Adam Kay's experience compared to my own
Dec. 15th, 2020 03:30 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
whitewriter Extract of text from "This is going to hurt" by Adam Kay:
I'm discussing a case with my colleague Padma in the coffee room after antenatal clinic, and a midwife leaps into the conversation with, "We actually don't like to use that word anymore." Wondering what outmoded terminology we were actually used (Consumption?) Scrofula?), she lets us know that we said 'patient'. We should actually say "client"- calling them patients is not only paternalistic and demeaning, but pregnancy is a normal and natural process rather than a pathological one. I just smile and remember the wise words taught to me by Mr Flitwick, one of my very first consultants, with regards to arguing with midwives - 'Do not negotiate with terrorists'.
Padma clearly has no such qualms. 'I had no idea patient was such a demeaning term' she says. I'm, so sorry, I'll never use it again. Client. Client's much better. Like what prostitutes have.'
Reminds me so hard of when I was studying for the midwifery entrance interview. It's a paid position at your year level of RN to train for a whole year within the system. Comes with leave booked around your exam time and all the opportunities required to register on graduation (and the likely chance you'll have a job in the place you trained post graduation- or so I thought -apparently not, even after all that $ spent fixing you up into hopefully a half decent midwife). I practices saying "woman" instead of patient a lot. Since that was the terminology I had been instructed to use. Woman centered care, family centered care. The care of the woman. Working with women.
etc.
I still stick to it today. I always talk about my "woman" or my "lady". It's become a habit.
Other terms come up -- delivery. We're not to say we want to deliver babies -- we're meant to say, we want to help women give birth.
There's a bit where he talks about his contract ending at midnight but his shift continuing until 8am (because he was rostered on a night shift) and then his staff card stopped working right bang on at 12:01 -- and how they can't get a good computer system working or properly staff the place yet the staff beep card is perfectly coordinated.
Reminds me of the failings of our own system at SSH.
Reams of paperwork- all saying the same thing in a different way. A machine that makes it 4x the time it would take out to dole out Paracetamol --endless empty rooms and hallways built but unfunded because they built something larger than required currently to avoid building it later (actually not a bad idea) but missing a neonatal alarm system that MISH has (despite being an older building) to make it easier to call the paed to an emergency -- and these stupid scarf swings from the ceilings that no one uses but probably cost $500 a pop. Like for why couldn't you just put the money into better systems (alarms/a better paperwork or paperless system) but no-- there's these swinging scarfs someone in management thought we just 'had to have'.
How about thicker walls to drown out the sounds of another woman's screams? Nope let's just put in bluetooth speaker system in the room instead- which require engineering to reset the speaker when they stop working (we can't trouble shoot it ourselves, someone has to go somewhere with a ladder not at 2am when we need the music for distraction, so that's no help..)
(These quirks don't seem to exist at MISH ICU though - I think we do great. Its smooth. Its public. We have a great system... will I be saying the same thing in 2 weeks when I go back to 50% nights?).
Two different districts, two different specialties - same system (public).
Best joke in the book:
A new midwife supervisor, Tracy, has started this week and seems absolutely lovely- calm, experienced, and sensible. She is now the second midwife supervisor on the unit called Tracey, the current one being a flappy, angry nightmare. To avoid confusion, we have nicknamed them 'Reassuring trace' and 'non-reassuring Trace'.
(The joke harps back to CTG interpretation -- and whilst most things are explained with footnotes in the book, this one isn't. But any midwife will get the joke). I haven't met a single midwife called Tracey yet .... I wonder if they all quit- maybe due to jokes like this.
The ending of the Adam Kay's book is a terrible mirror image of the stresses SSH is currently going through. I myself still feel like an outsider there - most likely because I came right after it all happened but with SSH currently living through the consequences of 'it' right now this means I live the stress too. Unexpected fetal death. It happens, and it rips everyone apart from the midwives directly involved - the doctors - and effects flow on down the line to the juniors that join on.
The last thing in the book is an open letter to the Secretary of state for Health (UK) Adam says how doctors from the UK run to Australia because our system is fairer on the staff than over there. He says how politicians and managers need to come and work in the hospital and see what actually goes on in there if they're to say things like "we're all in it for the money". Shockingly true. Don't get me started on the "birth rate plus" program management has us filling in forms for at SSH it really makes my blood boil (but quietly, as I still sit and fill in another damned form... along with all the other damned forms we need to fill out ...)
The Ministry of Health (Australian govt.) need to come and work a shift with us at SSH and just see for themselves. Rather than making us fill out endless forms - only to then tell us we're fudging the numbers for more funding.
