Tuesday, 29 March 2011

First Bank Shift

"Everyone gets everything he wants. I wanted a mission, and for my sins, they gave me one." - Capt. Willard, Apocalypse Now

"Hi, Absentbabinski? Are you still available to work tomorrow?"

It was 8pm on a Friday night and I was just starting on my first drink. I could say no. I could get my drink on and have a lie-in tomorrow. I could also start paying my credit card bill off.

"Sure, what ward?"
"Jeremy Kyle - It's Elderly Care (ah, shit) or there's A+E?"

I've never worked A+E and I'm not cleared to give IV meds at St Clabert's, so I'd end up being an annoying, over-paid HCA. I guess it's eldery care, then.

"I'll take Jeremy Kyle. Long day?"
"Long Day, 0730 start"
"Okay, thanks"

A quick bit of mental arithmetic tells me I'll have to get up a bit before 6am. So time to stop drinking, get my Best Dress together and pack my lunch.

I end up in bed at 10pm (a personal best for me), dreading a ward full of crazy old people and staff who couldn't care less. It's a bit of an open secret that (at least in the NHS) elderly care is staffed with either the most caring, skilled and professional nurses who will always be ready to help or... Well, people who aren't the above.

Cue a night of broken sleep and fear.

When I get on the ward the night staff are smiling. Smiling. They had a busy night but they're friendly and helpful and explain how the ward runs. They point out the changing room and when handover will start. I quickly realise they are the former of the two classes of nurses and I think "I'll be able to do this".

We get handover, I introduce myself to my patients and grab a drugs trolley. I've got two patients with IV Abx, but everyone else is on the usual blood pressure meds, anti-arrythmics and laxatives. I can do this. I only have to argue with browbeat encourage one patient to take their tablets. My patients are by and large lovely. I take waaaay to long to finish my drug round (my motto for the day is "I haven't done this for six months!"). There are only a couple of washes I do because the HCA I'm working with is efficient (more so than I am) and industrious. I get two admissions but they are straight-forward, old people who've fallen down. As per elderly care I have more than my fair share of pooey bottoms but I don't care - in fact on some level I like it. It's one of the bits of nursing I've always loved, helping someone do something that they can't do for themselves. And making the experience as normal and natural as possible. 

The shift was really good. I liked the people I was working with, and to their credit they decided I wasn't that much of a liability and asked if I'd like to come back next time they're down a pair of hands. 

I said "sure".

Monday, 28 March 2011

A case of the Mondays (again)

faffed around
jeans crumpled after they've been tumble-dried
No time to make the bed
Waited in line at the train station, only to find I had money on my oystercard
Missed my train
Running late
ATM only dispensing 20's, no 10's

Realise school starts an hour later than I thought.
Been sat by myself only to have a good friend say she'd been here for an hour downstairs.


P.S. These diamond shoes are too tight and all these Benjamins won't fit in my wallet.

Monday, 21 March 2011

Oh, and another thing

So I went for a run on Sunday:

Not a great time for a half-marathon, but I was glad to get in under two hours. Next time, I'll have done more training.

This just seems plain wrong

So I found this on someone's YouTube video whilst I was looking for a nice Pulmonary Embolism video. I know I shouldn't be surprised, but it's just depressing that this kind of thing goes on; naturopathy is pretty much one of the worse kinds of bunkum but seeing someone promoting it and denouncing actual medications that work to prevent death? It just seems wrong.

I always figured that the alt med users were like atheists in foxholes when they became seriously unwell. You bad-mouth medicine whilst it can't cure your muscle aches/ lethargy/ "bloated feeling", but when you get diagnosed with cancer or have an MI you're all about the "western medicine". Guess I was wrong. Sadly. Apparently you can get a DVT and think that "blood cleansing" is the way to go.

Friday, 18 March 2011

Knowledge-worker hands

One of the things that revision time always gives me is time to reflect. Nominally, I'm sat on my bed looking through powerpoint presentations, or reading old notes, trying to condense pages of information into bullet points so that I can remember and regurgitate it on demand.

Revision is boring. Occasionally I have learn something for the first time because I missed (by choice or by the fairly dreadful course planning) the lecture, but mostly I am revisiting or, indeed, revising, my knowledge base. Whilst I slog through the material I will confess my mind starts to wander a bit, and one topic that I keep on coming back to is my role in life as a man, whatever that means. And like any good physical exam, I start at my hands.

The phrase "knowledge worker hands" I stole from Merlin Mann, and it refers to that nice soft palm and fingers experience that comes from living via the keyboard or whiteboard. When I nursed, my hands were invariably dry or cracked from the alco-gel or the soap I used dozens of times a day. There were callouses from pushing and pulling things all day long. I came to see them as nurse's hands. Working hands.

