My balance of power

Yesterday did not get a post as I was very tired after getting home. The day was as usual for the ward- hectic, and with a few million jobs to be done after the weekend and the ward move. I was in "area 1" on the ward. Area 51 would be more accurate to describe what was going on in there. There was one patient who has been very abusive to staff, and has some involvement from the mental health team. In the afternoon I sat in on the MDT meeting for the patient. I started the day by phoning the people needed to attend: Next of kin, Social worker, Occupational Therapist, and the Discharge co-coordinator nurse. All agreed the time and said they would be there. I even spoke to the discharge co-coordinator when she came to the ward near 10am and confirmed the meeting as I was discussing one of my patients who is awaiting panel for social services and she confirmed that she would be there at the time specified. So I was a bit put out when after waiting 15 minutes for them to turn up at the meeting to be told by the discharge office that she was only in till 2pm and had left the hospital. Thankfully another member of the discharge team showed up.

The end result was that we needed and official diagnosis made by a psychologist. So, I phoned the mental health link team at the nearby acute psychiatric hospital and they said phone neuro sciences up in my own hospital as they have a psychologist. So, I phoned the hospital switchboard to be put through to the department in Neurology. Well, that's incorrect because what actually happened was that I phoned the number for switchboard on several occasions and the phone rang and rang and rang each time. So, having been given the number of a community mental health centre where the same psychologist works, I phoned them instead. Whereupon they told me that the psychologist is on holiday until the 4th October which seeing as this was supposed to be an urgent referral was a bit longer then what was needed. By now we were steaming up to 4pm and so knowing that bog all gets done with referrals after this time phoned the mental health team back up. They got the same story you got, and then agreed that the Psychiatrist would phone the ward staff up tomorrow (which is today) and would have a word with making the diagnosis. I find it odd as while they were on the ward last week, they came out with the best ever excused for not doing something: "The referral form only asked about the persons cognition" [n.b. this is not the true reason though have altered this for confidentiality]. Well, that's nice but it would be nice if they had bothered putting down WHY the patient was that way in the first place. But no, they will only do what the form says. So, in the future, I will write "Do this (referral x), put down some details don't mess me about sunshine".

After dealing with the insanity of the ward, I had my competencies signed off by my mentor and wrote on the tripartite sheets (there is no official tripartite for placement 5). This went well and all were signed off. There were one or two side points which were not due to them being too specific to have been met on the ward but as its a formative placement that's no worry. So, nice to know that it has passed and now I only ave two days left before moving on.

Speaking of which, went up to the new placement area (Cardiac surgery) and have got my off duty for next week. Seems to be the same as when I worked on the ward next door which did the same but has the Cardio thoracic HDU and took less pre-operative patients. This means that I will be able to get to grips with this type of patient on this ward.