The Chaos of Medicine: The New One

Sunday, January 8, 2012

The New One

It's been six months since I started working at the local nursing home. Originally a summer job for six weeks, but I never left. Gradually, there is a transition from being 'the new one' to being experienced enough to solve most problems independently. I can imagine this transition is faster than in most professions because of something most health care professions have something in common: there are not enough people to carry the workload.

During the first few weeks I was surprised about the amount of responsibilities I would have, as I was completely untrained and inexperienced. During evening shifts, I am alone, attending to about 8 patients. I need to know what they can and cannot eat and drink. Without any medical training, I need to be aware of the consequences of diseases. I was also unpleasantly surprised about finding out how easy it is to access patient records. No background checks before I was hired and no limitations to browsing through information of every patient I worked with. Why would they ever do that?

As I worked more, I had a lot of contact with more experienced nurses and assistents. Sometimes I would hear them complain about a colleague who was completely unmotivated and made no attempt to hide it. Still, that person had not and will not be fired. Why? There is no one to replace them. I realized this was the reason why I get so many responsibilities: they have no choice. Not enough trained personnel. The access to patient records is also related to this problem. Patient records are essential in providing good care. When temporary employees are considered substitutes instead of helpers, they do need the access.

The most important question in this situation: is it really a problem? I do think it is. The steep learning curve may be necessary and there is supervision during day shifts and there is always someone available when questions arise. This is not unlike medical school and I have learned a lot during the last six months. My real concern is the vulnerability of the patients with this construction. People are hired too easily. 16 years old? No problem! History of abuse? As far as I know, they would not find out. If they do hire someone who does not belong in a nursing home, this person is only fired in case of serious misbehavior, because there needs to be replacement. During evening shifts, you are alone 90 percent of the time with 8 patients. In my opinion, this system carries a large threat.

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