ClaireMacl

GI bleeds can have horrible postural drops... but you handed it over and that completely relieves you of any guilt in reality, in your head, I know it's a different thing! Try not to worry, it really wasn't your fault.

We don't have smoking shelters in our hospital. We have to go out of the grounds of the hospital, cover every part of our uniform and, even on night shifts, stand in an extremely dodgy part of London where stabbings happen very often. I'm giving up smoking soon (have only smoked for months), partly because of that, partly because of my health... but I'm still so annoyed at the mentality of the managers who believe putting workers at risk is more important than "saving face" in this new world of non-smoking workplaces.

My immediate thought would have been a subdural.. I'm very surprised they didn't do a CT and instead just went on a whim! I hope the lady was ok in the end.

At our hospital, the ITU SHO (junior doc) comes down to assess the pt, writes orders and generally the anaesthetics team will be there for any ITU patient for the whole time they are in the ED, so we have no problems with pain control etc. Sounds like a nightmare for you tho!

I've seen soo many relatives try to dump their relatives on the hospital because they couldn't cope or didn't want to before. It breaks my heart every time. One, which admittedly I nearly lost my cool with, was a girl in her 20s, still lived with mum, mum was an alcoholic and kept falling etc while drunk. Her mum was always drunk and she had noone to help. We done every test possible because the daughter came out with a ton of symptoms which the pt didn't exhibit. It was a cry for help, I didn't spot it. The daughter refused to take her mum from the ED, said she couldn't do it anymore. Initially, I said that she had no choice and told her the docs had cleared her mum. She walked out, then came back. Thankfully, by that time I'd figured it out (had too many alcoholics in my family) and got handfulls of helpline numbers for relatives etc. I talked to her about my experiences and she smiled and said thank-you and would try. Also had the most heartbreaking experience of seeing a very old person just dumped outside the hospital, unable to walk, in the middle of winter. I'd just started ED at that time and couldn't believe they done that... took security some time to realise he'd been dumped

Neither Casualty or Holby are realistic and while we are at it, thank goodness No Angels is starting its last series... but then ER and House are actually worse in terms of nursing realism. I mean last week on House, the man himself was caring for a patient who fell to the floor, turned to camera and said "Now this is why I invented nurses.... 'Clean-up on isle three'"! At least in casualty and holby nurses do nursing jobs, such as starting IV's. They often get it wrong, but I love shouting at the telly, particularly in Holby, and telling them what they done wrong :)

I'm wondering why you have to mention personal counselling which is not related to depression? I see no reason why you have to mention it really.... if you did, then you have a good explanation! As for PVD, I don't see that is going to make a difference at all. I went to Kings, which had a horrible recruitment process... I didn't disclose personal counselling as it was personal, but did disclose that I had seriously broken my leg just prior to admission and had fixation... I was followed by the doc around the building as an assessment for 30 minutes, most amusing, yup, I really could walk normally, lol. Oh and when I first qualified, I was scruitinised on why I had been on anti-d's a few months before qualification. I explained that I'd broken up a serious relationship and needed it to get over it. The only thing they said was that if I needed to go back on them, I should get in contact. I understood why, seen the press stories!

Accreditation of prior learning only applies to the UK, therefore isn't relevant to this thread. I qualified after a sociology degree and qualified in two years Yes, we are out there... but it makes no difference to overseas students as they most likely would not be able to APEL out of the subjects we did.

It's all so rediculous! Ok, I got a good rating from AFC, but I feel limited now in where I can move to as I know it will affect my scoring even though (obviously) my skills won't change. Maybe I should adapt my Sociology degree and go waste time blowing bubbles and cooing at babies and get the same grade

Any thoughts on the play therapist at band 5 then, OG?

I have a problem with this given the situation I was in the other night. I have no idea if the doctor was anti-smoking, but we had a COPD patient who was basically refusing all treatment. He had been there an hour by the time I got on duty and all documentation was perfect "patient refused bp, pt refused nebulisers, pt refused oxygen" etc etc by the nurse. The initial doctor, one of our own and very good also documented the same and wrote "referred to medical team". One hour later, I'd been battling with the patient and family to accept treatment, being really brutal, explaining that if he didn't, he might stop breathing, it wasn't enough. The medical doctors probably hadn't been told how bad the situation was. Sure, this guy smoked, but he'd called an ambulance! His spO2 was 67% most of the time. I ended up running to the junior doctor and saying he was going to die, given what she'd been told, I'd doubt she'd have believed me. But she came... she immediately called an anaestetist and the ITU doc. Minutes later, he went into PEA, miraculously we got him back. His family were more than grateful, they were in tears telling me that they were just glad that their last memories were not of him struggling for breath and understood he might not make it, they also said they understood why I was so urgent in my requests. Quite a few things have hit me since then... was the original doctor dismissive of this guy in his early 50's because he had been a smoker?Did ANYONE think that his refusal of treatment and distress may have been because of hypoxia? Personally, I overrode the original doctor and made the situation urgent because the patient was a human being in severe suffering and had a caring family beside him who didn't want to see him die that way. He might not survive being extubated, but his family was so happy to see him not in distress that I am sure I done the right thing. Who can put another human being through severe pain and suffering when we wouldn't do it to an animal?

