Monday 25 August 2008

Worthy Cause

Whilst I accept few people actually read this I feel it is necessary to point some attention at an organisation which is becoming increasingly important in Hampshire.

The Hampshire and Isle of Wight Air Ambulance Take catagory A calls all over hampshire and nine times out of ten are able to get their casualties to hospital quicker than a road ambulance. However unlike the Hampshire Ambulance Service(on the roads) the Air Ambulance Receives NO government funding and operates entirely on voluntary funding.

Take a look at the site.

Basics

Any regular readers will know that I occasionally rant about the importance of not forgetting the basics.

D - Danger to yourself, the patient or bystanders.
R - Responsiveness of the patient.

A - Airway is clear?
B - Patient is Breathing?
C - Circulation is adequate?
D - The Patient has a disability?

In a healthcare service which is full of cool toys, allowing us to test, probe and prod a patient it is sometimes easy to forget the above come first.

I was once faced with a patient who had a potential spinal injury. We had immobilised as best we could but we only had our first aid kits on us and we were awaiting the arrival of one of our nice, fully kitted out ambulances(including a spinal board). They were still three minutes away when the inconsiderate patient decided it was time to stop breathing. Now you have a choice. I moved the patient into a position where I could start resuscitation. This meant comprimising his spine. Guarentee of Death trumps chance of getting paralysed.

This was a fairly easy decision however similar situations can occur with greater stakes. My advice is, and always will be, REMEMBER THE BASICS.

Monday 18 August 2008

Rant

Firstly I had some very good news today. I am now a second year nursing student. YAY!

Unfortunately karma is an evil bitch. Half of one of my back teeth broke off. This feels and looks bad. So I phoned the dentist for an emergency appointment. The Following conversation took place -

Receptionist: We have an emergency appointment a week tomorrow.
Me: How is it an emergency appointment if its in eight days?!
Receptionist: Well you dont sound like you're in much pain.
Me: I'm glad to see the NHS train you in the art of triage, however if I want someones opinion on fonts and margins I will ask you, if I want someones assessment on my tooth, I WANT TO SEE A DENTIST.

The result being I have an emergency appointment in eight days time. Wooo!

Thursday 14 August 2008

Update

Unfortunately one or two personal and academic problems have prevented me blogging too much of late and to be honest as I'm on a break from the wards I probably wouldnt have much of interest to say anyway.

During my time off I have thrown myself back into St John Ambulance. Which despite being an organisation with a poor reputation, which is mostly down to most of its senior members spending their time acting like catty teenage girls, has nurtured me. Before I joined I had no interest in healthcare, I didnt know enough to even think about it. After an incident whilst looking after my sister I asked my neighbour, who is the Divisional Superintendant of a local division, if he could take me down so I could learn some first aid. The confidence and the skills the organisation has given me is something I am grateful for. Most of this gratitude is aimed at this one man who introduced me to sja, and thus the world of healthcare.

You may ask why I would think anyone would find this interesting? Frankly I dont. There are three people I can honestly say have drastically effected the person I am today. The above man is one of them. The other two are teachers.

During secondary school(year 9 I think) I was bored. Very bored. I'm not saying I was terribly bright but in comparison to half of my year I was einstein himself. So I stopped paying attention in class, My grades slipped and I spent most of year 10 in the bottom set. It was during year 10 that my german teacher told me that if I even got an F in GCSE german It would be a miracle. This woman was the least professional teacher I had ever met. Fortunately at the end of year 10 she decided she didnt want to teach german any more and moved on to IT and Drama. So we had a new German Teacher. Mrs Hogg. This woman single handedly got my arse in gear, she took a student who was facing near impossible odds at passing and I ended up getting a C, had I been in the higher set I would have gotten an A. She didnt just motivate me towards german though, She opened my eyes and I ended up getting very pleasing grades for my GCSE's. Mrs Hogg died last month.

Whilst my eyes had been opened thanks to Mrs Hogg, I started paying attention in all my classes. This included Biology. Any of you who know me, know that Biology is my first love. This wasnt always so. Mrs Clarke is largely responsible for this. She tought the subject with such passion and vigor that I couldnt help but fall in love with it. I can still remember the first day I started listening in one of her classes and Biology suddenly made sense. Without this teacher my natural aptitude for biology may never have been realised and I would be almost utterly without passion and cause.

So to these people I thank you.

Friday 8 August 2008

Human Rights

Something I want to explore over the next year or so are the ethical issues tied up in nursing convicts. Especially those who have committed crimes which outrage the modern British morality.

According to the Nursing and Midwifery Council code of professional conduct(NMC, 2008). A key responsibility of nurses is to be their patients advocate. We apply professional knowledge and experience to act as our patients voice. In theory this requires impartiality, but it is impossible to know someone well enough to express their wishes and still be impartial. So if a patient is a rapist, murderer or paedophile this should not change the level of care they receive. Now factor into this the simple truth that nurses are human, and have been raised as most people in this country with a certain morality. Will power alone should be enough to ensure the patient receives professional and adequate clinical care, however it can not influence our interactions or preconceptions about this patient. As a professional you will not let your patient suffer neglect. It is your duty to treat and aid anyone who is in need. However a large part of nursing care is in the patient-nurse bond.

I would also like to ask those of you poor sods who actually read this blog. If you have twenty-eight patients and one is a recently convicted paedophile in need of high care, Would this effect the magnitude of resources you divert from other patients in order to care for this convict?

Friday 1 August 2008

Rules and Doctors

Recent EU regulations are limiting the amount of hours doctors can work. Currently doctors are not allowed to work more than 52 hours a week, this is soon to go down to 48. You may cheer this change as a means of improving patient safety. I believe the european working time directive poses a much greater threat to standards of care. This directive means that there are fewer doctors available on wards at any one time. The NHS cant afford to hire more doctors to pick up the slack. As a result more than half of scotlands hospitals are in the process of closing. This also means that other professionals have to work harder. Nurse Specialists are suffering massively increasing loads of patients, and general ward nurses who do perform some tricky procedures are still working up to 80 hour weeks in order to cover understaffing. How is this not a risk to patient safty?