Tuesday, 30 January 2007

Breaches before safety!!

Some wag (not me) changed a screen saver on the works pc to: 'A&E Breeches before safety'. Just about sums up the culture at present.

Had a patient who became unwell just prior to transfer. 10 minutes before her 4 hour time was up. Vitals were ok, repeat ecg not too bad, but the sister in charge was almost losing it trying to move this patient out before she breached. This was the same sister who earlier tried to place a highly clinically unstable patient with a PE into a low dependency bed on the clinical decisions unit. One look at this patient tells you they are sick, however add that to her poor vital signs leads to the fact this person needs a higher dependency bed. I made sure she got one, and was castigated by this sister for doing this.

Therefore, the wag who typed 'breaches before saftey' is right on the ball when it comes to summing up the current climate in my A&E Deopartment. It is not helped when some of our seniors lack clinical acumen.

Saturday, 27 January 2007

Cheating Death Part I

As an A&E Nurse it seems I get more dead people than the local Co-Op Funeral Shop. It comes with the territory that I get people die.

The other day I had 4 cardiac arrests! 3 died and one I dispatched to the ward. 25% success, not bad for a failing trust. Cheating death is always a losing battle but I will give it my best shot. The only downside is the relatives. I have lost count of the times that I have had to tell a relative that their loved one has shuffled unwillingly off this mortal coil. It can be heartbreaking. I have not become immune to this suffering, it affects me, however I can often be strong to the point of brutal dispassion. I can often be weak as well.

The young drug addict who dies, the RTA who was drunk and crashed into a tree. These deaths although sad are emotionally reconcilable. The 32 year old cardiac arrest who just drops is just shit though. Most of the time in A&E and in the NHS it is just a case of processing patients. A bit like Tesco's, but less cost efficient!

Occasionally it is these cases with the relatives that makes you realise that is why you are a nurse. Because you can support these people in their time of need.

It is just as unfortunate though that you are a nurse, because you know what can happen to the human body. Sometimes I wish I knew nothing, just like Joe Public (before the internet that is!), then I would have not worry so much about what might kill me!!

All these blogs in one day....busy or what?

You may wonder why so much action has occured today on this blog spot. I have transferred entrys from a rival blog.com to blogger, and not wanting to let anyone miss out on the previous years blood sweat and beers (tears) I have proverbially 'cut and paste' to this site. They are all in correct order (unlike some of the cut and pastes our surgeons do at work), however that is another story.

Hung out to dry (or die) !!!

Had an 85 year old cardiac arrest. Had hung himself. Dead. He had tried two years ago with a shotgun. Obviously not successful. This time obviously he was.

Don't pee on my head and try and tell me its raining!

Doctors are funny beasts. We have a A&E SHO who appears to be obsessed with urine. Every patient, regardless of presenting complaint is required to produce a urine dip. It is getting extreme, the next cardiac arrest will undoubtably need one. Don't remember a UTI being a reversable cause of arrest. He becomes exceptionally agitated when water is not produced, as if it is our fault the demented lady in B bay can't give a sample, (not so much she can't pee as the bed will testify however getting it into a recepticle is another matter). The best trick is to use your nose. If they smell; UTI. Unless they come from a certain part of town, then its their natural aroma.

Ready Steady Cook...or not!!!!

Before starting in A&E, I nievely thought that vegetables, especially carrots were more sorted for eating, jullienne, diced or roughly chopped.

This young man, came in by ambulance (his first mistake) had allegedly been playing sex games with his girlfriend. (Miss July we think..well thats the edition of the mag he had). Anyway a carrot was now properly stuck up his bottom. Unable to get a clear X-Ray due to the translucency of the organic root veg it was left to our jovial Staff Grade to remove. Like a puppet master, the rather large hand of this doc dissapeared up this lads back passage. A quick root around and hey presto a 7" carrot appeared. A quick wash and it was returned to the lad for posterity. He then had to be admitted to ensure that he hadn't perforated his bowel. Lets just say that hospital dinners are shit at the best of times but we heard that the man was constantly asked if he wanted vegetables!! He probably got fed up by breakfast.

The Beginning

This is the start of an online journal of the ups and downs that becomes of a career within an Accident and Emergency department.

In order to adhere to the NMC Code of Conduct, names and my place of work have been changed or removed. However rest assurred, if you come to my department after doing something silly to your self you are fair game to my colleagues and myself. We have to have some entertainment.