Huge News

Have just signed a contract with Harper Collins.
They plan to have my manuscript ready for July/August 2012.
It's look at nursing from a male perspective.
7 years of work has gone into getting to this stage, so am very very excited.
Will let you know more soon.

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Taking it easy at work, the best therapy.

Nursing is fun, relaxing and peaceful. What a load of rubbish you must be saying, but it's true.

Let me explain:

Mr Davidson had been with us for ten days now and we'd gotten to know him pretty well. He was waiting for a bed. Not any old hospital bed, but a bed in the rehabilatation unit. Mr Davidson was recovering from a stroke.

The effects on his body were not unusual. If you leaned forward you could decipher his mumbling, he could walk with one nurse, but couldn't feed himself as his right hand lay at his side, his fingers curled like claws, and when he tried to use his left arm, well, it's pretty hard to cut your food with one arm.

"Evening Jack" I said as I walked in the room. He raised his head from his chest, and waved his good arm in my direction and mumbled a reply. "Back in a tick with your pills" I said, picking up his drug chart and heading back out the door.

By the time I got back his dinner had arrived and I began our routine.

1. Turn on the bedside radio to the 'Golden Oldies' station, just loud enough to provide a nice bit of background noise.

2. Sit back, put my feet up, open the dinner tray and commence cutting up the food and delivering it to his mouth.

3. Talk about sport, women, politics, or whatever seems to make Jack laugh.
(note to self, do not make him laugh while eating, may choke, swallowing is ok, but not great)

4. Enjoy time with patient.

5. Realize I've spent 15 minutes with patient and hastily leave room after making sure he's had something to drink and his call bell is within reach of his left hand.

Conclusion:
1. It doesn't take a RN to feed a patient, but I'm sick of seeing patients with food trays left out of reach, left to get cold or not used at all.

2. It's a nice part of the job and it's a chance to assess your patient eg Swallowing worse or better, movement of limbs, cognitive function etc.

3. These jobs should only be delegated to assistants if they are skilled. I don't like giving away these jobs, but realize sometimes I must.

4. I'm a pretty disorganized nurse at times as I always make time to spend with a patient, even if it's only an extra five minutes.

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Why nurses don't complain

I'm working an agency shift, first time in new ward, in a new hospital. The hospital is Swindon hospital, a hospital in England. It's brand new (well, it was at the time) and looks impressive, seems well staffed. I'm about to begin my first night shift.

Handover - The nurse who is to hand over me doesn't do this. She goes through a list of names saying - 'Joe bloggs is fine' and 'Mr Smith shows no change' and leaves. I know nothing about my patients.

I stop her from leaving the ward, asking about my handover, "Joe blogss in room 1 is unwell, we nursed him on the floor." She then exits the building.

I go to room 1 and find a man unconscious, naked, on the floor. Call the doctor to come and see him, but he's busy in the emergency room. I call the head nurse on duty for the shift. She's about ten years younger than me, and probably been out of college only one, maybe two years at most. She doesn't come to see my patient.

I go back to patient and eventually wake him with a very strong sternal rub. He's obviously a man off the street, the sores, the smell, the large doses of benzodiazepams prescribed in his chart give it away.

What about the other patients I know nothing about.

The first 6 bedded women's bay, I can see an infusion, oops, it's an insulin infustion. Patient won't wake up. Blood sugar reading says 'lo'. I turn off infusion and slowly open the dextrose saline while calling doctor again. Doctor still won't come, just gives me verbal orders to open up the dextrose a bit. I do an ECG, I do this for all unconsious patients, regardless of what we think may be the cause. Rapid AF. Check her notes, this is something new. Get on phone to doctor and yell at him. He comes to see the patient.

It's now one hour into my shift, haven't finished a round of my patients yet. Don't know what is wrong with anyone. Haven't started my evening drug rounds, let alone the IV meds.

Why didn't I walk out then? Why didn't I lay a complaint?

The answer is simple.

1. If I do walk out, I'm in big shit. How could I leave people in a life threatening situation. I should have walked out, but weighing up the pro's and cons is not simple.

2. If I complain, they will find lots of things I did wrong eg Meds not given, or given at the right time. IV fluids behind. Fluid balances not complete. There are so many things I just couldn't do because of the situation I was in, but if it comes to a court case, they will crucify me.

Conclusion

I may be taking a risk naming the hospital, but this story is only the beginning of a series of horrendous things I witnessed at this place. I want someone to take notice. Nothing will happen of course, but then that's the conclusion I've drawn. Nothing will change.

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Random worries

1. Try asking your doctor this, "If I were your son/daughter, would you still give me that course of antibiotics?" I bet the answer will be no. I've done it many times.

2. Why am I really at the doctor? What exactly are your expectations and are they realistic.

3. If I spend 4 hours or 24hrs in the waiting room at my local emergency department, can I handle the fact that I don't need any treatment. The doctor probably only gave you a bandage for your non swollen, non deformed, non bruised, sprained ankle that you can walk on fine, because he wanted to make you feel that something had been done.

4. Can I cope with the pain? A sprained ankle will hurt, especially the next day. I used to walk it off, I know this is the opposite of the correct treatment for a sprained ankle, but growing up this is what I thought you did. Guess what, it worked. I walked off the pain and was soon running around again.

5. Know what a bruise looks like. This may save you a trip to the doctor.

This may sound a bit harsh, but I've seen a patient who came to me because he wondered what the lumps were on his face. He had two pimples on his chin. I also had a patient who had a bruise to his thigh. He was fine, but said he'd never had a bruise before, he was 18yrs old.

I don't know what is happening to the world when people grow up without living, but it's pretty damn frightening.

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