Doctors and nurses-are you happy here?

mcdermla

Sitric wrote: »

"newbies in every job get treated like ****"

Do they though? My background was engineering and I was really well treated in every job I had.

Does this just happen in medicine/nursing? Or is it Ireland? Is it really as bad as some of the threads on here portray?
I have a bunch of friends in the middle of their internships in Sweden and Norway and they all love it. Even the guys in the UK and Scotland seem pretty happy.

Even worse than bloods, why in the name of god do doctors have to take the ecg's? And again, i'm not finished school so my impression of this problem is based on hearsay. Maybe it's not true. Is it? However, I worked abroad as a nurse in an a&e last summer. All ecg's taken by the nurses. Got zero training in how to take an ecg because that's exactly how much training is required.

I can't speak for every job out there but in my experience student nurses get the menial work, which is a shame because that'll keep you busy all day and you don't learn anything unless you're on a specialist ward or have a nurse willing to teach you things. So for the first three years of the degree you do free laboour; they put 90 euro towards travel expenses for every six weeks of work but this may be done away with soon. That being said I remember during my theatre placement the CNM talked me through so much and taught me all the surgical vocab, and a consultant surgeon talked me through a mastectomy while he was doing one, which was way too much for me to hear obviously but it shows he takes an interest in students. I've had some ****ty experiences, on some wards there isn't a lot to learn. But I remember one ward that was full of elderly people and one had myxodema and it came up in one of my exams, and I wound up getting a first in it, so I suppose you learn by osmosis, everything teaches you something.
In A&E the nurses are trained to take ecgs but inevitably doctors wind up doing it too. Some hospitals have cardiac technicians who'll do it (that's open to correction!)
I worked in a hotel for nearly a year as bar staff and our conditions were appalling; the ladies changing room stank and the staff toilet's door handle was broken for months, and the shower had spiders in it all the time. It was a bit insulting to work long hours and be expected to not complain, but it's like that in a lot of places. And the duty managers of course had less hours and better conditions. So as far as I know, hierarchy definitely makes a difference where you work. Sorry that was super long and probably irrelevant!

mcdermla

Sitric wrote: »

There is a HSE document/program looking at taking advantage of the fact that almost all of the foreign trained nurses working in Ireland are trained and competent to take bloods. I think it was also looking at what training was required to "upskill" (what a word) any nurses not able/not happy to draw blood.

Has anyone seen this? I read it ages ago and can\t find it now.

Haven't heard of it but it sounds like a good idea. I remember a lecturer telling me that she has some nursing friends who complain that they spend more time doing paperwork than actually seeing to their patients.

docbroc

Know ye nothing of nursing politics ? An Bord Altranis and the INO are worse than the mafia. If you wonder why nurses wont take ecgs/bloods/cultures/use central lines/give first doses its because they use them as a stick to hit the HSE for more money. Everything a nurse does or doesnt do is the subject of laborious negotiations of which patient care doesnt even get a look in. I remember in a certain hospital in the west where overnight a particularly crazy matron decided no nurse would give any IV medications. Or even inform anyone when those medications were due. It took over a year to sort the mess out, the mortality rate was huge. It only ended after this uberbitch was promoted ( cant be fired) to a cushy job in another hospital. Where she promptly tried the same thing again. Each nurse had to be sent on a weeks course and paid several thousand pounds in training fees to "upskill" to do a job they had been doing for decades.

On the ground I find nurses to be great but if you have any dealing with the upper echelons watch out. Part of the reason working conditions for NCHDs are so terrible is that large amounts of time are spent doing nursing jobs. We are effectively subsidising their 35-37 hour weeks by working 60-70 hour weeks. There are hospitals where the nurses in coronary care units wont do ECGs, haematology units where the nurses wont take bloods. Instead they rely on some half dead intern/sho to do the job for them. Its madness and it jepordises patient care but sadly..............

mcdermla

docbroc wrote: »

Know ye nothing of nursing politics ? An Bord Altranis and the INO are worse than the mafia. If you wonder why nurses wont take ecgs/bloods/cultures/use central lines/give first doses its because they use them as a stick to hit the HSE for more money. Everything a nurse does or doesnt do is the subject of laborious negotiations of which patient care doesnt even get a look in. I remember in a certain hospital in the west where overnight a particularly crazy matron decided no nurse would give any IV medications. Or even inform anyone when those medications were due. It took over a year to sort the mess out, the mortality rate was huge. It only ended after this uberbitch was promoted ( cant be fired) to a cushy job in another hospital. Where she promptly tried the same thing again. Each nurse had to be sent on a weeks course and paid several thousand pounds in training fees to "upskill" to do a job they had been doing for decades.

