31 May 2010

37.5 hrs

just finished 3 consecutive long shifts. in previous jobs i'd be complaining about the workhouse and the life sapping hours spent there, particularly when the weather's been so fine. but, i'm one of the luck ones. i actually like my job.

a bleep requesting an urgent ecg. normally everything is 'urgent', but this time the staff mean it. a patient is having extreme difficulty in breathing. the whites of her eyes bugling, she stares wildly at me as i walk through the curtains. iv access is of greater importance and anyway, she's not sitting still enough for a meaningful ecg.

no time for the usual ritual, opening up packets and searching for the best vein. skin cleaned, i look straight at her, unsure if she can tell what's going on, i still explain that i'm about to stick a needle in her arm. she's really gasping for air, shoulders heaving up and down. i pin her arm down on the side of the bed, conscious of how rough this must seem. i look up, the three staff nurses are now joined by the sho. nothing like a bit of pressure.

needle on skin, pushing through dermis, waiting for the back-flash of blood in the barrel. it comes. advance the cannula, withdraw the needle, take bloods at the same time and bung the end. the lady doesn't even seem to notice. her skin is so clammy the dressing wont stick. a bandage quickly applied.

fluid and pain relief flow. oxygen and nebs being blasted into her face. she's still wide eyed. return to the ecg. the bio tabs aren't sticking, again she's too sweaty. nurses help dry her skin, i place the tabs, one on each limb and six across her chest. my hands moving quickly and being careful not to cause a tangle of leads and tubes.

no one is speaking. her heart rate is spiking at 210, breathing still shallow and rapid. her whole body shuddering for air. the screen reading is pointless, there's too much interference, with each gasp the leads pick up limb movement. the nurses try and hold her arms still, pressing the tabs on to her damp, cold arms. i attempt reassure her, "your heart rate's coming down (it was but not significantly), we're just having trouble getting a reading because you're moving so much. but don't worry, it's important you keep breathing..." i can't believe i just said that and with a smile too. fortunately she understands, she gives a little nod. the tension in the cubical is released.

just my small role in the care of one of our more poorly patients. by the end of my shift, she was breathing on her own. not everything is as urgent but it's no less satisfying. i get to go home feeling like i've made a difference.

.....granddad is doing well and making massive improvements with his walking and is now in a rehab unit. he's had a few set backs though, due to a nasty uti. his confusion has been upsetting grandma but hopefully this will pass. my two days down there last week, felt harder than any shift at work.


Groover said...

The closer to home, the harder it probably is. I hope your grand dad makes further progress quickly.

Amazing to read the nurse's account on sticking a needle in someone's skin. With my weekly blood tests I found that ... engaging?

Red Bike said...

I don't know how you do it. I would have freaked out!

trio said...

It is harder when it is someone close to you. My mum is a nurse but she found it so hard caring for her mum when she went over to Ireland to give my uncle some relief.

You sound really important at work, no wonder you enjoy it. Guess two days are never the same!

SS:Mtn Biker said...

Prayers and great,warm thoughts being sent to your Grandad,I hope he continues to get better and better.

Very intersting post. Tina is current;y working towards a nursing degree here,she'll enjoy this one as well :-)


kate said...

groover- weekly tests, ouch! i imagine with you being so athletic though you have corking veins, making the job a little easier. thanks for your thoughts :)

red- probably best you don't change career then ;)

trio- definitley harder. i'm trying not to take certain things personally, as i know she can't help it. as for being 'important', no more or less than the others. but it does feel good to be part of a team and know that you can do you little bit.

ss- thanks for your words regarding my granddad. i'm not actually qualified-start training next year. hope tina's course is going well. it must be tough going back to school and having to raise a family too.

Runningbear said...

Reading what you've written about work makes your decision to change so obviously the right one - so good to hear that you're thriving on the change.
Very glad too your Grandad is improving all the time and hope he's back with grandma soon. Best wishes, RB.

Joe Newton said...

Total respect for you and your fellow professionals. Whatever they pay you isn't enough.

kate said...

rb- leaving the 'work house' was the second best decision i ever made. the first being, leaving social services ;)

joe- thanks, i shall let my boss know ;)

lesleyh said...

Gosh Kate the WHW is gonna seem like a walk in the park by comparison. That wifey ws lucky to have you there and good news for gramps :o)

ultra collie said...

sounds like you could do with a dose of escapism soon kate ;-)

vdubber67 said...

Wow. Beats my unimportant work nonsense. Must be cool to do something for a living that actually means something etc...

Good news re your Granddad too!



kate said...

lesleyh- ha! it's gonna be walk anyway ;)

uc- yeh, i think you're right. a nice little mini break to the highlands should do it!

vdubber- just realised how sanctimonious and patronizing i sound. mainly, i'm just pleased i like my job for a change :)

swiss said...

lol, welcome to my world! i'm always astonished at these gumby drs/nurses who stand about waiting for someone else to do what is really a stunningly basic intervention. fair enough if it's a difficult stick but otherwise no excuses.

i had an incident the other day where some numpty had taken the cannula out of a frail flash pulmonary oedema person despite instructions to the contrary. naturally when we came on she was proper sick. and then the ccu staff took the hump because i told them not to bother even trying to cannulate as my suppport worker had more experience than them, especially with someone in extremis. to their credit at least they wanted to have a go but no decent patient assessment in that respect whatsoever. in the end we got them sorted tho with minimal feathers ruffled!

reading this i thought, mainly because my support workers know this stuff, that in view of your training plans you might, if you get time to hang about, want to make a mental note of what bloods your doing, what drugs are getting given, what's on the ecg and what (most importantly) does the patient look like. my lot are quite into this and i can totally rely on them (not that the management share this view)to do what i want, recognise rhythms and know when to phone me etc

from your perspective i think it'll add a good dose of practical interest. not that it'll show up in your training (!!) but it'll stand you in good stead for beyond that

kate said...

"minimal feathers ruffled" - hahaha! that seems like half the challenge most days!

that's good advice and i'm trying. some of our nurse practitioners are brilliant and i've been learning loads. struggling a bit on the ecg's though but my brain doesn't seem to be able to compute the 3d image part of it! will try harder.