Learn to Speak-UP

The hospital is said to be one of the "toxic" work environments a professional is exposed to. Yeah, "toxic"- we hear it in the laboratory, in the emergency room, in the wards, in almost all of its corners. I came across a discussion forum and even the "call center industry" is quite adapting the word. toxic to its work vocabulary. (Is it due to the fact that some of this industries are absorbing the "nurses" who are in the long-list of waiting their turns to achieve that American dream-"deferred"...)

Take this scenario as example,
The patient who was stable the whole day shift suddenly alarms you with its ailing vital signs, in a few blink of an eye... he goes into shock, you responded like a superhero directing almost all the necessary scene. Your doctor has been called but "darn" he can't fly coz he's attending to a set of patients at the ER. You felt you are doomed, so using all the theories possible, you magnificently done all nursing matters, then the doc arrives... instead of going to "attend" to the dying patient. He continuously fires at you with his foul mouth while you are reporting the measures you have done while doing another multi-tasking to assume the needs of the "master".

He mentions,
"Increase oxygen, give this shot...", then he writes the order. You are still monitoring the patient then the machine falters, you want to scream. You did all your resourceful ways to manage the patient, then he revives. BRAVO! You don't feel good not because the patient has been revived but as you see yourself in the mirror, you have come to realize that you lost your dignity in just a blink of a second.

You wanna release your concerns to a standard "nurses conference". The head nurse is sticking to an agenda that, "Hey we will discuss only the vacation leaves, Christmas is approaching. No buts!" This has become the usual scenario. You tried to convince your colleagues that some of the system are taking part of the difficulties at work, you want to simply end a cycle of inefficiency: when will the new machine be delivered, do we have enough tools and emergency medicines, the telephone lines are scratchy, the charities, the annoying mistreatment of other members of the health team- you basically can't open your mouth because someone just put a warning on the term called, VIP. You're pissed most especially when the other colleague just said her piece of negativity, "It's no use, nothing will change"... A sign of powerlessness.

Nurses are taught to prioritize the patient at all times because the patient is the center-fold beneficent of such care we render. Who takes care of the nurse? the doctor? What I'm trying to say is the idea of speaking up; it should not be impeded for the nurses own release of that "stress". We hear stuff like "verbalization of feelings" in therapeutic communication but the idea should also include the carer. Allowing the nurse to be himself, be human in the work environment should not be a detriment to the institution. The administrative officials may interpret this as "activism" but the core is to basically bring out the best in each of the carer and other professionals. No one dares to cross the administrative level because of the unwritten protocols that has been embedded in the work environment. So as the "silence" goes on, the cycle can be destructive to nurses as an individual and collectively. A nurse should be allowed to complain in order to give rise to work-related issues. This is not about nurse-centered approach activism but this is all about for patient-centered advocacy that requires doses of solutions that is needed for the creation of changes in the system needed.

Certainly, how to avoid that without facing a threat of getting fired from service? Can a nurse be threatened just because he simply informed of cheaper choices on where to buy anesthetic agents wherein his core principle is "just to inform because it is patient's right"?

It takes a collective effort to really materialize those changes. It may start from one work area to another.

In an article by Diana J. Mason, PhD, EIC of American Journal of Nursing, she wrote the following in which the article discussed about "nurse's powerlessness":

1. Identify the most pushing challenges in the immediate environment.
2. Initiate dialog with colleagues to find solutions to the problems.
3. Remain actively involved in the solutions until they're working.

No one should be fired for being assertive in speaking out nurse's concerns, one should be allowed to speak and respect, even when angry...