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.
Showing posts with label Hospital. Show all posts
Showing posts with label Hospital. Show all posts
Friday, 26 December 2008
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.
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.
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.
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 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.
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!
Subscribe to:
Posts (Atom)
