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.

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?

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.

Another Day...

We have a patient sitting on the floor and shouting for a nurse.



After he's decided to jump off the trolley and take the mattress and bedding with him.

Now, nurses generally don't like things on the floor, just generally (especially patients), but in this case, we let it slide.

Welcome to the NHS.

HCA got back

More like HCA got back pains...

Clinical induction is possibly the most boring thing ever. No offence to the people that have to do the sections, but it's tediously boring and you're just throwing facts at us. It's like being at school, but so much worse, because 1) we don't particularly care and 2) we don't care because barely any of it applies to us or will be of use to us.

However, manual handling today taught me that I'm likely to do my back in because I'm young and because we apparently do everything wrong when it comes to manual handling in A&E. Drag lifts, carrying stuff, not using the hoist.... ever (which was embarrassing when one of the immunology nurses told me we kept it in one of the toilets) and not having slide sheets and handle extensions. I could blame the last one on CAU/ITU/Ward but I can't, because we don't have the equipment. Or at least I've not seen it.


On different note, midwives have some of the best stories ever. (Admittedly if you're pregnant, they're not)

It's Day 7...

...in A&E.

I managed to do my UKCAT last week, 650 average, lower than last year (675) but I suppose it'll have to do.

I've been at work for 2 weeks now, and there's been some interesting stuff going on, notably we declared a major incident for something something something*, a prolapsed bowel (which I can only describe as.... intestines falling through the arse. literally) which the surgeons didn't believe. Yes, they didn't believe the bowel had prolapsed. In fairness, I didn't believe it, nor had our middle grade seen it before.

But yes, all in all, work is good. Though I didn't like the 3 long days in a row I've just had. Translation - a 12hr shift (8am-8pm) on Tuesday, Wednesday and Thursday.

I want to send off my UCAS next week, but stupid trust induction next week. Oh well, a reference from one of the consultants and an academic one from my (former) head of sixth will have to get done during my induction week instead. Arse.

*Nothing personal - just if I said you probably could work out where I work and who I am. Not so sure I'm that comfortable doing so yet. Though probably major incident is enough to work that out - get googling!

Results are out! Results are out!

Could be better, but then again I'm an arse (and hungover). And have very academic focused parents.

AAAB.

B in psychology (side note: it's a fake science, so it's ok, no need to panic).

Looks like I need to start ucas again. Arse.

But I do start my job in the ED as a HCA as from Monday. Arse.

Job Front

So I now still provisionally have a job.

However, I do have all the paperwork sorted (yay), CRB is clear (yay), Occupational Health cleared me (yay), references have been written and checked (yay) and I've also started my hep B vaccination (not so yay - hurty deltoid).

So I'm told I have a induction to the trust and basic training for a week in 2 weeks. The week after results. The same week I have the UKCAT. Balls.

A healthcare assistant in a Greater London ED applying for medical school (again). Nobody told me it everything could clash this much?

Job Hunt

Hurrah! I have a job.

HCA in an A&E in the Greater London area. Yay me.

12hr shifts I'm told. Not so yay.

3 or 4 days a week. Yay!

Then I realised I'm working in an ED in Greater London. I'm gonna die. Not so yay...

And Here's Where Lives Are Ruined....

.... specifically mine as I start blogging.

Why? Existential I am this morning (night?) sitting at 1am starting a blog.

Maybe I'm blogging because I'm insecure, because I actually have no friends or because I have a few Healthcare Assistant interviews/assessments coming up and am feeling rather apathetic about it.

Or maybe I just wanted a diary of things when it comes to writing a personal statement because my long term memory is shocking. Or maybe I don't exist.

I don't know.

I don't care any more.

I need to get out more....