tag:blogger.com,1999:blog-8778398741227710262024-02-20T10:08:34.411+00:00Hippocrates Got LostIf found please return to medicine.Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.comBlogger130125tag:blogger.com,1999:blog-877839874122771026.post-54466644666439135922012-12-06T09:34:00.001+00:002012-12-06T09:37:27.588+00:00New BlogHey guys. I have started a <a href="http://retpigboy.blogspot.com"> New Blog(click here)</a>.<br />
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This has been a good blog and saw me through my training and beyond. However due to my degenerative eye condition I have made a lateral career move to a non clinical post and I don't feel the basis for this blog is relevant any more. I hope you will join me in the new blog.Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com1tag:blogger.com,1999:blog-877839874122771026.post-46824978666248597712012-03-27T20:55:00.001+01:002012-03-27T20:55:53.111+01:00HomeIt's my birthday today. To celebrate this my wife has brought me home, sort of. We are staying in Mevagissey some forty minutes from where I was born and raised. Today we visited the harbour town of Polperro, by far my favourite place on the globe.<br />
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Tomorrow we hit lands end, st michaels mount and portreath. It's amazing the therapeutic effect being home has had on me. I haven't felt this good in years.<br />
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In summery there is always something special to be found in remembering where you came from.Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com2tag:blogger.com,1999:blog-877839874122771026.post-3396566728455386402012-03-18T22:03:00.001+00:002012-03-18T22:03:34.646+00:00Who am I?This may be self exploration or self indulgence. Either way it's a question I've been asking myself a lot recently. <br />
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I have a degenerative eye condition, my father died when I was young, my mother became an abusive alcoholic, I joined the military and as a result the people I formed the closest relationships with in my life are now dead. Does any of this tell me who I am?<br />
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I am married to an incredible and beautiful woman, I have a job I love most of the time for which I am paid very well. I have a mortgage and life is very secure. Does any of this tell me who I am?<br />
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I am very intelligent, more intelligent than most, often in my life I have had to insult myself, dumb myself down or even invent lies about mistakes I've made in order to prevent people around me feeling threatened by my intelligence. If you do this long enough you start to believe the lie you make for yourself and this leads to chronic low self esteem and confidence indirectly knocking down your assertiveness. As a plus everyone I know in life and work always refer to me as a "really nice guy". Is this who I am? <br />
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How do I find the answers? And why do I feel I can't be truly happy until I know?Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com1tag:blogger.com,1999:blog-877839874122771026.post-35706880333148178962012-02-29T10:27:00.001+00:002012-03-04T07:13:41.803+00:00SocialIn all fields of nursing there is a term that induces intense headaches. "Social Discharge". Perhaps the patient has been declared medically fit, perhaps they came in with a minor complaint that could have been resolved by a GP but some social concerns were flagged by the nurse in A&E. For example the patent may live alone and be dishevelled, unwashed and by all appearances unable to look after themselves. <br />
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Whatever the reason at some point a nurse, usually a ward nurse will have to start the social services referral process. First you fill out a "Section2" when you first identify the patient may have care needs on discharge, this is filled out before the patient is medically fit for discharge just so social services have the patient on their books and are roughly aware of what the patient may require with this you have to fill out a box entitled "Estimated Date of Discharge". Can you imagine how hard it is to guess when a patient may be ready to go home when they first present to you?<br />
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Next up the "Section 5". This is a joint work between the nursing and medical team saying the patient is medically fit. On this form you suggest what care the patient may require, residential home, nursing home, home care, caters coming into the home up to four times per day. This then gets faxed off.<br />
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That was the easy part. Now you have to get together in a room with a social worker, physiotherapist, occupational therapist, nurse, doctor, dietician, speech and language therapist and a case worker whose job it is to co-ordinate proceedings. The purpose of getting all these highly paid, highly experienced professionals in the same room is to decide who pays for this patients post discharge care. If their care needs are severe everything will be funded by the primary care trust(pct). This never happens. Of their care needs don't meet the pct requirements it's down to social services. Social Services funding is means tested. If the patient has more than £12000 worth of combined assets then the patient is required to partially find their own care. <br />
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So after completing and faxing over twenty forms and then attending this meeting which can take hours. Bare in mind a ward nurse attending this meeting has twelve patients on the ward not being looked after as well as they could be for the duration of this meeting because the nurse "holding the fort" has twelve patients of their own. What is the inevitable outcome of all this? The patient isn't suitable for state funded care and will have to stay in hospital until the family have made private arrangements.<br />
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I was sat in that meeting for two and a half bloody hours! I am a high dependency nurse my job is to care for two very sick patients. When they are more clinically stable they go to the wards. I'm lucky in that my job very rarely involves discharges and social meetings. Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com2tag:blogger.com,1999:blog-877839874122771026.post-70237238937030263102012-02-25T15:22:00.001+00:002012-02-25T15:23:04.937+00:00Specialist CareI hate this, I am sat at my desk looking at a patient recently sent to me from one of our cystic fibrosis wards. <br />
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Because we have wards staffed with nurses who are highly skilled and experienced in CF care I very rarely get to work with this kind of patient. Also because we are a high dependency unit I very rarely have to provide end of life(palliative) care. This patient is flirty-four, this is by far the oldest CF patient I have even heard of. She has been moved Into my care for end of life nursing.<br />
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It's not that I don't want palliative patients however my knowledge of her condition is textbook only, I fully admit I lack the skill and intuition that CF nurses have.<br />
