Friday, 26 December 2008

My changing times

It is a curse to live in interesting times. Strange as I am always living in interesting times. That happened just about that time I stood under a ladder and kicked those 13 black (sorry "Rainbow") cats while smashing mirrors.

So, the country is going to the dogs, a cereal has got the nation addicted* and all of a sudden people are worried about owing money. Seems now that while it was fashionable in 2003 to be arse uppers in debt, being skint is the new rich (or some other such twaddle that those media obsessed tossers who have been the ones both casing and being affected by the current climate can use). Well, I have been a busy bunny, and occasionally sort of working as a staff Nurse. I have realised one thing recently with the money I get paid. When I was on the Acute medical ward, I would be expected to work Mon-Sun, on either days or nights. There are 6 types of pay I could get:
1) Basic salary, taken during Monday to Friday, during office hours. This is my basic £20224 salary.
2) Night duty enhancement. Any night shift, which used to be 19:15-07:45
3) Saturday enhancement- Basically 1.25 times the wage for during the week
4) Sunday enhancement- 1.75 times normal wage for working on a Sunday
5) Bank holiday enhancement- Paid for working public holidays
6) Overtime enhancement- 1.5 times wage for working any shift not on my usual off duty.

When I went to Cath Labs, I knew that there would be a pay cut. This was because I was only getting payment 1. No nights, bank holidays, Saturday, Sunday etc. I make up some money by working on my old acute ward, and at a local primary care hospital on their rehabilitation ward as a bank Nurse. I realised something the other month. I was getting paid just as much for doing 2 Sunday overtime shifts (that's 23 hours) as I was for a full months worth of enhancements (which would be somewhere about half of my time at work). I have checked, and between May and December, I have paid £970 in National insurance, and £1778 in tax, making £2748 paid in tax, for earning to date £12742. So, that's roughly £3000 to the government, and £10000 for me, or just under a third to the taxman who gets money FROM me for doing f**k all TO me. Greedy b******ds! So, I can get just a much for 2 shifts as an entire month. No wonder productivity is down.

Well, I have had a sort of alright Christmas. My Nan passed away very suddenly in the hospital where I work at the beginning of the month, which has put a dampener on the season.

At work though, thinks have been looking up. I have been forging ahead after getting bogged down with some of the angioplasty work, and have made good inroads with my Pacemaker and ICD scrub procedures. We had the local news in a few weeks back with their cameras. The camera man put a camera down on my Charge nurses sterile angioplasty trolley and got a terse "What are you doing!" yelled his way from him (funny how they edited that bit out though). Thankfully I was next door in pacing with my hat a mask on. Don't want the high-ups recognising me. Specking of the high ups though, the health care commission visited the division last month (did not see them in the labs though). One of the consultants for a joke walked in with a large alcohol dispenser in his scrubs, and walked around dispensing gel into his hands in quick succession saying "The healthcare commission are coming, the health care commission are comming, clean hands, clean hands, the healthcare commission are comming". His "More hot towels" joke about the latest project for the labs I found very amusing. Especially when in a procedure he said "More Vycryl...more hot towels, more hot towels".

Life may be the sh*ts but there is still some (bad) humour.

*Erratum. It has come to my attention that the "Credit Crunch" is in fact a term relating to the financial screw up, and not a novelty cereal. I would like to thank the lawyers from Kellogg's for pointing this out.

Friday, 28 November 2008

My Ghost stories

I'm naturally sceptical, but as its winter all the dark nights inevitably lead to the old ghost stories being trotted out. In all my career, I only ever recall there being one time when there were ghosts talked about. It was back in 2005 on my first placement. A patient was to be admitted with a chest infection. The ward was nearly empty and a few of use were sitting near the nurses station filling in paperwork. Not sure how the conversation started bu there were a number of stories told.

