Monday, 15 September 2008


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.


Chris said...

That's interesting, as I could probably be seen as one of those who does not believe analgesia has any real place in first aid. I do, just rarely.

I don't like giving things to people who should have them themselves - adult women who are at that stage in their menstrual cycle, for example) should have their own with them, and not rely on us providing their paracetamol. A headache is not going to really cause a problem, if it's that bad, maybe they shouldn't have come to/remain at the event.

On the other hand, there are situations in which it is appropriate, and in that case, I would never withold it.

Chris said...

And talking about stall owners not being able to afford time off, I once strapped up a guys ankle which was quite probably fractured, as he steadfastly refused to go to hospital to get it checked for exactly that reason. Sometimes you can only do your best

Asclepius said...

Honestly the situations i've been in with SJA and as a student nurse I dont care what the outcome is for the patient as long as I can lay in bed at night and say I did everything I could