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, 26 December 2008
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".
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 birth...it 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.
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 birth...it 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!
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.
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.
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.
Monday, 30 June 2008
New vision for NHS
Yes, I know that I am on holiday but I am not jetting off until Thursday, so I have taken a look at the new vision for the NHS that the Department of health has released.
Now, I have read the beginning, and the forward is by the leader into the MMC fiasco. So, it is somewhat less alarming (I hope) to read of the effect of modernising Nursing careers. Now, visiting health professions and patients may be rubbing their hands with glee as another Nurse bashes the government. Well that will, and will not be happening.
The fundamental problem with Nursing care in the NHS is that too often, both in my own practice as a registered nurse, and from the reports made in media and by other staff nurses, ratios are unsafe. It is impossible for the nurse to always give every patient the same amount of attention. Clinical decision making is an important skill to posses as a nurse as this allows individual nurses to assess and attend/delegate patient care on a rationalised system. The theory postulates that care is given on a basis of need and priority under a guided framework utilising evidence based practice, not in an unco-ordinated and fragmented nature. Textbooks state that clinical decision making is the application of critical thinking. Critical thinking is accepted as being one of the skills that is possessed by people who are trained and taught within higher education, such as universities. The new vision for the NHS welcomes this idea of Evidence based practice, and that Nurses are the professionals that are most likely to shape the experiences that patients have while on wards. While the NMC are currently making a study on the effect of an all graduate profession, it is to a certain extent agreed that better patient outcomes and better quality of thought as a nurse will come from a graduate Nurse. This seems to be a common consensus between the government, the professional regulator and from the profession itself. While there are some very good points to be made by having an all graduate profession, there is one barrier to this.
The sad, and indeed true, problem with having an all graduate profession is the people that would train to be nurses. A degree nurse on the ward is not better then a nurse with a Diploma in nursing in doing their job per-say. This may not always reflect the problems that people may have while training, and the fact that like it or not, the average student nurse is female, aged 26, with one child. I admit, as a Male, 23, with no children, I am far from average (though this does not ergo mean that my perceptions are any less average opposed to the wider professional opinion). As a common factor, the Diploma with its bursary is a far more attractive option with the current rise in the cost of living. While the report may suggest better training, more career pathways for nurses, and a graduate training, there should be other considerations made to accommodate this within the wider pressures that society places upon individuals. A move that could lower the number of people graduating and entering the profession is not a move in a positive direction.
Only other thing is that the report seemed to be very vague:- they want to do things to improve the nursing profession, but the problem is the wording of the report was far too broad and vague in its meaning that it could be interpreted in a number of ways.
Now, I have read the beginning, and the forward is by the leader into the MMC fiasco. So, it is somewhat less alarming (I hope) to read of the effect of modernising Nursing careers. Now, visiting health professions and patients may be rubbing their hands with glee as another Nurse bashes the government. Well that will, and will not be happening.
The fundamental problem with Nursing care in the NHS is that too often, both in my own practice as a registered nurse, and from the reports made in media and by other staff nurses, ratios are unsafe. It is impossible for the nurse to always give every patient the same amount of attention. Clinical decision making is an important skill to posses as a nurse as this allows individual nurses to assess and attend/delegate patient care on a rationalised system. The theory postulates that care is given on a basis of need and priority under a guided framework utilising evidence based practice, not in an unco-ordinated and fragmented nature. Textbooks state that clinical decision making is the application of critical thinking. Critical thinking is accepted as being one of the skills that is possessed by people who are trained and taught within higher education, such as universities. The new vision for the NHS welcomes this idea of Evidence based practice, and that Nurses are the professionals that are most likely to shape the experiences that patients have while on wards. While the NMC are currently making a study on the effect of an all graduate profession, it is to a certain extent agreed that better patient outcomes and better quality of thought as a nurse will come from a graduate Nurse. This seems to be a common consensus between the government, the professional regulator and from the profession itself. While there are some very good points to be made by having an all graduate profession, there is one barrier to this.
The sad, and indeed true, problem with having an all graduate profession is the people that would train to be nurses. A degree nurse on the ward is not better then a nurse with a Diploma in nursing in doing their job per-say. This may not always reflect the problems that people may have while training, and the fact that like it or not, the average student nurse is female, aged 26, with one child. I admit, as a Male, 23, with no children, I am far from average (though this does not ergo mean that my perceptions are any less average opposed to the wider professional opinion). As a common factor, the Diploma with its bursary is a far more attractive option with the current rise in the cost of living. While the report may suggest better training, more career pathways for nurses, and a graduate training, there should be other considerations made to accommodate this within the wider pressures that society places upon individuals. A move that could lower the number of people graduating and entering the profession is not a move in a positive direction.
Only other thing is that the report seemed to be very vague:- they want to do things to improve the nursing profession, but the problem is the wording of the report was far too broad and vague in its meaning that it could be interpreted in a number of ways.
Sunday, 29 June 2008
My Hospital Drama
Just occasionally, on a 12 hour shift you have a half an hour or so that normally becomes the material of what the TV would have any member of the public believe is about 5 minutes of nearly every show. However, for the first time yesterday that (sort of) happened. I finally had my first compliment paid... by the bed manager who commented that I looked smart with a well presented uniform and for wearing a highly polished pair of shoes (Doc Martins to be exact).
Yesterday I had a patient who effectively ended up being on one to one supervision by myself and the other staff nurse in the bay (there were two staff nurses in my bay, no HCA), and a passing away, followed by the small half hour of "fun", which started with a call to the arrest team in another bay, then a patient falling, followed by A&E leaving a patient in a bay. As the patient was considered better nursed on an electric bed, I along with the other staff nurse assisted the sister and staff nurse from the bay to transfer the patient/do obs as well as checking on the obs for a patient on an infusion done by yours truly. Then it was handover time, and now I am off on holiday.
After that shift, I am glad.
Yesterday I had a patient who effectively ended up being on one to one supervision by myself and the other staff nurse in the bay (there were two staff nurses in my bay, no HCA), and a passing away, followed by the small half hour of "fun", which started with a call to the arrest team in another bay, then a patient falling, followed by A&E leaving a patient in a bay. As the patient was considered better nursed on an electric bed, I along with the other staff nurse assisted the sister and staff nurse from the bay to transfer the patient/do obs as well as checking on the obs for a patient on an infusion done by yours truly. Then it was handover time, and now I am off on holiday.
After that shift, I am glad.
Sunday, 22 June 2008
My struggle
At work, I have had the first experience of the pain in the arse relative. That's a bit of a hot potato, remember there this is my private thoughts on nursing. Seriously though, I am back in tomorrow and I am not going to be surprised (or indeed bothered) to find that there has been a complaint put in by a relative. I am sorry, but I am not going to be bullied by a relative who is ACTIVELY LOOKING for a reason to complain, rather then those who actually complain because they have been the unfortunate person on the receiving end of things when they go wrong. Now, I am not going to give too much away, but when you are trying to deal with a patient who had just taken a serious and unanticipated turn for the worse, I cannot, and will not, attend to another task which can wait when failure to act with the clinically priority patient could result in a cardiac arrest. I am not, and will not, accept that a complaint of attending to something when the same said relative was asking where I was the day before when starting up THE EXACT SAME SODDING THING. Nor is is reasonable to complain when an increased risk means that awaiting at SHO on call means a 35 minute wait for me to keep the patient safe. I am astounded as to the lack of respect that is shown to the medical services by the general public. A further example of this was out on duty on Friday night with St John Ambulance. I had a casualty who was a fair distance into woodland at an event. Having treated, I asked for a carry chair to be brought, and we struggled to get the patient out to a road. I requested the ambulance meet us at the roadside so we could transfer the patient. On reaching the road, there was a lot of cars. None of which were prepared to make way for the ambulance coming the opposite way. I went down to meet the driver, and we decided that the best thing to do would be to take the ambulance stretcher out and wheel it past the car. While we were getting the stretcher out, one cheeky bitch wound down the window of her car and said "Can you move forward, I cant see?". FFS, IF you see an ambulance crew getting a stretcher out, you know its for a patient, and seeing as the driver of said car was parked way back from the road, what was wrong with driving forward a little bit and asking the police who were guiding traffic out for help? It was only on my asking a steward to stop the cars from coming down the road that we were able to safely transfer the patient.
If any member of the health service was to be as rude to the public as what the public are too us, people would be struck off.
If any member of the health service was to be as rude to the public as what the public are too us, people would be struck off.
Wednesday, 11 June 2008
Nurses: We really need you. Now fuck off!
Speaking (or, to be correct here typing) as a male nurse, I find there are many differing perceptions of the Nurse and the role which a Nurse has. I am aware that nursing is and I daresay will always remain a profession which is female dominated (though many long suffering husbands will say that is not the only thing that women dominate).