The first was of the ward where I was. One HCA said there was one night that she and another Nurse saw a black cat walk around from the side room, behind the desk and into the treatment room. The main out patient/minor injury unit was next door, and on more then one occasion it seems that a nurse in old uniform was seen. That's even more odd, as the old cottage hospital was said to be haunted by an old staff nurse who used to sit with patients who were dying, and was seen to do the same thing many years later.

Other Nurses had worked elsewhere. One said that she was at a hospital down south and came on her first day and saw a woman in a pink cardigan and a zimmer frame walk past her, and go into a day room. At handover, the nurse was told that all the patient were in bed. She mentioned the woman in pink to be told "That's impossible, she died overnight!". While at a different hospital, there seemed to have been a phenomenon of staff hearing a loud bang and walking sticks which had been on the wall found on the floor in a zig zag pattern without any explanation as to why. At the hospital where I am at, a different nurse told of a ward that is apparently haunted by a black man who does not speak English but is seen shouting at patients who seem to pass away a short while later. One woman was that distressed by the apparition that the nurse moved her to a side room whereupon the woman said "AHH, Its in here now!".

The CCU at the same hospital is said to be haunted by a man in black pyjamas who is seen walking into the toilets where a number of people have died. Apparently both staff and patient have seen it. The main entrance to boot also has been rumoured to be the place where a man with bad facial burns can be seen wandering with a drip stand.

The old General hospital (and a former workhouse) was reported to be haunted by two doctors. One was a surgeon who committed suicide by cutting his wrists one evening in the theatres. Apparently he then regretted what he had done, and went into the scrub room and started running the taps to clean the wound. The theatre would from time to time be found to have the water in the scrub room running without the taps on. Another doctor was supposed to haunt a corridor. A radiographer was walking from the locked door when a doctor asked for the way to another department. The was was locked but the security guard was up the corridor with the key. The doctor thanked them and walked away, and that was all was ever seen of them. Bit odd as there was only two doors to choose from. The old ambulance station has a grey figure seen on CCTV, and crews reported something grabbing their hair at the top of the steps. Something similar was reported at another ambulance station where crews felt a heavy hand pressing their right shoulder. Years ago at least two ambulances carried bodies to be seen by a doctor to the station for certifying, but nothing solid. One other reported ambulance station (now closed) was where an ambulance man collapsed and died in the station in the 1950's near the gents rest room. For many years, staff walking along there were pushed toward the wall.

On my old internship ward, one of the side rooms was reportedly haunted by a patient, and some patients reported a presence in the room.

All rather far fetched I think but entertaining enough. oddly though, the only really "spooky" thing in my time of Nursing happened when all the tales had finished and we were back to the real world. The phone rang, a HCA answered it, and put the phone down.
"That was the ambulance service" she said "That new patient we were meant to be getting was found collapsed at home and died in the ambulance on the way to A&E".

Saturday, 22 November 2008

My simple act of faith

There have been those days when one takes off the scrubs and thinks "whats it all for?". A few days back now was one of those days. The day itself for the elective part was easy. I scrubbed for a case which proceeded to angioplasty which was unremarkable. I remarked to the physiologist that "if the next one goes for by-pass we will be OK for the early finish". No prizes for guessing where the next case went to. It's not a nice thing to have to say- I know that we only see the patients in the Cath Lab for a short space of time, but even so some patients find the whole idea of surgery very daunting.

It was while restocking the lab with equipment that people were talking of the possible early finish, and it was said "yes, but there is still time for a STEMI". That's S-T elevation myocardial infarction, the common or garden heart attack. This was true, and yes, there was a STEMI phoned in. Knowing that we had a bit of time to play with, the lab was made ready, doctors bleeped, nurses scrubbed, drugs opened and equipment prepared.

At first we were told a name, and they would be seen in recovery.

Then we were told they would come directly into the lab.

Then we were told they were in the hospital.

Then the ambulance crew came in at a fast pace with the trolley.

Then we transferred the patient.