Since the start of my course, my hands became softer, better hydrated, fewer (if any) callouses. And I have begun to feel a certain disdain towards them. Maybe it's a loss of identity, or a natural distrust I have of soft hands on a man (utterly ridiculous, I know), but my hands became knowledge worker hands.

I've started climbing recently and I now sport callouses and scrapes and an ever increasing grip strength. I've started practicing Aikido again, after many years away from it and realised that I had lost any sense of the "killer grip" my new sensei talks about. The grip that when applied to your wrist causes your hand to claw up. I've picked up my guitar again and I notice my fingertips are soft and hurt after a short time of playing. I wonder if this is all a response to how I see medicine in some way. I know that it is hard and demands so very much, that surviving the long hours and ability to think on your feet is a skill. But my hands soften and that bothers me on a very fundamental level. I don't really understand why. Maybe this is material for a midlife crisis that's just been delivered a few years early.

My feet are runner's feet. My hands must not be knowledge worker hands.

Go figure.

Thursday, 17 March 2011

I am med student, hear me roar

I am up to my elbows in revision, scratching around my notes and the internet to try and make sense of nephritic vs. nephrotic syndrome or RDS vs. Transient Tachypnoea of the the Newborn, so I've not had time to come up with a topic for a blog post recently. I did, however, find time to have opinions about stuff on a friend's podcast, so if you wonder what I sound like, wonder no more:

Hear me talk

Disclaimer: I didn't think through everything I said, so take what I say with a pinch of salt. I'm not one for talking in absolutes if have time to think about what is coming out of my mouth.

Right, back to the books.


Wednesday, 9 March 2011

What are you afraid of?

Mrs Absentbabinski managed to score some free tickets to "Ghost Stories" this week. It's a play which is a little slice of genius and genuinely scary in parts. One of the stories (and I don't really think this is a spoiler) involves someone being awake and at work in the early morning and it made me think about night shifts and the quiet terrors they can generate.

I was reminded of the numerous night shifts at St Clabert's hospital (name changed to protect the... Innocent?) Generally once the excitement of drug rounds and cups of tea had settled and people were dropping off to sleep, I would take wandering around the ward (if I had nothing more immediate to do). The ward was divided into 4 six-bedded bays, one per nurse. I would slip into mine and sit in a chair at the far end of the bay and just listen to the breathing of my charges.

Around 3am I am fairly sure that there is some nadir of lots of the hormones that keep the crazy voices out of your head. At this time, if I had nothing more pressing on my mind, I would become convinced that one of my patients would try and die on me. It was irrational and I knew this. But I was sure that something was terribly wrong, so back I would walk, into the bay and I would stop at the foot of each bed listening and playing the beam from my pen-torch over the patient, just to sure.

I would also worry that there was something outside, that is to say that out in the grounds of St Clabert's, something evil was pacing around, just waiting for an unsuspecting nurse to look out of the window and see it and... Well, whatever would happen would be awful. Go figure.

I don't miss night shifts, and ironically I think the things that really should have got my pulse racing (the 3am biochemistry abnormal results, the haematemeses, the  people who would go off (mentally) the minute the sun went down, these things never really scared me. They were tangible and I was trained and/ or experience enough to be able to deal with them. The occult, hidden (and often ridiculous) things that the night holds, they pressed all the right buttons in my lizard brain that had been left running the ship whilst my higher functions had gone off for a nap.

Sunday, 6 March 2011

Acceptable, again

My school has an interesting way of grading our exam results: Acceptable, Cause for Concern and Unacceptable. You also get to know the range of the class’s score and the median result. But no A’s or B’s or curving the grade.

And I’m acceptable. More accurately I’m a bit above-average. And that is something I’m entirely happy with, because frankly, I’ve needed a win for a while now. I’ve been bogged down in feeling like I wasn’t good enough to, like I should stop this nonsense and head back into nursing where I could make a buck, be good at something and not feel like I was a pretender. My grade for the mock OSCE put me a little above average which is where I have been throughout my educational career. Primary school, secondary school, A-levels, previous university life - above average. Not top of the class, not a notably able student who’s full of promise, just a pretty good student.

So I can go into revision for the next round of exams (2 and a bit weeks time) with a more positive feeling than I went into the mock OSCE. And I've just finished a weekend at the family homestead, being fed and watered, drinking someone else's booze and seeing how my father is getting along. Aside from not being allowed raise his arm above his head, he's doing just great, which has also taken a load off my mind (and his, I rather suspect - and the rest of the family!)

Which reminds me, thanks for all your continuing words of support and comfort, it's really meant a lot to me.

I hope you've all had as good a weekend as I have :)