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As a result my end of life care for this lady will be merely adequate, any dying patient deserves more than that.Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com2tag:blogger.com,1999:blog-877839874122771026.post-9188355438100737982012-02-21T13:38:00.001+00:002012-02-21T13:38:45.674+00:00Precious PatientsEvery now and then we get patients in who are for one reason or another incredibly demanding. Some have spent years in expensive care homes with lots of well paid nurses and careers to cater to their every whim. These patients then come into hospital and expect the same treatment. Patent when the buzz you for the hundredth time to do something they are quite capable of, like moving a small object in arms reach to a new location still within arms reach they don't bother with words like "please" or "thank you".<br />
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It's hard to blame these patients it's how they have learned to live in their nursing homes. However you have two patients under your care as a high dependency nurse. By the time this precious patient is feeling better they have fallen back into their routine. However if you have one of these buzzer happy patients trying to monopolise your attention while waiting for a bed on the wards or a space back in their nursing home and a very sick patient who requires half hourly observations, multiple back to back IV's including inotropes and panic control on their relatives it becomes very difficult. <br />
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I am still trying to find a way to effectively help these demanding patients understand I am not the hired help without offending them. Sometimes you just have to be blunt with these patients so you can prioritise your time and ensure the sick patient receives the best treatment possible.Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com0tag:blogger.com,1999:blog-877839874122771026.post-20422719273960543252012-02-20T14:08:00.003+00:002012-02-20T14:08:52.968+00:00StressWell this year hasnt quite gone to plan so far. The prognosis for my eye condition has deteriorated considerably and shortly after receiving this news my wife suffered a traumatic miscarriage which almost cost her her life. She took three weeks off work to rest and recover, I did not, I threw myself into my work. I am not writing this for any kind of sympathy or shock reaction. I am writing this because my stress reaction interested me and I felt this was worth exploring.<br />
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Three weeks working fifteen hour shifts and single-mindedly ensuring my wife had everything she needed to get through this left me exhausted, lighter and sick. However I didnt feel stressed, over the years I appear to have build a complex mechanism for dealing with stress that operates entirely sub-conciously. I was fully aware that everything I had been through should cause me to feel stressed, a normal human being should feel stressed by these circumstances. I didnt feel stressed however all the symptoms were there, sleep loss, loss of appetite, my blood work showed evidence that my body was pumping out increased levels of adrenaline for a longer period than normal. I found I couldnt concentrate at work and then I became sick,<br />
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Which leads us to this post. My boss has insisted I take a few days off, he has been genuinely concerned about me and I suspect he has experienced a similar situation in his recent life. So I am sat at home, resting up and blogging to try and organise my mind. <br />
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I had never considered before the possibility that a person could be highly symptomatic of acute stress without actually feeling stressed. <br />
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Also normally I would not blog about anything this personal however the anonymity required for my nursing posts has afforded me to a freedom to bare all to complete strangers without fear or expectation. I have mentioned the cathartic application of blogging before however I am starting to wonder if it has a therapeutic application.Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com1tag:blogger.com,1999:blog-877839874122771026.post-54545373825110164302012-01-02T13:18:00.002+00:002012-01-02T13:18:20.677+00:00New Year, New RulesAs always I feel a sense of hope when starting a new year. What will I learn or discover in the coming twelve months, How will my life be altered, who will I meet and what stories will I have to tell come december?<br />
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I know this year will be filled with work, because every year since I turned sixteen has. Where will my career lead me this year? My plan is to stay where I am for at least another sixteen months(which will take me to the two year mark). I always intended to move on from this post at two years....or when the learning curve no longer satisfies me. Fortunately I am quite happy learning and developing my skills at the moment so in all probability I will remain on a specialist high care unit for a while longer.<br />
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I have two holidays planned, One for my birthday I want to return home to cornwall, however this will be my wifes first trip to my home county and I wanted to experience something new with her so we are going to Mevigissey on the south coast of cornwall, a place I have never been before(to my recollection). It looks beautiful. We are renting a cottage in March, hopefully this will avoid the masses of tourists that flood the streets of cornwall every year. If anyone has been there I would appreciate some feedback. My second holiday is my yearly fellwalking trip to the lake district. We may go twice, the first time I'll take my wife and one of my friends, as my wife dislikes fellwalking but enjoys the view and the solitude with a good book. This will allow me to safely tick a few more fells off my list. The second time I shall just take my wife and we can enjoy a cosy week perhaps just before winter when there is benefit to snuggling up by a fire.<br />
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Many of my friends and family have expressed an expectation that children are the next immediate step to my marriage, Whilst if my wife fell pregnant I would by no means be upset I am currently enjoying being a young newly-wed with the finances and time to see more of the world. However time changes many a plan so who knows how many members of my family there may be come December.<br />
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Unfortunatley there are also some expected deaths in my family this year, I hope that when these wonderful people pass it is in comfort and peace. They are stout methodists so I also hope they find some comfort in their peace and find whatever it is they are looking for beyond this life.<br />
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I feel I have ended this brief post(hopefully the first of many for the year) on a sad note. However it would be niave to expect the new year to bring only happy things. I just hope that the good outweighs the bad for myself, my friends, family and whatever readership I have retained on this blog.<br />
