The 3 B’s….Bumps, Bruises & Busy

Working in a ward can be dangerous. At least, it is if you’re as clumsy as me! I collect bumps and bruises like others collect stamps or coins. My shins are a permanent collection of purple and blue bruises, as are my outer thighs. I even have a bruises on the inner side of my upper arm. If there’s something to walk into, I manage it. If there’s something to trip over, I’ll find it. Heck, I can trip over air! I’ve managed to dent my forehead and cut my head in the past. Sometimes I’ll hurt myself but have no marks to show for it, like the time I almost smashed my patella to smithereens walking into the bed frame. I almost vomited it was that painful. My only consolation was to look forward to the impending beauty of a horrendous bruise. Except it didn’t happen. Disappointed is a slight understatement! I earned that bruise! 😂

Yesterday was verging on the shift from hell. We were very short staffed, both by nurses and by hca’s. By the afternoon, I was the only hca on shift. That’s a bit difficult when there’s a cohort bay that I need to work in, but the other bays still require assistance. Luckily, the big guy in charge (as in he’s high up on the management ladder) finally agreed we could close the extra bay.

It didn’t help ease the work pressure though, as it meant discharging around a dozen patients, transferring the patients from the closing bay to the now empty beds, and accepting admissions for the remainder of the empty beds. Which in turn means masses of paperwork to complete, beds/patients to move, bed management software to update, TTO’S to chase along with the usual hourly/2 hourly documentation to be done. 

We managed it, but with a lot of huffing and puffing from stressed out nurses, a few tears of frustration and stress, and wishing the clock would fast forward to the end of the shift. As the night shift was going to experience the same staff shortage as we did, spirits were not high. I think they almost got adequate staff numbers after my shift finished, but with some potentially very difficult patients on the ward, it would have gone one way or the other. I am just glad I wasn’t on the night shift last night. 

Almost all NHS Trusts are experiencing staff shortages. Staff leave frequently, but the recruitment processes to replace them rarely seem to happen until after they’ve left. I find this very peculiar. Once someone has said they plan to leave, and could they please have a reference, the managers ought to advertise the positions. By the time interviews have taken place, references and pre-employment checks done, there may be a couple of weeks difference in the employee leaving and the new recruitment starting. Instead, it takes several months of waiting for a newbie to start. I also find it absurd that a member of staff leaving a ward to join another ward in the same Trust, has to go through the same recruitment processes – it doesn’t take almost 2 months to ask for, and receive a reference. Other than that, there shouldn’t be any need for the same in-depth processes to be undertaken for a same-Trust position. 

We do have some new recruits starting soon. It’ll help in the respect of having bodies to cover the annual leave and sickness absences we’ve got just now. I believe there’s at least 2 hca’s starting. I’ve been allocated as a ‘buddy’, where the newbies will shadow me as I’m working. They’re classed as supernumerary for the first month or 2, so aren’t officially counted in the shift numbers. This is great, as it means that we can often be asked to lend a member of staff to another ward. Supernumerary staff can’t be sent to other wards, and we can’t leave them on their own without a ‘buddy’, so sometimes we are technically over staffed, but on paper we aren’t. A win-win situation for us 😉

We seem to be getting rid of the shit nurses now 😂 Only one or 2 left, but perhaps they’ll start to pull their weight and actually learn that to be part of a successful team, they need to muck in with everyone else. We don’t really need a repeat of the other morning when one nurse was virtually screaming at another nurse, entertaining as it was lol. 

I was exhausted last night and was in bed and asleep before 10.30pm. I woke at 05.15, realised the alarm hadn’t gone off so it wasn’t a work day, and promptly fell asleep again. I awoke again  around 7am and thought about getting up, but dozed again for an hour. Even with the sound sleep I had, plus the additional hour or 2, I’ve felt very tired today. My knees have been achy and my muscle have been spasming a lot. I’m definitely getting old 😨 I spent the day finished off my clay art piece. I’m quite pleased with it but as always, there’s things I’d do differently or change. From what I gather, this is perfectly normal for creative people as they are their own worst critic. I very much am my worst critic, and never feel 100% happy with whatever I create, even when people have said how beautiful my creations have been. As the husband says – I really need to work on my self confidence. Is anyone aware if where I can get some? Is it available on prescription? 😂 

Work day tomorrow, so early night for Cinderella here 😉 and I’ll leave you with a photo of my bruised leg (definitely not models legs!) And the offending obstacle ☺

Ignore the indentation from the seam of my jeans and my plucked chicken lookalike skin 🙈

You see that little donut shaped bit with the lever next to it? Those are lethal!

