China: Nightingale Ascending

Nurses in China suffer from overwork and long hours, and increasingly from physical and verbal abuse at the hands of their patients and their families, who are convinced that medical staff are corrupt. The journal Medical World WeChat account posted the resignation letter of one such nurse, who endured all this and more.

“It is just a few days into June, and already there are violent incidents against medical staff across the country. It’s sad. But fortunately I’ll soon be spared the fear, because I’m leaving this profession. From now on I’ll no longer need to work night shifts, be constantly on the alert, hurry to change IV bags, do endless health examinations or work night shifts with a bulging waistline like my pregnant “sisters.”

I graduated from nursing school in 2012 and have been working in a provincial, tertiary level-A hospital [a large, top-rated general hospital]. I think many people are overjoyed when they first enter a tertiary level-A hospital, as are their families. But after a while most people lose their way: Am I going to do this all my life?

We perform endless health examinations every month. Exhausted after a day of work, we can barely open our eyes. But we still have to study, and take exams from time to time, every month. The exam questions are weird, with many of them having nothing at all to with nursing. Of course, if the leaders think they do, they do. It doesn’t matter anyway.

When our own family members fall ill, or when we ourselves do, we still have to work. When our family members get sick, they blame us for taking little time to care for them and being concerned only about work.

When we get sick, our department will say it’s short of people and ask us to “hang in there.” A few months ago, there was information on the Internet about a hospital nurse who had asked for sick leave because she was running a fever, but she was turned down by her superiors. She ended up dying of a brain herniation. I have no idea whether the leaders in her department were held responsible, because the world soon forgot. We are ordinary people, after all, not angels. If you die, no one will remember you. [The information about the nurse who died was in a letter published on DoctorPDA, a WeChat account for medical workers that is authorized by the Chinese Medical Doctor Association.]

Even more ridiculous is the perverse system that praises medical staffers for working while ill. The leaders in our department are no exception. I remember one time a nurse asked for sick leave. Our leaders actually said, “One should not quit a battle because of minor injuries. Look at her [indicating a third person]. She continued working with an intravenous drip in her hand. If you ask for sick leave like this, everyone else will do the same. You should just hang in there.”

Later, that nurse suffered consequences — chest pain and shortness of breath. I really don’t understand, what did they mean by “if you ask for sick leave like this”? Can we only ask for sick leave when we are dead? We’re not angels. We are human beings made of flesh and blood. We are not Iron Men.

From the beginning of my internship I provided care for my patients, washing their faces, feet and hair, trimming their nails and cleaning their bodies while they lay in bed. These were things anyone with a primary school education could do just as well. Our leaders never seemed to notice that we were busy, and they gave those things a beautiful name: quality nursing. A few days ago, my mother wept as I was trimming her nails and washing her hair and feet, because she had just realized that her daughter washed the hair and feet of strangers in the hospital.

I remember when I was doing my internship, I often came across perverted middle-aged men who were too fresh. One time, in the department of endocrinology, a middle-aged man with a gold necklace who was swarthy, fat and bald said he felt lonely and asked us to “play” with him. We ignored him, so he went to our supervisor and pestered her.

Another time, our supervisor used an electronic blood pressure gauge to measure the blood pressure of a skinny old man who had final-stage lung cancer. The old man’s arms were far too thin for the device to measure his blood pressure properly. His family grew furious: “What kind of a nurse are you? What’s the point of you? So stupid! I say your hands can only hold a penis!”

It was a female family member who said that. Can you imagine?

When I first started working, my wage was 800 renminbi [about $130] a month. Now it’s a little over 1,000 renminbi. Can you imagine what kind of a life it has been? I had started working, but I still had to live off my family. I would earn 50 renminbi for a night shift of 10 hours. That’s five renminbi an hour. Did I spend so many years studying for so little money and such hard physical labor? All for less than a housemaid? Is this how an angel lives? Some patients and their families have no respect for us. Some even make passes at us in public. Is this how an angel lives?

Night shifts, checkups, theory examinations, exhausting work, little rest and low pay. We can take all that. But the most frightening thing is the threat to our safety. The medical environment has become worse and worse in recent years. Now, someone with a knife can just walk into a hospital and attack a nurse. Police officers only rushed to stop that attacker after he had struck her four or five times. [Ms. Yan is referring to the attack on the Kunming nurse and reports that, although there were plenty of people nearby, no one went to her defense.] I want to ask, officers, were you eating feces?

The frequent reports of violence against medical staff, I think, have broken every medical worker’s heart. Even more heartbreaking is the fact that many people in our society applaud such incidents! Ordinary people vent all their anger against doctors and nurses. They think doctors and nurses are to blame for the expense and difficulty of seeing a doctor. Society’s trust in medical workers is completely gone, with many people drawing up wills seeking financial compensation even before they undergo surgery.

Recently, a person I studied with, who worked as a doctor in a tertiary level-A hospital’s ear, nose and throat department, resigned. The news was hotly discussed in my Weixin “moments” [a WeChat discussion channel] for two days.

Afterward, I had a long chat with him. He said there is a saying in the stock market: “The greatest heroes are those who take the shares that are unwanted by the state” [a form of self-sacrifice for the state]. But in the medical world, this would be: “The greatest doctors are those who deal with problems unwanted by the state.”

If you act like a bulletproof angel, you should be prepared for tens of thousands of arrows piercing your heart. If you can’t take it, don’t pretend you can, or you’ll be struck by lightning. [According to a traditional belief in China, people who lie will be struck by lightning.]

I admired his courage back then. Today, finally, I handed in my own resignation. I want to live a stable, simple life, without having to be on call all the time, one in which I can wake up naturally, walk my dog after work and take time off on weekends. To the great “Lady With a Lamp,” Florence Nightingale, I say: In your time, you were a saint. But this is my time. I’m going back to being me.”

Translation from the New York Times.













Original resignation letter, from the Medical World account on Weixin.


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