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Happy New Year EveryoneAsclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com0tag:blogger.com,1999:blog-877839874122771026.post-59431574824985555062011-11-13T08:53:00.001+00:002011-11-13T08:57:27.144+00:00Perfect MomentsLife has been so hectic recently, When I am not at work I'm thinking about work. Financial and other such issues work their way into my head too.<br />
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Not so now.. Its a beautiful sunday morning. I am sat with my cup of freshly brewed coffee, the beans I bought from salisbury market yesterday(a wonderful Gautamalan dark roast). My wife has just left for work but we spent a great day together yesterday, and I am listening to song light folk music.<br />
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This may not be your idea of perfect, dear reader. However my advise to you is this go into the world today and seek out your perfect moment. Find it, sit in it, take a deep breath and smile. This is what life is, a series of perfect moments interconnected with unimportant worldly matters.Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com3tag:blogger.com,1999:blog-877839874122771026.post-67712047279422146782011-11-11T10:00:00.001+00:002011-11-11T10:10:32.177+00:00This Weeks EndThis has been a rough week. I have worked far too many shifts, most of which have involved heated clashes and extreme differences of opinion in appropriate patient care with other professionals. It has been a week of fatigue, anger and frustration.<br />
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Fortunately I now have six days off(just part of my offduty, I worked the first four days at fifteen hours a piece of this week and next week all my shifts are at the end of the week). This would be a much more welcome piece of information if I were not broke. I am being paid well enough, I am very careful with my money and dont really go in for luxuries, I am a very practical person. So why is it my wages are lasting less and less each month? I've noticed no obvious increase in any of my bills or normal expenses. I am still managing to cover all my outgoings but it it a little troubling,<br />
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I guess this will be just another month of work and staying at home. It could be worse I guess.... <br />
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<br />Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com0tag:blogger.com,1999:blog-877839874122771026.post-5479692207735744922011-11-06T19:03:00.001+00:002011-11-06T19:03:25.052+00:00Just BusinessThe following is based on a conversation I was having at work the other day with a few of my medical and nursing colleagues.<br />
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We are all feeling a little disenchanted with healthcare at the moment, More and more the focus is being shifted from patient care onto costs and public ratings. If you look in the stock cupboard of any ward in my hospital, on the shelves beneath the boxes containing all the equipment we use on an hourly basis, are labels telling us how much each item has cost the hospital.<br />
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Pharmaceutical companies spend hundreds of millions researching and trialing new drugs, and if the drug works really well they pub a massive price tag on it. In some cases this prices the NHS out. We cant afford to buy drugs with high efficacy ratings. I know drug companies have to recoup their investments but once they have done that and start making a substantial profit they still dont drop the prices, so my patients are receiving treatments that whilst still largely effective are not the best on the market.<br />
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My hospital recently had a status upgrade, we are now a foundation trust, this means that we receive a slightly increased budget from the Department of Health, but more importantly we get to say how we spend our money. In a normal trust the DoH give you x amount and say you have to spend 10% on this department and 4% on this department. So this financial liberty is a great first step in ensuring we can provide better care......right? I mean we can personalise our budget so departments like sexual health can be downsized as in this area there is an unnecessary abundance of sexual health clinics, the hospital should not be required to provide another, superfluous service. Cutting off the fat should be a good thing.....RIGHT?!. Apparently not, my hospital has just spent over £320,000 on the name change, literally just adding "foundation" into its name on all the signs and headed note paper. £320,000 is how much it would cost to hire thirteen new staff nurses for a year. However clearly the name change is more important. I am sure there is some legal issue requiring the immediate name change however it just annoys me when I am struggling on a ward that has to rely in agency staff of questionable skill and training on a daily basis. Even the best agency nurse wont work at full efficiency on a ward that is not her own.<br />
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The nature of healthcare and medical progression is such that it is now possible to offer individually tailored treatments for most ailments. Something like asthma, you can now manufacture drugs in a lab based on an individual patients precise unique physiology, offering a treatment so good its almost a cure. We cant afford that, so when I get a brittle asthmatic in, a normal every day human being whos caught a cold, and she asks me if there is anything else I can do to stop her suffering(and having lungs so inflammed the body is screaming for more oxygen would be my definition of suffering) and I tell her "the salbutamol, aminophyline and magnesium are the treatments we give all our asthmatic patients, you'll be feeling better again in a few days". How can I keep a straight face knowing there are drugs out there that could have her home the next day, or even prevent the acute episode to start with, but they are too expensive for the NHS.<br />
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Most Doctors and Nurses get into the job because we want to help people(its sure as hell not for the money or the high quality of life health work provides). Unfortunately our bosses are keen to remind us a hospital is a business.Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com0tag:blogger.com,1999:blog-877839874122771026.post-85894553951760575282011-07-28T09:21:00.000+01:002011-07-28T09:21:21.278+01:00Energy DrinksI was just reading a facinating case study about a patient who was admitted to an emergency department in London. The patient presented with repeated unexplained fits, he was unconscious, tachycardic(fast pulse) at 160 with an irregular rhythm. His oxygen saturations were 52% on air(should be over ninety, anything less than eighty is extremely worrying). All this paints the picture of a patient in a lot of trouble. He had a past medical history of heroin and cocaine abuse however was in a halfway house following a successful rehabilitation process. His toxin screen and drug tests all came back negative but his blood ph was extremely acidic at 6.2 (I wasnt even aware this was compatible with life).<br />