The odd day off.

It’s been a busy few days in work. Monday saw us initially with 2 nurses and 1 (me) healthcare assistants. Not good! We managed to borrow a nurse from another ward, and a little later, another nurse from another ward. We also had a bank staff healthcare assistant. it still meant we were very stretched, but funnily enough, the ward seems to move smoother when we are short staffed. The more staff present, the more hectic the day is, with the feeling that little has been achieved. Odd.

We had a fall on the ward, just as I was coming back from my break. I’m going to keep a note of who was present when a patient falls. The nurse from the first ward and the bank HCA were the ones in that bay. It makes it worse that they were in the cohort bay – meaning that bay should never be left unattended for any reason. I’ve a feeling that by keeping a note of who was in a bay when a patient falls will see a trend: staff present will either be bank/agency or from another ward. I could be wrong…..but when we have staff on that aren’t ‘our’ staff, (apart from the shit staff!) there seems to be an increase of things happening that shouldn’t, or things not done that should be done. Time will tell.

As I got into work on Monday (early) I could hear a nurse giving someone a right telling off. At first I thought it was a patient that had perhaps been arguing or been rude, but it wasn’t. It was a nurse having a proper go at another nurse for being lazy and not helping during the night shift, tending to her own patients (basically doing the medications and nothing else!) and not assisting with any other patients. I can believe this happened, as the nurse in question really is a lazy bitch! It is rare for her to help wash a patient or make a bed, or to assist a patient to the toilet or do a set of obs. So, I couldn’t really blame the other nurse for having a go at her. It was the way she did it that stunned me. She didn’t take the lazy nurse aside and have a quiet go at her, she yelled full blast at her. I could hear her from the ward entrance, so the patients all definitely heard it too. Very unprofessional!! The lazy nurse didn’t say a word the entire time. Sorry, but I wouldn’t have been able to shut my mouth if someone literally screamed in my face like that, even if it was deserved! But it did provide me with some ore-shift entertainment lol.

I spent the day running about between 3 bays, which was fine. In two of the bays, the patients were pretty much self-caring, so it was really only a case of making the beds and doing the obs when they needed doing. The other bay was a little busier, but again, most were self-caring, just a little more needy than the other 2 bays. Not that they really needed anything, but they seem to be the type to think that as they’re in hospital, they need a lot of attention. Either that or they are mollycoddled by their partners/families. And of course, each is sicker than the others, or have had more hospital admissions or longer admissions than the other. But they are a nice enough group, so I can tune out of their ‘poor me’ stories.

I was pretty exhausted by the time I got home. I was in bed and asleep by 10pm and didn’t waken once until the alarm went off. I didn’t even hear the husband come to bed, which is like having an elephant sit beside you as he just thumps down. He’s going to break that side of the bed before long – it’s already creaking and groaning in protest. I won’t be getting another wooden framed bed again!

Tuesday was the day from hell. I was paired with the lazy nurse who had been shouted at the previous morning. Her first words, which were frequently repeated, were that she was so tired as she’s just finished her night shifts the morning before (like I wasn’t aware and I hadn’t heard her getting a bollocking lol) and she was doing 2 long days as well blah blah blah. I wasn’t interested in being sympathetic, as I already know she’s lazy, and knew her fatigue complaints meant she really would do nothing except meds all day. So, I jumped in first and told her which patients could be managed with the help of one staff member, and which ones could attend to their own personal hygiene, and then I sat and cohorted –  in other words, I babysat the rest of the patients and let her get on with it. She hates cohorting even more than she hates helping people get washed and making beds!

It ended up going from bad to worse; one confused patient trying to just walk away and trying to go home, another who pissed on the floor, and another who refused to eat or drink anything. The latter then dropped his sats and ended up on 98% cold humidification. We had a new admission coming, and needed a cohort bed, so opted for the most stable patient to move to another bay. He was furious and started ranting and raving and refusing to move, but eventually allowed staff to move him, while he complained the entire time. Another patient decided to vomit all over his tea, and the new admission just lay there like he was in a coma, (he’s not) so he could be interesting once he wakens up more. The poorly patient started to respond to the cold humidification oxygen therapy and decided he was not going to keep his mask on, no matter what we or his wife said or did. The patient who tried to leave earlier decided he was going home with his family and took a huge amount of persuading to remain in the ward. And I had a bucket load of obs to do while everything was kicking off! I have never been so glad to see the end of a shift arrive!

