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.

6月份才刚过几天,几天时间里,全国多地发生暴力伤害医务人员的事件。这让我很难过,庆幸的是,很快,我就不用再害怕这些,因为我即将离开这一行业。从此以后,不用通宵夜班,不用提心吊胆,不用被催着接瓶加药,不用无穷无尽的准备检查考试,也不用像其他的姐姐那样挺着大肚子上夜班。

2012年,我从卫校毕业,进了省里的一家三甲医院,工作至今。我想,很多刚进入三甲医院工作的人,都会很高兴,家里人同样也会很高兴。同样的,时间久了以后,很多人也会很迷茫,难道这份工作真要干一辈子?

每个月要应付各种没完没了的检查,上了一天班回家,累得眼睛都睁不开,竟然还要背书,而且每个月要不定期的考试。而且考试的试卷还很奇葩,很多的考点跟护理半毛钱关系都没有,当然,领导说有,那就有吧,反正也无所谓了。

家里有人生病的时候,甚至自己生病的时候,还是不得不去上班。家里人生病了,怪你没时间照顾,只知道上班上班上班。自己生病了,科室也说缺人,你再坚持坚持。前几个月,网上的新闻说,某医院的护士,发高烧请病假,领导不批准,最后那个姐姐死了,脑疝。我不知道最后那个科室的领导有没有被问责,因为全世界很快都忘了这件事情。毕竟我们只是普普通通的人,不是真正的天使,你死了,没有人会记得你。

更加可笑的是,病态的制度,竟然为带病上班的医务人员叫好点赞。连科室的领导也不例外。记得有一回,科里有个姐姐要请病假,领导竟然说,轻伤不下火线,你看谁谁谁,手上挂着点滴坚持上班,你这样随随便便就请假了,那以后大家也都会争着要请假,还是再坚持坚持。后来,那个姐姐因为没有休息好,留下了后遗症,经常胸闷气短。我真不明白,什么叫随随便便请假,难道死了才可以请假吗?我们不是天使,我们是人,是血肉之躯,不是钢铁侠。

从实习开始,我就要给病人做生活护理,洗脸、洗脚、洗头发、剪指甲、床上擦浴。其实这些事情,一个小学文化的人来做都可以做得很好,我们的领导却无视我们的忙碌,而且美其名曰优质护理。前几天,我帮我妈妈剪指甲、洗头发、洗脚的时候,我妈妈竟然哭了,因为她刚知道她的宝贝女儿在医院经常要给陌生人洗头发洗脚。

记得实习的时候,经常会碰到一些猥琐的中年大叔,言语轻佻。有一回在内分泌科,一个又黑又胖又矮的大叔,脖子上戴个金链子,说他很寂寞,要我们陪他玩。我们都没理他,后来他又跑过来一直缠着我们老师。还有一回值夜班,我们老师用电子血压计给一个肺癌晚期,骨瘦如柴的老头子量血压,老头子手臂太细,血压一直测不出来,然后家属就开始发飙了,你是什么护士,干什么吃的,那么笨,我看你的手就会摸男人的小鸡鸡!而且,说这话的,竟然是个女家属,你能想象吗?

我刚开始上班的时候,一个月的工资是八百,现在也不过才一千多。你能想象这是什么生活吗?我出来工作竟然还要跟家里人要钱吃饭。这是天使的范儿吗?一次夜班也才五十块钱,十个小时,平均一小时五块钱,多么廉价的劳动力,我花了那么多年的时间去学习,最后我的劳动价值还比不上做家政服务的!这是天使的范儿吗?有的病人和家属,对我们一点都不尊重,甚至有公然调戏的。这是天使的范儿吗?

夜班多,检查多,考试多,工作累,休息少,工资低,这些也就算了。最可怕的是,我们的安全竟然得不到保障,几年时间,医疗环境越来越恶劣。现在,竟然可以有人随随便便拿着刀,随随便便走进医院,随随便便把护士砍了。而且围观的警察竟然可以等歹徒砍了四五刀以后才冲上去制止,我想说,警察叔叔,你是吃屎的吗?

频发的暴力伤医案,我想,看过新闻的医务人员都很伤心。更叫人伤心的是,社会上竟然有很多人拍手叫好!老百姓把各种怨念都转嫁到医生护士身上,他们认为看病贵、看病难都是医生护士造成的,整个社会对医务人员的信任已经荡然无存,甚至有些人还没进手术室就立好遗嘱准备索赔。

前一段时间,我的学长,某省级三甲医院耳鼻喉科的医生,辞职了。在朋友圈火了两天。后来,我和他聊了很久,他说,股市里面有句话,“侠之大者,为国接盘”,在医疗界,应该改成“医之大者,为国接盘”,一副刀枪不入的天使样子,就要做好被万箭穿心的准备,如果承受不了,那就不要装逼,装逼被雷劈。

当时我很佩服他的勇气,今天我终于也交了辞职信,我只想过安安稳稳简简单单的生活,不用提心吊胆,睡到自然醒,下班溜溜狗,周末度度假。对伟大的提灯女神南丁格尔,我只能说,在你的时代,你是女神,而这是我的时代,我要回去做我的女神经病。

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

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