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It turns out he had drunk a mug of coffee and six cans of red bull in the space of four hours. This had taxed his heart, brain and lungs.<br />
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My sister drinks loads of energy drinks more or less constantly. I cant help but wonder what effect these drinks are having on her and where they may lead.Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com0tag:blogger.com,1999:blog-877839874122771026.post-64938493714038511292011-07-24T09:34:00.000+01:002011-07-24T09:34:34.906+01:00TragedyThis comment started as my facebook status however one of my contacts(at the time very drunk) posted some incredibly inappropriate comments in reply so I felt I should move the original statement here and invite any who could present a sensible comment to do so.<br />
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Any loss of life is a tragedy however the fact Amy Winehouse is getting more media coverage than the ninety-five dead in Oslo and the twenty(potentially up to fifty) victims of that nurse in manchester suggess we have some serious priority problems in this country.<br />
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I will admit to having taken issue with Amy Winehouse in the past on the basis that anyone who has celebrity status has a responsibility as a role model. Amy influenced a new generation of teenage drunk junkies.However was she like that before she became famous? I refuse to believe anyone becomes addicted to anything willingly, some trigger usually provides the push. Her passing so young is very sad. I would not normally hazard a guess at cause of death before it has been officially released but I feel it is a safe bet that it is something drink or drug related.<br />
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On the other side of the coin, the near one hundred dead in Oslo were the victims of a randomised attack by an extremist. The victims gunned down at the youth camp made no choices that could have forseeably resulted in their deaths, they were just in the wrong place at the wrong time. As far as the bombing goes I have to admit my heart stopped when I heard a developed country had been bombed. Whilst the act was horrendous I am very glad the "terrorist" was a Norweign national and thus an internal issue. We all know the result of the last bombing on a developed western country by an eastern power.<br />
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Rebecca Leighton a twenty-seven year old nurse has been charged with deliberately contaminating bags and ampules of saline with insulin. We use saline for everything, mixing IV powders into liquids to be injected, we add drugs to bags of saline for long duration infusion and we very frequently give saline bags on their own as they are designed to quickly hydrate our patients. Where I work almost every patient has a bag of saline going up constantly. What sickens me is that all of our patients are vulnerable, they have placed their faith in us as nurses and the thought of someone abusing the trust has sent shockwaves throughout the nursing world. There are no good reasons insulin would be introduced into saline unless for immediate use. I just hope that this does not effect how safe my patients feel in my care, I work really hard to build and maintain the crucial patient-nurse trust. And once again these were victims of the actions of another.<br />
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All three cases are tragic however I do feel hundreds of innocents dying superceeds the potential suicide or accidental overdose of a girl who knew which path she was on and where it would ultimately end.Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com5tag:blogger.com,1999:blog-877839874122771026.post-48583059559787418042011-06-28T11:30:00.000+01:002011-06-28T11:30:40.812+01:00New JobAs the title suggests this post was intended to be about my new job. I am now a Medical High Dependency Nurse(sort of semi-specialising in respiratory high care). I love my new job I am encouraged to think about my patients. I am now equipped with training(and the beginings of experience) that allow me to assess, analyse and intervene with highly unstable patients. This is much more my environment. The move was made largely thanks to my wifes constant nagging(I was miserable and disinclined to do anything about it) but also something Sage said that went along the lines of "ask yourself two questions, why are you miserable and is the cause likely to change" the answer to both was no so I moved.<br />
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Due to the highly sensitive nature of most of my cases at the moment I dont really feel comfortable posting about them(maybe later). Fortunately I have other material. Last night (27/06/11) a new series aired on channel four. Sirens is a dark comedy based loosely around the works of Brian Kellet(Tom Reynolds). I admit at times the combination of dry wit and blunt please the masses comedy grated on my nerves a bit however I found it very entertaining, worryingly accurate of the mind-set of most healthcare workers and carrying an interesting and important message.<br />
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Without giving too much away, three ambulance techs go through a particularly traumatic call-out, this episode follows them through the post-trauma reaction. Adrenaline had flooded their systems creating a euphoric high, they then become very restless and then they experience an adrenal crash. This is summed up in the title of the episode "Up, Horny, Down". The EMT most directly linked to the traumatic event declares he can defy his biology and control this reaction. He spends the next twenty-four hours trying not to given in to these adrenal responses. As it turns out his efforts are just another defence mechanism, allowing him to distract himself.<br />
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This hit home rather. On a day to day basis most healthcare assistants, nurses, doctors, emergency medical technicians and paramedics see and do things that the human body is instinctively progamed to avoid. Yet time after time we throw ourselves towards these situations. All healthcare professionals are more than well acquainted with the "Up, Horny, Down". In addition to this it doesnt take long for any new healthcare professional to discover their own defence mechanisms that allow them to move on following a traumatic event and deal with the adrenal response. Mostly this does involve learning how to distract yourself.<br />
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The constant exposure to this sequence of events is incredibly unhealthy and against every biological urge. We just keep dealing with it and there are surprisingly few mental health issues related to healthcare work(except the slightly higher than average alcoholism rate). I cant help wondering that long term effect this system will have on me, my wife and my friends.Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com2tag:blogger.com,1999:blog-877839874122771026.post-8065224531349527382011-06-14T10:14:00.000+01:002011-06-14T10:14:00.910+01:00Married! The FinaleSo far I had gotten through the ceremony and my speech without slipping up. I was fully aware that my only three duties that day were the ceremony, the speech and the first dance.<br />