However, I was amazed to read last week of the news that nurses will be struck off the NMC register far more easier then it currently is. I am not saying that the removal of those who are maverick or take a cavilier approach to their work should not be suspended. However, this means that malicious reports could be used. I had a run in with a manager as I was stabbed in the back by my HCA for... well, I dont really know what there were on about. I remember them saying that 2 patients needed pressure mattresses (I was tied up with a moribound patient and assisting another side room patient initially on the shift and the HCA was covering the bay which is how they found that before me) and so I said "Yes, that sounds good. Have you ordered the matresses?". Well, buggered if I know what the manager was on about but I am fed up of the job and want to leave (not nursing, just the ward:- come back cardiothoracic's, all is forgiven!). Another thing that was winding me up was the manager saying "I dont ask enough questions". WTF? I ask loads of sodding questions, and have worked in the same area on an equally crappy ward (read Nursing Student blof from "My first day-My half time") and have approached staff when unsure. I mean, what the hell am I to ask if I know what I am doing (which is mostly dementia/geriatric care evn though I am supposed to be on a chest medicine ward). Do they wand me to stop a staff nurse and ask "What is the capital of Denmark?
What makes me puzzled is then they come out with "we value nurses" or "respect each other". Funny, seems to me that no bugger respects me and I feel valueless. Worst thing is, I actually was being nice to the ward and never let on for a moment my cyicisim.
However, I was amazed to read last week of the news that nurses will be struck off the NMC register far more easier then it currently is. I am not saying that the removal of those who are maverick or take a cavilier approach to their work should not be suspended. However, this means that malicious reports could be used. I had a run in with a manager as I was stabbed in the back by my HCA for... well, I dont really know what there were on about. I remember them saying that 2 patients needed pressure mattresses (I was tied up with a moribound patient and assisting another side room patient initially on the shift and the HCA was covering the bay which is how they found that before me) and so I said "Yes, that sounds good. Have you ordered the matresses?". Well, buggered if I know what the manager was on about but I am fed up of the job and want to leave (not nursing, just the ward:- come back cardiothoracic's, all is forgiven!). Another thing that was winding me up was the manager saying "I dont ask enough questions". WTF? I ask loads of sodding questions, and have worked in the same area on an equally crappy ward (read Nursing Student blof from "My first day-My half time") and have approached staff when unsure. I mean, what the hell am I to ask if I know what I am doing (which is mostly dementia/geriatric care evn though I am supposed to be on a chest medicine ward). Do they wand me to stop a staff nurse and ask "What is the capital of Denmark?
What makes me puzzled is then they come out with "we value nurses" or "respect each other". Funny, seems to me that no bugger respects me and I feel valueless. Worst thing is, I actually was being nice to the ward and never let on for a moment my cyicisim.
Wednesday, 4 June 2008
my nemesis
I have today met my nemesis on the ward. More of that later, I have been a busy nurse (though no doubt in the new and improved way that Nurses can be struck off I have been a lazy, workshy layabout). Ladt week I did two overtime shifts as well as the three rotad shifts, so that was5 shits in 7 days then have just come home sick from my third shift this weel. I am a bit annoyed at the moment. Not in the way that there is always NHS conflict, but at the way that it seems whenever we do anything good on the ward, we are critiacised by the management over something petty. We have a new matron on the ward. All of us got a toung bashing. The one they got me on was a patient who had their catheter bag left too low on the bed by a physiotherapist (who i must admit is way too attractive to have me grass them up) and part of a nebuliser which had been left inside the mask. While these are fair, I was drawing MST and Oromorph with another nurse (seperate times of course), had just helped with a bay who had a patient slide off a bed, seen to infected patients, and sent 2 referals and appeased a relative over the phone who had been passed incorrect information by somebody in the family. So yes, I had not seen the catheter that was touching the floor, I was a bit tied up trying to do a million and one other flaming jobs at the same time. But if you want me to be able to meticulosly see every last detail, give me more nurses and less patients. I would not mind, but you never hear them saying "thanks for comming in at short notice on youy off" or "well done on not having any of you patients get MRSA last month" or "your patients seem generally happy" or "Your record keeping and drug administration is very meticulous, well done". Well, its easy for me to get het up. But I can still have the last laugh (as long as I get another job offer that is), as when 4 1/2 months are over, I am going with the finish of my contract from a short staffed unit, so they can take their nit picking,the job along with all the mind numbing fuckwittery and shove it
Saturday, 17 May 2008
My new consideration
*In an effort to stremline services, Staff Nurse musing will only be published on a three day-shift basis. This is generally because staff Nurse M is knackered after shift and usually cannot be bothered doing much except eating, showering, and going to bed*
I dont know what it is, but I have felt drained this week. I think part of it was that I have squeezed a lot into the 7 days. Well, lets go over what I have been up to.
Saturday 10th May: St John Ambulance duty at a Junior school football tournament. Now, I was OK being up early for this one as the school it was being held at was a few miles away. Hey, this could not be a busy duty right? Nope. Have a guess how many people I saw, and how many in total. Go on, guess...5, 6, 0? Nope. I saw 14, the total number of people who required the attention of the St John Team was 43. These were (all bar one) very minor stuff- ice packs for sprains, people kicked, sprains etc, but enough when there were only 6 people, and no ambulance, and the fact that we ended up sending somebody back to division to get more gloves, ice packs and patient report forms.
Sunday 11th May
Last match of the premiership season. I saw three people in the match before the somewhat down-playing message of "A disturbance in the south stand" turned out to be a near riot which resulted in several injuries. As there were only the crowd doctors on duty, the first aid post I was in was asked to take a head injury, even though while waiting the other post phoned to ask if I could attend a "cut finger". Evetually, ambulances were arranged to bring the injured people who required hospital attention to A&E.
Monday
A half shift as I was due to do a course on wednesday. I opted for the late shift as this is better for me. I worked on a shift which required many social care referrals, some basic nursing care, some uneventful drug rounds and one new admit from a home who took alot of my time.
Wednesday
Course day run in conjunction with the ICU on acute management of patients. Basicaly the ABCDE approch to dealing with the ill patient. Sort of along the lines of the advanced first aid. There was talk of us now being able to prescribe 0.9% saline under patient directive in an emergency only (for rapid infusion over 10 minutes, not like parental fluid therapy), though I checked and my ward does not subscribe to it. I know the aim was to give a framework to structure patient assessment/management. One think that struck me was the way it almost sounded like being "Don't think outside the box, but feel free to think wholly within the flow chart". Who needs clinical knowledge when a flow chart will mean a trained monkey can do the job of a nurse eh?
Thursday
I lumbered into a twelve hour shift on a different bay. 7 patients, two planned for discharge friday, two for thursday. One was... how can I put this... challenging to deal with. Mainly with the way they just sat and said/did nothing. I dont mean that the person was paralysed or could not speak, I mean they literally just sat there. What topped it off was the arrogant expression they wore constantly. It was a relieve to send them home.
I also had my first enema to do since being a student, the result was 1000% sucessfull, and I spent many a happy hour cleaning faecal matter up for most of the day from my patients.
Friday
For some reason, everyone had a shit day. I mean that both physically and metaphorically. Highlights included an infection being traced down, the other staff nurse I am preceptee for doing the two dischages (which I may add took hours of her time), a patient who "fell" twice (or as I imagine, actually laid on the floor deliberatly to try and stop going home), some washes, a transfer, and everyone being very depressed.
I dont know what it is, but I have felt drained this week. I think part of it was that I have squeezed a lot into the 7 days. Well, lets go over what I have been up to.
Saturday 10th May: St John Ambulance duty at a Junior school football tournament. Now, I was OK being up early for this one as the school it was being held at was a few miles away. Hey, this could not be a busy duty right? Nope. Have a guess how many people I saw, and how many in total. Go on, guess...5, 6, 0? Nope. I saw 14, the total number of people who required the attention of the St John Team was 43. These were (all bar one) very minor stuff- ice packs for sprains, people kicked, sprains etc, but enough when there were only 6 people, and no ambulance, and the fact that we ended up sending somebody back to division to get more gloves, ice packs and patient report forms.
Sunday 11th May
Last match of the premiership season. I saw three people in the match before the somewhat down-playing message of "A disturbance in the south stand" turned out to be a near riot which resulted in several injuries. As there were only the crowd doctors on duty, the first aid post I was in was asked to take a head injury, even though while waiting the other post phoned to ask if I could attend a "cut finger". Evetually, ambulances were arranged to bring the injured people who required hospital attention to A&E.
Monday
A half shift as I was due to do a course on wednesday. I opted for the late shift as this is better for me. I worked on a shift which required many social care referrals, some basic nursing care, some uneventful drug rounds and one new admit from a home who took alot of my time.
Wednesday
Course day run in conjunction with the ICU on acute management of patients. Basicaly the ABCDE approch to dealing with the ill patient. Sort of along the lines of the advanced first aid. There was talk of us now being able to prescribe 0.9% saline under patient directive in an emergency only (for rapid infusion over 10 minutes, not like parental fluid therapy), though I checked and my ward does not subscribe to it. I know the aim was to give a framework to structure patient assessment/management. One think that struck me was the way it almost sounded like being "Don't think outside the box, but feel free to think wholly within the flow chart". Who needs clinical knowledge when a flow chart will mean a trained monkey can do the job of a nurse eh?
