Monday, 3 November 2008

New Ward

So I'm settled on my new ward. Gastro Medical and Surgical. Its an interesting place to be. I've experienced a surgical ward on my first placement, and a medical on my second. Caring for both sets of patients in the same place is interesting.

Yesterday we had two patients who were dying, very slowly. Both had a GCS* of 4. I have never known anyone come back from that. One was hooked up to an insane number of machines, and tubes, ranging from ECG to Riles tubes. This patient required a lot of care as the doctors hadnt officially stated he was no longer for active treatment. The ICU consultant came down to assess him and decided that ICU care would do nothing for him.

The second patient was on the liverpool care pathway** and whilst she didnt require regular monitoring she didnt have a riles tube in so despite the fact she was unresponsive she was constantly vomitting into her oxygen mask.

I have to admit, I have cared for patients who have weeks/months to die before, and I have cared for patients who are peri-arrest. This was my first experience caring for patients who were stuck somewhere in between. It was eye-opening.

*Glasgow Coma Scale: a system of assessment that more accurately determines a patients state of conciousness. Lowest GCS is 3(one point in each of the criteria). Highest GCS(and hopefully the GCS of you the reader) is 15.

**LCP: A set care plan for the dying, It requires discontinuation of all treatments and close monitoring of medication for pain relief, nausea relief, etc. The idea is to make the patient as comfortable as possible.

1 comment:

Sage said...

Personally I think you guys do an awesome job, and not something you ever get that much credit for.