Time (and the lack of it)

Somebody else who's running out of time, today

Finally, I have finished two essays. One for Tuesday, and one for the 5th september, so it will be now simply a case of checking for typo's, double checking the reference list and making sure it all makes sense.

So now I have to write a 3000 word report up for palliative care in the community. There are two problems with this. 1) I have not got to hand the plan of a report from which I am supposed to write the essay to the structure of. 2) The tutor I need to speak to has an email address listed which no matter how I try it bounces back to me.

So, I have decided the easiest way to proceed is to get the two nearly done essays out the way and then focus all my energy between tomorrow and the 5th september on doing the report (I have the source references to hand so there will be some structure to start with and then all I need to to is to find other references as they are needed while writing). I am also awaiting the results of another essay which I am really wanting to hear back that I have passed.

There is only one problem with all the above plan. I am supposed to work 3 shifts a week. There is I know 4 days where I am off duty. The problem is that you then need to write the three day off as I am too tired to do much after being up at 5:30am for a shift that lasts 12 hours. Then there is the first day off which usually involves me catching up on all the sleep I have lost over the work days (I am terrible at getting off to sleep at night- I have done a few 12 hours shifts on only 3 hours sleep). So, you call that three days between now and the 5th September to get cracking on an essay. Good job I can work fast.

My defining moment

I once said that there was never any time where I felt that I have had that one defining moment in Nursing. Well, today was as near as I have been in a while. Today I was with my usual caseload of patients and all was proceeding smoothly. All the patients had their medication given, been washed, and were all in good spirits. I was to go for my morning break at 10am but after working through doing a flush and an IV line did not in fact start the 15 minute break until near 11am. I made my usual round of the patients, told them that I would be away from the bay but that the HCA would be keeping an eye on them. I make a point of this informal chat as it allows the patients to be aware of my whereabouts, and for me to know that they do not need anything in the immediate time.

Well, when I returned, all was well bar one patient who seemed a bit quiet. I was making another patient comfortable in the chair with the pillows when something made me take a look at the patient mentioned before and think "Somethings not right here". The patient looked a bit pale and seemed to be breathing heavily and rapidly. I went over, asked if they were OK and they seemed very distressed. They said that it was due to the new tablets they had had that morning (though this was several hours ago at the time). I was concerned that this could have been an allergic reaction so immediately started following the accepted protocol of laying the patient down, getting a set of obs and getting help. I got the patient onto their bed, got the dynamap which was next the patient, took a full set of observations, took down the information from the patient who was reporting SOB and chest pain. I alerted the HCA who put the patient on oxygen, and while I was doing the ECG the HCA called the staff nurse and the doctors to come down. All was well in the end, but it was one of those moments where the training really started to kick in. It was interesting to say the least.

Took the doctors ward round in the afternoon which was uneventful, though was the first one I have ever done which was a tad nerve wracking. In the afternoon I had a vist from the tutor in the essay which caused all the confusion who was really helpful. He said that considering the essay was bashed out that the standard was good. It would not pass at the moment as there was little mention made of the future implications of the subject, but said that if that was written in the same way as the rest and the current content tidied up that it would get well above 60 based on his opinion at the time (subject the change though).

NHS moral: How can we improve it asked Alan Johnson MP

Its a long list and it starts with "£1 million".

The daftest test ever

Look at the above image. Notice something? Yes, the answers are correct but have been marked wrong. That was the same questions as set on the universities online formative drug calculation test. I am not saying that we should not do the tests, but what use is that? It means that even though you are right, you are wrong. Cynically I think that's a microcosm of the university, but until I get a reply back from the module leader, I am buggered if I am going to do it again as that's TWICE the thing failed even though the answers were correct.

Yes, I know that drug calculations are a big part of the latest target for improvement with all sorts of crazed missives going off saying that you should get 100% in drug calcs to pass and other such far fetched rot (its an exam so factor in performance anxiety, stress, when the hell did you have to do 30 calculations straight off the bat in the ward and so on the arguments are soon see to be too much "Blue sky thinking" not "Real world thinking").

Words fail me as to how we are on one hand expected to know this but then marked down by the computer on the answers. If it's right, its right. If it's wrong, its wrong. There is no road between.

To paraphrase Dr Rant, the daftest exam ever or I'm a little teapot!