On the ground I find nurses to be great but if you have any dealing with the upper echelons watch out. Part of the reason working conditions for NCHDs are so terrible is that large amounts of time are spent doing nursing jobs. We are effectively subsidising their 35-37 hour weeks by working 60-70 hour weeks. There are hospitals where the nurses in coronary care units wont do ECGs, haematology units where the nurses wont take bloods. Instead they rely on some half dead intern/sho to do the job for them. Its madness and it jepordises patient care but sadly..............

Heh, mafia! Wish I could say it myself but unfortunately I'm still only a student so have to remain diplomatic.
I've met some interesting CNMs in my time. I remember one who expected me to know everything about a patient I had never been assigned to, and berated me in front of the entire nursing staff for not taking a keener interest in patient care. It turns out she didn't know anything about the patient and was using me as a scapegoat. It was pretty bad.
To be fair, I know a lot of nurses who wish they had more hours. There's no over time at all now for nurses and, as the pay is pretty average, 35-37 hours a week is hardly enough. I know there have been strikes, but pay has always been the main issue. If they had more responsibility their pay would increase, so naturally they're given the bare minimum.
I agree that some nurses won't do what they're trained to if there's an obliging intern around, I've seen it happen. I've heard stories of interns being abused by nurses and as soon as they get higher in the job, turn around and abuse the nurses. This is just hearsay though, feel free to correct it.
Doctors and nurses traditionally worked together with patient care as their priority, but then politics and hierarchy got in the way. It's a messy one to fix.

Sitric

docbroc wrote: »

If you wonder why nurses wont take ecgs/bloods/cultures/use central lines/give first doses its because they use them as a stick to hit the HSE for more money.

Part of the reason working conditions for NCHDs are so terrible is that large amounts of time are spent doing nursing jobs. We are effectively subsidising their 35-37 hour weeks by working 60-70 hour weeks. There are hospitals where the nurses in coronary care units wont do ECGs, haematology units where the nurses wont take bloods. Instead they rely on some half dead intern/sho to do the job for them. Its madness and it jepordises patient care but sadly..............

These jobs were a big chunk of my days work as a nurse. I was lucky in that the rest of the nurses working there were all pretty senior so they had years and years experience, I got taught a lot. But there was no way we would wait for the doc to do this stuff, there was a nurse doc ratio of around 4:1, the place would have stopped working if we'd had to wait everytime.

Sitric

" It was a bit insulting to work long hours and be expected to not complain, but it's like that in a lot of places. And the duty managers of course had less hours and better conditions"

Regarding this point, i've had lousy jobs over the year, particularly part time student jobs where the conditions were pretty dreadful but i've never experienced these conditions as a professional, people wouldn't stand for it

mcdermla

Sitric wrote: »

" It was a bit insulting to work long hours and be expected to not complain, but it's like that in a lot of places. And the duty managers of course had less hours and better conditions"

Regarding this point, i've had lousy jobs over the year, particularly part time student jobs where the conditions were pretty dreadful but i've never experienced these conditions as a professional, people wouldn't stand for it

This was a full time job, and most of my colleagues were older than me and working there a lot longer than me. It was professional for them

sam34

Sitric wrote: »

These jobs were a big chunk of my days work as a nurse. I was lucky in that the rest of the nurses working there were all pretty senior so they had years and years experience, I got taught a lot. But there was no way we would wait for the doc to do this stuff, there was a nurse doc ratio of around 4:1, the place would have stopped working if we'd had to wait everytime.

