Monday, 12 May 2008

Monday, bloody Monday

The horror...

What a palava. For parents who can't control their kids using technology we have... a piece of technology! Good, old fashioned parenting goes further out the window, it seems.

Anyway, onto the nursing. Firstly, I wasn't allowed to leave early today, despite there being nothing left for me to do. Nice one.

Prickly issues today regarding Doctors. Don't get me wrong, I'm not about to start generalising, but these issues are probably transferable around the world. The situation: We have a patient on ward recovering from an Myocardial Infarction on the ward. Ex-cancer patient, ex-alcoholic (on Librium). Irish descent, lovely sort. This patient has a few visitors who will come and take them out in a wheelchair for some fresh air or down to the cafe, nothing strenuous. The patient has been with us for a while due to poor scheduling and communication between hospital and is understandably bored.

Today the consultant doctor told the patient (in no uncertain terms) that leaving the ward was a big negatory, due to some slight chest pain. The consultant was quite casual about this, despite it's importance to the patient. At first they were quite polite about the issue, but once the consultant had gone the patient approached me stating, to paraphrase: "I haven't committed a murder, I'm not a prisoner, and [the consultant] has no right to force me to stay here. Tell them, or I'm discharging myself." This was, clearly, a bit of a problem. I apologised (again) arguing the consultant had the patient's best interests at heart but they would have none of it. My mentor tried a little more, but the fact that English is a second language didn't seem to help things. Eventually we found a SHO (Senior House Officer) attached to the consultant to speak with the patient, but they are still arguably understandably fucked right off.

As implied above, I think the main problem seems to be the fact the consultant was quite casual about essentially locking this patient up in a ward for the duration. The patient has been quite understanding about errors before, and I can understand how you can think people are taking you for a soft touch. Essentially, if he wanted to leave I wouldn't jump on him - heart condition aside - to keep him within the walls. In general, it was perhaps not the best move by the consultant to order something rather than discuss it with the patient.

And it sort of compounds a common issue in my experience. The nature of the work of the medics means they are not around all the time. Nurses are. And so nurses are the ones who, more often than not, have to deal with unpopular policy. Even if they themselves don't support such policy.

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