Today I have spent chilling and crafting. I’m back at work tomorrow for a short shift (normal shift to other NHS staff, but for me it’s a short shift) and then back in on Friday. I’m hoping we have enough staff on and that the ward has calmed a little by then, but it’s highly unlikely! I have some training during my shift on Friday, so I’ll be able to escape for a bit 🙂 Saturday will be more crafting. A lot of people, from family to friends and work colleagues, have all said they couldn’t be bothered with an arts and crafts hobby. The usual reason is they wouldn’t have the patience. I find it almost therapeutic. I have the radio on and craft away, in a world of my own, with time to think about whatever pops into my head. It helps me focus and concentrate while also relaxing me. I didn’t used to have a hobby until a few years ago, when I tried fusing glass. I loved it, but it was quite expensive and even though I sold the odd item, it wasn’t enough to cover the materials. After having a crafty hobby, I found myself without anything for about a year, and I almost felt depressed. I’d enjoyed the glass fusing so much and felt such a sense of achievement when I made something nice, and now I didn’t have anything to occupy me or my mind. Earlier this year, I decided to have a play with polymer clay. I’m now addicted to creating things! Some have worked out wonderfully, while others are disasters. But, even the disasters are good, as they help teach what works and what doesn’t. I’ll post about my efforts before long and add some photos. For now, I’m off to bed for my 5am alarm clock 😦

I survived!

Night shifts are done….until the next ones in a few weeks. Both went quite well, last night especially seeing as one of our closed bays was reopened during the day. It’s quite frustrating as not only does it mean extra patients to care for, there’s also the fact that the ward budget does not cover these additional beds being opened. That, in turn, means staffing levels aren’t adjusted to provide additional nursing staff to cover the extra beds. It happens all over the country, not just at my place of work, but it really shouldn’t be permitted to happen in any Trust. It affects patient safety. It may not be obvious that it can and does affect patient safety, but with additional bay of patients to care for, the already stretched staff have to stretch themselves even further. If even one patient deteriorates, or has some kind of urgent medical issue (over and above their presenting medical issues), the highest priority has to be with the one who requires that urgent assistance. The other patients will continue to be cared for, but may have to wait longer for things like pain relief, especially as controlled drugs such as Oromorph require 2 nurses to measure out the dosage, check it, and sign the controlled drugs book. The nurse caring for that bay of patients may not immediately be able to get another nurse to assist with it due to the medical urgency with the other patient. But, in the true style of NHS staff, we just get on with it and do the best we can, with the staff we have available to us on each shift.

Anyway…..back to last night’s shift. I’m going to open up a little here about something that happens to/for/with me fairly regularly. It’s something I have struggled to believe in, come to terms with and accept, but I now accept it for whatever it is. Some of you may be able to relate to this, while others are going to be like “what a load of shit, don’t believe it for a minute”. So what happens? Well, I sometimes see a white mist in certain areas of the ward. For those who have experience of nebulisers (either as a care giver administering them, or as a patient receiving them), this white mist resembles the mist from the nebuliser. Except it’s not a confined or small amount of mist, it kind of floats in an area of the ward. Last night it focused on one bay, with some going slightly beyond the bay. When I’ve mentioned this mist, nobody else has seen it. I used to blame it on being tired, my eyes playing tricks, but it can happen at any time on any shift. Last night, or rather this morning, at around 1am, I saw this mist and mentioned it to the student nurse I was chatting to.

So, what’s the big deal about this mist? Well, it only ever happens in the leading days or hours before a patient passes away. It only happens on this ward (it’s the only ward I’ve worked on in this hospital). I have worked in other hospitals as well as nursing homes, and I’ve never experienced this. I have no idea why it happens, or why it’s just me that sees the mist. It’s not something I openly talk about to work colleagues, purely because I don’t want to be seen as some kind of loony freak. But last night, for a moment I forgot I don’t mention it at work. And so I said to the student nurse “I can see the mist, Patient X hasn’t got long to live. If he lives another couple of days I’d be very surprised, but I think he will die this morning at some point”. Naturally, the student was a little stunned at my revelation. Thankfully she didn’t freak out lol. We ended up discussing it further, and I told her about the time I saw an aura above a patient’s head several years ago. That patient died around 3 days later. The student told me about the time she saw a care home resident going to the toilet, and got concerned because the lady was gone for quite some time. She went to investigate and asked a colleague if she had seen the resident, and was told that that resident had passed away 2 weeks earlier (the student had been off work on annual leave and hadn’t known about the death of the resident). So, thankfully, the student nurse was quite intrigued about my revelation.