i've worked in about 9 different hospitals in this country and in each and every one it was the doctor who had to do bloods, ecg's, cannulation, first doses etc

its a major cause of inefficiency in the system

mcdermla

sam34 wrote: »

i've worked in about 9 different hospitals in this country and in each and every one it was the doctor who had to do bloods, ecg's, cannulation, first doses etc

its a major cause of inefficiency in the system

That's weird because as far as I'm told, nurses only do ecgs in a&e, and everything else is the responsibility of the doctors. Not saying that's right but in my experience a lot of nurses aren't allowed to do them, unless in a&e, and it depends on the nurse and their training

sam34

tracker-man wrote: »

If you had been forewarned, would your decision to do medicine have been influenced in any way? If you had all the nasty details would you have considered something else? Or still done medicine...

sorry, just seeing this now

all things considered, i would still have done medicine

but i was very naive going into it and really had no idea what was ahead of me

i would have liked to have some realistic idea of what lay ahead, so that it didnt hit me like a train when it happened

i coped, obviously, but it was damn hard, a struggle at times and i think that forewarned would have been forearmed

i'm not trying to dissuade anyone from doing medicine, but i'd hate for anyone to get to a stage where they say "if i had known then what i know now i wouldnt have done it"

it must be really sh1tty to get to a stage where you say that after devoting so much to your career

Sitric

I am actually very grateful to some of the posters here for giving me a more balanced picture of how working as a junior is going to be.

I come from an engineering background, where it could be very stressful but was pretty well paid and if we had to work a 60hr week we were very well looked after, not sure if i'm ready for the reality of the endless shifts without sleep. I've done a lot of on call work and many many nights and your concentration and speed of thought really can suffer sometimes but I was working with computers and electronics so if I made a mistake or took a bit longer to fix something, well it cost money but nobody died. That scares the sh#te out of me.

Don't get me wrong, I love it, i've never enjoyed anything as much in my life as the study of medicine but i'm afraid the practice under those conditions won't live up to my expectations.


"i've worked in about 9 different hospitals in this country and in each and every one it was the doctor who had to do bloods, ecg's, cannulation, first doses etc
its a major cause of inefficiency in the system"

Sam34, or anyone else for that matter, do you think anything can be done in Ireland to change the situation above? They seem to have managed it in the rest of the world.

Narkius Maximus

Sitric wrote: »

I am actually very grateful to some of the posters here for giving me a more balanced picture of how working as a junior is going to be.

I come from an engineering background, where it could be very stressful but was pretty well paid and if we had to work a 60hr week we were very well looked after, not sure if i'm ready for the reality of the endless shifts without sleep. I've done a lot of on call work and many many nights and your concentration and speed of thought really can suffer sometimes but I was working with computers and electronics so if I made a mistake or took a bit longer to fix something, well it cost money but nobody died. That scares the sh#te out of me.

Don't get me wrong, I love it, i've never enjoyed anything as much in my life as the study of medicine but i'm afraid the practice under those conditions won't live up to my expectations.


"i've worked in about 9 different hospitals in this country and in each and every one it was the doctor who had to do bloods, ecg's, cannulation, first doses etc
its a major cause of inefficiency in the system"

Sam34, or anyone else for that matter, do you think anything can be done in Ireland to change the situation above? They seem to have managed it in the rest of the world.

U.S.: work about 80hrs/week, strictly regulated. It's very demanding but they produce 'attendings' in 3-5years.

U.K.: Max 48hrs, apparently, shift work for all grades of trainees. They've invested heavily in employing more doctors, appointing staff grade doctors etc to attempt to ensure EWTD compliance. It works to a degree.

Dunno about Oz/NZ but everybodt raves about the place so they must be doing something to keep people happy.

Ireland: Employ just enough juniors to keep system going. Rely for years on getting doctors to work overtime, up until recently, 2001-02, without pay. Gradually increase numbers but still not enough. Publish Hanly, Buttimer, Fottrell reports on EWTD, and training in general. EWTD known for years but ignored. Financial crisis, budget cuts, attack NCHD pay, implement EWTD for 'safety', 48hrs continually ignored, wages not paid but hours worked. Piss off sufficient numbers of trainees, they emigrate. Medical council decide that non eu doctors, who prop up our health system with very little thanks, have to get a new visa per new job (3-6 month contracts, and charge a couple of hundred snots per visa). Ireland now a very difficult place to come to work. Manpower crisis waiting to happen. Then decide that for every new consultant 2 NCHD psots to be sacrificed, following on 900 NCHD training spots to be cut for July 2010. Oh did I mention? More graduates than jobs in 2012. Absolutely Genius.

