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Health and nursing assistant or medical assistant (m/f/d)

Below you can read an interview with nurses and medical assistants at our clinic:

In the interview: Kathrine (56), Ulrike (46), Yvonne (29)

You work as a nurse and medical assistant in the care team at the Kiel Pain Clinic with patients who often have decades of suffering behind them. How do you adapt to these people?

Yvonne: There is no recipe, you are trained by your colleagues and grow psychologically into the task. At first we went along with the rounds and listened to the conversations that the boss had with the patients. He sometimes asks...

Kathrine: ... “Sister Kathrine, on how many days a month can a migraine patient take painkillers?”

Yvonne: Exactly. There is a distance learning course with which you can qualify as a “pain nurse”, but we have our exclusive in-house training here, so to speak. For example, there are the lectures given by our senior physician, which patients really enjoy going to. If we have time, we do that too. Our doctors also often go to conferences and tell us the latest news. We read the relevant books and all have our professional experience. A certain knowledge of human nature is also part of it. And we have regular training courses in the clinic here, where doctors come from all over Germany and also from abroad. Of course we are there too.

Ulrike: We all come from classic acute hospitals and it was quite a change at first because basic care is not the top priority here, i.e. taking pulses and fever, making beds, applying bandages, asking about bowel movements, taking patients to the toilet …

Did you miss that?

Ulrike: Yes, that's how you learned it.

Yvonne: That's just part of it.

Kathrine: Here the patients can and should get up most of the time and become active themselves. According to the motto: “Get up, take up your bed and go…”

Ulrike: In acute hospitals, the focus is on the sick organ; here, the psyche and the whole person play a much larger role. We listen and try to respond to each individual. As a sister you have to be willing to do this, otherwise you are in the wrong place. In other clinics it is a firm rule that painkillers should only be given as needed. So the patients have to come and “ask” for painkillers; they chase the pain and reinforce passive behavior. Here we learned that you can prevent pain right away, get ahead of it so that it doesn't occur in the first place. Nobody has to ask for medication as needed. If you need something like this, patients are given it at their bedside so that they can decide for themselves when to take something. And we reinforce patients when they have managed to manage their own pain.

Kathrine: We beg the patients but also, as they say in northern Germany, we look after them. If you have been taking your medication incorrectly for years and have to take a break from painkillers, you may find yourself lying down and suffering for eight days. Then we are there and encourage you and say: “You can do it too!”

Do you need more patience with patients here than in other hospitals?

Ulrike: The prerequisite for patience is having time in the first place. We have them here.

Yvonne: We are a specialized team of sisters. In terms of the number of patients and in comparison to usual hospitals, we are well staffed. That's why we can take the time.

Kathrine: That's another thing: the psychologists are in the house from 8:00 a.m. to 5:00 p.m. - but we can be contacted as early as 6:00 a.m. and stay until 8:30 p.m.

Does someone with a broken leg behave differently than someone with chronic pain?

Ulrike: The leg breaks, it is repaired and after a few weeks everything is fine again. But our patients have a history of suffering spanning 15, 20 or 30 years. That shapes her. Not just them, but also their families, their entire environment. I think they are much more focused on themselves than patients who have just broken a leg. They become more aware of their bodies and their experiences and behavior change.

Yvonne: Many people are introverted, they have had a long odyssey from doctor to doctor, from hospital to hospital and know the feeling of being quickly dispatched according to the motto: “You're actually completely out of therapy, just don't come back!” I think some of our patients initially have little hope that we can really help them, but rather think that we are just another stop on this odyssey. They are initially very skeptical of us. In my experience, this is what sets chronically ill people apart from others.

Kathrine: The skepticism starts with the fact that, according to general public opinion, any type of opioid painkiller is a drug. The fact that you can easily eliminate pain and not become a junkie is also a work of persuasion that we have to do.

Ulrike: The patients ask a lot of questions, sometimes very differentiated…

Katherine: …us sisters too.

Ulrike: ... although there was a detailed discussion with the doctor beforehand. But we are the ones who bring them the medication. We have to explain again exactly why you are getting the medication, what it does, and what side effects might occur. I think this allows us to build a relationship of trust. Explaining is very important.

Yvonne: I also think it is very important to address patients by name.

Kathrine: The same applies vice versa. There are patients who always just call out “Sister!” That annoys me a bit. Then I go and say: I have a name too.

So you also educate the patients a little bit

Ulrike: Sometimes that’s part of it.

Katherine: There are distant patients who immediately start calling us on a first-name basis: “Sister, can you…” Then I say that I am Sister Kathrine and that I would like to be treated.

Yvonne: We sisters agree on this point.

Why is this so important to you?

