30 November 2007

Night shift 1

I thought I'd let you in on what I'm currently up to.
You see, I finished university for the day at 17.50 and started a nightshift at 19.00.

The time is now 23.48 and so far I have:
  • Cleaned urine off the floor twice
  • Changed 8 beds completely
  • Cleaned 4 patients up completely
  • Changed 9 pads
  • Persuaded 3 patients with dementia to return to bed
  • And drank 1 can of diet coke and 1 smoothie.

More as the night proceeds.

21 November 2007

Medical school eccentricities

A few things have come to mind lately that are odd about medical school compared with other university courses.

Do you mind if I ramble for a bit? Good, thought not.

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Our PBL tutor was enquiring this week about what we thought of the assessment scheme at uni, with particular reference to OSCEs.
I had a slightly embarrassing issue last year with the final OSCE of the year. A GP from my practice (the student one) had been assessing me on a particular station. My PBL tutor came to speak to me during the coffee break and said that she was certain that the examiner hadn't recognised my face. Given that I'd been to see her for 'girls problems' 2 days previously, it wasn't my face I was worried about her remembering....

I find it really unsettling that a GP you can consult about the most intimate of things can then be marking your clinical performance. It's just wrong.

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I'm now a fully registered student for this coming academic year, thanks in total to all of you lovely readers. Therefore, when my student loan did come through last week it's gone straight in my ISA until the university demands my fees.

My uni is odd. You try and offer them money but they won't take it until they invoice it. Therefore, the entire amount paid to date has gone into my telephone ISA. The theory is that I will probably forget it's there, until I need to pay the uni at last....

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Yesterday I went for a parentally funded hairstyle change. The big thing about medicine that many students (who aren't on the course) forget, is that we get assessed on our external appearance, therefore it's advisable not to look like you've been dragged through a hedge backwards. For all I have some piercings, they're very well covered when I'm around patients.
Therefore, one of the big problems medical students here seem to have is finding suitable clothing for placement. In my case, it often involves Primark.

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I've been cycling around and about for over a year now, and haven't fallen off recently - huzzah!
But at some point, I must tell you about the most painful accident I've had in the last 12 months....

19 November 2007

Reasons to love the NHS

Most hospitals (as far as I know) have a medical assessment unit (MAU). If you need to be admitted to hospital due to a medical problem (i.e. not surgical, physically traumatic or related to pregnancy) then you will likely end up on this ward after you've been seen in accident and emergency.

I work in our MAU a lot. They have staffing problems and a rapid turnover of what staff they do have. It's accepted that nurses and auxiliaries either love or hate it. I fall into the former category, although sometimes I wonder why.

This is an example of my latest shift there...

0625 cycle to work. My booked time is 06.45 - 1930.

0650. The wind is really strong when I was cycling in and I end up walking for some of the journey to avoid being blown off my bike. Consequently I'm late. However, the bank has confused the times and I'm actually 10 minutes early. Just enough time to run to the vending machine in (a very quiet) A&E. Chocolate and diet coke are breakfast.

0700 receive handover from the nightstaff. Every bed is full, and I'm helping 2 staff nurses look after 12 patients. Sounds easy, really isn't.

0725 handover done, meet my staff nurses for the day. One of them, E, is a nurse I've worked with many times before on this ward, and we get on really well. Time to start washing the patients. Slight problem. A lot of the patients are acutely unwell and can't really get out of bed, so need a blanket bath. Those that can get up either have a wash in a chair beside the bed (as do those on cardiac monitors) or fight each other for the small number of bathrooms. Beds are made.

0800 breakfast arrives. Due to infection control implications, beds can't be made while patients are eating food. Have just enough time to go and help the auxiliary on the other side of the ward with some of her beds and patients. She returns the favour while her patients are eating.

0830-1030 all my patients have had a wash, had breakfast and had their beds and clothing changed.

1030. Time to start doing the observations round. Blood pressure, pulse, respirations, temperature and oxygen saturation levels are done and documented for every patient. This gets interrupted a lot on this ward due to patients needing the commode.

1100 while helping a patient off a commode I can hear shouting and swearing coming from the bay next door. A patient has just come in from A&E and is 'kicking off' at nursing staff. I go and see if they need a hand behind the curtain. It's an interesting sight. All I can make out is a thrashing patient being restrained by nursing staff. Rather wrongly, I can hear him spitting in the face of one of the female staff nurses, and some of it hits me in the arm. It's not a pretty sight.
I give them a hand until security arrive and join the throng. Staff from A&E and MAU are arguing with each other about who this patient should really be with, and words are said. I beat a hasty retreat to get my lady with the commode sorted again.

