Friday 26 September 2008

Explaining All

So all of my fellow nursing students are in lectures. I'm on placement and in lectures. This is exhausting me. As so many people keep asking me why this is I thought I'd just post it on here and direct them all to it. Makes my life a little easier.

In order to pass a placement you have to have certain proficiencies signed off by your mentor who is responsible for guiding your education on the ward. I got through 11 weeks of the placement, there were two more to go and my mentor came up to me and said 'I cant sign your proficiencies off....I've never been behind a curtain with you and a patient'. She was quite correct, she just set me tasks and I got on with it either myself or with another nurse. Two weeks was not enough time to be observed doing all of the required things, she'd effectively failed me on this placement. She had never seen me do a damn thing. I explained that I felt it was unfair I was being punished for this and removed myself from the ward pending a chat with my academic tutor. My academic tutor got me into negotiations with the ward and I am back. Making up time sort of. However I could not be granted an extension on the handing in of my documentation for this ward because the university do not condone having a student in full time lectures and full time work at the same time(however unofficially this was the deal that was cut for me). This is why I am exhausted. And it seems I've failed the placement regardless of weather my proficiencies are signed. Where this leaves me I have no idea.

Wednesday 17 September 2008

Understaffed

My ward is Acute Medical Respiratory. Due to the critical nature of most of our patients Our standard compliment is Four trained Nurses and Three healthcare assistants.

One shift recently there were two trained and one healthcare assistant(and myself but i'm 'supernumerary'). The ward sister got so pissed off with the EMAU sending us critical patients with our limited staff level and no warning that she locked the doors to the ward. The next morning there was only one trained on. These shifts were hell, I was doing things a student nurse shouldnt be doing without supervision. However we got through the shifts with no problems and I realised I always feel closer to my colleagues when we are massively understaffed. The nurse I worked with both shifts was wonderful, we communicated volumes through a simple glance at each other, I knew what she was going to need before she needed it and she knew what I was thinking. Its a level of teamwork I have not experienced in some time.

Sometimes in this job its the people you are working with that makes it worth doing.

Monday 15 September 2008

Lack of Posts

I've not really been around for a while, this means I've not written or read many blog posts. There are two very good reasons for this, firstly the insane hours student nurses have to work. and I am now Engaged. This means my time is even less my own ;).

Priorities

I'm going to ease up on the nursing posts for a while as between my ward and my university I'm having enough of it. Fortunately I have been on duty with St John Ambulance a few times recently and have several infuriating stories I can relay.

Patient approaches me with a sever limp. He complains of a chronic pain in his knee and is barely able to pressure bare on that leg. I dont carry nor am allowed to dispense the medication for the condition he says is causing the pain and the strongest analgesics I can administer are paracetamol which are barely going to touch this. I decide its in the best interests of my patient to radio for one of the three on site doctors so they can deliver some more appropriate pain relief. The casualty gets bored of waiting after half an hour and returns to his business (a stall at the event) and notifies me where he will be when the doctor arrives*.

The doctor arrives at my first aid post and I outline the situation. We have a long debate which turns into an argument. He does not believe that analgesia has a place in first aid. I pointed out that from the patients inhibited ability to walk he will likely fall over and suffer a worse injury. The analgesics may allow him to walk a little more steadily and thus reduce the risk of a fall. After a little more exploration of this concept the doctor gets bored of me and gives in, he administered some prescription meds, I filled out the paperwork and the patient was not brought to our attention again that day (which suggests to me he did not suffer a further injury).

Interestingly a year ago I would probably have agreed with the doctor, analgesia has no place in the field. Its interesting how my new role as 'student nurse' has shifted my attention onto patient care standards.

------------------------------------------------------------------------------------------------------------------------
*this may seem like a slightly silly thing to do if the patient is in real pain, however many stall owners at this event put every penny they have into representing their businesses there, whilst he was away from his stall his livelihood was in peril.