How to Fight insolence and Win

"... l’homme sensible, comme moi, tout entier à ce qu’on lui objecte, perd la tête et ne se retrouve qu’au bas de l’escalier"

Paradoxe sur le comédien (1830) by Denis Diderot

I have heard my fellow house officers complain that sometimes, when they try to get nurses to do their jobs, they were occasionally stonewalled by said nurses with a variation of this comment: "Your salary is bigger than mine - why don't you do it?"

This must not be an unusual occurrence because I have heard this from multiple sources, but I tended to blow these accounts off because I rarely encountered difficulty working with the nursing staff, and in the times I did I have never been met with this despicable degree of defiance. I make it a point to cultivate a cordial working relationship with them and especially with their bosses: the nursing sisters and the matrons. I also took the advice of an internal medicine specialist, and started breakfasting with them in the pantry, a room traditionally (and jealously) regarded as the nurses' domain.

Today, I flexed my executive muscles a little, because according to my job description, I do technically wield managerial clout. A nurse from one of our four medical wards called me to inform me that a warded patient, a young lady, is having a spot of diarrhoea. When I asked her to clarify a few things for me (like how many episodes of diarrhoea did she have, what is the consistency of the stool, how are her vital signs, et cetera), she said:

"I don't know. Why don't you come up and see the patient yourself?"

I was on the ground level at the time, attending to another patient, and the runny girl was all the way up on the ninth. Now, I don't ask these questions for fun. They help me to assess the severity of the patient's condition and allow me to prioritise on the ones that need my attention the most - and diarrhoea is one of those things that ranges in severity from inconsequential to life-threatening. These half-arsed referrals are sadly part of the norm here in the Sarawak General Hospital but today, I decided I wouldn't stand for it anymore.

Two matrons were sitting nearby and I asked them, "Is interviewing a patient for medical history and assessing that patient's general condition part of the nursing school syllabus?" It was rhetorical because I already know the answer. I tend to pay attention to the lectures that the nursing students training in our hospital receive because I am of the opinion that knowledge is power even if we don't always know how a bit of knowledge will prove handy in the long run.

"Yes," both matrons answered proudly. See what I did there? One of them even grabbed a random patient's case note near her and showed me a clerking sheet that a nurse had filled out.

"Oh, okay," I said. "I was just wondering because a nurse just called to inform me about a patient who is having diarrhoea, and when I tried to get her to tell me how bad it was, she simply told me she didn't know and asked me to 'come see the patient' myself."

The faces on these two matriarchal ladies turned severe. "What is the name of that nurse?" they enquired.

"I didn't ask but she's from Medical 4," I told them.

One of them picked up the phone, called up the offending ward, and asked for the offending nurse. Once she got ahold of her, the matron began quizzing her about the same patient's condition - basic bits of information that she is suppose to know and report to any doctor with whom she works with should the occasion arise - and she totally flubbed it, ticking off the matron. I know it's schadenfreude but I couldn't help enjoying the ensuing drubbing she received. That one's not going to cross me in a hurry, I can tell you.

Later that day, I finally encountered the legendary "your salary is bigger than mine" remark from a nurse that I have never liked, and she smacked me with it right after I had asked her to do something well within the scope of her duties. And you know what? I was ready to deflect it, because preparation is the only sure vaccine against treppenwitz.

I took out a piece of scrap paper from my pocket and wrote '4500' on it. "This is roughly how much I earn per month," I said. That was a generous estimate, but what the hell - I was feeling charitable. Also, I don't really know exactly how much I make in a month. I figured that so long as there's money in the bank whenever I need some, I am making enough.

Next, I write '108'. "... and that's how an estimate of how many hours I work a week," I added. Again I was underestimating my work hours. That number came from three 12 hours days and two on-call days in which I work a stretch of 36 whole hours. The fact is, even on my short days I usually work longer than a clock has face. Today, for example, I punched out 15 hours. I was so busy that I did not even eat lunch. Let's not forget that I slave on every single day of the week, with zero days off. I have heard of Victorian coal-miners that got better working hours that I do.

"Let's take a 30 day month. I'll throw in 24 hours more. That's two normal working days for me." I continued, scribbling as I went along. After brief demonstration of primary school arithmetic, showing my work as I went along, I produced: "That's only about 9.87 ringgit per hour."

Then, looking at her squarely and steely in her eyes, I asked: "How many hours do you work in a week and how much is your salary?"

"Never mind," she said, clearly embarrassed, and slinked off to do her damn job.

P.S. This is also for all you other assholes out there who think I earn more than you per hour of work performed. Clearly, I'm not in it for the money.

You won't like him when he's angry,

k0k s3n w4i