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.

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.

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.

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.

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!