Thursday
I lumbered into a twelve hour shift on a different bay. 7 patients, two planned for discharge friday, two for thursday. One was... how can I put this... challenging to deal with. Mainly with the way they just sat and said/did nothing. I dont mean that the person was paralysed or could not speak, I mean they literally just sat there. What topped it off was the arrogant expression they wore constantly. It was a relieve to send them home.
I also had my first enema to do since being a student, the result was 1000% sucessfull, and I spent many a happy hour cleaning faecal matter up for most of the day from my patients.
Friday
For some reason, everyone had a shit day. I mean that both physically and metaphorically. Highlights included an infection being traced down, the other staff nurse I am preceptee for doing the two dischages (which I may add took hours of her time), a patient who "fell" twice (or as I imagine, actually laid on the floor deliberatly to try and stop going home), some washes, a transfer, and everyone being very depressed.
Thursday, 8 May 2008
My Nightmare
I am regretting the choice I have made, and also that while I had an interview for the ward that I interned on I did not get the job as I was second (to somebody who has been qualified longer as a staff nurse. Its nice but not much compensation).
I have been in Nursing in some form since 2005. Last night was beyond a shadow of a doubt the worst shift I have ever had to work. As I write this my gut feeling is to try and find another ward to work on as I seriously do not even want to go back.
Last night I was originally only going to have a normal "Day" team. I.e. One x6 bed bay and x2 side rooms. As the ward next door was short, the other staff nurse was sent next door, and I inherited all 16 patients. This was not a problem, what happened next was.
The main problem is that with a high number of dementia patients on the ward, there is one in particular who I am the nurse for. Unfortunately they are very confused and get very aggressive. I am bound by the code of conduct to maintain patient confidentiality and thus I will abide my that. However, what did culminate was the patient literally running off the ward, being found by the night sister in a different area, and being confused. I was running between a dying patient and somebody with SOB, while watching over my other 14 patients. Not a great start. I had already asked the SHO for advise re:sedation and was told that there was nothing they would be able to advise. By the time this happened, the night sister had the patient back on the ward. The end result with the whole incident was me, the doctor, the night sister and my HCA being hit by the patient, and having to forcefully inject sedatives for their own good.
I hate this job.
I have been in Nursing in some form since 2005. Last night was beyond a shadow of a doubt the worst shift I have ever had to work. As I write this my gut feeling is to try and find another ward to work on as I seriously do not even want to go back.
Last night I was originally only going to have a normal "Day" team. I.e. One x6 bed bay and x2 side rooms. As the ward next door was short, the other staff nurse was sent next door, and I inherited all 16 patients. This was not a problem, what happened next was.
The main problem is that with a high number of dementia patients on the ward, there is one in particular who I am the nurse for. Unfortunately they are very confused and get very aggressive. I am bound by the code of conduct to maintain patient confidentiality and thus I will abide my that. However, what did culminate was the patient literally running off the ward, being found by the night sister in a different area, and being confused. I was running between a dying patient and somebody with SOB, while watching over my other 14 patients. Not a great start. I had already asked the SHO for advise re:sedation and was told that there was nothing they would be able to advise. By the time this happened, the night sister had the patient back on the ward. The end result with the whole incident was me, the doctor, the night sister and my HCA being hit by the patient, and having to forcefully inject sedatives for their own good.
I hate this job.
My Two nights
Bank holiday Monday and Tuesday were two night duties for yours truly. The compliment of nurses in the night is reduced to two staff nurses and two Health Care Assistants (HCA). This results in there being 16 patients to each Nurse/HCA pairing. One takes the top end, the other the back. I was assigned to the top end of the bay to where I had been for the three day shifts.
I began on Monday by being talked through the routine for the ward in the evening-this is different for the night then the day. After having the hand over, I was back with a slightly larger caseload of 6 patients. The side rooms were with my preceptorship mentor. I began with a medication round. There are a lot of nebulizers used on the rounds as well as tablet medications. In addition, some of my patients request a lot of PRN medication so it is usually worthwhile noting of they mention anything while I am doing my preliminary check of the the bay at the start of the shift. The round was done, and there was then the IV antibiotics and the controlled drugs to be done near 10pm. Rather then people doing these separately, usually there are the two nurses in at the same time to check the controlled medication and the IV antibiotics to save waiting.
This was the way for the two nights which for me were tied up dealing with a patient who has predominantly mental health problems associated with advancing years. This was to be the bigges factor the the shift last night (see above).
I began on Monday by being talked through the routine for the ward in the evening-this is different for the night then the day. After having the hand over, I was back with a slightly larger caseload of 6 patients. The side rooms were with my preceptorship mentor. I began with a medication round. There are a lot of nebulizers used on the rounds as well as tablet medications. In addition, some of my patients request a lot of PRN medication so it is usually worthwhile noting of they mention anything while I am doing my preliminary check of the the bay at the start of the shift. The round was done, and there was then the IV antibiotics and the controlled drugs to be done near 10pm. Rather then people doing these separately, usually there are the two nurses in at the same time to check the controlled medication and the IV antibiotics to save waiting.
This was the way for the two nights which for me were tied up dealing with a patient who has predominantly mental health problems associated with advancing years. This was to be the bigges factor the the shift last night (see above).
Saturday, 3 May 2008
My two days
Seen patients, several passed away on ward, beaten up by patient with confusion, cornered by mental health patients, managed to go off duty with keys, got security badge, spent most of time on medications, bed baths, Dynamap buggered, assisted when first on scene to emergency on ward, commoding and paperwork. Feel knackered.
Patients seen to appreciate care so not all fully lost.
Sums up the life of a modern staff nurse really. Florence would be spinning in her grave.
Patients seen to appreciate care so not all fully lost.
Sums up the life of a modern staff nurse really. Florence would be spinning in her grave.
Thursday, 1 May 2008
My Genesis
I was in the hospital changing room this morning. I had just put my uniform on, and looked in the mirror. I saw a staff Nurse in the reflection. It was with mild horror and a smidgen of excitement that it turns out the staff nurse was me.
Yes, this is my first "proper" shift as a Staff Nurse after qualifying. I was initially bloody terrified. I mean, I have never been on the ward, and now people would not be looking at me and saying "Have you seen a staff Nurse about?". Nope, this time it would be "oi, you!". Oh dear.
Well, having been greeted and given the mandatory cup of tea, I was introduced to the staff Nurse who I was working with (who shares my last name). We agreed that rather then me shadow fully, that I would take the bay patients and work observing initially, and then take on a small caseload myself. We started the drug round first off. That was the first big step. Before, as a student nurse, if I did medications they had to be checked and countersigned by the registered nurse. When we started, the other staff nurse said "Have you got you PIN through?". I have, so the round was left to my own devices. The round did take 40 minutes. Now, before you all snigger and think "Daft bloody newbie" I may point out the first patient was bad at swallowing and so I was the one who gave the tablets literally, and with two of the patients there was no medication sent up with the overnight admissions. This necessitate my going through the ward drug cupboard and ordering several medications from the pharmacy department. It was at the same time, one of the wards consultants came into the treatment room who also has my last name as well. That was rather odd. Anyway, that done, I did the washes. Two were straight forward while one was a patient who needed changing.
The day wore on with the same pattern emerging. I did some dressings, some patients needed turning, some were admitted, all had paperwork done/risk assessments completed/nursing plans put into notes e.t.c. One change I found was if one of my patients asked for PRN medication. It was a massive change to be able to say "Right you are" and then get it there and then for them rather then play "Hunt the Nurse". This happened several times.
All in all, the day was steady. The ward manager spoke with me several times to ask how I was getting on. She thought that I had crammed a lot into my day. I did say that my approach to work is to initially ask when unsure. I have worked for 3 years to get my PIN. I would much rather be ridiculed for asking about something that seems trivial rather then have the ward manager come to me and say "I need a word with you as you should not have done..."
One thing I have found of today is that while I checked, double and quadruple checked my medications and drug cardex, I am still full of nagging doubt. About what, I really don't know. I think it is the after effect of the nerves wearing off. I am back in tomorrow.
Yes, this is my first "proper" shift as a Staff Nurse after qualifying. I was initially bloody terrified. I mean, I have never been on the ward, and now people would not be looking at me and saying "Have you seen a staff Nurse about?". Nope, this time it would be "oi, you!". Oh dear.
Well, having been greeted and given the mandatory cup of tea, I was introduced to the staff Nurse who I was working with (who shares my last name). We agreed that rather then me shadow fully, that I would take the bay patients and work observing initially, and then take on a small caseload myself. We started the drug round first off. That was the first big step. Before, as a student nurse, if I did medications they had to be checked and countersigned by the registered nurse. When we started, the other staff nurse said "Have you got you PIN through?". I have, so the round was left to my own devices. The round did take 40 minutes. Now, before you all snigger and think "Daft bloody newbie" I may point out the first patient was bad at swallowing and so I was the one who gave the tablets literally, and with two of the patients there was no medication sent up with the overnight admissions. This necessitate my going through the ward drug cupboard and ordering several medications from the pharmacy department. It was at the same time, one of the wards consultants came into the treatment room who also has my last name as well. That was rather odd. Anyway, that done, I did the washes. Two were straight forward while one was a patient who needed changing.
