Well 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.
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,
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.
I had never considered before the possibility that a person could be highly symptomatic of acute stress without actually feeling stressed.
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.
Monday, 20 February 2012
Monday, 2 January 2012
New Year, New Rules
As 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?
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.
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.
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.
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.
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.
Happy New Year Everyone
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.
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.
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.
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.
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.
Happy New Year Everyone
Sunday, 13 November 2011
Perfect Moments
Life 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.
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.
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.
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.
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.
Friday, 11 November 2011
This Weeks End
This 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.
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,
I guess this will be just another month of work and staying at home. It could be worse I guess....
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,
I guess this will be just another month of work and staying at home. It could be worse I guess....
Sunday, 6 November 2011
Just Business
The following is based on a conversation I was having at work the other day with a few of my medical and nursing colleagues.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Thursday, 28 July 2011
Energy Drinks
I 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).
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.
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.
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.
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.
Sunday, 24 July 2011
Tragedy
This 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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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