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The latter was causing me come concern. I had been receiving dance lessons in order to respectably pull off my first dance. I am not exaggerating when I say I am completely unable to dance, its never been a requirment in any training or education I have received, added to this while all my peers were informally learning to dance by going to nightclubs I always opted for a nice warm pub.<br />
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The DJ called for myself and my wife to take to the floor for our first dance. Lonestar - Amazed started and we started our.....routine. It was going perfectly and I was rather proud of myself for not placing my size fourteens on either my wifes dress or her tiny feet. We were about thirty seconds from the end of the song. I was nearly done! ....then disaster struck, the audio cut out. The DJ was terribly embarressed but promised to sort it out swiftly. At which point five of my friends sprung into action - A sound engineer, an electronics engineer, a network engineer, a functioning genius and most importantly a pub landlord who had his own mixing desk in the boot of his car. Within five minutes we were set back up. We restarted our first dance and completed it well. So I managed to get two first dances. This situation didnt bother me, everything elese was going so smoothly that this just added a little character to the evening. Myself and my wife then took our own mothers to the dance floor and everyone else joined us. Halfway through the first song one of my best men did something that really impressed me, He cut in for a dance with my mother. Good Man!<br />
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The rest of the evening passed without event, the hog roast was stunning, the DJ sang various incredible tributes to the ratpack and then did the rounds performing magic tricks. I wasnt expecting magic! The night ended with a few songs tailored for my enjoyment - Kansas, Boston, etc<br />
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All in all it was a perfect day. We got to celebrate the most important day of our lives with those we love, ate well and got to party well afterwards. We liked the hotel so much I ended up booking hte honeymoon suite for another night and spending the following day in the spa. <br />
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|The day after we set off for the lake district where we spent a week doing absolutely nothing and loving every second of it. Now we are just waiting for the official honeymoon in september......Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com2tag:blogger.com,1999:blog-877839874122771026.post-58253674109429702462011-06-12T10:48:00.000+01:002011-06-12T10:48:49.289+01:00Married part Two<div style="font-family: inherit;">Waking up the morning of my wedding I had a bath(with bubbles) and prepared a cereal breakfast for my best man(still my guest, rules of hospitality always apply!). Unsurprisingly I had no appetite. We donned our suits and he, having trouble with his cravatte offered me assistance with mine "they are tricky buggers to put on, let me sort yours out".</div><div style="font-family: inherit;"><br />
</div><div style="font-family: inherit;">Later that day, just before the ceremony I had my chat with the registrars, during which I explained that I was legally and physically fit to marry under the laws of the united kingdom. One question that amused me as all anachronisms do - "are you free born and a citizen of the United Kingdom?". Fortunately in this day and age I was not born a slave......strange question!</div><div style="font-family: inherit;"><br />
</div><div style="font-family: inherit;">Shortly after this I was stood in the hall, the majority of my guests sat before me and my best men stood beside me. At this point I should stress that the temperature when leaving my house was twenty-eight degrees, that was at half past nine, it was now midday, as people piled into the small room the temperature steadily climbed to what was apparently my melting point. On occasion a guest would arrive late, the music would stop as the door opened, when realising it wasn't my bride the music restarted. After the fifth time this happened my nerves were shot. Eventually the bridal party arrived at the door, headed by our reluctant page boy.</div><div style="font-family: inherit;"><br />
</div><div style="font-family: inherit;">When I caught sight of my near-wife I became breathless, as she walked towards me and stopped beside me I became aware of the registrar saying something. I still have no idea what it was, my entire universe was focused on how incredible the woman beside me looked. I know it sounds cliche and because of the cliche I thought I was equipped to deal with the situation.....I wasnt.</div><div style="font-family: inherit;"><br />
</div><div style="font-family: inherit;">Before the ceremony formally started my best men took their seats and a very dear friend stood. She was shaking uncontrollably in front of seventy odd people. However her voice rang out beautifully as she delivered our chosen reading. Shakespeares sonnet 116, I know its well used but I like it and the friend delivering it has a voice of pure fragile beauty perfectly suited for this one task.</div><div style="font-family: inherit;"><br />
</div><div style="font-family: inherit;">"Let me not to the marriage of true minds<br />
Admit impediments. Love is not love<br />
Which alters when it alteration finds,<br />
Or bends with the remover to remove:<br />
O no! it is an ever-fixed mark<br />
That looks on tempests and is never shaken;<br />
It is the star to every wandering bark,<br />
Whose worth's unknown, although his height be taken.<br />
Love's not Time's fool, though rosy lips and cheeks<br />
Within his bending sickle's compass come:<br />
Love alters not with his brief hours and weeks,<br />
But bears it out even to the edge of doom.<br />
If this be error and upon me proved,<br />
I never writ, nor no man ever loved."</div><div style="font-family: inherit;"><br />
</div><div style="font-family: inherit;">She delivered this not just in pure, clean, crystal clear english. But also in perfect Iambic pentameter. No small feat when suffering severe stage fright. </div><div style="font-family: inherit;"><br />