The day wore on with the same pattern emerging. I did some dressings, some patients needed turning, some were admitted, all had paperwork done/risk assessments completed/nursing plans put into notes e.t.c. One change I found was if one of my patients asked for PRN medication. It was a massive change to be able to say "Right you are" and then get it there and then for them rather then play "Hunt the Nurse". This happened several times.
All in all, the day was steady. The ward manager spoke with me several times to ask how I was getting on. She thought that I had crammed a lot into my day. I did say that my approach to work is to initially ask when unsure. I have worked for 3 years to get my PIN. I would much rather be ridiculed for asking about something that seems trivial rather then have the ward manager come to me and say "I need a word with you as you should not have done..."
One thing I have found of today is that while I checked, double and quadruple checked my medications and drug cardex, I am still full of nagging doubt. About what, I really don't know. I think it is the after effect of the nerves wearing off. I am back in tomorrow.
Tuesday, 29 April 2008
Musing on my final hours till work
There are a number of things which as a student Nurse I often thought would be beyond me. In the early days of training, the notion of ever wearing the blue slides of a staff nurse on my tunic was one of them. In 36 hours time, that however is going to become a reality. It shall be my first proper shift as a staff nurse (albeit a supernumerary one). I am going to pick my uniform up tomorrow. I hope by then that the trousers will have arrived or else there is going to be a quick think of what to wear Thursday. I am not sure how the trousers had not arrived by last Friday, but I was told that there are "orders being delivered all that time" so fingers crossed that all works out well. Starting my first day without trousers would be bad, not to mention embarrassing all around if the ward manager demands I wear uniform issue trousers only. My girlfriend has laughed a lot about that.
Of course there are all the thousand and one other worries that I now have:- Will I like the ward, will I get on with most of the staff (I am guessing there will be one person who will rub me up the wrong way), will the other professions be OK, what will my caseload be like, and will I (after the 3 months away from ward Nursing) settle into the ward OK. I have worked at the hospital, and I am comfortable with all that. I am sure that most of this is just nerves before shift, but if it all goes pear shaped, I could be in for 6 months of hell.
On the positive side, I have nursed patients with the conditions as medical sleep outs before, and had a few emergency cases with St John related to the area. I have met some of the staff, one of the FY2 doctors was on my internship ward for a while, and one of the consultants on the ward was holding clinics when I worked on an out patients department while in second year of training. The good points outweigh the bad.
Unfortunatly, having to be up at 5:15am for days is a pain.
Of course there are all the thousand and one other worries that I now have:- Will I like the ward, will I get on with most of the staff (I am guessing there will be one person who will rub me up the wrong way), will the other professions be OK, what will my caseload be like, and will I (after the 3 months away from ward Nursing) settle into the ward OK. I have worked at the hospital, and I am comfortable with all that. I am sure that most of this is just nerves before shift, but if it all goes pear shaped, I could be in for 6 months of hell.
On the positive side, I have nursed patients with the conditions as medical sleep outs before, and had a few emergency cases with St John related to the area. I have met some of the staff, one of the FY2 doctors was on my internship ward for a while, and one of the consultants on the ward was holding clinics when I worked on an out patients department while in second year of training. The good points outweigh the bad.
Unfortunatly, having to be up at 5:15am for days is a pain.
Friday, 25 April 2008
My bust blood vessle
How I have manged to keep my head from exploding over the last few days is both beyond me and a testament to my self control. I have been told that my start date for the ward of Hospital B is to be the 1st May. I am not sure if I am going to work Thursday, Friday and Saturday but I really am not fussed-it is nice to think that the start time for me is actually less then 6 days. I am not sure what I am to wear though as only my tunic has arrived (I think the patients would not be pleased if I turned up wearing only a tunic and boxer shorts- though that may raise a laugh).
Anyway, I should be glad to be here, as my mate and I were nearly killed in the ambulance the other morning (more of that later). I was out on Tuesday with my mate and his girlfriend to take a St John Ambulance (Renault) down to the county HQ to pick up a Land Rover based ambulance. The Land Rover is the only one which has a tow bar fitted for towing First Aid posts. Once we picked the Landie up, we went back to the main HQ of my area (the original County HQ before two counties merged in 1999). There, we saw the first aid post. I thought that the FAP we were to use was an old caravan. The one we had was in fact an ex-mobile office. To say it was a mess is an understatement. We could write in the dirt inside the cupboards in the clinical area, and the fridge in the staff part had black mould inside it. Most of the response bags were full of out of date bandages and dressings. In one there was only a triangular bandage, a bottle of mineral water and a trauma dressing. What use would THAT be in an emergency I wonder? It took the three of us 5 hours to clean and re-stock it.
On Wednesday, me and my mate took the Land Rover, with the FAP on the back and had to take it on a 50 odd mile trip to the event where it was being used. Wednesday was the set up day. We were going along without too much problem, when about 3 miles away from the destination a lorry (the class 2 HGV type) pulled out across the road right in front of us on a corner. If my mate had not had the time to straighten the wheel up and do an emergency brake, that would have been one heck of a crash (the FAP on the back tends to want to flip the Land rover over. Imagine the post flipping up and over on a busy road in rush hour and falling on top of cars...). Anyway, we got to the location still alive and set up the post. The day was quiet and there was only one person who I saw (minor injury). While I seeing to that, my mate and another first aider who had met us at the event treated another person.
Yesterday, I was there. I started off in the firsts aid post and we had only just started when me and a fellow member who took induction together had two patients. One was sent back to event while the other I advised to seek the attention of their GP or practice nurse to follow up treatment. It was while with the second one that I got very annoyed with an ambulance service EMT who was working the event with St John who kept butting in and interuppting wanting to know how long we would be. I asked if there was another patient, though it seems there was none. They seemed to think good patient care can be delt with in a dismissive manner. Arse.
Thats about the highlights. The end to an arsey week was me arguing the toss with my divisional superintendat about me wearing a Fob watch. The hospital and the latest research suggests that wrist watches should not be worn. This is the opposide of SJA policy. Gun to your head, where DO you sit on the debate?
Sunday, 20 April 2008
My dwindle
Two duties over the course of the weekend. The good news is that it seems that my bad spate of patients with St John Ambulance is coming to an end. Last Wednesday I was at the international match for the under 18 side. There was a shortage of members at the game and I ended up covering both the First Aid post and a corner at the opposite side of the field (where I was for the majority of the game). There was no injuries (bar one which was seen by another corner and required no real input).
Saturday saw another premiership match. I was deployed to the first aid room of the stadium. Over the course of the last few matches this has been where within a few moments of the gates opening there had been at least one person present. In fact there was nobody seen in the first half and it was near full time before there was anyone presented. The person who did complained of pains. I had a look at them and could not find anything seriously wrong and suspected there was nothing more then a minor ailment that was causing the problem. However, to be on the safe side, I asked for the duty Doctor to attend. In due course, he did. Unlike certain other medical bloggers, I believe the type of person who joins a volunteer organisation which consists primarily of volunteer First Aiders is not like some of the anarchic opinions offered on the blog sphere. Indeed, the Doctor listened to my handover, agreed that I seemed to be on the right lines and carried out a full diagnostic check to back up our findings. That done, a recommended prescription was given and I administered the medication to the patient. That concluded the match.
Today, I was covering a half marathon. I was put with another St John Ambulance volunteer, this time somebody trained to Ambulance Aid 1 standard. As there was a Paramedic and myself there, it was decided that I would form a response team for the far part of the course. We were due to mobilise to a roundabout on a closed road, before moving to a leisure centre. The first part went well (the roundabout bit near the start). At 11:30 we were told that we were going to be picked up by an event mini bus and taken to the second deployment point. After being picked up, we overheard there were patients. These were being seen to by both the ambulances that were on duty. In the meantime, we were driven down a road that turned out to be gridlocked and we sat for over an hour in this state. This was not good as we were the only people left free to respond to a call. Indeed, there was a message come over the Marshall's radio of a patient at one of the points, though there was no message passed to St John. I did radio it in but there seemed to be no immediate need for us. After a while, we were told by the radio to alight near where we were and take up position there. By this time most of the runners had passed us in the mini bus anyway, so we were treated to a quiet hour and a quarter while the last runner came up. After a run back in the ambulance which was following the last runner, I got off duty (with a free tee shirt).
In the world of my job, I have decided that "Hospital A" are really not for me and have told them I shall not be taking up the post. I have been treated better by the other hospital. They have been far more pro-active and welcoming, and the kind of ward that does that is the kind that normally will try to take care of its staff. While it is only a 6 months contract, I have been successful in the post for the community hospital near me. By the time the paperwork is all sorted, I am hoping that this will be roughly time to finish and change jobs.