Can't wait to return the book for the next person to read.
I'm discussing a case with my colleague Padma in the coffee room after antenatal clinic, and a midwife leaps into the conversation with, "We actually don't like to use that word anymore." Wondering what outmoded terminology we were actually used (Consumption?) Scrofula?), she lets us know that we said 'patient'. We should actually say "client"- calling them patients is not only paternalistic and demeaning, but pregnancy is a normal and natural process rather than a pathological one. I just smile and remember the wise words taught to me by Mr Flitwick, one of my very first consultants, with regards to arguing with midwives - 'Do not negotiate with terrorists'.
Padma clearly has no such qualms. 'I had no idea patient was such a demeaning term' she says. I'm, so sorry, I'll never use it again. Client. Client's much better. Like what prostitutes have.'
Reminds me so hard of when I was studying for the midwifery entrance interview. It's a paid position at your year level of RN to train for a whole year within the system. Comes with leave booked around your exam time and all the opportunities required to register on graduation (and the likely chance you'll have a job in the place you trained post graduation- or so I thought -apparently not, even after all that $ spent fixing you up into hopefully a half decent midwife). I practices saying "woman" instead of patient a lot. Since that was the terminology I had been instructed to use. Woman centered care, family centered care. The care of the woman. Working with women.
etc.
I still stick to it today. I always talk about my "woman" or my "lady". It's become a habit.
Other terms come up -- delivery. We're not to say we want to deliver babies -- we're meant to say, we want to help women give birth.
There's a bit where he talks about his contract ending at midnight but his shift continuing until 8am (because he was rostered on a night shift) and then his staff card stopped working right bang on at 12:01 -- and how they can't get a good computer system working or properly staff the place yet the staff beep card is perfectly coordinated.
Reminds me of the failings of our own system at SSH.
Reams of paperwork- all saying the same thing in a different way. A machine that makes it 4x the time it would take out to dole out Paracetamol --endless empty rooms and hallways built but unfunded because they built something larger than required currently to avoid building it later (actually not a bad idea) but missing a neonatal alarm system that MISH has (despite being an older building) to make it easier to call the paed to an emergency -- and these stupid scarf swings from the ceilings that no one uses but probably cost $500 a pop. Like for why couldn't you just put the money into better systems (alarms/a better paperwork or paperless system) but no-- there's these swinging scarfs someone in management thought we just 'had to have'.
How about thicker walls to drown out the sounds of another woman's screams? Nope let's just put in bluetooth speaker system in the room instead- which require engineering to reset the speaker when they stop working (we can't trouble shoot it ourselves, someone has to go somewhere with a ladder not at 2am when we need the music for distraction, so that's no help..)
(These quirks don't seem to exist at MISH ICU though - I think we do great. Its smooth. Its public. We have a great system... will I be saying the same thing in 2 weeks when I go back to 50% nights?).
Two different districts, two different specialties - same system (public).
Best joke in the book:
A new midwife supervisor, Tracy, has started this week and seems absolutely lovely- calm, experienced, and sensible. She is now the second midwife supervisor on the unit called Tracey, the current one being a flappy, angry nightmare. To avoid confusion, we have nicknamed them 'Reassuring trace' and 'non-reassuring Trace'.
(The joke harps back to CTG interpretation -- and whilst most things are explained with footnotes in the book, this one isn't. But any midwife will get the joke). I haven't met a single midwife called Tracey yet .... I wonder if they all quit- maybe due to jokes like this.
The ending of the Adam Kay's book is a terrible mirror image of the stresses SSH is currently going through. I myself still feel like an outsider there - most likely because I came right after it all happened but with SSH currently living through the consequences of 'it' right now this means I live the stress too. Unexpected fetal death. It happens, and it rips everyone apart from the midwives directly involved - the doctors - and effects flow on down the line to the juniors that join on.
The last thing in the book is an open letter to the Secretary of state for Health (UK) Adam says how doctors from the UK run to Australia because our system is fairer on the staff than over there. He says how politicians and managers need to come and work in the hospital and see what actually goes on in there if they're to say things like "we're all in it for the money". Shockingly true. Don't get me started on the "birth rate plus" program management has us filling in forms for at SSH it really makes my blood boil (but quietly, as I still sit and fill in another damned form... along with all the other damned forms we need to fill out ...)
The Ministry of Health (Australian govt.) need to come and work a shift with us at SSH and just see for themselves. Rather than making us fill out endless forms - only to then tell us we're fudging the numbers for more funding.
Can't wait to return the book for the next person to read.