Every country has there problems, ours worse than most because of lack of vision from all authorities-HSE, DOH, Training bodies, individual consultants etc etc.

To change, we need a massive shift of mentality, otherwise the gash that is seeping a lot of our graduates abroad is going to open into a gush, and those left will struggle in the mire.

Sorry, very bitter today. USMLE studt driving me bonkers.

Sitric

I hope you have the goljan lectures!

I am thinking about doing all my postgrad training abroad, actually giving serious thoughts to the US. A friend of mine just got a really decent residency in NY for emergency med, it's tempting! That exam though......

lonestargirl

Sitric wrote: »

I am thinking about doing all my postgrad training abroad, actually giving serious thoughts to the US. A friend of mine just got a really decent residency in NY for emergency med, it's tempting! That exam though......

I have a friend (US citizen, RCSI grad) who just matched EM too. It's a nice residency program, 3 years, all the rotations in the emergency room are shift based so there is no call (in his program you do 16 12hr shifts per month), you still have to do floor/SICU/CCU rotations which do have call but it's not so bad when you are mixing them with non-call months. This friend is currently a surg prelim resident and both he and my husband are on EM this month, same shifts and everything. I wonder if the patients are perplexed by all their residents having Irish accents!! All the attendings are impressed with their ability to diagnose based on physical exam rather than blindingly giving everyone a CT.

Sitric

(in his program you do 16 12hr shifts per month)

Wow, that's just 48 hr's a week! I would almost say that's too good to be true but I know my friends program is 4 yrs with max 56 hrs per week, shift based too. He's already worked a summer in this ER so knows it's not bull, that's the max they work. Sounds alright no?

mcdermla

Sitric wrote: »

(in his program you do 16 12hr shifts per month)

Wow, that's just 48 hr's a week! I would almost say that's too good to be true but I know my friends program is 4 yrs with max 56 hrs per week, shift based too. He's already worked a summer in this ER so knows it's not bull, that's the max they work. Sounds alright no?

Wow that seems so doable and so much safer. I'm defo not staying here if I do medicine

nevevix

HI all,

im a nurse, RGN Graduated 2 years ago this august. I went straight on to do a msc by research after graduating. I do like nursing but from the time I was training I knew I didnt want to stay in nursing forever. I thought I wanted to do the msc & then the registered nurse tutor course in galway and then look for teachin exp & try so lecturing but I know know its not me. I did some lectures to the 2nd year Bsc students & did enjoy it, but academia is SO SOOOO far from what I thought it wud be. Im due to finish my msc nexy april & Im SOOO clueless as to what to do. I am thinking about sitting the LC chemistry & applying to do pharmacy either at RCSI or Sunderland. I have never did chemistry but I enjoyed pharmacology in college & i really want to further my career. It hard keeping motivated doing my msc now though coz I know that I will do somthing different next year. I will either apply for pharmacy & I will have to work my ass off for 4-5 years and I know I would be SO happy then if I got it, but Im terrified I wont be able for it etc & its financially going to be difficult. Also, I heard pjharmacy in ireland has a very high failure rate & sunderland is much easier but I wud be happier doing it here coz I dont want to move to england but If i thought I would fail here I would go to sunderland. If i dont do pharmacy I would probably apply & do public health nursing which would be ''ok''. I would like it but I know deep down I would always think ''what if'' etc. but I know doing Public health is an easier option.... i dont know! i really am confused and need advise pleeeeeeease! just finished a 15 hour shift & need some advise haha


thanks
:D:D:D

femur61

Just to clarify I am neither a nurse or pharmacist. To the layperson and who has friends in both. The reason it is easier to qualify in Sunderland because at the end of the day you don't make decisions on medication neither do nurses but they don't pretend they do by only letting the elitely intelligent in to their profession. Nursing is an invaluble job, the nurses work so hard here.

Pharmcists are don't have the authority to prescribe medication or diagnose a serious illness. Neither does a nurse but that is the reason why in the UK you don't need as many points to obtain a place on the courses.

