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.

The Wisdom of the NHS

My trust, in its infinite wisdom, have decided to put me on a 2 day study day to provide a "basic knowledge" base for daily practice - measuring and recording vital signs of patients.

I've even been given homework. Label the basic anatomy of the chest and respiratory system, what is pyrexia, hypothermia, how should I take a pulse. (This grade A in A Level biology might finally pay off for me)

This would sound great, if I haven't already been doing it every shift for the last 4 weeks since I started. Make that 9 weeks by the time I start the study day.

Don't even get me started on the fact I have to do a study session for HCG tests, but curiously, not for ECGs...

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)

Oh My God

Clinical induction has to be the most boring thing I've ever had the misfortune of sitting through in my entire life.

I'd rather be working. At least it's a 3 day week (unlike the 5 day induction), and I'd be able to get my ucas sorted as well.

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!