Sunday, 7 December 2008

Drinking it In

Every shift I turn up at work half an hour early. I grab a cup of coffee and sit in plain view of the ward. Its the only time you get a chance to do this. Once you start working you have the blinkers on and you cant really get a feel for whats happening on the rest of the ward. So i sit, and I watch, I watch where the carers are focusing the most attention (even if they dont realise it themselves) I assess which patients will need two for assistance with a wash and which will need one. I note the noisey dementia patient who was probably screaming all night and make sure that is the last bay I go to so the others in there can get some rest once I have moved her to a cubicle.

I sit there and let it wash over me. And I have to say, its an incredible feeling. I am definitely an acute ward nurse. The ward is my home, and whilst I have the highest respect for scrub nurses I could never be one, I dont have it in me, and as far as community goes? I dont have the stamina to see hundreds of patients who all need wound dressings every week. I love wound dressing but not in that quantity.

On equal note I dont think I could be a surgical nurse for all of my career. This is more down to preference I am a medically minded person. I love the intricies of renal failure and the challenges of COPD.

I am an acute medical ward nurse.

Saturday, 6 December 2008


Yesterday we saw one the patients the entire ward had grown very fond of die. Thankfully it was very quick and painless. The mood of every member of staff on duty, from the sisters to the domestics dropped. Later than shift we had a quiet moment, someone (one of the class clowns) cracked a barely amusing, entirely inoffensive joke. The resulting laughter from everyone lasted several minutes and washed away the low moods. It was just the catalyst we needed to release it all.

Unfortunately in this job you dont really have time to stop and think about the bad things. A patient you cared about dies, you have to keep going because if you dont other patients will. The job doesnt stop to let you heal. In some ways I am grateful for that because if I stopped to think about every patient on any one ward who died I would probably end up killing myself.

The Job doesnt stop, so we cant either.

Friday, 5 December 2008

Three Patients

Well i'm back to fighting strength, which is good. I'm also doing really well on this I'm told. I have to admit that I am going to miss it. My time with them finishes on the 12th but I have four shifts to make up so it might be a little later than that. Its been a good placement and I've regained all the confidence I lost on my last placement. I am also enjoying being a student nurse on placement with no assignments hanging over my head.

Yesterday we had a patient who went for a liver biopsy, when he came back he hadnt had the biopsy and had an acitic drain inserted(a tube inserted to drain large collections of fluid). The bag this was draining into was only 500mls. after the first two hours of emptying this bag every half and hour I decided to attach a 1.5 litre bag. To my amazement the fluid was draining even faster, it appears as long as there is space it will drain incredibly fast. This fluid loss obviously had to be compensated for so we were hanging bags of FFP(Frozen Fresh Plasma) and towards the end of my shift we had to clamp off the drain and hang bags of saline. All in all the man lost almost 10kg in a few hours. This cant be healthy! but he said he felt great and the doctors didnt seem concerned.

We have another patient who was doing so well, he's been with us for months and was medically fit for discharge until he contracted the D+V the ward was closed with, he finally got over that and seems to be in decline again. His blood pressure is in his boots, he's tachycardic, and very pyrexial. All of which leads me to believe he's septic despite the high doses of antibiotics he's on. This is an example of a patient you cant help but get attached to and at 90 years old I am not sure he'll see discharge this time.

Patient number three had the entire staff of my ward in tears yesterday(myself included). He is dying, he is very much at peace with his fate, he has at best a few weeks left and just wants to die in hospital so his family dont walk into his room one morning and find him dead. He had written a poem to his wife that is by far the most beautiful thing I have ever read.

So theres my three patients, the healthy, the declining and the dying.