Recently I have been mulling over fond memories of my later childhood. Spending whole nights playing various computer games with my friends, exchanging witticisms over irc. Sunny summer days spent sitting on the grass in a nearby towns park just relaxing. I used know exactly when my favourite authors next book was due out.
Now my life is all sixty hour weeks, assignments, wedding plans, mortgage payments. As far as my favourite author goes even if he hadnt died I'm certain I wouldnt be able to name any of his recent books. As for my friends, I see very few people from those days. I suppose this is just what growing up is and I am certain there are stresses and problems from those times that I am not remembering.
There is nothing in my life currently I would want to be without, I am in a really good place. However I wouldnt mind a touch of the carefree days of youth entering my life again just for a while.
Friday, 15 January 2010
Snow
I had promised myself I wouldnt blog on the tedious matter of the snow. However it is directly effecting my work so its hard to avoid.
Personally I love the snow, I have a degenerative eye condition called retinitis pigmentosa(RP) which makes me as good as blind at night. However the is now this nice reflective white stuff everywhere meaning I can safely walk around at night now(and I love night time). Also as I have size 14(UK) feet and always wear my magnum boots I have no problems with slipping.
Professionally I am concerned about the strain this is putting on the local hospitals. The larger of the two local acute hospitals was completely out of beds for several days recently forcing ambulances to divert to a much smaller and already strained hospital(where I work). My hospital has reopened a ward to try and take some the strain. This ward is entirely staffed on a day to day basis by bank staff, there are no permanent staff on this ward at all. I have got plenty of shifts booked there as a healthcare assistant (the money is good) however it cant be good for patient care to have different staff on every shift throughout their admission.
A&E departments are swamped by fractures(mostly elderly) and the ambulance service is overwhelmed by people who are perfectly able to get to their gp's office but have decided that an ambulance is a much warmer way to get a paracetamol prescription for their headache.I honestly believe these people should be fined, I am certain that the income generated by these fines would pay for a lot more paramedics, nurses and even a doctor or two.
Personally I love the snow, I have a degenerative eye condition called retinitis pigmentosa(RP) which makes me as good as blind at night. However the is now this nice reflective white stuff everywhere meaning I can safely walk around at night now(and I love night time). Also as I have size 14(UK) feet and always wear my magnum boots I have no problems with slipping.
Professionally I am concerned about the strain this is putting on the local hospitals. The larger of the two local acute hospitals was completely out of beds for several days recently forcing ambulances to divert to a much smaller and already strained hospital(where I work). My hospital has reopened a ward to try and take some the strain. This ward is entirely staffed on a day to day basis by bank staff, there are no permanent staff on this ward at all. I have got plenty of shifts booked there as a healthcare assistant (the money is good) however it cant be good for patient care to have different staff on every shift throughout their admission.
A&E departments are swamped by fractures(mostly elderly) and the ambulance service is overwhelmed by people who are perfectly able to get to their gp's office but have decided that an ambulance is a much warmer way to get a paracetamol prescription for their headache.I honestly believe these people should be fined, I am certain that the income generated by these fines would pay for a lot more paramedics, nurses and even a doctor or two.
Sunday, 6 December 2009
Cynic
As far as I am aware it is impossible to work in healthcare without eventually becoming a cynic. Here are a few of our more regular experiences.
Drunks who have fallen into the gutter and as a result are covered in minor abrasions and have suffered a possible head trauma. Observe them for four hours, take blood, hook up to a big bag of sober-up-juice(saline) take GCS every half hour, listen to them explain how they only had one pint.
Women who have been beaten(and occasionally raped) by their spouses, several broken ribs, lacerations to the face and possible skull and limb fractures. X-Rays to all effected areas, GCS every half hour, ECG to rule out cardiac damage as a result of thorasic trauma, listening to them explain how they either fell down some stairs or how their spouse is a good man and wouldnt have done it if they hadnt set him off.
Parents who when faced with a child suffering a high temperature, vomiting and diaorrhea decide that they dont need a doctor, they need homeopathic herbs and spices. By the time the child reaches us they are massively dehydrated with a blood pressure so low it can barely push blood around their body and a pulse so fast that the chambers of the heart barely have time to fill. Listening to them explaining how medicines are poisons and pollute the body and soul*.