</div><div style="font-family: inherit;">The rest of the ceremony took place with ....minimal tears. Once it was all done we all retreated to the lawn for photos. At which point my wife told me that my cravatt was the wrong way around(thank you best man). A small point which NO-ONE else picked up on but which she is clearly never going to let me forget. A great number of photographs were taken in various places. Bubbles were used in the place of confettii as we were in the New Forest and it seems they get a bit shirty about people throwing loads of paper around. We then formed a recieving line and greeted all of our guests into the hall for the wedding breakfast(a massive lunch). My brain was struggling to keep up with the ettiquette as person after person appeared in front of me (do I know this person well enough to hug? is a handshake appropriate.....AHHHH!). After more hugs, kisses and handshakes than I care to remember we were introduced to the room as "Ladies and Gentlemen, please be upstanding for the new Mr and Mrs ******". We were then walked into the room and to our seats via the long route. Orders for the starters were taken and these incredible little plates were placed in front of us, I chose the salmon....it was a good choice. When main course food was ready we were taken up by the staff, they asked us what we wanted and collected it on a plate, and carried it with us back to our seats(I could get used to this). At this point we were all fairly well plied with wine and it was obvious in the room it was having good effect as a social lubricant. The guests then went up for food, surprisingly for both families not one person complained about the food(it was that good). After a number of speaches(my best mans going down in infamy). We exited the room and everyone was given time to relax before the reception. I took this time to investigate my room and have a shower. As it turns out my room was bigger than my house and I got a little lost inside it. The shower was much needed. I got back into my suit and found myself at the bar with a double straight GlenMorangie(my favourite whiskey).</div><div style="font-family: inherit;"><br />
</div><div style="font-family: inherit;">I sedately socialised with friends and family and greated friends as they arrived for the reception. </div><div style="font-family: inherit;"><br />
</div><div style="font-family: inherit;">This is a good place to end part two. </div><div style="font-family: inherit;"><br />
</div><div style="font-family: inherit;">Lessons from this part - Never trust another man to dress you. Your best mans speech will almost always beat yours, In extreme times of dire need your family may behave themselves.</div>Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com0tag:blogger.com,1999:blog-877839874122771026.post-50368509745912242092011-06-10T15:22:00.000+01:002011-06-10T15:22:55.233+01:00Married! part OneBreaking News: I have fallen from the noble bacheolar ranks.<br />
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After years of planning, saving and a surprising amount of stress I got myself married on June 4th at Careys Manor in Brockenhurst. For those who dont know the manor its a very large manor house/four star hotel in the middle of the new forest.<br />
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The night before the wedding my wife stayed at the hotel and enjoyed their spa facilities. I stayed at home with my best man and enjoyed a bottle of wine with some friends. Whilst my wife was being pampered I was recieving regular phone calls from people we entrusted with small but vital tasks. Things like taking my MP3player and speakers and switching the music from Einaudi which was playing whilst people were milling around to Jason Maraz which my wife chose to walk down the aisle to. This small task just involved pressing a button and I had previously felt bad that this was the only task I had given one of my closest friends. However this friend has a gift for overcomplicating things and had decided my speakers were too weedy for the task so he had acquired some very large "monitors"(to my lack of knowledge they are little more than just speakers) with a mixing desk, ripped my music and attached all this to a laptop. I get a phone call at 2200 the night before I am to get married saying he cant get this system working and appears to have lost the music I gave him in the first place. Some people just have a gift for overcomplicating the simplest of tasks. I strongly suspect this issue would not have arisen had this friend not fallen under the influence of another, an electronics engineer of our aquaintence. Fortunately My friend from glasgow had just arrived(following a ten hour drive down) and he was staying in a B&B near Careys Manor. We threw my stereo and a second mp3player in the back of his car. At which point friend A called back saying he "thinks" he's sorted it. We left my kit in the back of the scottsmans car anyway.<br />
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I have to confess with slight shame and embaressment myself and my best man were unsure of how to put cufflinks on.....we had to consult youtube. This was his suggestion and it was a good one, This is why I chose him as best man. He didnt have all the answers but he knew where to get them.<br />
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The night before the wedding was hot, very hot and stuffy. I probably wouldnt have slept through my nerves anyway, however I could definitely have been more comfortable, I dont do a good job tolorating the heat at the best of times. Its funny though, my nerves were entirely focused on administration. People have been hasing me for about a year now "are you nervous". I have been with the new Mrs Asklepius for five years, known her for a lot longer, I had no nerves about marrying her, frankly if I was to have any doubts I would have felt them years ago. However given the sheer number of people we were relying on for this enormous organisational feat I was worried about it all falling apart.<br />
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As it turns out things couldnt have gone more smoothly. From the second I arrived the Manors wedding facilitator sat me down at the bar with a complimentary pint of guinness(which I've just realised I didnt drink). She told me to relax and mingle with my emerging guests and she would fetch me when the registrars arrived for my pre-wedding chat. <br />
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This is probably the best place to end part one of my wedding day.<br />
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The lessons to be learned from this section - Always have a backup plan no matter how much you trust the person performing the small vital tasks. At no point on your wedding morning will you be sat still long enough to enjoy a pint, If in doubt.....youtube will probably have the answer.Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com1tag:blogger.com,1999:blog-877839874122771026.post-32022163177139261792011-06-10T14:58:00.000+01:002011-06-10T14:58:38.214+01:00I'm really back this time.After many false starts I decided to leave this blog until I had more time and some new experiences to tell you all about. The last few months have probably been the most active of my life. I have(I hope correctly) set my next five posts up to time release so this blog should be increasingly active. I also have drafts for at least ten more based on notes I have been making for the last three months.<br />
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A little indicator of what has been going on in my life - I am now married! I have a new job, I have discovered various new ales and my reading list is finally getting smaller after years of books being added at a greater rate than I can read.<br />
