Working Conditions in Philippine Hospitals

[LadyHazy]

So I was fortunate enough to get a job at a private tertiary hospital recently. I am very grateful for my job: The pay is good, the benefits are better than practically all of the hospitals in the area, and the staff is friendly and supportive. The working conditions in this hospital are also better than most. It comes nowhere near the ideal 1:4-5 nurse to patient ratio, but I'll take it over the ratios they have over at large public hospitals any day.

The thing is that I've been assigned on what is probably the most challenging of floors in our hospital. Like the other floors, we can handle as much as 15-18 patients at a time but my working place is THE place for unstable patients. While other nurses will flinch at the sight of one patient with an ET or Trache to a Mech Vent, an NGT, an FBC, and two IV lines, I can and have had up to three such patients at one time (with about ten other more stable patients on the side).

Don't get me wrong: I like it here better than the other floors. It's challenging in a way the other wards could never be. However, when things get busy (as in a code, or a single patient's v/s going unstable, or simply a bazillion new doctor's orders at a time), I get extremely delayed with my work. It's so exhausting that I get prone to other little slip-ups that my ego is left wounded and questioning whether or not I truly deserve this job or to even be a nurse, for that matter.

Most of the older, better, and more experienced nurses I work with have gotten used to this routine, and I figure that I probably will get used to it too, eventually. However, I do think our patients deserve better than this. Eight hours can only last so long, and so it's virtually impossible to find the time to turn three patients to sides or to measure intake and output every two hours without the SO's full cooperation, especially when you also have orders to suction secretions every hour and to feed two patients per NGT every four (unlike the ICU, we do not have enteral feeding pumps, so you're essentially standing there, feeding with an asepto syringe watching precious minutes tick away.)

Yes, I can finish all my priority work, but I kind-of miss doing all the little things that define nursing care, things I were able to do back in my student days when my patient loads were significantly lighter. I once was able to successfully distract a little boy from pain by talking with him and helping him draw some of his favorite cartoon characters (not a traditional nursing intervention, but it worked better than his meds did!) Now, my idea of pain management is tramadol or whatever-in-the-world-the-doctor-ordered and nothing much on top of that. I had no idea how much nursing as an RN is different from nursing as an SN... Patient loads do make a difference; I think I can attest to that.

I hear working/hospital conditions are no better across the country. So my points for discussion are:

What do you think of the working conditions in the hospital where you work/volunteer and what are they like?

Why is the Philippine hospital system like this?

What effect do these conditions have on your patients/clients?

How could we make these working conditions better?

[official02]

What do you think of the working conditions in the hospital where you work/volunteer and what are they like?

I am working as a volunteer staff nurse in a public tertiary hospital. The patient's census is ranging from 22-35. The ratio of staff is 2 staff nurse, 1 nursing attendant, 2-4 volunteer staff nurses. Staffs here have good working relationship with each other which makes the work more lighter. Most of the patients are stable although there are some who are critically ill and necessitates advanced nursing care. It is always like there is a mini-ICU in the ward. For instance, a single patient has NGT, Tracheostomy, Oxygen with suctioning and nebulization orders, CVP line, Catheter, IVF, and worse if with mechanical ventilator. So, you get the picture? Really needs tremendous attention. Moreover, we need to bring some patients away from the floor and back to the floor for check-ups which is really exhausting. What makes this condition favorable for the staff nurses and NAs is the large pool of unpaid, volunteer, registered, professional nurses who renders the fundamental, direct, hourly patient care.

Why is the Philippine hospital system like this?

Nothing new. The government gives low priority to the health care system. Public health care delivery system is detrimental to the unfortunate ones. Patients expect a competent care but to no avail is far-fetched. Nurses exerting much effort to attain the best possible quality care given to patients are always limited. Low nurse to patient ratio, work overload, no job security, little benefits, and you always need to go hierarchical system which is politically damaged. New registered nurses aiming to secure a good paying job find their place to too much exploitation from the olds. The government has never appreciate our existence and importance.

What effect do these conditions have on your patients/clients?

How could we make these working conditions better?

It is far from idealism.

Give the government an empowering seismic waves for them to wake, learn, and act!