Tablecloth

tablecloth [ˈteɪb^əlˌklɒθ]

n

a covering spread over a dining table before the is set
v
a medical technique used to remove SECAmb vacumattress under a patient with spinal pain, by use of a scoop (which probably belongs to LAS, or it is actually ours, who knows anymore) to lift while pulling the mattress from under the patient.

Ah Fuck It...

I do realise I don't post on blog as often as I should. In part I wanted it to be a diary-ish thing for me, and partially just to vent anything publicly.


But neither happened really.


So I'm still a Health Care Assistant in an Emergency Department somewhere in SW London/Surrey, I'm applying for medicine (again) and didn't get in (again).

What do I do now?


I'm thinking something like travelling. Opinions?

Smallpox. Who Knew?

As I wish a Merry Christmas (albeit late) and a Happy New Year (albeit late) to you all while I receive a rejection from SGUL (albeit early. and post interview. FML. Don't worry, they at least told me before Christmas. FML), I have a story to share. So gather round girls and boys while I cheer myself up.

As a Healthcare Assistant/Auxiliary Nurse/Nursing Assistant/Call it whatever you like love - I'm still paid AfC Band 2/Nursing bitch, I don't get to see much of the A&E world aside from majors, and the occasional times I'm allowed to play in minors, with the odd few times (usually nights) I wander into resus and stay there for a few hours.

But I'm never allowed into triage. Well, not never, I did "shadow" during my supernumerary week in triage.

But coming off a night shift, one of our day nurses is trying to track down one of her patients and is cycling through the system trying to find the name. Just so happens, it appears a patient checked themself in with "? smallpox" on that day.

Smallpox. The only disease that man has successfully eradicated. Nice. Who knew it was still knocking around in London?

Maybe Not...

I've decided that if I ever become a doctor or nurse or "healthcare professional" (thank you senior management for an ambiguous job related to hospitals), I've decided that I'm not doing psych or geriatrics.


Because seriously, the nights A&E doubles up as a Care of the Elderly ward or a low-security psych ward aren't fun.

Although 6 police officers dogpiling on a lady who's off her head is hi-friggin-larious.



And speaking of becoming a doctor, my UCAS has been sent and I am waiting.... patiently.

If you go down to A&E today

...you're sure of a big surprise.


Stalkers, vomiting post sausage roll (yes, that is exactly what we were told in handover) and being blown over by the wind.

Ahhh Saturdays in the ED.

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.

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?