Parents who are themselves vegans or vegetarians and are forcing such a diet on their infants, as a result the infant is now in the lowest survivable body mass index and will probably suffer permanent damage to all their bodily systems.
As a result of this I think its understandable that I have become a little more pragmatic and cynical. I still treat every patient with respect and ensure whatever dignity they have left is maintained. I perform tests both based on what they tell me and what I suspect to be the truth knowing that the day I refuse to believe a patient is the day I am wrong. It also appears that I can be a cynic and an optomist.
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*The comedian Tim Minchin has an eternal place in my memory for this line - "Alternative medicine is either not proved to work or proved not to work, do you know what they call alternative medicine that is proved to work..............medicine".
Drunks who have fallen into the gutter and as a result are covered in minor abrasions and have suffered a possible head trauma. Observe them for four hours, take blood, hook up to a big bag of sober-up-juice(saline) take GCS every half hour, listen to them explain how they only had one pint.
Women who have been beaten(and occasionally raped) by their spouses, several broken ribs, lacerations to the face and possible skull and limb fractures. X-Rays to all effected areas, GCS every half hour, ECG to rule out cardiac damage as a result of thorasic trauma, listening to them explain how they either fell down some stairs or how their spouse is a good man and wouldnt have done it if they hadnt set him off.
Parents who when faced with a child suffering a high temperature, vomiting and diaorrhea decide that they dont need a doctor, they need homeopathic herbs and spices. By the time the child reaches us they are massively dehydrated with a blood pressure so low it can barely push blood around their body and a pulse so fast that the chambers of the heart barely have time to fill. Listening to them explaining how medicines are poisons and pollute the body and soul*.
Parents who are themselves vegans or vegetarians and are forcing such a diet on their infants, as a result the infant is now in the lowest survivable body mass index and will probably suffer permanent damage to all their bodily systems.
As a result of this I think its understandable that I have become a little more pragmatic and cynical. I still treat every patient with respect and ensure whatever dignity they have left is maintained. I perform tests both based on what they tell me and what I suspect to be the truth knowing that the day I refuse to believe a patient is the day I am wrong. It also appears that I can be a cynic and an optomist.
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*The comedian Tim Minchin has an eternal place in my memory for this line - "Alternative medicine is either not proved to work or proved not to work, do you know what they call alternative medicine that is proved to work..............medicine".
Wednesday, 25 November 2009
Bank
I have been working bank shifts as a healthcare assistant in my trust. Just to earn a little extra money. At first it was liberating having next to no responsibility. All you have to do is worry about washes, feeds and obs, everything else is the nurses job. This soon became quite frustrating a patient becomes breathless or starts desaturating and as a student nurse I would shove them on oxygen. I cant do this as an HCA I have to ask the nurse. A patient complains of chest pain I cant just put them on high flow o2, do an ecg and show it to a doctor, I have to wait until a nurse appears so I can ask her if its ok.
I was in a bed space yesterday with a nurse and the patient starts vomiting large quantities of blood, the nurse asked me to get a doctor or another nurse in there as quickly as possible. I go out to the nurses station where the doctors are discussing their rounds and I shout, "we have a problem with a patient, we need help NOW!" everyone, every last one of the doctors and nurses in sight said "find someone else, i'm busy". So i go back to the bedspace and hit the resus alarm, this gets some fairly immediate attention. Despite the fact this tactic worked in the face of overwhelming stupidity I spend the next two hours being shouted at for misuse of the alarm and making the senior sister look like an idiot.
When I'm qualified and running a ward if I EVER see a member of staff ignoring an urgent call for help I will see to it that even if I cant fire them the only favourable option available to them will be to quit.
The patient survived, just about.
I was in a bed space yesterday with a nurse and the patient starts vomiting large quantities of blood, the nurse asked me to get a doctor or another nurse in there as quickly as possible. I go out to the nurses station where the doctors are discussing their rounds and I shout, "we have a problem with a patient, we need help NOW!" everyone, every last one of the doctors and nurses in sight said "find someone else, i'm busy". So i go back to the bedspace and hit the resus alarm, this gets some fairly immediate attention. Despite the fact this tactic worked in the face of overwhelming stupidity I spend the next two hours being shouted at for misuse of the alarm and making the senior sister look like an idiot.