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Hopefully at least some of this will provide passable reading to anyone still keeping an eye on this blog.Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com2tag:blogger.com,1999:blog-877839874122771026.post-90615238918924720852011-02-19T18:05:00.000+00:002011-02-19T18:05:37.858+00:00BalanceIts taken several months of soul destroying work. Dragging myself out of bed every morning with no real incentive past the desire not to be beaten. Going into work and coming home feeling aweful. But I have finally found a balance. The negative aspects of my work are still present but I have somehow found myself happy again recently. I am not taking my work too seriously(past the life or death decision making). My plan is still to leave this ward as soon as I have reached the one year mark. One years experience is invaluable in nursing and it is the stage at which newly qualified nurses are expected to move on to new areas in order to expand their field of experience.<br />
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I have discovered one or two new hobbies. Astronomy being the first. Following several hours in a dark field a month ago with a friend and an expensive camera I suddenly realised how mind blowing some aspects of astronomy can be. With the naked eye you can actually see other galaxies, entire clusters of solar systems with light that has taken hundreds of thousands of years to reach us. Many of the stars visible may be long gone. unc<br />
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I have also started working on my family tree with the use of various local records and internet sources. Fortunately I have a fairly uncommon surname ....infact most of the surnames in my family tree range from uncommon to rare. Theres a lot of interesting stuff in there and I have dug up a few photos of my family from many generations back and I have even found a hand written letter, written by my great-great-great-great-grandmother. Between the spelling and the handwriting its taken me nearly a month to decipher it.<br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgKmIfGgWZrR0D7__48F6Yn585oJzvYW1DYobQJJwvIahQmX489QSYNJSiwC4Vb8lIgw_XmszDD812k6G8I9H4SW-JwVbZ6Khd5kngWnakgDRVNDOB9khJAEkv3LxLwiCBlB3nPJjJaB9Q/s1600/dcae6c01-8543-4269-a374-f3d5b8efb1b2-0.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="251" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgKmIfGgWZrR0D7__48F6Yn585oJzvYW1DYobQJJwvIahQmX489QSYNJSiwC4Vb8lIgw_XmszDD812k6G8I9H4SW-JwVbZ6Khd5kngWnakgDRVNDOB9khJAEkv3LxLwiCBlB3nPJjJaB9Q/s320/dcae6c01-8543-4269-a374-f3d5b8efb1b2-0.jpg" width="320" /></a></div>I've also managed to find my great-grandfathers world war two RAF dogtags. The trouble is I am still fairly new to this so I cant figure out where I can search for records with just a surname and service number.<br />
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In addition to this I've also rediscovered my geeky side. I've spent a week off fixing laptops, PCs and coding in perl. Its been incredibly therapeutic. Although I have to admit one of the laptops is bothering me. I'm still not entirely sure what was wrong with it, or how I managed to fix it.....but its working now. This is a perfect example of how my mind works I am never satisfied with a solution if I dont have a complete understanding of the problem. Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com1tag:blogger.com,1999:blog-877839874122771026.post-52509500537398179532011-01-06T12:50:00.001+00:002011-01-06T12:50:55.568+00:00Viney!I've had a week off and as. Result I have been calm and relaxed. So this morning I've tuned into Jeremy Vine just to experience a healthy amount of rage and frustration. One idiot caller in particular phoned stating that "the NHS is in ruins because all these cheap foreigners are taking english nurses jobs". Tuis made me wince. Its people as ill informed as this that keep the bnp going.
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<br>So I thought I'd shoot holes in this statement here.
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<br>1. every healthcare professional in the NHS is being paid on a banded system. I am a staff nurse so I am in pay band five. I am on Exactly the same pay as every other staff nurse in the country regardless of race, gender or eye colour.
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<br>2. There is no shortage of nursing jobs in this country. Infact both trusts I have worked at have declared crisis because they can't fill all the nursing posts they have.
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<br>3. The reason nurses from places like the Philippines appear to get more jobs than english nurses is because the level of training in the philippines is far better than the standard of training here. Most philippino nurses graduate with education and experience that takes an english qualified nurse ten years to catch up with. Also all of the phillipino nurses I've worked with have worked harder than anyone else whilst english trained nurses have spent more time complaining.
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<br>This caller really annoyed me and I think its because hers was the voice of the vox populi. Ill informed, ready to blame everyone but herself, but violently prepared to voice her opinion. In some small way I can see a comparison between people like this and a certain German political movement in the 1920/30s.
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<br>There we go. Another rant over. I hope everyone had a great Christmas and new year.
<br>Sent from my BlackBerry® wireless deviceAsclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com0tag:blogger.com,1999:blog-877839874122771026.post-7603349212380479062010-12-23T13:44:00.000+00:002010-12-23T13:47:52.358+00:00Christmas<p class="mobile-photo"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh9FM_s0X0lzz96iFDG6PvPLG2T5a6Vq8o70JAMGakBRFNsZGCMEN04QznamL52__VV5fiVUH2mCPWBovB_jKb0z2wXVLOvcVefpNid3_acCYLEFOWOZyZuHNt-Hqmx2l7muvHXGl7havs/s1600/%253D%253Futf-8%253FB%253FSU1HMDAwMDctMjAxMDA2MDMtMTY1Mi5qcGc%253D%253F%253D-772359"><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh9FM_s0X0lzz96iFDG6PvPLG2T5a6Vq8o70JAMGakBRFNsZGCMEN04QznamL52__VV5fiVUH2mCPWBovB_jKb0z2wXVLOvcVefpNid3_acCYLEFOWOZyZuHNt-Hqmx2l7muvHXGl7havs/s320/%253D%253Futf-8%253FB%253FSU1HMDAwMDctMjAxMDA2MDMtMTY1Mi5qcGc%253D%253F%253D-772359" border="0" alt="" id="BLOGGER_PHOTO_ID_5553874062664461810" /></a></p>I have a couple of days off now before my fourteen hour shift christmas day. Myself and my fiancee are currently on the A34 on our way to Cheltenham where two of her friends are getting married tomorrow. I have recently discovered how to post by emailing from my phone. Empowered by the spirit of adventure I thought I'd use this system for posting today and I've even tried to add a picture of my first activity when I get to Cheltenham. Although I'm not sure of I can add pictures this way.
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<br>I'm glad to have the day off. My body is still aching from my shift yesterday. My ward is the only ward in our division that isn't closed to admissions due to diarrhoea and vomiting. This means that when ICU needs to move a few patients out to make room for the very sick all of their high care patients are coming to us. Every patient I cared for yesterday was very sick. I am very proud of myself, I did not bow to the pressure of my superiors to work faster and spend less time with each patient. I took my time, prioritised and yes I did forego my breaks and I even left an hour late but everyone one of my patients became stable largely due to my actions. I even found the time to feed two patients and acquire some mouthwash for one patient who has developed very painful mouth ulcers which are limiting her nutritional intake.
