My job is making me sick.  Well, I guess it isn’t the job itself, per se, it’s the fact that my level of work related stress is so incredibly high, and my ability to recover between shifts is non-existent, that my defenses are simply down for the count.

When I say sick, I don’t mean, “oh, well I just can’t face going to work today so I’m going to call out” kind of sick.  I mean, pulling over on the side of the road on the way to to work so I can puke, stopping in gas stations to purge myself in the bathroom kind of sick.  I’ve had dysentery and frankly I’ll take that over this.  It is without a doubt stress related but legitimate illness none the less.  Fevers, the whole nine yards.  Even water becomes a luxury because I can’t keep it down.  This is the second time in a month this has happened to me; I’ve also begun having migraines with disturbing regularity after a period of several years with less than one per year.  These too have picked up in severity; I never used to actually vomit with migraines although I would be nauseated.  I’m not so lucky any more.

As some of you might know from my previous posts, I work in a very busy metropolitan emergency room.  It means that we take care of a high volume of patients daily, regardless of whether or not the trauma services are needed.  I recently heard the numbers:  last year, we cared for an average of 150 patients per day.  This year, we are caring for an average of close to 200.  Now, fifty people doesn’t maybe seem like that much, but you multiply that by the fact that each nurse is caring for an average of close to 6 additional patients per day, it adds up.  Each of those people is another assessment; each more than likely means lab draws, IV’s, medications, re-assessments, other treatments as needed, final assessment, discharge, and escorting to the discharge area.  All of that needs to be crammed into the same time period as the previous patient load used to be, and means that everyone is constantly under time pressures as well as direct pressures by management to ‘move them through!’

When I went from being a firefighter paramedic and working 24 hour shifts to being a nurse and working 12 hour shifts, probably the biggest surprise to me was the fact that working a 12 hour shift is as mentally and sometimes physically taxing as working a 24.  That’s because as a nurse, you don’t get ‘down time’ in between patients.  You always have at least one, usually more, and you are always thinking ahead to what has been done, what still needs to be done, who is sitting in triage and will probably be your next patient and what will be need to be done immediately for that patient, and so on…for 12 hours.  Now, I’ve worked 24 hour shifts and worked two jobs at a time for nearly 20 years, but this is without a doubt the most stressful job I’ve ever done.

Add to that the fact that our administration is –wasting- hundreds of thousands of dollars on ‘consulting groups’ to *supposedly* increase our productivity, and we are in a constant state of flux because of that, and there are now constant and unrelenting pressures on us to produce as though we were assembly line worker s pumping out auto parts, and you can maybe understand that my level of stress has been bumped up by more than a few notches in the last eight months or so.  The fact that we are a not for profit organization, and that people come to our facility from all over the Valley specifically because of the reputation for quality care we have sustained for nearly 50 years, doesn’t seem to matter to our administration.  They have lost sight of the fact that we are non-profit, and only care about increasing the profit margins, I would guess so that their salaries remain completely OUT of line with the rest of the line staff, and so that they continue to accrue ridiculous bonuses for said ‘productivity’.  If you are getting the idea that I’m bitter about that you’d be right.  If you are getting the idea that I’m not alone in my feelings of stress and alienation you’d also be right on the mark.  Administration approved the purchase of pizza for the entire hospital last week….big whoop.  Yeah, that makes up for treating us like crap for the last year.  Totally.

As you might guess, it shows in sick calls, in short staffing, in the numbers of people – many of whom have been at our facility their entire careers – leaving for other places and jobs where they aren’t treated as cattle herders and brow beaten constantly.  Our facility got rid of the incentive pay for extra shifts a couple of years ago; I recently heard it is probably being brought back because it’s nearly impossible to get people to come in on their days off any more.  They can’t get pool people to stay because they can work elsewhere and be treated better (which is saying something very significant when you consider that our facility, for many years, was almost impossible to get hired into unless someone died) In fact, it’s now down to when they DO get someone to work extra, they send people home based on how much they make per hour rather than who is next on the go home list.

I actually think the way our facility’s administration thinks is related to our culture at large.  The dysfunctional value they place on themselves as being necessary to the functioning of the facility while they remain completely oblivious to the problems at the level of the baseline reason for the facility’s existence seems to be to be related to the profits and bonuses of Wall Street executives.  Their bonuses too are completely out of line with the line staff salaries.  They too value themselves as entirely too valuable while ignoring the fact that their companies wouldn’t work without the little people do actually do work for them.

I recently heard on BBC radio that a study was recently done using college level business students at a major university.  The premise of the study was to see if bonuses raised productivity or if the threat of punishment – to management – raised it.  It turns out the threat of punishment – not only losing bonuses, but losing position, motivated managers to do their job properly – to actually manage – and be involved in the day to day activities that were tied to the punishment.  Performance significantly increased for the group with the threat of punishment.  Now, what that says about human nature I wouldn’t like to guess, but I think it’s worth noting that our administration is utilizing the threat of punishment – for lower level staff – as a stick while keeping any and all bonuses for our increased productivity for themselves.

I have no good conclusion for this rant except to point out that I – someone who has been pretty resilient for a lifetime – am becoming as I get older, prey to stress related illness.  I shudder to think what that might mean if I were to become disabled.