When I'm qualified and running a ward if I EVER see a member of staff ignoring an urgent call for help I will see to it that even if I cant fire them the only favourable option available to them will be to quit.
The patient survived, just about.
Sunday, 15 November 2009
Oh Dear!
In the course of research for an assignment I discovered that the most common sources of heparin come from porcine(pig) intestinal tracts. This normally wouldnt bother me, most of the medications I administer (or occasionally take myself) come from animal sources. However we use a modified version of heparin, enoxaparin as prophalaxis and treatment for blood clots in whats probably 70% of the patients in my hospital. Its very commonly used.
My problem is that I had no idea it was procine based, most of the staff I work with had no idea it was porcine based. I have certainly had jewish patients in the past. I must have at some point administered enoxaparin to them. Normally I give little consideration to religious elements of care, I appreciate they are important but I prioritise the body over the soul, I let the hospital chaplains worry about that. However this is a fairly heafty rule in the jewish belief structure we are unwittingly breaking.
My problem is that I had no idea it was procine based, most of the staff I work with had no idea it was porcine based. I have certainly had jewish patients in the past. I must have at some point administered enoxaparin to them. Normally I give little consideration to religious elements of care, I appreciate they are important but I prioritise the body over the soul, I let the hospital chaplains worry about that. However this is a fairly heafty rule in the jewish belief structure we are unwittingly breaking.
Busy, Oh So Busy!
In the last month or so I've moved house, passed the placement from hell and been working in all the free time I have to pay the bills. I think things are settling down now but sometimes its hard to tell. I had intended to write up a load of posts and time release them. I'm guessing i've lost a large portion of my reader-base but hey, thats not why I started doing this.
Friday, 18 September 2009
Swine Flu
In 2007 over five thousand infants and elderly people died from "human" influenza. The every day, run of the mill flu. This statistic is actually a vast improvement on the previous years, largely thanks to the greater use of the flu vaccine in vulnerable people. Why is this not reported in the news every year? because it happens every year and thus it is not news. However a few hundred people die from a virus that is almost indistinguishable and certainly no more fatal and the media use exercise their ability to cause mass hysteria. Whilst these deaths were indeed deeply tragic the majority of them came from nations with undeveloped healthcare systems where the general populous live in third world conditions. In the nations with more developed healthcare systems, including the UK, most diagnosed cases took place largely due to clinical and professional assumption. Currently one in every two hundred "confirmed" cases of H1N1 have been laboratory confirmed and they are symptomatically identical to the "human" flu.
The Department of Health current risk catagories for this "pandemic" is word for word identical to that of the yearly flu risk publication. The very young, the very old, and anyone with a chronic condition. Chronic Condition is a very broad term for any disorder or disease that can not be cured. This however does not mean it is fatal and can not be managed. This could be something as reletively harmless(if well managed) as Diabetes or a rapidly deteriorating disease like Motor Neurone Disease(MND). Several chronic conditions will not effect a patients vulnerability to influenza, however many conditions like Systemic Lupus Erythematosus(SLE) and other auto immune conditions require treatments that will effect a patients immune system(immunosurpressants mainly).
My arguement is not that swine flu is not a serious condition(it certainly can be). It is that it is no more serious than the annual flu and all this media and public hysteria may well draw attention away from the seriousness of the annual flu, many may not get vaccinated this year(or only get covered for swine flu) and a massive unnecessary loss of life may ensue.
The Department of Health current risk catagories for this "pandemic" is word for word identical to that of the yearly flu risk publication. The very young, the very old, and anyone with a chronic condition. Chronic Condition is a very broad term for any disorder or disease that can not be cured. This however does not mean it is fatal and can not be managed. This could be something as reletively harmless(if well managed) as Diabetes or a rapidly deteriorating disease like Motor Neurone Disease(MND). Several chronic conditions will not effect a patients vulnerability to influenza, however many conditions like Systemic Lupus Erythematosus(SLE) and other auto immune conditions require treatments that will effect a patients immune system(immunosurpressants mainly).
My arguement is not that swine flu is not a serious condition(it certainly can be). It is that it is no more serious than the annual flu and all this media and public hysteria may well draw attention away from the seriousness of the annual flu, many may not get vaccinated this year(or only get covered for swine flu) and a massive unnecessary loss of life may ensue.
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