Saturday, 25 April 2009

A&E: Day Four

My fourth shift started with my primary mentor in majors, we had a couple of chest pains(?MI) and a headache with left sided vision impairment and limb weakness. All very pleasant patients. And then I got asked to take a set of obs on a patient in resus because they were rammed in there and didnt have the time to juggle everything. Seven hours later I left resus.....

It was incredible, juggling obs, drawing meds and just generally identifying jobs that needed doing and doing them before the qualified staff realised they needed to be done. At the end of my shift I got a chance to chat with two of my patients in resus(they were on half hourly obs and nothing else in there needed doing). One lady in her late eighties came in with chest pain(i'm told she was a little bit in love with me). I find that a lot of elderly patients get spoken down to. as though they have no right to know exactly what is happening to them as long as their progeny have been filled in. I do not agree with this, as long as the patient is competant and willing to know, they have every right to know whats going on with them. This also seems to help me form nurse-patient bonds. This patient was very stable when I went off duty.

Another patient was a lady probably in her late fourties, overdose of paracetamol. her fifteenth suicide attempt in the last twelve months. This told me several things. The patient felt rewarded by the attention her suicide attempts acheieved, the patient shouldnt have been in a position to make a second suicide attempt, let alone a fifteenth. She should have been sectioned under the mental health act. As a result I felt obliged to give her my most professional behavior, I did everything by the textbook, with no more than the professionally required level of warmth. Its a shame, the patient was such an intelligent person and she was wasting her life by trying to end it.

On the other hand we all over our stories and people dont end up like that unless a series of events has guided her path there. To be honest I had no idea what to do non-medically that would be in her best interests. I am sure she will survive to discharge and in all probability make another attempt, who knows one day she may accidentally succeed.

There was another patient who died under circumstances that really effected me but it is probabilty disrespectful to recount the events of his failed resuscitation on a public blog. Needless to say there are some parts of the job I will never enjoy.

However I have had another great day, largely thanks to the staff I have been working with. I am more than ready for my two days off now and a bit of sleep.

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