Wednesday, 21 October 2009

My Day with LAS

I was out as an observer with LAS the other day, and like they said:

"[We] (observers) are the kiss of fucking death".

12hr shift and not one trauma. Where are the dying people of London?

I was in Central London for a good while and not a trauma (where most of it happens apparently) - though someone did step on something sharp and called an ambulance.

But the other thing was the sat nav was busted, it was telling us that we were about half a mile out from where we actually were. Now, in the area where I and the crew were stationed, that's not really a huge problem as the three of us knew our way round the area (generally), but when you start getting council estate areas where none of us knew where we were going there's a problem.

So that's the morning gone - getting the sat nav repaired.

And everything I've heard about anaesthetists being slighty.... odd were confirmed to me while I was out with LAS. To be honest, I'm not even sure if he did work there... I mean an anaesthetist that's not wearing scrubs and wandering around A&E majors? I know there's usually a uniform policy about not wearing theatre scrubs outside of theatres, but I don't recall anyone in any surgical department listening to that rule.

One more observation, Guy's Hospital is one fancy hospital. I reckon it's because it doesn't have an A&E. Sadly, nobody agrees with that theory.

Monday, 19 October 2009

The Rythm of the Beat

So I'm now roughly 8 weeks into the job, and even though I am the baby HCA with no prior experience, I think I'm finally getting the swing of things.

And I'm actually starting to learn something - that I (as a HCA) shouldn't be doing ECGs downstairs in A&E (though looking where some nurses place the electrodes, I'm not sure even nurses should be doing ECGs), I shouldn't be doing BMs without an NVQ, that I also need training for β-hCG tests as well (what training I'm supposed to get with the instructions and results taped to the wall is anyone's guess) and I wouldn't be surprised if I'm told soon that I shouldn't be doing neuro-obs/GCS or ward transfers (except CCU, ITU and HDU, because they're fair enough really).

So that would leave me doing... just obs and dipping pee? To add some icing to that cake, I was told my training wasn't sufficient enough either (because putting a BP cuff and pressing NIBP is immeasurably difficult?)

But on a less ranty/more serious note, I am starting to learn stuff, when it's appropriate to do an ECG, paracetamol for pyrexic patients, generally what blood tests should be run for patients (even though I'm not taking blood yet), fluids for postural drop and when to actually recognise somebody is fairly sick just from their obs (because the girl who was pyrexic, tachycardic, hypotensive, +ve hCG with back pain scarred the shit out of me as my first thought was ?ectopic - fortunately she knew she was pregnant and had previously had a normal scan earlier in the week, but muggins here was sent in without a CAS card to know what was going on). Though nobody would teach me how to do a manual blood pressure, even on my vital signs study day... Admittedly there are no manual cuffs around, but that's not the point.

And nothing particularly phases me any more, which is nice. I supposed 8 weeks of dealing with poo, people having fits (seizures) in cubicles, open fractures and elderly ladies with dementia slapping you hardens you to this.

Though I've heard whispers that St George's decided to close their A&E twice on both of the weekend evenings... to everything (including priorities). Now I know that area around George's, and Kingston, Mayday and St. Helier aren't equipped for neurosurgical or cardiothoracic surgical related trauma (nor am I that sure that they're properly equipped for plastics, ENT and maxfax trauma either?). Are George's just more overwhelmed than the other trauma centres?

Friday, 9 October 2009

I'm gonna get fired soon

Hopefully not, but chances are I could guess the reason why if I did.

Why do some nurses find the overwhelming urge to be a bitch to everyone that they don't work with (as well as their patients)?

And it's especially the HCAs... because the SNs are able to stand up for themselves and you wouldn't dare have a go at a SR/CN, especially a SSR/SCN, or even Matron.

What do you want me to do when the saline hasn't been hanged? I'm not allowed to handle her cannula (unless I remove it). Do you want me to take her back to A&E, get a nurse to hang the saline then bring her back up? Waste my time and yours? You want me to hang the line, and because I'm not trained, give her a massive air embolis and kill her? (Don't worry folks, I'm far more competent than that)

No? Then stop looking at me like I'm incompetent.

End rant.