Yvonne: I have respect for my patient and expect the same from him, even though I am much younger. I don't use the first name of the Aldi saleswoman either.

Ulrike: It also happens out of self-protection. We like to listen. But there must also be limits.

Katherine: This also includes leaving business at the clinic. The way I do it is that I get home and deal with what happened here in ten minutes and then the end of the day begins.

Ulrike: I'll talk to my husband about it briefly. Someone needs to listen to me, just like I listen to patients. But you also learn over the years not to let everything get too close to you.

Kathrine: That depends on your own life experience. I have experienced some strokes of fate and that puts some things into perspective.

Do you find pain patients difficult?

Yvonne: That is a prejudice and perhaps one reason why this clinic was created. It is said outside: Pain patients are not really sick, they shouldn't behave like that!

Ulrike: That's why we say that pain patients are often real “biters”. Keep your teeth together and just don't let on how bad you feel.

Yvonne: Here you have the feeling that you are being taken seriously.

Kathrine: They say: “I'm finally being believed!” Many women have migraines, and the husbands don't accept it at all and always see it as a fake illness so that they don't have to fulfill their marital duties. For many, we are the last straw they are clinging to. We don't find them difficult because we care for them and encourage them.

Yvonne: Our handovers are important. We exchange our experiences and give each other tips on how to deal with patients. I'm the youngest and sometimes a little too spontaneous, and then I get advice from the older ones about how I could have handled this or that situation differently. This helps.

Ulrike: Incidentally, I think you should treat patients the way you would like to be treated yourself.

Do women with pain behave differently than men with pain?

Yvonne: It's the same here as in real life: women last longer. In my experience, men are more sensitive to pain and go to bed quicker than women. They suffer more. You often can't even tell from looking at women.

Are there certain types of pain that you are more accepting of than others?

Ulrike: That's how it is outside in society.

Yvonne: Our profession is no exception.

Kathrine: Nurses in other hospitals often think that we all have a little “hash meh” here.

Ulrike: That we do undemanding work. We are seen just like our patients outside.

Kathrine: Do you know the term Bahlsen's disease? Soft biscuit.

Ulrike: And sisters who get involved in it are perhaps the same way.

How do you behave when you are in pain?

Yvonne: Unreasonable. People always say that when you are in pain you should reduce stress and try to lead a balanced lifestyle. I'm not like that! I have great expectations of myself and I want to see through what I have set out to do. This may also have something to do with my zodiac sign, Gemini. For me everything has to go quickly, quickly, quickly. When I clean at home, I don't just clean one room but all of them.

Ulrike: I am the typical fish who is supposed to be predestined for this job. I like the relaxation training that we offer in the clinic. We always say to the patient: “You’ll probably have a quarter of an hour a day to practice!” – but don’t think that I regularly allow myself this quarter of an hour!

Kathrine: We all have back problems, it's an occupational disease. The step position helps: lie down, legs up on a cube and after half an hour the spine is relieved so that you can continue. I do this after work and can then take care of my household.

In nursing professions there is the concept of burnout, of being burnt out. Have you ever experienced this?

Ulrike: Every now and then in a weaker form. There are times when you say: “Oh God, I have to go again, I can't do it anymore!” When you work in the job for a certain amount of time, that's just how it is. Then you are no longer really receptive. The colleagues know this and say: “You do other work now and we’ll leave you alone for a while.”

Yvonne: We'll sort that out between ourselves. For example, today is my tenth day on duty and it's almost the weekend. It was about time! I am a person first and a nurse second.

Kathrine: And as humans, we sisters sometimes meet outside the clinic, two of us walk together, others talk on the phone. As head nurse, I can actually always be reached by phone at home.

Ulrike: I think our good collaboration is also due to the fact that there is someone from every decade of life. Everyone benefits from this. The younger ones bring the latest knowledge from their training and the older ones bring their professional experience.

 You invest patience and care – what do you get in return?

Ulrike: A lot. Very very much. Just yesterday a patient said to me: “Today I'm pain-free for the first time in years!” When a newcomer gets out of the elevator up here, we can tell by looking at him, oh, he's not feeling well, he's very depressed. When he walks home walking upright, with a smile on his face – wonderful, what more could we want!

Kathrine: Even if the patients can only make it through the beginning in the two or three weeks with us. At home they have to stick with therapy.

Yvonne: Here I see again the meaning of why I became a nurse. Many patients say when they arrive: “If I don't get help here, I have no hope anymore.” The best thing is when they say afterwards: “I have confidence again, I'm doing really well and I know that I can do it "I'm doing better at home now." That's a success story. At the end we hand out evaluation forms and the sisters almost always get an A on these forms. Because we simply enjoy the work and enjoy it. It's so great when we can help patients get through the bad days and they thank you with such a good review.

 

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