Thursday, August 20, 2015
Well, as you can tell just by reading the title, the evening went off with a bit of a whimper.
As I have mentioned previously, the ward has a capacity for 10 acute beds.
Yesterday when I arrived to work, we had 5 beds occupied by older aged people with various ailments.
There are always two staff rostered to work each shift and if anyone presents to the emergency area, the person in charge has to assess, triage and treat those who rock up except on weekends when there is a designated nurse to work in the A&E unit as well as the other two staff in the ward.
Not long after I had logged on ( yes, we do that here too, only by phone!) and we had had handover, one chap arrived. Seems he had stubbed a toe some weeks before, elsewhere, and now because it was sore and a little swollen he decided to come to see what miracles Bright Hospital could perform.
After looking at said toe and commiserating with his pain, I informed him there was no doctor on site and he would do well to take himself off to the one and only clinic in Bright to see a doctor as there was naught I could do. All said in my politest voice I might add, so off he went.
Without giving names away, and not long after, a person of HIGH esteem was sent in by a local doctor because of nasty pasty gastro- intestinal symptoms and a good dose of an URTI as well.
Fortunately for me, this person was well versed in this hospital's practises and was able to do her own paperwork etc., so the pressure was off a little as yet another walked in feeling just as crappy as she.
By now I am thinking is there something going on in the community that is going to cause 50% of the population to present for me tonight, but it fortunately slows down after this second presentation, so I can get on with doctors recommended treatments for both.... IV fluids, antiememtics, antibiotics, paracetamol etc. and all the paperwork that goes with each presentation.
One doctor decides to admit, the other doctor decides to let the second presented go home after successful treatment and so, I can return back to the ward and focus on the in patients again.
The person I am working with is amazing. By the time I felt it safe to return to the ward, she has done all the observations, given out medications and assisted people with eating dinner. All I can do is thank her profusely which seems paltry given all she has had to do in my absence.
Eventually the shift draws to a close. My hands are dry and sore because of the constant washing and drying. I am thirsty because of not drinking enough water through the course of the shift but my brilliant side kick senses this and brings me a hot cup of milo before the night staff arrive at 10:45 pm.
We sit down to handover, myself and two nurses somewhat younger than myself, but well experienced all the same and they ask me how my shift went. As this was the first time I had met them both, I hesitated in my reply, then threw caution to the wind and replied, " Well, at least no-one died on our shift. All patients are alive and well". Fortunately there was laughter with this reply and handover was completed without much ado.
One admission which made the bed status six patients, and three A&E presentations, not bad for my first in charge shift in my new life.
Monday, August 17, 2015
As you know, recent times have seen my better half and I create a change of environment and lifestyle with our move to new wide open spaces.
We love our home, as we did previous homes of course for many reasons, but this place with its magnificent bird life and multi tasking on the property have given us both a new lease on life.
With this move, came the opportunity for me to expand my work style as well and may I say it's been quite the change.
I am working bank which means casual call in at two local hospitals, one which is 10 minutes away, the other, 40 minutes away.
The drive to both is neither arduous nor fraught with traffic. The main concern, especially at nighttime is to stay alert and watch out for kangaroos and wombats. They are reknown for causing major damage to cars here, just as much as anywhere else. There are also occasional deer to be on the alert for as well but fortunately, I have encountered none other than the odd bunny on my drives to and from the workplaces I now frequent.
I've had to draw on my dormant nursing skills as the majority of people I now care for are elderly and medication rounds are fun times as I like to know what I'm administering, so I have a dog-eared copy of the Mims booklet on the trolley as I go through the list.
What I really find fascinating is chatting with these elderly folk discovering their backgrounds and attachments to this area. There is 'A' who has been a farmer in the area all his life. He once lived close to where we reside now for a time and we have spoken about farms in the area and local history, including the story of three little boys who drowned during a flood some 100 years ago.
There is 'B' who was a young Jewish child living in Germany at the onset of the Second World War and now has traumatic flash backs to her experiences back then and consequently trusts no one now. Her workife profession was that of a palaeontologist which is particularly fascinating. One evening when she was agitated, I found some photos in her drawer and we spent an hour or so reminiscing about her extended family and this seemed to pacify her a little and caused her to smile for a time.
All come from different walks of life and have had varied experiences during their lives. One older lady was a psychiatric nurse in England and when we spoke, she shuddered at what she had witnessed back then in various institutions.
Not all memories recounted were bad but it's funny how we tend to recall those snapshots of time that fill us with sadness and fear before others when asked.
The work loads are very different to what I am used to also.
We have time to sit and chat with our patients, we have time to feed them if they need assistance and I am re-learning all about slings and steady eddy's as time goes on too.
I will retain my midwifery for as long as I can... One hospital had a first time mother birth on the weekend and I was on call to come witness the birth. I was called in just before midnight on Saturday evening and I got there about 15 minutes later.
One can understand that when I got there, I was greeted with a smile by one of the nurses telling me the woman had just already birthed and I had missed it all. Was lovely to walk in and see the relief on her (the new mum's) face though as I had had the pleasure of meeting her a couple of times in the days leading up to her labour as she was overdue and anxious not to have intervention.
Both she and her delightful partner had a birth plan and were not wanting induction but understood that it might be a possibility if spontaneous labour did not occur.
Needless to say, her labour was short and ever so sweet. She greeted me with 'No stitches!" and so, all was great in her world.
I have done fetal monitoring on one Mum who is classified as an elderly multiparous woman (45). This woman has had to book at one of the regional hospitals because of her advanced maternal age but with her track record of quick labours in the past, I have an inkling she will present to the closest hospital when the time comes anyhow so it's far better she has some recognition of the birthing room beforehand.
This week I have been asked to work in charge at one of the hospitals which I am a little apprehensive about.
The ward side of this work I am comfortable with, it's the emergency department of which I am to be in charge of that fills me with dread.
Each of these hospitals has an unfunded emergency department and have to deal with simple to major problems from time to time. I have been promised that the Div 2 nurse I will be working with is very capable and will support me, so I will just hope and pray no one rocks up with chest pain or anything I might find difficult to deal with.
Ambulances bring patients there too unannounced so, if you think of me on Wednesday evening, please send me a thought that all remains calm in my world and I haven't been inundated with chest pain and MVA's and asthmatics and all those horrible nasty emergency things I can think of.
The last time I worked in an emergency department was many years ago and my memory of that shift is of a boy who severed his arm after crashing through a plate glass window.
Let's hope history doesn't repeat itself on Wednesday evening!
Shall keep you all posted!