I removed, with help, the dressing gown, and prepped the groin.

Then the patient arrested.

We shocked. Nothing. Drugs. Nothing.

"can somebody else CPR?" the doctor asked as the patient was big. I stepped up.

I did CPR.

A physiologist did. A second physiologist did.

We shocked. Was the charge getting through?

I did CPR. The three of us took it in turns. CPR, shock, CPR, shock. We were trying that hard to get compressions the cath lab table was bouncing up and down with the force of our efforts.

Temporary pacing wire in. The compressions kept going. The C-arm swung into place. One poor sod was trying to do CPR and their glasses ended up half hanging off. They didn't stop going.

The screening was done. We shocked. More CPR. Non shock able rhythm. More CPR, more drugs. For 40 minutes we tried, for 40 minutes 3 of us did compressions, the anaesthetic team controlled the airway, the cath lab team put lines in, gave drugs, and made every effort to save the patient.

Starting to feel exhausted, I was the last person doing compressions...when the doctors agreed. There was nothing more to do.

I stopped the compressions.

The monitors recovered from compression rhythm. Only one long line was showing. I stopped, removed my leads, cleaned up the lab. I wrote the patient labels out. I checked the date of was today's date, "whats the date of birth" I thought. Then I checked the year. The only change was the YEAR. The patient was no older then my own parents. Only 20 years older then me. Heck, proberly if they have kids they are only my age. I packed the few belongings away. The worst thing was the small bag of tablets which had thoughtfully been packed for the patient. Nobody thought that an hour before this would have happened. We tried. I was one of the first to do CPR, I was the last. One cannot help but think how many shattered lives we come into contact with, even indirectly.

Monday, 8 September 2008

My Change of scene

Ahh, a new job. I am actually quite enjoying it. I would have written up more earlier but what can I say...I'm lazy, have had a busy few nights out and about and could not really have much to say.

Well, the new job is going well (for now) and there have been some interesting cases seen to. At the moment, as I am not working on a ward, it is really like going back to being a student again as I am needing to learn from scratch being in a cath lab. I have been scrubbed in for some cases, and the first week has progressed well. One of the problems I have had is that my staff ID badge (which doubles as a electronic Key Card to access certain locked doors in the hospital) has not been working. Basically, a mixture of the security computers being down, and then just plain not working. This means I cant actually get into the male changing room, which is a minor inconvenience. The blue scrubs look nice tho!

Sunday, 31 August 2008

My hymn called faith and misery

For those...anoyying pains
In less then 12 hours hours, I will be starting a new job. I shall be a Staff Nurse in a Cardiac Catheter Laboratory. Yes, I am going to be back in Cardiothoracics and I cannot wait for it.

Well, I am leaving acute medicine. It is with a mixture of thoughts and feelings that I leave the ward. I was not happy on there, that is true. There was a low moral on the ward, and I was happy to add to the general malaise by never having any shifts that every actually made me think "I really liked that". There was bad start to my internship placement when I was in Cardio last time as a student-mostly the bad feelings was that I really did feel like an outsider. Once I felt accepted, and had re-established my comfort zone, things were fine.

