Today i have been on an educational day learning in depth the anatomy and physiology of the deteriorating child including the factors which are involved in the biological processes of the human body. My mind now feels totally bambozzled with information. Throughout the day i was requiring regular glucose boosts just to keep me going...So i am assuming my brain was hard at work trying to absorb all this information and store it somewhere up there.
Yesterday I thought it would be clever to do some overtime at work (Yes, on a sunday in the ED!) I am trying to utilise my skills learnt in my previous course undertaken thus need to spend more time in resus to improve my knowledge, clinical skills and my confidence. Yesterday resus became an extention to ITU. I spent the whole of my shift working together closely with the intensivists which must be said i quite enjoyed. I was able to give timely appropriate care and treatment to individuals. It gave me a warm fuzzy feeling inside and reminded why I entered the health profession. I find the intesivists great to work alongside and really helpful, which was reassuring for myself.
On a low we had a gentleman come in with septic shock, who was moderately unwell suffering with severe hypotension which was not responding to fluid resuscitation, hes BP was in his boots roughly 70 systolic on arrival. I suddenly felt quite out of my depth when i had orders thrown at me from all directions. I managed but was left feeling my whole focus was on the physical aspect of care rather than the nicities - such as communicating effectively with the patient and family, although this was carried out it was at such a minimal level because I was the only nurse in the mad panic of stabilizing the patient - god,what i would do to have 8 arms/legs/tentancles like an octopus! : )! On the other side of the coin the septic patient was only discharged from the ED less than 24 hours ago, one day discharged home next day admitted to ITU. It just reminds oneself of how quickly a patient can or will deteriorate and stop compensating over a short period of time - Could the initial management and presentation of the patient 24hours before have prevented an ITU admission - had we got it completely wrong? Was it a failure on our behalf? Was fate and destiny in play here, was the outcome just prolonged?
It is these kind of stories the media loves to write about and 'paint the NHS' in a bad light, sensationalize all the stories! Lets face it im sure the title ' ED saves anothers life' would not sell papers aswell as sensationalized stories. Once again you can see a businness stroke approach in full play! Although it is more apt to use a business approach in selling papers and less apt to use this when saving lives or at least attempting too!
It must be said though I had conformed to the standards of the 'new NHS' the bosses seemed happy. On a lighter note we should be soon be recieving a new influx of staff, which should help in these kind of situations, one can always wait in hope and anticipation!
I left the department feeling cheery but fatigued both physically and mentally.
Seemingly yesterday seems to have had a positive effect on my self esteem, self belief and confidence. It must be noted though I may have possibly being feeling fatigued more so from my saturday night shenanigans. It just reminds me how things are not as 'black and white' as they are sometimes seen or percieved to be.
Once again I left ED feeling glad to be alive and living life.