Mary

locum-motion

If Pharmacy is what you want to do, why restrict yourself to just two Schools?
There are 16 in the UK and 3 in ROI. Apply to them all.
Before you do, though, ring them and ask them would they be willing to consider an application using your nursing degree and MSc. It's possible that they might not require you to do the LC Chemistry, particularly if there's any/much Chemistry involved in the Masters.

nevevix wrote: »

HI all,

im a nurse, RGN Graduated 2 years ago this august. I went straight on to do a msc by research after graduating. I do like nursing but from the time I was training I knew I didnt want to stay in nursing forever. I thought I wanted to do the msc & then the registered nurse tutor course in galway and then look for teachin exp & try so lecturing but I know know its not me. I did some lectures to the 2nd year Bsc students & did enjoy it, but academia is SO SOOOO far from what I thought it wud be. Im due to finish my msc nexy april & Im SOOO clueless as to what to do. I am thinking about sitting the LC chemistry & applying to do pharmacy either at RCSI or Sunderland. I have never did chemistry but I enjoyed pharmacology in college & i really want to further my career. It hard keeping motivated doing my msc now though coz I know that I will do somthing different next year. I will either apply for pharmacy & I will have to work my ass off for 4-5 years and I know I would be SO happy then if I got it, but Im terrified I wont be able for it etc & its financially going to be difficult. Also, I heard pjharmacy in ireland has a very high failure rate & sunderland is much easier but I wud be happier doing it here coz I dont want to move to england but If i thought I would fail here I would go to sunderland. If i dont do pharmacy I would probably apply & do public health nursing which would be ''ok''. I would like it but I know deep down I would always think ''what if'' etc. but I know doing Public health is an easier option.... i dont know! i really am confused and need advise pleeeeeeease! just finished a 15 hour shift & need some advise haha


thanks
:D:D:D

SomeDose

femur61 wrote: »

Just to clarify I am neither a nurse or pharmacist. To the layperson and who has friends in both. The reason it is easier to qualify in Sunderland because at the end of the day you don't make decisions on medication neither do nurses but they don't pretend they do by only letting the elitely intelligent in to their profession. Nursing is an invaluble job, the nurses work so hard here.

Pharmcists are don't have the authority to prescribe medication or diagnose a serious illness. Neither does a nurse but that is the reason why in the UK you don't need as many points to obtain a place on the courses.

Mary

Your post makes little sense. The points/entry requirements for courses are based on supply and demand, with a certain academic standard factored in also. No more, no less.

And, in case you weren't aware, suitably qualified pharmacists and nurses are permitted to prescribe in the UK.

Mr Cawley

Narkius Maximus wrote: »

More graduates than jobs in 2012. Absolutely Genius.

Every country has there problems, ours worse than most because of lack of vision from all authorities-HSE, DOH, Training bodies, individual consultants etc etc.

To change, we need a massive shift of mentality, otherwise the gash that is seeping a lot of our graduates abroad is going to open into a gush, and those left will struggle in the mire.

Sorry, very bitter today. USMLE studt driving me bonkers.

could you elaborate on this please? Thanks

Sitric

lonestargirl wrote: »

I have a friend (US citizen, RCSI grad) who just matched EM too. It's a nice residency program, 3 years, all the rotations in the emergency room are shift based so there is no call (in his program you do 16 12hr shifts per month), you still have to do floor/SICU/CCU rotations which do have call but it's not so bad when you are mixing them with non-call months. This friend is currently a surg prelim resident and both he and my husband are on EM this month, same shifts and everything. I wonder if the patients are perplexed by all their residents having Irish accents!! All the attendings are impressed with their ability to diagnose based on physical exam rather than blindingly giving everyone a CT.

"(in his program you do 16 12hr shifts per month)

"Wow, that's just 48 hr's a week! I would almost say that's too good to be true but I know my friends program is 4 yrs with max 56 hrs per week, shift based too. He's already worked a summer in this ER so knows it's not bull, that's the max they work. Sounds alright no? "

How is your friend getting on Lonestar?
Met my buddy last week, seems he was a little optimistic. He's averaging 80 hrs per week, without OT. Loves the job when he's there but hates his life. He looked exhausted, extremely skinny.