I am working in a private hospital on a series of agency shifts, to establish whether or not I want to take up a full-time position.

It is a holiday period and I am watching how the system colludes with certain surgeons who want to boost earnings. Normally, the surgeons do an average of eight or nine procedures over the course of a week. Yesterday, one of them did 13 in one shift.

The director of nursing endorses this unofficial policy, which really infuriates me. Examine the job title. It’s not “director of surgeons”, “director of profit-making” or “director of making-sure-surgeons-get-to- spend-the-whole-holidays-with-their-kids- without-loss-of-earnings”.

He or she should be protecting nurses from exhaustion, from 15-hour shifts (overtime seems as difficult to secure in the private sector as in the public one) and from days where we are unable to get to the toilet (“protected breaks” seem as difficult to secure in private hospitals as they are in public ones).

Clearly, nursing in this institution operates as a trickledown economy. The fat cats want more; the little mice go hungry.

Yesterday, I didn’t have time to hydrate adequately. Let alone eat. When I came home, I was starving and stinking with sweat. My breath was foul from anxiety and fear, because I had had more than half-a-dozen post-op patients in my care, and was worried about their pain-relief, their dressings, their drains, their lives.

When I got home, I needed to be held. But I also needed a shower, and to wash my hair, scrub my teeth and gargle with mouthwash.

I considered the impact of “me’’ on my partner, and headed for the bathroom. I wish others would consider the impact of their decisions, their so-called choices.

Decisions and their impacts

But surgeons in private hospitals – for a moment just indulge the generalisation – are not the only ones stuck in roadrunner mode. We live on an island where, it seems to me, the impact of our decisions, the impact of self, goes largely unexamined.

If I pull out too soon and block traffic, it is clear I have done something I shouldn’t have. But what about decisions that are less clear-cut?

When we dump nappies in the green bin? When we say to social welfare we are a lone parent, but are actually cohabiting?

Clearly, nursing in this institution operates as a trickledown economy. The fat cats want more; the little mice go hungry.

When, as TDs, Ministers or Senators, we do not take the shortest route to work from our “official residence’’ in order to claim the maximum mileage?

When Government sidesteps its responsibilities, and hands over the decision-making to a dehumanised system which then fails to apply even a modicum of decency to the equation? Hello Health Service Executive.

When the care of our elderly is assigned to profit-seeking private enterprises? When the care of the homeless is left to charitable institutions? When Capuchin monks feed the new poor, the old poor and the poor we will always have with us?

Disconnected

I believe it is easier to act this way when we are disconnected from one another. I believe we can so easily disconnect when we are being trained (from an early age) to assess and value one another on status, income, address, car registration, clothes, accent, and, in hospital, on the level of insurance cover.

Since I started in this private hospital, I have been asked at least three times what cover my patients had. That is understandable from a management point of view. What rankles is that it was the first question and, on one occasion, the only question.

I feel disconnected. I don’t like a lot of my patients. This morning, a real loudmouth – in for a cruciate ligament operation – was being wheeled down to surgery when he started shouting about his expensive watch being left behind in the locker.

I told him I was not a hat check girl. That his watch was none of my concern. I didn’t give a fig about the comment card he might fill in afterwards.

Perhaps that is a good thing. My days of being a pushover seem to be numbered. But I wonder about when “no longer a pushover’’ tilts into selfishness.

I look around in this private hospital, with its glossy water features and fountains and Italian tiles. I see many decent people, many trying to serve the patient. (I also see many patients who have spent their life savings on their hospital stay. Paying for relief from pain and suffering.)

But I also see workers here who do the bare minimum, who have opted out of the public system, opted out of the chaos.

Maybe I’m jealous. I’d love to have the ability to walk away from my patients and take my lunch at my leisure, do the crossword. And chill out for a few years.

Ultimately, I don’t think the private sector is for me.

Perhaps if I learned a lot more self-care, I could remain in the public sector. For me, that would mean eight hours sleep a night. I’m not asking for time to do a Pilates class or to have a personal trainer. The reality of my life now is I am often too exhausted to play with my children, sometimes too knackered to make love.

Maybe I could cut down on hours. The financial hit would be a worry, but I could do an agency shift if things got really rough. We could find a way.

Maybe I could work in a hospital down the country and pay half the €1,400 we fork out for a tiny two-bed house.

I grew up on a farm, and I’d love a bit of space. I’d love a garden, a dog, a vegetable patch. But really, I’d love less worry.

I grew up dreaming of being a nurse. Of owning my own house. Dreams retreat. Reality intrudes.

The author’s identity is known to The Irish Times.