Friday, 16 May 2008

The Long Day that was...

I should've penned this last night, but I was far too on the tired side.

Yesterday started with a bump. I was going to be working with a Bank Nurse. A Bank Nurse who I've met and interacted with before. My second mentor, someone I respected muchly, didn't like this person (who I will from now refer to as Insipid Bank Nurse [IBN]) which got my spidey sense tingling from square one.

I was pleasantly surprised, though, when IBN asked me what I'd like to do - drugs or meds. I spent two months doing lots of observations, so I chose drugs - and dispensed well enough to recieve compliment. I was a bit sycophantic but I shrugged it off. It was now that I realised the choice from earlier was a pointless one - I was going to have to do the obs after the drugs, anyway, which I got on with.

These details do only act as a precursor to what really happened. At around lunchtime one of the Support Workers grabbed me. One patient, suffering from End Stage Heart Failure and insulin dependent Diabetes, as well as being on a Not-For-Resuscitation Order (unknown to them or their family), was slumped in their chair, food dripping out of one side of their mouth, quite unresponsive. A group of us launched into action, getting the patient into bed and checking their observations. I made sure to check their pupils which were sluggish, but vaguely responsive and of average size. Vaguely responsive describes the patient, who was sort of slurring but aware of what was going on. Observations seemed normal for them - tachycardic, but otherwise fine. We bleeped the patient's SHO and ran some tests to rule out any sort of cardiac problem. The ECG, for example, looked normal.

I stayed with the patient as investigations went on. To cut a long bit of a long story short, it turned out the patient's blood sugar hadn't been checked before lunch. On finding this, the team began to enact protocals for diabetic patients in hypo and the patient slowly made a recovery (especially after a direct IV injection of dextrose). IBM then began to try and cover their bases and shift the blame. They assumed it would 'automatically' be checked and gave me this underhanded "It wasn't your fault" speech. If I wouldn't have been looking after the patient closely, I might have looked up and replied: "You're fucking right it wasn't my fault. You're the registered nurse here, you knew about the condition and the buck stops with you, fuckhead." But I didn't.

By the time the furrore calmed down it was past my kick out time. DGN was just coming on to start an equally hectic late shift. Thinking fast, I asked if I could stay on. A long day would buy me a day off, which I was in dire need of, whilst opportunities to work with DGN are not to be passed up.

I did a little exit poll with some staff members about IBN. DGN told me IBN was a 'funny one' but agreed with me about where the buck stops. Several other members did, too, so I put a pause on having a word with the ward manager. If anything like this happens again, I'll think about it, but not today.

The late shift was a bit of a blur. I made myself useful, which always feels good. The only incident I can remember is that of a group of Doctors organising a patient move. From our ward to the Heart Care Unit. They did, usefully, inform neither us nor the patient. Which meant it put a bit of a rush on proceedings. Trebles all round?

So, after quickly chronicling* all of this I'm off to enjoy more of my day off. I need to make birthday presents, read my favourite journals and try not to spend too much money. I might have to accept two out of three...

* Try saying that three times fast.

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