Sunday, February 26, 2012

The inside scoop on Hospitals in Mexico

First of all I have to remind you I'm by no means and expert on this considering this is the first hospital I have worked in. But I do ask our new nurses where they worked before and what it was like. It seems to me that we are the norm as far as private hospitals go. The only place that is more standardized like I am use to is the IMSS.  The other thing about the nursing jobs here is that the pay is so very low. Most nurses get no more than 4-5,000p a month. I am getting more than that because I entered at a supervisor level. The nurses at the IMSS get 7,000 a pay check and only work three twelve hour  shifts per week. Which is way more money and way less hours than me. My plan is to go sign up for a job at an IMSS but apparently it takes years to get accepted into one of the positions.
Basically when you walk into my hospital it is beautiful. It reminds you of a hotel but with nurses stations. The nurses are well educated in school but once they are out the hospitals do not maintain a proper continuing education program. This is something I have been pushing for since I got into the hospital. No one seems to understand the importance of it. Or like many people have told me the higher ups are just afraid to give to much education to the lower positions. This is not only in the hospitals but pretty much is the rule in the work force here. To be honest the only personal experience I have in the states is in Hospitals and the last one was a teaching hospital so this totally rubs me the wrong way. Im going to do my best to keep this post objective and not go into my rants. So here I wont explain how utterly important it is for continuing education in health care.

Since October I have tried to encourage changes such as continued education, starting an orientation program for new nurses, placing resources for the nurses at the nursing stating (drug books, references on processes, an easier and safer documentation practice, etc.) And everything I try to implement gets denied. I am basically not being allowed to do what they told me they hired me for. Finally I asked for a job description because my position was completely made up. I was getting sick of wasting my time trying to plan and implement things when I was always held up and denied at the last min. I had no idea what the heck they wanted me to do from day to day. Now I am a Supervisor B, with basically administrative duties. To explain it best Im doing all the crappy paperwork that the head nurse doesn't have time to do.

The worse part about all of this is that the things they do focus on are so silly. They are insane about the dress code. For example I have gotten "talked to" like three times for my presentation. The first time was because apparently I wasn't using enough bleach on my uniforms. Then it was that I don't paint my shoes enough and the looked dirty. They were clean but scuffed, here you have to wear the old school leather white nursing shoes. Can I hear a Blech from any nurses out there. This last time I was told that my little fly always were to messy and I need to start putting gel in my hair. And don't get me started on my tregas earrings. Basically the supervisor in charge of checking this sort of thing was ticked off because I explained to her that she was doing something illegal and when she argued with me about it I brought it to the head nurse. What was she doing  you might ask. Well in health care we write with pen only in the charts. This is so that nothing can ever be erased. If you make a mistake here you are suppose to put (parenthesis) around it and rewrite what you wanted. One day I found some nurses taking pieces of tape and ripping off what they had written and writing over it. I very nicely explained to them that this is the same as using white out and is illegal. A short time later one of them told me that the Supervisor does it all the time. YIKES!!! So the same nurse who walks around sending people home for scuffed shoes and fly aways thinks its ok to falsefi documents as long as you cant tell. Yes that is what she told me when I confronted her about it. That the nurses shouldn't do it because when they do it its ugly but when she does it it looks nice and you cant even tell she did it. Sigh!!!!!!!!!!!

To be honest a lot of the problems within the private hospitals here (and yes I have asked around) is the chain of command or lack of use of it. For example the above mentioned Supervisor is no more than a supervisor. But many of the changes I have wanted to make the head nurse thought were valid and could work. This of course was when I as alone in her office with her. But when we would bring it to the Supervisor meetings I would be immediately shut down by this supervisor. And worst of all the head nurse would immediately agree her. Basically if it comes out of my mouth they quickly scruntch up their lips and shake their heads no.

Also the horrible communication. They are giving us a course on Lean Healthcare which is a system of organization and communication from Japan. We used this system at the last hospital I worked at in the states and it was great. But to be honest with the way things are here its next to impossible to implement any of it. We have no intranet, all the supervisors of nursing and the head nurse use the same email address, there is no calender of events or meetings. You usually don't know about a meeting until like 10min before hand. Mind you most of this kind of thing doesn't really reach the patient but turns out to be a horrible working environment. And happy nurses make happy patients.

The few suggestions of mine that have been put into place they are sure to wait a few weeks after I suggest it and then suggest it as if it were their idea. This also is very common in all the workforce down here. There is no since of encouragement to employees who do have good ideas. They are to afraid you will raise up above them. Again this is so hard for me to swallow because the hospital I came from encouraged growth. I never push this kind of thing or try to make sure everyone knows the idea came from me. This is because I know they all know and there really isnt any point anyway. I have finally given up on giving any ideas for the betterment of anything. I realize that if I do they will just get turned down. I have resigned to just doing what they ask of me and no more. My husband made it very clear that this is what is expected here. And Im finding its true. The supervisor I mentioned above has back off quite a bit. This all makes me so sad because I have so much to offer and instead Im organizing the charts of discharged patients and doing secretary work.

Actually I may even look into another teaching job next week that will be the same pay but half the hours. I'm pretty sure I wont get seguro or Infonavit and because of this I have to discuss it more with my husband. But as excited as I was to put my nursing uniform on I think its not where I should be. I haven't even touched a stethoscope in over a month. Athough I hate the job hopping, I guess its ok because Im still learning so much about the work force here in Mexico which is nothing like where I grew up. I had one job from the time I was 16-18 at a nursing home (thats a long time for a teenager). Then another job from the time I was 18-21 at a hospital until I moved to St. Louis to go to school.Thats when I worked at Barns and had that job from the time I was 21-28 when I moved to Mexico. I have almost had more jobs in two years than I did in over ten years of working in the states. I know there isn't a perfect job and the grass isn't always greener, but I think its time to start being a realist and accept that maybe nursing isn't what I should be doing down here right now anyway. I do want to apply at the IMS and maybe even in Tepa. But for now if I can make the same amount of money but have more time with my kids maybe I should be teaching.