My patience trying patient

Given the fact that this morning it was raining quite heavily it was nice to be at work. Today was a return to the same bay where I was covering yesterday, though this time I was covering the role that is normally associated with the duty HCA (though I was not being used as a substitute, simply having the floating task as I had been joined by a male colleague student nurse who is an ex-HCA from the same hospital having served for 13 years in post). This was nice as I was able to undertake a few different tasks on the discharge of several patients in the catchment area of the ward for discharge by ambulance this afternoon. What made this even more unusually is that it was my dear old mother who was the ambulance crew who took one patient off another bay for us. I know that she has complained that she has gone up onto wards and has been told that a patient is in "Bay 2 bed D" which of course means nothing to the ambulance crew, or find that control send them too early for the ward staff and that the patients are not ready and/or need medication sorting out. Today, bar one patient was was handed to mother as pathology were causing delay, all ours were ready and waiting and also meant that several new admissions were sent straight into us which sped up other wards.

One annoying things is that the patients I had yesterday were starting to get a bit wearing by them wanting one thing, changing their minds, then wanting the original request before deciding they really wanted the second option all along. There was a few moments today when that was really starting to try my patients as there were some in particular where the effects are more behavioral rather then illness based. I was more involved in the observations of patients, and even did a manual BP today which is a rare thing (though the second one I have done on the ward).

The patient was shouting out nearly all day (I did investigate as initially I thourght it was one of my side room patients. The one thing that did get to me was that the person was repeating the same name over and over again which was the same as my own...definatly something haunting about hearing an invisable voice you thinks calling to you).

Still, cant complain as the day was steady and productive and cant really moan about that shift. Of course some of that steady and laid back gait which people thourght I was exhibiting today has a far more benigne reason. You see, I normally walk quite fast, but this morning I had to hurry as I thourght I was running late (I wasn't in the end but at the time I thourght I was). Anyway, I managed to make a small skin tear on my right heel, so anything over "moderate amble" speed meant the "Oh bloody hell thats stinging" pain sensation, so the net result was a gentle amble through the ward. This while done for my own comfort also made some think that I was taking a calm and collected approach. I must admit it was a bit more therapeutic then my normal "Mad man tearing on another errand" speed that sometimes is used. I think that we all managed to get the patients seen too with good personal care but also got through very smoothly. Now I am home, I am cracking on with two essays and the letter asking about jobs.

My best laid plans of mice and men

It SHOULD have been easy: Two patients, and a third to oversee. One needed a discharge doing. Let me just say this: Even seen Peter Snow's swingometer on the election nights? Pretty much that's how the discharge went for the unfortunate patient and the family. It has meant getting back to doing the basic nursing care on the patients (washing, making beds, catheter care, feeding and fluid balance) which was a change.

Today has been a steady day apart from that. Didn't take much in the way of breaks though but that was partly through my own choice. The morning break I was called out to see to something and plodded on past that, and for lunch I went to the cafeteria thinking people had already gone. I had my lunch then nipped back up as I then wondered if the staff had been late going down. Lord knows where they were but I ended up missing them as it turns out they were sat at the back of the canteen, not the middle as I thought. Still, I got some work done which was good.

My weekend administration

This is my last day off having managed to have the weekend off the ward. I am back on tomorrow. The weekend has been up and down. Was out for a few hours last night and went to see a mate of mine as well as my girlfriend, and have been trying to sort out paperwork. Unfortunatly I have cut it fine for renewing my library loans but I think I have managed to avoid going over (not that having to pay £2 is a big deal).

I have been trawling CINAHL and the British Nursing Archive for some articles for an essay and fine tuning the next two submissions.

I am tonight going to start to write up my letters for application to the NHS trusts for the January qualifying. I am not sure what to put in the letter but will have a think. The trouble is "Gimme a job" being written in a fancy way usually means trying to sell yourself and I am not normally that vain. The plan is to go to all the departments in the hosptial and put a letter into the ward manager, write to the local PCT and fill in a generic application form to approach on three fronts in my own area, then go to a hospital in the next county to ask for a job. I have been told that my grandparents are wanting to move to the other end of the county, if that happens then there is always chance that there can be application made to other areas as well which will be nice, and I also want to contact a private aero-medical firm where I know the operations director. Then I will search Nursing standard and the NHS jobs website.