I'll start by saying I'm UK based, as I've noticed most here are US based.
I've been working in my Crit Care area for nearly 6months. We have consistent issues with getting medical cover, and, due to training changes, a lot of the junior doctors we have don't know how to place Art or Central lines (kind of important, ya'know!). So I've become used to treating blind for a few hours until an art-line is in place, lots of real close monitoring and quick responding.
What I'm not used to is a patient waiting 16hrs to get an NG inserted after one came out overnight. I get that overnight on a Saturday, an NG that just finished a feed isn't a high priority. I understand that, even though the night doctor promised he would do it, he passed it onto the day team. I even understand that they said they would wait until the patient had been reviewed on ward round.
What I don't understand is why that patient missed 3 medication rounds and the start of an increasing feed regime because the doctor was busy.
The main reason this annoys me is that I can insert NGs. The Trust I worked at before didn't require a doctor to sign off, and if the pH of the aspirate was suitable and there were no adverse symptoms with a small amount of water, this could be used.
I agree, that's not best practise, and a chest X-ray is much better, but surely I should be able to site the gosh-darn thing, so all the doctor has to do is (remotely, if necessary) order and review the chest X-ray .
Who sites NGs where you work? What training do you require if you site them? And how is the NG confirmed as correctly sited?
I'd like to see if my first Trust was a one off, or if I would be justified in requesting the training from my ward educator.