Saturday saw another premiership match. I was deployed to the first aid room of the stadium. Over the course of the last few matches this has been where within a few moments of the gates opening there had been at least one person present. In fact there was nobody seen in the first half and it was near full time before there was anyone presented. The person who did complained of pains. I had a look at them and could not find anything seriously wrong and suspected there was nothing more then a minor ailment that was causing the problem. However, to be on the safe side, I asked for the duty Doctor to attend. In due course, he did. Unlike certain other medical bloggers, I believe the type of person who joins a volunteer organisation which consists primarily of volunteer First Aiders is not like some of the anarchic opinions offered on the blog sphere. Indeed, the Doctor listened to my handover, agreed that I seemed to be on the right lines and carried out a full diagnostic check to back up our findings. That done, a recommended prescription was given and I administered the medication to the patient. That concluded the match.
Today, I was covering a half marathon. I was put with another St John Ambulance volunteer, this time somebody trained to Ambulance Aid 1 standard. As there was a Paramedic and myself there, it was decided that I would form a response team for the far part of the course. We were due to mobilise to a roundabout on a closed road, before moving to a leisure centre. The first part went well (the roundabout bit near the start). At 11:30 we were told that we were going to be picked up by an event mini bus and taken to the second deployment point. After being picked up, we overheard there were patients. These were being seen to by both the ambulances that were on duty. In the meantime, we were driven down a road that turned out to be gridlocked and we sat for over an hour in this state. This was not good as we were the only people left free to respond to a call. Indeed, there was a message come over the Marshall's radio of a patient at one of the points, though there was no message passed to St John. I did radio it in but there seemed to be no immediate need for us. After a while, we were told by the radio to alight near where we were and take up position there. By this time most of the runners had passed us in the mini bus anyway, so we were treated to a quiet hour and a quarter while the last runner came up. After a run back in the ambulance which was following the last runner, I got off duty (with a free tee shirt).
In the world of my job, I have decided that "Hospital A" are really not for me and have told them I shall not be taking up the post. I have been treated better by the other hospital. They have been far more pro-active and welcoming, and the kind of ward that does that is the kind that normally will try to take care of its staff. While it is only a 6 months contract, I have been successful in the post for the community hospital near me. By the time the paperwork is all sorted, I am hoping that this will be roughly time to finish and change jobs.
Tuesday, 15 April 2008
May the farce be with you...
...instead of me! Some interesting developments with the much fabled tale of me ever actually being employed as a Nurse. A week gone Friday, I was interviewed for a post in a community hospital. The exact post was split between working on the ward (where I was for my first placement) and minor injuries (something that I would be used to being a St John Ambulance volunteer). I have not been contacted by the people who interviewed me. However, after I had popped out yesterday, I came home to be told that somebody had rang from "Hospital A" looking for me. I rang the number which was left and this gave a pre-recorded message from a doctors surgery. I phoned the number given for the HR department of Hospital A and they said it was not them. On checking 1471, I was given a totally different number (makes a change as usually the numbers say "not given"). Anyway, it turns out that this was for the PCT which have a similar name to where hospital A is. They were after a reference for contacting. Now, I find this odd. Why phone asking me for a reference when I have not even been contacted to say if I have got the job or not.
Then today, even more movement. Now, I have little good to say of the CRB check as they have cost me £2000 in lost earning potential. I got a CRB back today. Ah-ha, those who have bothered to read cry, Hospital A finally got a CRB for you? Nope, Nope, Nope. The CRB check I got back today was for...Hospital B! The ones who sent their check away second. Work that one out if you can! Potentially, the future could map out as this:
1)Accept the post offered by the PCT as this is a full time permanent contract.
2) Commence work with Hospital B ASAP. This will mean earning money again, and be a 6 months stopgap.
3) Fill in the forms required for the PCT and await the start date. Given the time which has elapsed in the first 2 job offers, this could easily run for 6 months if I can start soon!
4) Turn down the hospital A post when I am contacted by writing.
However, if I have not been successful with the PCT, I may well just keep on with Hospital A who will keep me on longer then 6 months. I need to see the paperwork to confirm this before I can make any firm final choice.
Then today, even more movement. Now, I have little good to say of the CRB check as they have cost me £2000 in lost earning potential. I got a CRB back today. Ah-ha, those who have bothered to read cry, Hospital A finally got a CRB for you? Nope, Nope, Nope. The CRB check I got back today was for...Hospital B! The ones who sent their check away second. Work that one out if you can! Potentially, the future could map out as this:
1)Accept the post offered by the PCT as this is a full time permanent contract.
2) Commence work with Hospital B ASAP. This will mean earning money again, and be a 6 months stopgap.
3) Fill in the forms required for the PCT and await the start date. Given the time which has elapsed in the first 2 job offers, this could easily run for 6 months if I can start soon!
4) Turn down the hospital A post when I am contacted by writing.
However, if I have not been successful with the PCT, I may well just keep on with Hospital A who will keep me on longer then 6 months. I need to see the paperwork to confirm this before I can make any firm final choice.
Saturday, 12 April 2008
My brief work
Well, that's another St John ambulance duty, this time the league one side. Only one patient, with queried fracture to limb. Only required a second opinion from a paramedic. Advised to attend A&E to get seen to. That was the duty, which otherwise saw a dismal performance by the home side.
I am back there on Wednesday when the England under 18 side are against Austria (so time to polish up my GCSE German perhaps?) and also now have 30 days till I have induction.
I am back there on Wednesday when the England under 18 side are against Austria (so time to polish up my GCSE German perhaps?) and also now have 30 days till I have induction.
Sunday, 6 April 2008
My knowing when to quit
Today is freezing and has been snowing. Of course, it's JUST the weather to go to a Football match on duty with St John. I walked to division the other night as it was a pleasant evening. Today is a total opposite.
Well, with an early kick off time, we were required to get to the stadium for a much earlier briefing then usual. The complement was of 24 first Aid qualified St John members, 5 Ambulance aid members, two Nurses (including me) and two Doctors. I was sent to a first aid post with two ambulance aiders and two first aiders. The room was set up and when the corner teams left, it all went quiet. For about 5 minutes. Then we had a person present. After asking the basic few questions that we always ask, ie whats wrong, any pain, what symptoms are etc, it soon became clear that the problem was a medical one. Now, I may be good a patching up wounds and looking after people who have been seen and need care. However, I am not trained to diagnose. Knowing this was defently "not one for me" I unceremoniously asked for the duty Doctor to come over and see the person as this was clearly a job only Doctor would be suitable for. So, with them on their way, I set about doing the observations, and gave a handover when they arrived and thus, the patient was seen and assessed and the apropiate steps taken for them. With this going on, there were other people who came in over the course of the match. Both of these were seen by the other people in the first aid post (after all, this is a team effort and there was no reason for me to stick my ore in).
With an uneventful last part of the match, the last call of the day made to the post was simple, and there ended the match. The journery back in the snow was cold, and traffic was a bit heavy. Still, all is well that ends well. Today also is a great way of knowing when to quit while ahead.
Thursday, 3 April 2008
40 days
Annoyed? No, I'm just f"&king rabid at the moment. "Oh yes" they said "Have a job with us" they said. Oh really matey boy? Just what they forgot to mention is that the fourth bridge will take less time to paint then I will have to wait to start either sodding job.
I have already gone through the CRB check and how that is stopping everything. Now though, there is another spanner in the works. Induction. I have no idea what I am supposed to cover, and frankly hope it better be worth my time as opposed to a day being told something which anybody who has worked on any ward in any hospital already knows. So, where are we up to:
"Hospital B":- After taking 3 weeks to arrive, the letter confirming my tempory post, CRB check and occupational health decleration have been sent off-on the first postal day mark you. Undoubtedly, they too will want to have their own CRB check as opposed to the recent St John Ambulance CRB check which arrived a few days ago. I cannot fathom out why they are so obsessed with a CRB with their own name on the top when a check arrived a week ago that is just as good. Their argument? "They are only valid on the day they were printed". Nice, but I am pained to point out it took 7 days for the St John Ambulance CRB to arrive (more of laying into St John Ambulance later in this post). A small point is that when a CRB check comes to my house, the body requesting the check actually gets the check 24 hours later...or 48 hours after the valid period. Can you see the flaw in their reasoning? Yup, the CRB with their name on is, using their own criteria, invalid. I have a uniform on order, though am not going to collect it until I have reason to believe that they can give me a start date before the other hospital. In addition, they sent me a letter stating to attend trust induction... on the 2nd June! If that is how long they are going to take, then they are definatly dead in the water.
Hospital A on the other hand were phoned by me on Tuesday. I have not heared anything from them so wanted to check see what was happening. As you may be aware, the CRB went in to them on the 5th March. The check can take 3-6 weeks. It is at [drum roll here]...stage ONE. Basically, it's arrived at the CRB building. Thats it. Now, what really annoys the hell out of me is that the CRB is a government body (it is subsumed from part of the Home Office). They also get paid for each CRB. So why is it then that it takes 6 weeks to effectivly search the CPS computer database which is like google search for criminals? Lets remember here a few other govenment bodies:
Job Centre Plus:-Department of Work and Pensions: 2 weeks to clain Job seekeres allowance.
DVLA- Department of Transport- How long do you think it will take them to contact you if you fail to tax or SORN a car when the tax is due? Proberbly 3 working days but not 6 bloody weeks thats for sure!