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<br>Having spoken to the other newly qualified nurses on the ward we are all equally displeased and have even gone as far as saying we are wasting our days off panicing about our next day at work and who we might be working with. The knowledge I am not alone in feeling this way has helped me considerably. I am enjoying the acuity and the patient groups. Who I work with and the lack of support are obstacles to be disregarded until such a time as they can be overcome.
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<br>I wish all of my readers a very happy Christmas. Eat well, drink to the upper range of your limits and most importantly be safe.
<br>Sent from my BlackBerry® wireless deviceAsclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com0tag:blogger.com,1999:blog-877839874122771026.post-55308768125658552102010-12-20T12:39:00.000+00:002010-12-20T12:35:20.136+00:00Vintage WhineSo it turns out that I'm not enjoying being qualified. I am enjoying the job, just not where I am doing it. I am entirely unsupported and the team I'm working in consists of people who don't know or like each other. Not exactly a friendly environment. I have to admit I am currently living day off to day off.
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<br>I was trying to hold off posting until things picked up however all evidence suggests this won't happen so here I am submitting another whiney post.
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<br>Sent from my BlackBerry® wireless deviceAsclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com2tag:blogger.com,1999:blog-877839874122771026.post-85990483163551226032010-10-18T09:27:00.003+01:002010-10-18T09:46:47.485+01:00QualifiedYep, the title says it all. I am now a qualified nurse. I have completed my course and been given an entry on the Nursing and Midwifery Council(NMC) register. I have started a job as a Staff Nurse on a general ward at a local hospital. The last few weeks have been filled with a sense of blinding terror and headaches induced by all the new paperwork in this new hospital. As soon as I qualified I felt I had forgotten everything I had learned over the last three and a bit years. Fortunately this doesnt appear to be the case.<br /><br />I have enrolled on a preceptorship program. This effectively gets my post-qualification education off to a good start. Including things like respiratory and cardiac study days. I also have a semi-experienced nurse on my ward who is there to assist my development. Its all very cool.<br /><br />I have been working on my ward for three weeks now and I have to admit I am only just starting to find me feet. During this supernumerary period I am supervised in everything I do. This is accompanied by phrases like "You dont have to do it this way but its how I do it" from the senior nurses which of course oblige me to "do it their way" whilst they are supervising me. I finally started finding my feet when we were too understaffed to allow me any supervision so I could do it all my way.<br /><br />I have to admit there is a large part of me that regrets not going straight to A&E but I still believe its essential to my core development to get experience in a specialty area first. I am however missing my highly acute patients, we have had one or two on my ward but most of the patients have fairly high care needs but few medical or acuity needs. As is true on a lot of wards in a lot of hospitals many of my patients are in with us for a "social sort out", they have complex or increasing social care needs and need a bed with us whilst social services work their magic. I fully appreciate the importance of this system for the patients however I believe there should be special wards designed just for this purpose so social patients arent taking up acute care beds on wards with staff with specialty training and experience.<br /><br />There we go. My first post back, my first post as a qualified nurse ending in a micro-rant.Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com5tag:blogger.com,1999:blog-877839874122771026.post-60734068747554524312010-05-03T21:52:00.002+01:002010-05-03T22:02:25.171+01:00PoliticsI'm currently on a break from university. This time is intended to allow us to apply for jobs and prepare ourselves for life in the real world. Many people have asked me what it feels like to almost be a qualified nurse. To this I tend to explain that if I were a blacksmith having completed an apprenticeship I would be considered a journeyman blacksmith. The journeyman is someone who has fully learned the core of their trade but is far from being a master. I am soon to be a journeyman nurse.<br /><br />Whilst I am waiting to start my final placement I have been getting rather interested in the political situation. Over the last two weeks I have found my self at one point or another supporting each of the three main parties. After weeks of seeing the pro's and con's of each of the parties I have come to the following conclusion. I really dont care who is in power, all I really want is for tomorrow to be more or less the same as yesterday. Where there are sick people there will always be nurses. so I will always have a job(a job I love), I have a mortgage, a gorgeous fiance and a very mischievious cat. My world is a near perfect place. In the coming years there are things which may further enrich my life. By and large nothing that truly matters to me will be effected should any one of the party leaders become prime minister.Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com3tag:blogger.com,1999:blog-877839874122771026.post-8531397978240958152010-04-05T11:41:00.002+01:002010-04-05T11:54:55.756+01:00Time off.....AGAIN!I am approaching the end of my course, qualification awaits. All I have to do is pass this final placement. Which given the proficiencies I have to demonstrate shouldnt be a problem. These a proficiencies that frankly any third year student nurse should have been proving for over a year now.<br /><br />The trouble is I am currently on a very very long easter break from this placement. Eight weeks!. Most people seem to enjoy a bit of time off. I love the odd day doing nothing. However there are no bank shifts going at my hospital due toa combination of closing wards and everyone else being off and wanting work. My personal problem is that when I am left without work for a prolonged period I always seem to find a way to very expertly derail my life. This usually involves a combination of boredom and either over-exercise or over-drinking. Whilst alcohol doesnt cause me to make as big a fool out of myself as it seems to most people. It does trigger a massive personality change in which I become a complete and utter bastard. Fortunately for me I am marrying a girl who knows how to handle this. Generally with strong words or a series of increasingly painful slaps around the back of the head.<br /><br />I just get sooooo bored when I have no work to do.Asclepiushttp://www.blogger.com/profile/09374111673604085654noreply@blogger.com0