1120. My ladyandthecommode's family are not pleased that I had to leave their mother sat on the side of the bed after taking her off the commode, and even less pleased that I had to leave the commode in situ (although covered over). I explain in broad terms that I needed to help the staff out, but they weren't very understanding. They complain about the patient in question swearing loudly and why did we allow people like that onto a ward with the elderly. Not really very much I can say.

Between 11.30 and 13.00 I manage to get the 10AM observations done, and then have to escort a patient to MRI.

1400. The next 2 hours are spent coaxing my patient into having an MRI and consequently having to go into the scanning room with her to hold her hand. I've got to say, it's the first time the underwires on my bra have moved like that! I feel proud, however that my patient manages to have the scan. She tells all the staff that she wouldn't have gone in without me, which makes me smile.

16.30 back to the ward and time to try and replace my cartilage stud, which had to come out during the MRI experience. Have to get E to repierce it for me.

1635 - get my first rest break of the day. Yes, you read that correctly. After a bar of chocolate and a can of diet coke all day, I get the first chance to eat at 16.35. We're meant to get an hour a day of rest. It doesn't happen on MAU.

1700. One of my patients has perforated her bowel. She is 90 years old and the prognosis isn't good without surgery. There is much to-and-fro about whether to operate or not. Eventually the decision is against surgery. She will probably die, and quite soon. She hugs and kisses myself and the staff nurse, saying how wonderfully we have cared for her. We both have a tear in our eye when we head back to the nurse station.

1800 - spitting patient needs a cannula removing from his arm. None of the nurses want to do it, so I offer. Security are hovering near my shoulder. I figure that if he does hit or spit at me, at least I've tried and learnt from the experience. Ironically, he lays there like a kitten and the cannula comes out without any problem.

1805 and time to start the Obs round again. Finish just in time to hand over to the night staff, dip 3 samples of urine and send 2 off for analysis.

1930 head outside and hope my bike is still locked up. Time to cycle off into the night to my second job, and do the hospital thing again at 0700 the next day.

16 November 2007

My perfect night in...

It's been a really long uni day today. It's been a really long uni week.
Hopefully I'm getting a friendly face to visit next week, but until then.

Tonight has been declared:

"MerysandhousematedrinkredwineeatchinesetakeawaywatchChildrenInNeedanddouniworkinseperaterooms"

Ok, everybody clear now?

So if you see me online, feel free to disturb me. I probably won't be working very hard.

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Update: I think I will always love Jason Donovan. My housemate seems less than impressed and has just booted me out of his room.

12 November 2007

Mum speak

I was just wondering if anyone can translate from mum-text speak into english.
I’m sat quietly in the library listening to Radio 1 while slyly texting my mum. She has this really annoying habit of abbreviating into text speak when there’s really no need. She rarely sends a message long enough to warrant abbreviation, and as a result I get really frustrated when I receive a message like this:

“ U wernt sn t ty wer u wnt r u doing t oni te”

Any ideas?

11 November 2007

two years, three months, twenty-five days.

Just after this blog started I began seeing a you. We met in an unconventional manner but it didn't matter because we hit it off straight away.

Things went well despite the distance, and I loved you more than I have ever loved anyone in my entire life.

So right this moment, I feel hurt, devastated and as if my world is about to end. I've cried so much I feel like throwing up at the moment. I'm not quite sure what will happen now. Things haven't been right between us since I moved down south for university.

I sat outside the student union crying after hanging up the telephone. I couldn't actually move for a while, and stood outside shivering with cold and tears. I'm not saying this to guilt trip you, in fact I'm guessing you've probably stopped reading the blog now.

I was upset by your text message. I didn't really understand it to be honest.

I couldn't even bring myself to drink, I couldn't face the inevitable hangover I would induce. I have enough of a headache from crying.

It's a good thing I'm not working at the hospital tomorrow. I'm not sure how I would have managed.

I still love you, no matter what. It's just a shame you don't feel the same way.

07 November 2007

Blimey Guys...

I want to say a huge massive thank you to all of you! Between all of you who have either donated, or sent messages of support, you have all reduced me to tears of joy.

Basically, I needed £1000 up front to the university to allow me to register as a 2nd year student and get my loan for this academic year. On top of this £1000 I owed them a further £1600. So courtesy of you wonderfully generous individuals, I have now raised £1700 in donations.

I'm more than happy to receive any further donations which will obviously go in the direction of my debt, but I am capable of working off the remaining £900 in installments to the university.

So what I'm saying is one huge thank you to each and every one of you. I really couldn't have done it without you, and I feel such a weight lifted off my shoulders because of your generosity.

I promise, I will pay the deed forward when I'm in a position to do so.

For now, I will leave the link to paypal as it is, but change the wording on it.

Thank you all so much.