Had a bloke brought in feeling sorry for himself. Been stabbed in the back and had a laceration to his scalp. Was attacked by a mad man he said. Met him at the ambulance door and in the 20 seconds it took from being off loasded from the ambulance to coming into A&E he had managed to smoke a rolly.
By the time I left I wanted to stab him too, annoying GOMER!!!!
Thursday, 8 February 2007
Saturday, 3 February 2007
Time of the month!!!!
Had a spotty chav and his chavette girlfriend attend A&E. He rushed in like it was an emergency.
'Have you got any paracetamol?' piped up the boy chav; 'she's got period pains'.
'Nope' we all replied. They left. Obviously confused themselves thinking we gave a damn!
GOMERS!!!!
'Have you got any paracetamol?' piped up the boy chav; 'she's got period pains'.
'Nope' we all replied. They left. Obviously confused themselves thinking we gave a damn!
GOMERS!!!!
Donor Cycle
At last, a trauma worth shouting about. Motorcyclist verses concrete bollard at high speed.
ABC's were deranged, he had a GCS of 3 and multiple pelvic and bilateral femur fractures. He was fortunately intubated quickly as things were not looking grand.
It was them the delays occurred.
A long wait for CT, a long wait in CT and then a long wait to ITU. Not straight to theatres. Fortunately the patient did not breach. (Joke). Not a good prognosis as he was developing coagulopathy and profound metabolic acidosis
It frustrates me intensely that patients wait so long to reach their appropriate destinations. Early intervention in trauma leads to potentially better outcomes. All the hard work initially carried out can be so easily let down when the patient reaches coagulopathy and then becomes unfit for surgery.
Who's heads do I bang together?
ABC's were deranged, he had a GCS of 3 and multiple pelvic and bilateral femur fractures. He was fortunately intubated quickly as things were not looking grand.
It was them the delays occurred.
A long wait for CT, a long wait in CT and then a long wait to ITU. Not straight to theatres. Fortunately the patient did not breach. (Joke). Not a good prognosis as he was developing coagulopathy and profound metabolic acidosis
It frustrates me intensely that patients wait so long to reach their appropriate destinations. Early intervention in trauma leads to potentially better outcomes. All the hard work initially carried out can be so easily let down when the patient reaches coagulopathy and then becomes unfit for surgery.
Who's heads do I bang together?
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.
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!!
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.
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