Things have not been fine elsewhere though. The ongoing relationship with my girlfriend has ended once and for all, as things have gone past the point where things could be salvaged. I regret that happening, but I know that the best thing to do is to move on, and see if I can find somebody else. Another thing that really annoyed me was a total- idiot- who went on a dangerous ego trip while on duty with St John the other day and basically started running the duty even though they are not supposed to duty manage (not trained for the role) and even though they were supposed to be "non-clinical" decided to go off to see a suspected medical emergency. This was odd as no-one radioed it in, and when a steward directed us to the call, we found them and somebody else in with the "patient" who then gave me and the AFA I was with a load of lip. YOUR ONLY A BLOODY FIRST AIDER, SO EVEN THOUGH YOU MAY THINK I'M "JUST" A NURSE, I'M A DAMN SITE MORE KNOWLEDGEABLE THEN SOME HALF-WIT WHO DOES A WEEKEND COURSE THEN THINKS THAT THEY ARE BETTER THEN A CONSULTANT IN TRAUMA MEDICINE! I have a code of conduct, accountability, professional registration, 3 years of UNIVERSITY training, and the ever present fact that I deal with acute patients every day I am at sodding work. I can recognise my limits, and work within them, but these idiots have not got a clue sometimes, nor any of the above mentioned qualities. Yes, you may be good at bandaging, but over-empowering the under qualified to think that they can make decisions which should only be made by those who are trained and qualified professionals is dangerous. On one call I was at, I said to the patient to have a check from A&E by a DOCTOR have have a small check done because I KNOW THAT TO NOT DO WAS TO MAKE A CHOICE ABOVE MY TRAINING. When I'm not sure, I ask a doctor, another nurse or arrange the patient to be checked elsewhere (I once told a patient to follow up with either a GP or practice nurse and wrote a continuation sheet for the follow up appointment as I needed to go to greater depth then the PRF allowed. I did that as I was aware of the NHS services the person would need to access, and had a good knowledge of how the follow up should work. I only know that because of my NURSE training. A 16 hour course alas, does not. For now, I am annoyed at SJA. They expect Doctors, Nurses and Paramedics to treat them as equals (they are not), but then show no respect to their superiors. Dangerous.

Thursday, 21 August 2008

My generalised anger

I am a tad discommoded tonight as I write this as I was intending to currently be on a night shift. I however turned up onto the ward and found that my shift has been swapped to tomorrow and Saturday [while now trying to remember if they were changed from nights to days or not altered from nights-ed].

Now, it has been almost a month since I last posted anything on here. I think that this blog is less posted then my old one, mainly because I have been away from home a lot an/or too tired to bother writing posts (especially when you write and see "comments 0" which makes me wonder if anyone reads this).

One of the main things that really gets on my nerve is the endless supply of trouble which tends to come with express delivery to the ward. Anything, even the most smallest thing, seems to be on the ward at the speed of light. However, I have see pinned to the notice board a letter written by the relative of a patient and they discuss at great detail the care given by a nurse on a particular day- I happen to be the nurse mentioned. The letter was very pleased and thankful for the care that the relative of the patient received. Did not see that one getting mentioned much!

Trouble is something relatively light for me on the ward. I have put a lot of incident forms in about patients of mine falling, and bar two about one incident, have occurred on nights when staffing levels are reduced (but not the number of patients who are at risk of falls). Pseudo science I know for staffing levels, but I guess with enough prolonged submission the shift will go from anecdote to supporting evidence in the official channels. Apart from a run in with a relief HCA the ward has been busy but no major disasters have occurred save for a minor injury one day. What does wind me up is the fact that the hospital is woefully short of beds and we seem to be a dumping ground for A&E and the AAU as they are driven to distraction by the 4-hour target et al (no doubt some A&E nurse is blogging about how unco-operative wards take all day to have patients discharged and gives them a headache arranging patients beds on wards...).

Biggest problem for me is my other half. She is currently going through a rough time and dispite my trying to be their, she is pushing me further and further away. Oh dear.

Tuesday, 22 July 2008

My overkill

It has been two weeks since I have been away. It was only on returning and being on shifts that have left me worn out and physically and mentally exhausted that have made me realise that half the problem is that the needless pressure which is placed on the ward has been the reason that we (the ward) have a reputation for being hectic.

Still, when you have 8 patients all with developing complex social problems and the strain which all nurses have on an acute medical ward, something has to break. As I have said, I am only on the ward for a six month contract for the maternity cover. Thankfully I yesterday had a phone call regarding an interview from a job within the speciality I like. I have got it. Now, I can leave, and make a fresh start in Nursing. I cant wait.