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.