On the up side, they have said that I must attend induction...then one for me being [another drum role] 12th May. Yesterday, that was 40 days. Anyone recall Noah and his flood? 39 days from today. Jesus, in that time I could have seen a job advert, applied, been interviewed and put in 4 weeks notice and STILL have a day or too off. No wonder the NHS is in a staff crisis if this is how long Nurses have to wait. I mean, think here for a moment. I know "hospital B" are at screaming point with their Nurses. There is a real chance that I am going to turn down that job offer. Not only have they been short prior to my arrival, they have been short during these few weeks. If/when I turn down the job offer, they will be shorted for an even longer time as well. I know they my job there was to cover for maternity leave. The kid will be having its 10th birthday before I get on the ward at this rate.
Now, for St John. 3 weeks ago, I had my interview with the county Nursing officer. I was phoned up on Tuesday by another divisions superintendant who was wanting to know if I was free to work as a Nurse in an ambulance working out from a hospital in another county to where I live. I said yes to it. Only to find that county have no record of my Nursing registration. They think it is a bottleneck between my divisional superintendant (who has since assured me that paperwork is with NHQ and will chase it up) and county HQ. Aparrently the "checks" take time. What effing checks? You have my PIN number, go on the NMC website and use the employers checking service! What is it with me and paperwork? I have 39 days of this hell to endure!
I have already gone through the CRB check and how that is stopping everything. Now though, there is another spanner in the works. Induction. I have no idea what I am supposed to cover, and frankly hope it better be worth my time as opposed to a day being told something which anybody who has worked on any ward in any hospital already knows. So, where are we up to:
"Hospital B":- After taking 3 weeks to arrive, the letter confirming my tempory post, CRB check and occupational health decleration have been sent off-on the first postal day mark you. Undoubtedly, they too will want to have their own CRB check as opposed to the recent St John Ambulance CRB check which arrived a few days ago. I cannot fathom out why they are so obsessed with a CRB with their own name on the top when a check arrived a week ago that is just as good. Their argument? "They are only valid on the day they were printed". Nice, but I am pained to point out it took 7 days for the St John Ambulance CRB to arrive (more of laying into St John Ambulance later in this post). A small point is that when a CRB check comes to my house, the body requesting the check actually gets the check 24 hours later...or 48 hours after the valid period. Can you see the flaw in their reasoning? Yup, the CRB with their name on is, using their own criteria, invalid. I have a uniform on order, though am not going to collect it until I have reason to believe that they can give me a start date before the other hospital. In addition, they sent me a letter stating to attend trust induction... on the 2nd June! If that is how long they are going to take, then they are definatly dead in the water.
Hospital A on the other hand were phoned by me on Tuesday. I have not heared anything from them so wanted to check see what was happening. As you may be aware, the CRB went in to them on the 5th March. The check can take 3-6 weeks. It is at [drum roll here]...stage ONE. Basically, it's arrived at the CRB building. Thats it. Now, what really annoys the hell out of me is that the CRB is a government body (it is subsumed from part of the Home Office). They also get paid for each CRB. So why is it then that it takes 6 weeks to effectivly search the CPS computer database which is like google search for criminals? Lets remember here a few other govenment bodies:
Job Centre Plus:-Department of Work and Pensions: 2 weeks to clain Job seekeres allowance.
DVLA- Department of Transport- How long do you think it will take them to contact you if you fail to tax or SORN a car when the tax is due? Proberbly 3 working days but not 6 bloody weeks thats for sure!
On the up side, they have said that I must attend induction...then one for me being [another drum role] 12th May. Yesterday, that was 40 days. Anyone recall Noah and his flood? 39 days from today. Jesus, in that time I could have seen a job advert, applied, been interviewed and put in 4 weeks notice and STILL have a day or too off. No wonder the NHS is in a staff crisis if this is how long Nurses have to wait. I mean, think here for a moment. I know "hospital B" are at screaming point with their Nurses. There is a real chance that I am going to turn down that job offer. Not only have they been short prior to my arrival, they have been short during these few weeks. If/when I turn down the job offer, they will be shorted for an even longer time as well. I know they my job there was to cover for maternity leave. The kid will be having its 10th birthday before I get on the ward at this rate.
Now, for St John. 3 weeks ago, I had my interview with the county Nursing officer. I was phoned up on Tuesday by another divisions superintendant who was wanting to know if I was free to work as a Nurse in an ambulance working out from a hospital in another county to where I live. I said yes to it. Only to find that county have no record of my Nursing registration. They think it is a bottleneck between my divisional superintendant (who has since assured me that paperwork is with NHQ and will chase it up) and county HQ. Aparrently the "checks" take time. What effing checks? You have my PIN number, go on the NMC website and use the employers checking service! What is it with me and paperwork? I have 39 days of this hell to endure!
Sunday, 30 March 2008
My frustrating week
It has been an interesting week for me. The job hunt is still on, and I am trying to not loose my temper. This is however, difficult. Having spilt with my Girlfriend on Tuesday, and have finally got my St John CRB check back, I was hoping that it would be a week to make up some ground on commencing a post. Not to be. I went into the ward of "Hospital B" (see posts below) and indeed, they have sent me in to order my uniform, and started getting a security badge. "Great" I thought "all I need is that contract they were going to send out and I will be well away". Yeah, right!
Yesterday, I was sent a letter from the hospital. Who, have only now decided to write to me saying that there is a job offer for me. While the ward sister has written on the occupation health form that I am to start in April, the letter states quite clearly that I cannot start until all the pre employment checks are through. The CRB form was actually within the envelope which had the letter in. Adding insult to injury, was the statement that I am down to attend the trust induction... on the 2nd June! FFS! I know the media bang on about the high number of Nurses who are due to retire, at this bloody rate even I will be an OAP before I start a damn job! I am going to have to call back into the ward and sort this out. I would say "Hospital A" are going to be back in the running, but even they are staying quiet so both offers seem dead in the water at the moment.
So, after a frustrating week of progressing in a mainly backwards direction, I have thankfully kept some of my skills up with St John Ambulance. This weeks duty was the league 1 side who were at home. Having got there and found there was an argument shortly after arriving, there was a lot of people needing to be spoken to. This resulted in the corner teams deploying early, and me grabbing my lunch and standing underneath some metal steps for shelter out of the rain. After finishing and wandering to the corner, I noticed there was no county ambulance at the ground. When the team intended for the corner came out, and went in an informed the duty manager who in term spoke with the ground manager. Thankfully, the ambulance turned up at 3:20pm. Turns out one forgot they were going, and the other did not realise they were at the match. Oh well.
The game was uneventful, and I busied myself with preparing the first aid post and leaving my equipment on a dressing trolley. This saves me having to rummage through my first aid bag. I asked the controller (a division superintendent) if there was any way of lowering the back of the bed in the first aid post. I remarked that if there was anyone who needed to be laid flat that I was not sure how to do it. I really wish that I had not said that. About an hour later, near the end of the match, the radio went off with a rather hurried "Sierra Papa to control [radio hiss]". That is the call sign for the stretcher party. They were not raised by radio. Another corner team radioed in with the fateful message "Stretcher party have mobilised to pitch, casualty expected, over". Yup, when me and the duty manager went out, sure as anything, there was the stretcher team picking an injured player up on a "Furley" stretcher, and they turned to face the exit to the first aid post. Damn! Normally, most players get sent to the dressing room, only if they need the bed do they get sent to the First Aid post. Well, I went back in and thankfully got the bed flat before the stretcher reached the post.
Yesterday, I was sent a letter from the hospital. Who, have only now decided to write to me saying that there is a job offer for me. While the ward sister has written on the occupation health form that I am to start in April, the letter states quite clearly that I cannot start until all the pre employment checks are through. The CRB form was actually within the envelope which had the letter in. Adding insult to injury, was the statement that I am down to attend the trust induction... on the 2nd June! FFS! I know the media bang on about the high number of Nurses who are due to retire, at this bloody rate even I will be an OAP before I start a damn job! I am going to have to call back into the ward and sort this out. I would say "Hospital A" are going to be back in the running, but even they are staying quiet so both offers seem dead in the water at the moment.
So, after a frustrating week of progressing in a mainly backwards direction, I have thankfully kept some of my skills up with St John Ambulance. This weeks duty was the league 1 side who were at home. Having got there and found there was an argument shortly after arriving, there was a lot of people needing to be spoken to. This resulted in the corner teams deploying early, and me grabbing my lunch and standing underneath some metal steps for shelter out of the rain. After finishing and wandering to the corner, I noticed there was no county ambulance at the ground. When the team intended for the corner came out, and went in an informed the duty manager who in term spoke with the ground manager. Thankfully, the ambulance turned up at 3:20pm. Turns out one forgot they were going, and the other did not realise they were at the match. Oh well.
