Thursday, 10 July 2008


I've had a few manic shifts recently. Those shifts where you are flat out rushed off your feet for the entire shift but when you look back you cant remember a single thing you have done. All of my interactions from putting a patient on a bed pan, to removing a patients cannula have mattered to the patient involved.

The truth is when you are truely, insanely busy in the hospital, you go on autopilot. You talk to the patient whilst your removing their wound drain, listen to them talk about their pet cat and you respond in a warm way. But you arent remembering any of this. And if the removal goes as it should there is no reason to remember it past adding a note to your handover sheet.

This doesnt bother me. You do what needs to be done and then you move on to the next task that needs to be done. Despite all this there is a place in the back of your mind that the hospital has infected. No matter where you are or what you are doing a small part of your brain is thinking about the ward, about a patient who was deteriorating when you left your last shift, who wont be there when your next shift starts, the MRSA screening you forgot or didnt have time to swab a patient for. The trick is making this part of your mind as small as possible

Today I got to insert my first NG(nasal gastric) Tube. This is a tube that goes up the nose, down the throat and into the stomach. Its used to aid a patient who isnt safe to take food orally(usually if they aspirate). This may not sound too impressive to any qualfied nurses who read this, as inserting them is so mundane by the time you qualify that they usually find a student to do it for them. However I am fairly sure it is the longest object I am legally allowed to insert into my patients.

Once the tube is in place you draw back some of the fluid from its end point and drop it onto litmus paper to ensure you have reached the stomach and found stomach acid. You then flush the tube with about 50mls of water to ensure it is clear and ready for food. You then connect a pack of high nutrition liquid to tube. This gets connected to a pump to ensure that you are feeding at the prescribed rate.

Its all fun. Despite how exhausted I am I have had two good shifts. I've learned a lot and had a lot of opportunities to make a difference in patients worlds. I suspect my shift tomorrow wont go so well. The cumulative fatigue was having a noticable effect on my performance today. I've got two more early shifts ahead of me and then a day off.

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