My night watch

I came on duty to find a hectic ward. There were several staff hurrying about and there was near non stops buzz of phone calls being received. There were several INR’s causing problems from patients who had been discharged a few days ago and there were a long list of jobs for the SHO to do. It was quite clear that while there was still the day SHO on duty that this was going to be left to the night staff to sort out, and thus at handover time the long list was handed over. There were several patients who required there to be blood samples taken by the doctor as there were some patients who it had been near impossible to get anything from. I was allocated initially to the taking of observations. This is a new one for the night shift as before only the ill patient’s had their baseline observations done in the evening but now this is for all patients. There were some very odd readings on the charts, though these were more a case of a normal abnormal reading if that makes sense. Moving on from the observations I was on the medication round and there was little to note from that barring two patients who were waiting for the INR to be prescribed and one who was going to have to wait until near midnight for there to be Aspirin given.

There was a new admission from A&E who had a high blood pressure, and so these were done manually as the machines had been playing up on the ward and were next to useless. I was then asked to do an ECG on the post PCI patient and that was done with out too much issue. On returning back down the ward to the nurse’s station, one of the patients had taken a coughing fit. The staff nurse then gave them simple linctus which did the job of sorting the cough for a little while. It was a short while later when the coughing returned that there was some bright red vomit brought up by the patient. There was initially some concern of this, until it was realised that this was most likely to be the red cough mixture. The patient then presented with some diarrhoea, which was put down to there being several days worth of laxative treatment rather then there being something nasty as the root of the problem (i.e. C Diff). The patient with the high BP was checked again on both arms which showed there to be a high BP still running. The on call medical registrar arrived on the ward and this was checked again (there was about an hour in the intervening period in which I was sat writing out an essay and cracking on with portfolio work between shouts to the buzzer for commodes and checking patients). I was about to leave when the patient told me that they had been in hospital before and were reluctant to have said anything about the high BP which has brought them into hospital. I immediately stopped packing my sphyg away and sat down and asked them what was the matter. The said that they were unsure about what was happening and how long their stay in hospital would be. I explained what hypertension is, and that there was going to be an ECG and a blood test done in the morning on them, and what that was going to entail. They thanked me for taking the time so sit and explain to them what was going on. It is these small moments that really make you have a nice warm feeling inside, when you walk away thinking “I really made a difference there to how that patient feels”.