The game was uneventful, and I busied myself with preparing the first aid post and leaving my equipment on a dressing trolley. This saves me having to rummage through my first aid bag. I asked the controller (a division superintendent) if there was any way of lowering the back of the bed in the first aid post. I remarked that if there was anyone who needed to be laid flat that I was not sure how to do it. I really wish that I had not said that. About an hour later, near the end of the match, the radio went off with a rather hurried "Sierra Papa to control [radio hiss]". That is the call sign for the stretcher party. They were not raised by radio. Another corner team radioed in with the fateful message "Stretcher party have mobilised to pitch, casualty expected, over". Yup, when me and the duty manager went out, sure as anything, there was the stretcher team picking an injured player up on a "Furley" stretcher, and they turned to face the exit to the first aid post. Damn! Normally, most players get sent to the dressing room, only if they need the bed do they get sent to the First Aid post. Well, I went back in and thankfully got the bed flat before the stretcher reached the post.
Monday, 24 March 2008
My hectic duty
Old photo taken at the football stadium I was at today.
There is a division one side who are a county duty for St John Ambulance. This brings my total number of duties to three within four days. I was expecting this to be a quiet day. In all the times I have been attending, there has only ever been one casualty, and that was pretty minor at that.
After arriving slightly late having being caught in the traffic, I was told that I was going to be in the First Aid post. There was a Paramedic crew who arrived about 10 minutes after I did. There was nothing much to report and the game kicked off. After about half an hour, a steward came into the first aid post with a causalty who had slipped and fallen and had a leg injury. I treated with Ice pack and the Paramdic had a look in at the patient as well. Just as we were about to discharge the patient, a st john ambulance member came in and was found to be having an asthma attack. Eventually, an ambulance was called to evacuate them to A&E. Just as the ambulance crew were about to leave, a call came over the radio of a collapse in the stands.
It was a child who had collapsed. They too were taken to the first aid post and were looked after by the Paramedic crew and myself. Following the arrival of the parent, it was decided that it would be best if an ambulance was called to take them to a hospital with Childrens services. This took place just at the end of the match.
Following this, me and the duty officer went to the town's A&E department to check on the member who had been sent up. They were doing better and we spent an hour with them before leaving once we found out they were being kept in and that relatives were on their way.
I am back there on Saturday. I hope that it will be buisiness as usual. At the moment, I shall be going to the ward for a rest.
Sunday, 23 March 2008
My jinx
Yesterday, I was covering a football match at a local stadium with St John Ambulance. Having being picked up by my mate in the St John Ambulance, after picking up another first aider, we headed for the stadium. Arriving, we found there were plenty of St John Ambulance volunteers on duty. This was including another Nurse who is a St John Ambulance member, and a Doctor who is in St John Ambulance. There were a number of county ambulance paramedics and EMT staff in the ground. I met one of the EMT who I worked with while on the ambulance service. It was nice to catch up with him. While we were preparing for the briefing, a person came into the first aid room who needed attention. Following their dispatch (I had nothing to do with them) the briefing sent me to a first aid post. Having being joined by a First aider who has just started their Nurse training and the St John Ambulance crew, we waited for the match to start and prepared the first aid post. After the corner teams had left to take up position, it was a matter of minutes before the biscuits had been found and I was about to have one. Then, just as I had literally taken on bite, a first aider burst into the room and announced "I have a casualty here with eye injury". Quickly hiding the offending biccie into my pocket, I donned a pair of gloves and set about seeing to the patient. There was a few moments spent writing my report out and all was well. After two of the members went to get something to eat, my mate came back in with some free pies (one of the division first aiders happens to work on one of the catering stands and gives SJA volunteers free pies). I had just taken one bite when there was a knock on the door. Normally this is just kids messing about. When my mate went and opened the door, we found that it was actually a person wanting treatment. Strewth!
While he was dealing with that, and I filled in the PRF, I heard another person come in and heard conversations about an accident. I looked around the screen, and saw a person who was injured. Thankfully, they were in the competent hands of the Paramedic crew who were in the stadium.
After both patients left, and the room was tidied up, I set back to having my lunch. I was reluctant to actually eat anything else as it seemed that every time I was having something, a patient was turning up. I hate to think what would have happened if I had gone for something larger, such as a burger. Stadium exploding was high on our reckoning.
As we had lost time, the first half was over. Having some of the corner teams come in for a refreshment break gave a few new faces. At the start of the second half, they deployed back to their positions. We settled down for what was to be an uneventful second half. We ended up getting bored and playing hangman. The game ended with nothing more then a snow shower. After being stood down, I went and changed my top over in the ambulance and then went and met my girlfriend and had a meal then went back to hers. As I left home at 12:40 yesterday and got back near 2pm today, it would seem that I cannot claim 26 hours on duty. Shame as it is supposed to be "door to door" times that we record.
Friday, 21 March 2008
My Road Race
It being Good Friday, there was a St John Ambulance divisional duty to cover, a 10k road race. I was aware there was a race but was initially told it was a cock up and it was relating to a duty next month. It was not which is why it was last night at 10:30 pm I said yes to doing the duty with one of the new cadet members (who happens to be a mate as well- I was on my first placement when he was there for 2 weeks works experience).
Personally, it would have been nice if it was a better day for the race as it was bloody freezing cold. The sun was out when we made our way to the start of the race. When we arrived, we quickly found there was only 1 PRF (Patient Report Form- a document used by ambulance services for recording the details of casualties) and one ice pack between our two first aid kits. Thankfully, my other mate in St John (Divisional officer) had phoned up, but we both missed the call. I phoned him back and found he was phoning in to see how things were. I told him of the situation re: PRF and the ice pack. Thankfully, he was at the division building about to take a St John Ambulance down to Harrogate where there is a contract between St John and the hospital. He brought the ambulance down and I took some Ice Packs and Crepe bandages as well as yellow clinical waste bags as some PRF's. Having already spoken to the signing in Steward, we were told that another official would speak with us before the start of the race. In due course we were approached by an official from UK Athletics. The steward asked me to find him after the event to fill in a first aid report for the UK athetics new policy.
With everything ready to roll, the runners set off and we followed to the half way point and stood around freezing while not a lot happened that needed our input (this was good). After moving again to the finish line and freezing while waiting for the final runners to arrive, we headed up to the start point, signed off all the forms without too much hassle. Though I did get a free coffee out of the day.
Personally, it would have been nice if it was a better day for the race as it was bloody freezing cold. The sun was out when we made our way to the start of the race. When we arrived, we quickly found there was only 1 PRF (Patient Report Form- a document used by ambulance services for recording the details of casualties) and one ice pack between our two first aid kits. Thankfully, my other mate in St John (Divisional officer) had phoned up, but we both missed the call. I phoned him back and found he was phoning in to see how things were. I told him of the situation re: PRF and the ice pack. Thankfully, he was at the division building about to take a St John Ambulance down to Harrogate where there is a contract between St John and the hospital. He brought the ambulance down and I took some Ice Packs and Crepe bandages as well as yellow clinical waste bags as some PRF's. Having already spoken to the signing in Steward, we were told that another official would speak with us before the start of the race. In due course we were approached by an official from UK Athletics. The steward asked me to find him after the event to fill in a first aid report for the UK athetics new policy.
With everything ready to roll, the runners set off and we followed to the half way point and stood around freezing while not a lot happened that needed our input (this was good). After moving again to the finish line and freezing while waiting for the final runners to arrive, we headed up to the start point, signed off all the forms without too much hassle. Though I did get a free coffee out of the day.
Thursday, 20 March 2008
The hospitls dont like me...they think I'm a homicidal axe weilding manic!
Well. I have a job. But I don't. Which is why I have just got off the phone speaking to a very polite woman on the Job Centre plus phone line. Well, I am sure that I made a different phone call from the average caller. Still, I am deep in the mire with money (Well, deeper then normal). I have £60 left on my overdraft limit.
So, rather then go under, I reluctantly have had to claim the "Dole". This is a situation which I really did not want to have happen. However, events outside of my control have forced my hand. More Hobson's choice really, though a choice of a sort. I have out-waited my CRB check it seems. Until there is a CRB check which confirms that I am not a child molesting, axe wielding homicidal manic from Borstal, both hospitals acceptance procedures have ground to a halt.
Yes, I am facing a dilemma about which job to accept. The short solution is to see who phones me up first and says "Can you start on date X". The whole reason I took the first job was that they simply happened to be the first ward to phone up and say "We are offering you a job". Still, I am sure they given the high standard of care I give it is only Fair they have first dibs on me. That was before another ward phoned up and gave another offer. Now I have a problem.
Hospital A phoned me up first. They are offering me 37.5 hours a week and a permanent contract. However, Hospital A is 23 miles from where I live. It will mean two long bus rides. I have not worked at hospital A before, though have experience in the speciality. Hospital A is a foundation trust hospital. While the building was constructed in 1968, it is earmarked for demolition and moving to a very nice village in the next few years with a merger of another nearby hospital from the same trust.
Hospital B is the hospital I trained at. They are offering me 6 months contract (temporary) and 30 hours a weeks. Hospital B is closer, though I have not worked on this ward. I have experience of allied services to the speciality though. There was suggestion of permanent staff being taken on. However, these posts were advertised on Monday.
I also have two interviews comming up. One in the same division as my last placement, and one in the community hospital ward where I was for placement 1.
