First time deployed

To another ward, I was told to report for work this afternoon. The surgical high dependency unit was short on staff today so they required manpower from the other departments. Who knew I was worthy to be deployed to help out at other wards!

Naturally, I was not thrilled when I first found out I was going to be working in an unfamiliar environment, moreover a surgical unit; I did several postings in the orthopaedics discipline and my internship at a surgical ICU, but it has been medical ICU the moment I stepped out of the nursing student uniform. Well, the shift went by and I did okay, with the help of the kind nurses in the ward.

It has been a long time since I filled up a an OT checklist.

And the learning continues.
 

Handwriting

Mine needs improvement.

In primary school, I remember being spoken to by numerous teachers regarding my handwriting. In Year 3, there was this teacher who even went to the lengths of summoning me to her office during recess, just to practise writing more neatly. It was only half of the recess time, she had a heart. Many years had passed now, unfortunately my handwriting remains just as terrible if it did not become more worse. Writing this, I recall a clinical instructor back in the hospital who once said to me, "you can make a good nurse, but your handwriting sucks!" Hehe! I did not argue with her but took note of her words with a smile. May God bless these good people and anyone else who warned or tried doing something about my penmanship!

This evening at this moment, I am sitting at a local cafe near where I live; here not for the food but rather access to the Internet. Do you know that in some places you just write down your order on a piece of paper, usually in codes, and the waitresses will collect that paper and key in what you want and soon bring your food to your table? Where I am practises just that; and I just received the wrong beverage because the waitress mistook what I wrote - "607" for a "601" and thereby served me white coffee instead of tea, which I had been craving for all weekend. On the brighter side, the manager agreed to replace my order and I am now awaiting to enjoy that cup of tea. As a grateful customer, of course, I intend to apologise to the waitress on my way out later. So glad for not having to suffer the consequences of not-so-good handwriting tonight.

Turning 22 this year, if I do not die in a terrible car accident or get caught in the middle of a gunfight. Is there still a possibility to make improvements in penmanship?
 

Low urine output

At the ICU we monitor hourly vital signs, sedation score, urine output and a few other things relevant depending on the cases. Yesterday my patient had only 2ml or urine drained over two hours. This time the staff nurse accompanying me was busy so I decided to inform the medical officer on duty.

"Doctor, doctor.. Patient so-and-so's urine output is pretty bad, only 2ml over the past two hours post surgery."
"Okay, noted. Give me a minute to come over." (Phew! I still feel a little anxious when communicating with doctors, not sure why)

 So the doctor came to check on her patient, and flushed the urinary catheter in case it was blocked. And it worked! However it did not take long for us to notice that it started leaking, and I got the stuff ready for the doctor to change the catheter.

Lo and behold, the urine just kept flowing as soon as the new catheter was in place! Poor patient, suffering from a distended bladder but was unable to express it. I felt a little foolish as I forgot to palpate to check if the bladder was distended; I felt useful as the patient's suffering was eased because I raised the issue to the doctor's attention, but what the patient probably felt was relief, which is, needless to say, more important than my feelings.


Intensive care nursing is about close monitoring of patients and judicious reporting to doctors.
 

No stand

Something happened last week, though I find it inconvenient to share too many details of the incident, I wish to pen down some reflections here.

It all started when I got a cut on the thumb while shaving a patient during one of the "less-busy" afternoon shifts. What followed from then turned into a long and chaotic day. Well, maybe not chaotic but let's just say I spent a good few hours away from my usual duties.

The case was brought up to a few different persons from both the hospital and my college. A lecturer came, my clinical instructor was around, and a nurse manager from the ward too got involved somehow. Many phone calls were made that day. I was brought to somewhere that functioned like a staff clinic. And then, the people managing the place got into the picture as well. Basically, I was down to two choices: put the case to rest and everybody pretends nothing happened, or to register myself in the clinic to report a workplace injury. The latter would require me to do a blood test, and a few memos need to be written by the school, the ward, and myself. Cutting a long story short, most of the people with me that day(and a few more on the phone) were split into two sides; sort of pressurising me(although they might not have meant to) to do what each group deemed appropriate. At that point of time I just wished I could either disappear into thin air or go back in time to be more careful while shaving the patient.

When I was with one "group" I began thinking I should do things as they suggested; buy when the other side started speaking I then felt inclined to taking their advice. Stuck in the middle, for nearly an hour there in the clinic.

I took the blood tests in the end because I felt it was the right thing to do since an injury was unarguably sustained and the blade was indeed used. The test results already came out and I am okay. But I realised how indecisive I can be when circumstances become difficult. Why did I not have a ground to stand firm on?

Viscous cycle

Each day before my shift starts I think I get myself ready for work. I shower, get dressed and occasionally prepare sandwiches. I am reminded to read up on some topics related to my current posting but often decide to do it on the train.
As I travel from where I live to where I work I indulge myself in my favourite music playing through the earphones.
When I reach the ward I find myself feeling lost and often a little bored during the first hour upon arrival.
Then a senior nurse or the clinical instructor comes along to check how am I doing, and never once fail to open up my eyes to see how lacking in clinical knowledge I am.
For the rest of the shift I will repeat to myself what I require to research or read up on.
On the way back from work I enjoy my favourite music once again.
By the time I reach the house, academics and clinical stuff are conveniently tossed out of my mind. I tell myself to prepare for the next day, the next day.