11 comments:

  1. Everything you have written about (your experience in the hospital) is exactly what my husband has been telling me, since the day we met, about what it's like to work in Mexico. There is no encouragement for doing a good job, there is no reward for doing a good job, it only causes problems for you. Instead they will do anything and everything to keep you down because they're afraid you might rise above them. This system ends up encouraging a bad attitude, even laziness, because there's absolutely no point in giving it your heart and soul. What for? There's no reward, not even a pat on the back and a "good job!" This country is still basically a fascist state that spends a ridiculous amount of time, energy, and resources on appearances. They seem to think that looking good is the only thing that matters. They think that proper function will automatically flow from proper form. How wrong they are. The rules for nurses uniforms are an excellent example. How absurd to focus on shoe scuffs and little wisps of hair, how utterly ridiculously totally ludicrous. But continuing education is a no-no because they don't want the nurses to get too smart! Meanwhile the patient is entirely left out of the picture! But as long as the nurses look perfect, then to them the whole picture looks perfect and that's all that matters. AAAaaarrrggghhhhh! Having grown up in a completely different system, living here can feel like being trapped in a Kafka novel. The Spaniards left their permanent mark on this country; at times I would venture to call it a curse. To say the least, it is surreal.

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  2. Now, I am worried! I am having surgery in a few days here in Monterrey! Do you know if this is the norm throughout Mexico? I am in Monterrey.

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  3. Without trying to sound like I am down on Mexicans, I must tell you I ran into the same things at the school where I taught. I know it's a different country with different methods, but it just went against all of my sensibilities. They actually stopped a group photo session because I had my hand clasped the opposite direction than the rest. I thought at the time that I must have unconsciously did it on purpose. Always going against the Mexican grain. HA!

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  4. Gail, THe AAAAaaaaarrrggghhh is my sentiments exactly. I love you how always get it.

    Stephani- To be honest it does seem like the norm throughout Mexico. But I do know that I have been told their are two hospitals in Monterrey that I would feel right at home at. This came from a well educated chemist who understands where Im coming from with all this. So maybe you will be at one of those hospitals. I wasnt trying to worry anyone just stating the facts.

    Rita- I love the unconscious going against the grain. To be honest I often do it consciously because I think its just so pointless.

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  5. Wow, it is so surprising to read all this. My husband works at a company in Gdl and it is actually the opposite. He's appreciated for the effort he puts into his job and has actually gotten promoted a few times. I am looking for work but now I'm scared. Hope things get better and you find a better job. Don't think you deserve that.

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    1. Hey there, I just left you a comment on your blog. But for all my other readers out there I want to say that my husband also works for a great company who does things like they are done in the states. This company basically takes in American companys so they kind of have to. He works for a call center and seems to really like it. If it comes down to it I may need to join him there.

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  6. Hello.
    You are clearly frustrated on how the system works in Mexico. It's understandable that you want to change it. Why? because you learned the "right" way. However, the "right" way will not work. I'd advise you to learn to navigate the system and adapt according to it, which seems you are doing. Also, you do not make generalizations which is good, unlike some of the people who commented above, calling Mexico a "fascist" country shows a lack of knowledge and judgement. Anyway, try new places and hopefully your perspective will change or best create your own business where those principles you are so fond of will be implemented. Likewise, I'd suggest to grow a network of friends who are connected in the medical field. They may point out a place that fills your expectations. Remember, you are a foreigner, therefore, your opinions and ideas are taken with caution which is sad and foolish of your superiors and coworkers. Mexico is not the US, stop thinking like it is, you will end frustrated and disappointed.
    Sincerely,
    A Mexican entrepreneur.

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    1. Mexican entrepreneur. I love what you have to say and you are so very right. I want to be clear that most days I love living and working here. The stuff you are saying is what my husband tells me often. And even though I know its not the US I cant stop thinking like an American. When your forced to work in a new country you start to realize how deeply ingrained so many things are in your thinking. Really I believe the hospital Im at will become better, but I think they will do it without any suggestions from me. Like you said they dont want to accept my ideas which is sad but its true. Also like you said I just need to keep looking and find my nich in Mexico, sadly it may not be in the medical field but I think Im ok with that.

      Thanks for your comment.

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    2. A comment to Mexican entrepreneur--my husband, a Mexican, born and raised in Guanajuato, calls Mexico a fascist state. And having lived here since 2005, I tend to agree with him. Perhaps you disagree because you haven't lived anywhere else. We have lived in the US and Canada, in addition to Mexico, and I have also lived in Germany. Living in other countries provides one with a different perspective vis-a-vis their native country. In other words, the blinders are removed. And just as my husband's opinion of Mexico has changed from living in other countries, so has my opinion of the US, by the way. And despite all the flaws that Mexico has, we are both happy to be here, and not in the US.
      ~~Gail

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  7. I am a nurse in the same boat as you. My husband has about 9 years to go on his ban and I am hoping to move myself and kids to Mx asap and am researching nursing jobs. Could you post on how you went about getting visa, licensed, etc?

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  8. Hey Anon nurse. I have posted quite a bit of stuff about getting a "visa" or FM2 here in Mexico. As far as your nursing lic you dont have to do anything except get a copy of your Diploma. There is no nursing board down here and no licence. They basically take a graduating exam from their university and then they work. No renewals or anything. How is you Spanish?

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