Now. Who to choose. Hospital A sent me a letter with the conditional offer in writing and have taken my CRB form and documents. After finally finding a (crappy looking) passport size photo, my occupational health forms have been sent in.
Hospital B have sent me nothing. I phoned them on Tuesday and was told that all the paperwork is with HR and that I will not hear anything until they send a contract out. Hospital B suggested that if the CRB check takes too long that they may start me off mid/late-April and await the CRB check. Were to be anything untoward on the CRB check, my employment would terminate. There will be nothing on the CRB check as nothing has never shown up on all the other CRB checks that have been done on me with my voluntary work, and uni. All were enhanced disclosures as well.
Hospital A however, have said that they want the CRB check back first. THEN I shall be contacted by the ward manager with a start date. This could take up to another 5 weeks (assuming 6 weeks maximum as quoted by hospital A staff records department). So, in short, I have two job offers, no firm start date, nothing clear with who is best to say yes to, and I have run out of money and have had to join the list of Nurses on the dole. Which, leads me to the best part.
St John Ambulance had a delay in sending off my CRB form. That went off 3 weeks ago. Apparently, neither hospital can use St John Ambulance's Enhanced disclosure check because "They are only valid on the day of issue". Indeed. But as it would take 24 hours minimum to post it through, that means their one is just as invalid. And seeing as I am writing this at home in my bedroom cursing the rain as opposed to a Police cell, it is safe to say I have not beaten a tramp to death with a traffic cone in an underpass. However, if I do that AFTER the check, all would be fine and well and I am classed as a safe staff nurse. That is assuming I actually ever get cleared to start on the sodding ward. That's the next problem. In their welcome propaganda, Hospital A (who at least has the courtesy to write as opposed to Hospitals B, being the mere Acute trust that they are who have sent diddly squat) state that "On your first day of employment you will attend the trust induction". That's nice, you throw a special induction day just for me! Then you read the last paragraph: "As a new employee of Hospital A foundation NHS trust, you must attend the trust induction day. This is held on the first Monday of each month. This will become your official start date. Your actual date will be confirmed after that. The training department will contact you in due course". Ah-ha. So, all I need is a letter saying I have to attend the first Monday for induction and I am almost there! Well, no. Because, I have not been written to yet regarding the induction on the 6th April. Anyone with a calendar will be aware that Monday 5th May is a Bank holiday. Usually, this means the meetings/courses etc are cancelled for the month AFTER So, no May (queried). Given the magical CRB must be returned before I even get to be phoned to negotiate a start, I am thinking there is more chance of aerial bacon then me getting on the April 6th induction.
Then add in the getting uniform sorted out, a staff ID badge, and off duty sorted out...
I am secretly hoping I get the job on placement 1 ward. If I do, I can stick to the 6 month job. The way this farce is playing out, it will take that long for me to be able to set foot in the door as a uniformed staff nurse!
So, rather then go under, I reluctantly have had to claim the "Dole". This is a situation which I really did not want to have happen. However, events outside of my control have forced my hand. More Hobson's choice really, though a choice of a sort. I have out-waited my CRB check it seems. Until there is a CRB check which confirms that I am not a child molesting, axe wielding homicidal manic from Borstal, both hospitals acceptance procedures have ground to a halt.
Yes, I am facing a dilemma about which job to accept. The short solution is to see who phones me up first and says "Can you start on date X". The whole reason I took the first job was that they simply happened to be the first ward to phone up and say "We are offering you a job". Still, I am sure they given the high standard of care I give it is only Fair they have first dibs on me. That was before another ward phoned up and gave another offer. Now I have a problem.
Hospital A phoned me up first. They are offering me 37.5 hours a week and a permanent contract. However, Hospital A is 23 miles from where I live. It will mean two long bus rides. I have not worked at hospital A before, though have experience in the speciality. Hospital A is a foundation trust hospital. While the building was constructed in 1968, it is earmarked for demolition and moving to a very nice village in the next few years with a merger of another nearby hospital from the same trust.
Hospital B is the hospital I trained at. They are offering me 6 months contract (temporary) and 30 hours a weeks. Hospital B is closer, though I have not worked on this ward. I have experience of allied services to the speciality though. There was suggestion of permanent staff being taken on. However, these posts were advertised on Monday.
I also have two interviews comming up. One in the same division as my last placement, and one in the community hospital ward where I was for placement 1.
Now. Who to choose. Hospital A sent me a letter with the conditional offer in writing and have taken my CRB form and documents. After finally finding a (crappy looking) passport size photo, my occupational health forms have been sent in.
Hospital B have sent me nothing. I phoned them on Tuesday and was told that all the paperwork is with HR and that I will not hear anything until they send a contract out. Hospital B suggested that if the CRB check takes too long that they may start me off mid/late-April and await the CRB check. Were to be anything untoward on the CRB check, my employment would terminate. There will be nothing on the CRB check as nothing has never shown up on all the other CRB checks that have been done on me with my voluntary work, and uni. All were enhanced disclosures as well.
Hospital A however, have said that they want the CRB check back first. THEN I shall be contacted by the ward manager with a start date. This could take up to another 5 weeks (assuming 6 weeks maximum as quoted by hospital A staff records department). So, in short, I have two job offers, no firm start date, nothing clear with who is best to say yes to, and I have run out of money and have had to join the list of Nurses on the dole. Which, leads me to the best part.
St John Ambulance had a delay in sending off my CRB form. That went off 3 weeks ago. Apparently, neither hospital can use St John Ambulance's Enhanced disclosure check because "They are only valid on the day of issue". Indeed. But as it would take 24 hours minimum to post it through, that means their one is just as invalid. And seeing as I am writing this at home in my bedroom cursing the rain as opposed to a Police cell, it is safe to say I have not beaten a tramp to death with a traffic cone in an underpass. However, if I do that AFTER the check, all would be fine and well and I am classed as a safe staff nurse. That is assuming I actually ever get cleared to start on the sodding ward. That's the next problem. In their welcome propaganda, Hospital A (who at least has the courtesy to write as opposed to Hospitals B, being the mere Acute trust that they are who have sent diddly squat) state that "On your first day of employment you will attend the trust induction". That's nice, you throw a special induction day just for me! Then you read the last paragraph: "As a new employee of Hospital A foundation NHS trust, you must attend the trust induction day. This is held on the first Monday of each month. This will become your official start date. Your actual date will be confirmed after that. The training department will contact you in due course". Ah-ha. So, all I need is a letter saying I have to attend the first Monday for induction and I am almost there! Well, no. Because, I have not been written to yet regarding the induction on the 6th April. Anyone with a calendar will be aware that Monday 5th May is a Bank holiday. Usually, this means the meetings/courses etc are cancelled for the month AFTER So, no May (queried). Given the magical CRB must be returned before I even get to be phoned to negotiate a start, I am thinking there is more chance of aerial bacon then me getting on the April 6th induction.
Then add in the getting uniform sorted out, a staff ID badge, and off duty sorted out...
I am secretly hoping I get the job on placement 1 ward. If I do, I can stick to the 6 month job. The way this farce is playing out, it will take that long for me to be able to set foot in the door as a uniformed staff nurse!
Wednesday, 5 March 2008
Jobs: They really are like buses!
Now, I am the sort of person who normally can worry. Nursing Standard would often have its letters filled with people writing in who had graduated, and then failed to find jobs. I have had a few job offeres now. Admittedly, it would have been nice to get them a bit earlier on then now. However, I am not going to look a gift horse in in mouth as it would seem the interviews are only taking place for jobs which I applied for 6 weeks ago. Potentially, I have a heck of a lot of ones to now turn down. This is annoying. Though good.
Sunday, 2 March 2008
My First post
Hello! This is the first post on this blog. Want to know what I was up to before as a Student? Well, you can. Its all on the old blog, warts and all.
Ah, I can see you looking at me now and saying "But, Nursing Student, you have changed your name! Who is Staff Nurse M?"
The short answer is: The same entity. I have now graduated. In the light of this, the old blog ID of "Nursing Student" was redundant, and "Nurse Staff" was too vague. So, much like a contemporary Dr Who, I have changed. Same Avatar, same profile, same link list. However, I have decided "Staff Nurse M" as this takes my last initial of my name. As a by-product, it could also mean "Mystery" as I still wish be be slightly obscure.
What have you to look forward to? Well, a comment on my personal view on the Nursing profession, the journey to me starting on the ward where I am going to be a staff Nurse, and the same old accounts of the work I do.
Ah, I can see you looking at me now and saying "But, Nursing Student, you have changed your name! Who is Staff Nurse M?"
The short answer is: The same entity. I have now graduated. In the light of this, the old blog ID of "Nursing Student" was redundant, and "Nurse Staff" was too vague. So, much like a contemporary Dr Who, I have changed. Same Avatar, same profile, same link list. However, I have decided "Staff Nurse M" as this takes my last initial of my name. As a by-product, it could also mean "Mystery" as I still wish be be slightly obscure.
What have you to look forward to? Well, a comment on my personal view on the Nursing profession, the journey to me starting on the ward where I am going to be a staff Nurse, and the same old accounts of the work I do.
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