remember to document that incident, did I speak to the parent correctly, what happened to that child we sent off in the Ambulance to the Specialist Hospital, what about the family of the child who passed away? 

Some days she just needs to talk, needs to let it out, some times just to be in the silence and to know that her unspoken words are being heard.

Don’t get me wrong, she is so passionate about her job, loves helping the children and their families, making a difference, and could not see herself doing anything else.

Sadly, as happened yesterday, the system that she works in, lets her and many of her fellow Nurses down big time. A decision was made, actioned immediately and without consultation, which undermines the more senior Nurses and sees them losing some of their potential income. My daughter is one of those impacted and it was tough for me to hear about this sudden change, especially after a day in which she and her colleagues had saved lives, made a difference and put in their whole hearts and souls. 

This is what happens when the system focuses on the head and follows the money, rather than considering the heart and doing what is right for our Nurses and for the patients that they care for each and every day.

Colin Smith, more often known as The Listener. Helping individuals to feel heard, think better and to learn how to listen. https://dexteritysolutions.co.uk