I wonder if there is a place where I can complain that a play therapist got band 5? Anyone got any ideas? I was told she got that band because she has a degree is child psychology... which got me completely and utterly steaming! I have a degree in Sociology, many of our nurses have health related degrees other than their nursing qualifications, yet they are not taken into account... how about equality? Does BA (Hons) DipHE (Adult) RN mean nothing for me as a professional, yet BA means a professional banding for a non-qualified member of staff!!!!!!!

I detested 8 hour shifts when I worked the wards (floors I guess), you'd get home at 11pm (supposedly finishing at 9.30pm) and would be up again at 5am to be in for 7am... madness! I would fall asleap after returning home from the morning shift and lose my entire day. I work 12s now and love them... though I've recently saught medical leave from doing 5 x 12 hour shifts in a row on nights, I find them so draining and end up sick. I now do 3, then 2 at another point in the month, works well for me!

Yup, I am in the UK, but it still sucks that a first world country does such a thing! I didn't get a break till 3am last night (started at 7.45pm) and because I had such critical pts and we were down in staff, there was no way... I transferred my post arrest pt (my first I brought back from PEA!!!!) to another hospital and when I came back, I took 5 minutes, yes, 5 minutes to myself (aka break) because they were hit so hard. I didn't mind, I'd hate to leave my collegues in such a mess, but still, being paid for it might have been nice, I think I clocked about 20 minutes break instead of 90 minutes last night!!!

Hi Jeepgirl, Interesting twist on this one! I was going to comment that the latex free gloves that I currently use are almost 3 times as thick as the non latex so wouldn't be at risk... but you got me thinking about alcohol rub, handcreams etc that I used prior to being declared allergic to latex, sooo many! There is a growing trend in our ED to people becoming latex allergic, noone has looked into why yet, despite the extra cost of us allergic people! I must do more reading on the subject, if you have any links, that would be lovely

Sorry Aidy, TOS on this site means we can't give medical advice, I advise you to go see your primary care as soon as possible. Best of luck.

I've worked in a UK ED for years and have treated many kids with suspected meningitis etc but have never ever been asked to assist in an LP. I think I'd freak! It's traumatic enough for that baby getting an IV line, can't imagine an LP (though I know its sometimes necessary)! Can I just say how great you all are that have assisted in this and the OP that I'd doubt it was anything they done at all!

....

I actually wish we clocked in and out of work! We are paid exactly on the hours on the rota and noone cares if someone is asked to work an hour late because someone is sick and waiting for cover or something. I also wish we clocked in and out for breaks, that way they'd see we can't take them most of the time!!!! Sounds like complete rubbish your management are pulling you on. I never ever finish on time after my 12 1/4 hour shift, usually 15 minutes late, sometimes more. If you have to document a recent development or the person you are handing over to is not on the floor on time, how is that your fault?

Ok, let me see... my first four months of nursing, I got Norwalk (Winter Vomiting Virus) whilst working, the most unpleasant thing in the world, esp if the sink isn't near the toilet I got flu once from a pt in that time too. Since then, I've been diagnosed with lupus and am prone to picking everything up! I still work, I love my job and figure if I rest as much as poss on my days off and ensure upmost personal hygiene (esp hands), I'll minimise illness. I won't even list the amount of illnesses I've had, since most are related to my proneness to picking them up Another nursing related disease, UTI's! I have pylonephritis at the mo. Not nice peeing needles with a temp/chills, lol! Self inflicted nursing disease too... proven over the years - work 12 hours, don't take toilet breaks because you're busy, don't drink water = nasty infections, lol. Nursing isn't for everyone, that's for sure... but illness for most people in this job is related to universal precautions. Take care and you'll be well (unless you're me, lol).

I've seen a documentary on kids that stay on breast for longer and it didn't end well! As you say, recommended is 6 months. Sure, 2 years is fine (ish), but next year, that kid will be going to nursery. If it were my kid or if my advice were asked for, start weaning now, if not earlier

I personally know nothing about ports. We had a regular patient in the ED for some time who was very difficult to cannulate (to the point anaethetists were called and failed), she has a condition which requires regular meds IV. She eventually got a port and attended the ED the week after, every one of us turned around and said we didn't know enough about them to even try! Not knowing and admitting it is so much better than trying and messing the whole thing up. This goes with assumed ports (though I would never even assume something was a port if it wasn't documented and even if I knew, I wouldn't touch it anyhow!). That pt is now managed by oncology as an emergency pt, much safer for her and us.

One thing I'm amazed about... a few people have stated that smokers leave the workplace for 15 minutes for a smoke break! I smoke and take it off my breaks, which I think is only right. I also only take 5 minutes out of the dept to smoke and by the end of the day, the work employer has actually had me on the floor for more time than the time I deduct from my break times! I do plan to give up, sadly, it may cost me more at the moment (it did last time) to give up than keep going - if my employer gave patches free (and seeing as it's the NHS, they should!), I'd do it tomorrow!

All of our burns pts get shipped out to regional burns units. Sorry I can't be of more help. Perhaps write to the director of the individual hospital and ask to be directed to the relevant person?

Had any less experienced nurse been looking after my pt today, I wonder what would have happened. The doctor clearly wrote "loading dose of Digoxin 500mg stat", we have many new nurses on our unit who don't even know what antiemetics are! I walked to the doctor and said "I think you may have made a mistake", she changed it, no probs. But just think.......