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.

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.

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?

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.

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.

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