Wednesday, 18 March 2009



When I first read this I couldnt believe it. I know there are a great number of chav's, football hooligans and various other bottom feeders out there but this is just insanely low. I want to put emphasis on the fact that SECONDS in emergency care can make a difference.

Admittedly this is from the daily mail, but I have substantiated it via other means.

Its Just Sick

Tuesday, 17 March 2009

Right Place

I have no problem with religion....well no problem that I can apply to this post. People can believe what they want, when they want as long as they keep it away from me. Faith, Religion and God even have a place in modern medicine, that place is in the waiting room.

There are more than a few people on my course (a very science heavy course) who are creationists, and believe that the universe was created 5000 years ago and the fossils are just a test of faith. There are other inappropriate beliefs going around the nursing and medical degrees at my university. At the end of the day this really scares me. If I have a patient under my care I use my knowledge of science, my understanding of the human body and my faith in my own abilities to treat them. Anyone who does the same is fine in my books, if they want to talk to their god(s) about it once they have dealt with the patient that is also fine. At some point there is going to be a scientologist applying for a medical or nursing degree, as this is a minority faith any university would be obliged to accept them. For those of you who arent familiar with this faith there are a number of ideas that I have no right to take exception to, what I do take exception to is the fact that they dont recognise a number of very common conditions. As far as they are concerned for example Autism isnt a real condition.

There is a time and a place for Religion, that place is not in the operating theatre or the ward, that place is the waiting room, or at home. If you are practising as a healthcare professional you are a scientist, to be anything else is negligent.

Monday, 16 March 2009

Catch 22

A patients blood pressure dropping can indicate nearly anything, couple this with raising tachycardia(Increased Pulse Rate) and pyrexia(Raised Temperature) and you probably have a patient suffering sepsis. Until the antibiotics sort out the sepsis(assuming a surgical pathway hasnt been taken) you have to deal with the patients blood pressure. it needs to be raised to a point where the whole body is receiving enough blood regularly. The popular method of doing this is hanging saline regularly as well as another IV fluid called gellofusin. The idea is that at least you are keeping the circulating volume up even if the actual contents is a little diluted when it comes to oxygen bearing red blood cells.

A common result of cardiac incidents, or general poor cardiac function is the collection of fluid in the preferies(Oedema), and usually this fluid makes its way onto the lungs. This is pretty easily resolved with a nice little diuretic we use called Furosemide. This causes any excess fluid in the body to be passed through the kidneys, into the bladder and given the condition of most of my patients straight into their cathater bag.

So what the hell do you do when you have a patient who has a plumeting blood pressure and is overloaded to the point where their lungs are severely comprimised?

The doctors caring for this patient decided to try and maintain a balancing act, putting enough fluid in to keep her blood pressure compatible with life whilst putting enough furosemide in to stop her drowning. Not an easy thing to do and I dont envy them.

Thursday, 12 March 2009


So tomorrow is the last day of my InterProfessional Learning Unit for this year. Myself and a group of medical students, ot students, pharmacy students and other nursing students have been auditing some bits and bobs on a neonatal unit. Its been fun but I really miss being a real student nurse so I'm glad this is nearly over.

One thing I haev learned from this unit is that neonatal care scares the hell out of me. I'm an adult branch nursing student. Adults and big, smelly and in general foolish. They are far less fragile than neonates(usually). In general if a neonate is sick enough to be admitted to a ward they are probably balancing on a knife edge. Adults get admitted for everything from a social sort out to the sniffles.

I also have a hard time connecting with paedeatrics and neonatal nurses. In my experiences adult nurses bond with the use of dark humour and grim satire. Paeds nurses are all happy and bubbly. Its probably hard to apply dark humour to critically ill babies.

After tomorrow I get to spend a few days in the lake district. to relax, recoup and drink heavily. Then i'm back and spending a few months in my local A&E department. I am really looking forward to this however I suspect my only duties are going to be taking obs. I cant imagine there is a lot in A&E students are allowed to do.