Now, before someone thinks I am “The Angel of Death” or some other such garbage, the patients are always very very poorly and their prognosis is they have limited time left on the earth. Some have been placed onto End Of Life Care. So generally, the patients are actually expected to die. However, there have been a few shock deaths where someone has rapidly deteriorated beyond medical help, so even though I see a mist, I cannot predict which patient will pass away; it could be the patient who has actually made a good recovery from their initial admitting illness/es and were on the verge of being discharged. These deaths make me particularly sad, as none of the staff could foresee their rapid decline. Even with these shock deaths, I have seen the mist prior to their deaths. I still have no idea why this happens to me. I’ve had a couple of friends, who I’ve confided in about it, who think I should take it further and learn more about this ‘gift’ and try to open it up further. I’m not sure it’s a ‘gift’, though I now accept it for whatever it is; I accept it happens to me and I can’t control it.

Back to last night’s shift; the gentleman in question passed away at around 2am. The student nurse was quite astounded. Perhaps not so much about him passing away, as death will always be expected in hospitals, and this gentleman was scoring high on the EWS system (a system we use which triggers alerts if a patient scores ‘points’ above 3; for example low o2 saturation levels can trigger a score of 1, as can a blood pressure of below 100 systolic). She was more astounded because I had told her about the mist, and the gentleman did indeed pass away soon after I’d seen the mist. I used to feel (inwardly) very upset when someone had passed away if I’d seen the mist. Now, I feel a sense of calmness. I don’t know who the calmness is for – me or the patient who has passed and is now no longer suffering. Or perhaps because I was able to foresee the death and it happened peacefully, and I am now in a position where I accept the mist is part of my working life.

The rest of the shift went without any drama. Even the patient who tried to climb out of bed every 2 minutes managed to sleep peacefully all night. It’s possible having his hearing aids removed overnight assisted his sleep 😉 I had mentioned to the nurse caring for him that I didn’t understand why he didn’t have his hearing aids removed at night, so she agreed to try it out and see if he slept better. A small victory which rewarded the patient with a much need proper night’s sleep, and the staff rewarded with not having to spend 99% of the shift trying to prevent him from climbing out of bed. (FYI, he is not stable physically to sit in a chair, he can barely hold himself up to transfer to a chair during the day, and requires constant supervision whilst in a chair, otherwise he will try to get up and walk away, leading to a potentially nasty or even fatal fall. Sorry, but that fall is not happening on my night shifts, and as one of the patient safety links for the ward, it is of my opinion that this patient remains in bed and supervised overnight for his own safety. There is nothing cruel in him having to remain in bed overnight – there just is not any staff to sit with him on a 1:1 basis, and his safety (along with every patient) has to be a priority).

The only drama, if it can be called that, was being shouted at by a rather unpleasant patient. Thankfully, these patients are not regular occurrences. At one point he shouted “I’m putting in a complaint about this fucking hospital”, but we never found out what his complaint related to. He was offered to be repositioned for his own comfort (he is bed-bound) – he declined. We offered to make him a hot drink – he declined. He was offered some snacks – he declined. He was offered assistance for toileting – he declined. To be fair, he does appear to have a dementia of some kind, though it hasn’t been confirmed or diagnosed. There is a lot of confidential things in his background, which could explain his behaviour as well. I tried not to laugh when he shouted very loudly at me to not shout at him…..we have to shout to communicate with him as he’s deaf! I’m glad that there are these little things like his comment that makes us smile, it helps release the frustrations we do feel when being verbally abused and unable to respond the way we secretly would like to! We are all human after all, and outside and away from the workplace, if someone spoke to us in the manner we sometimes get spoken to, we certainly wouldn’t be as restrained in our responses! I know I wouldn’t be lol.

The drive home from work was reasonably smooth, with the road being quite quick to begin with, but the traffic began to build up before long, which led to some slow stretches of driving. No lunatics driving this morning thankfully. After my lovely husband presented me with hash browns on toast (sorry, but I love some very random foods) and a cup of tea, I went off to bed and fell asleep quickly, only waking when my alarm went of at 1pm. I cannot sleep longer after the last night shift otherwise I won’t be able to sleep that night. It’s now 6.30pm and I feel very sleepy, but I won’t go to bed for another 3 hours or so. I’m back on long days over the weekend so need my sleep pattern to return to whatever passes as normal.

Tomorrow is a day off, so I’ll probably spend some time playing with some art. I’m not going to chat about that just now – it’ll get it’s own post before long. The main thing about my arty stuff is it’s a hobby and my therapy at the same time. And if I create something good…..bonus 🙂

Catch you next update. Take care 🙂

One down, one to go.

After having about 10 minutes doze yesterday, I went to work knowing it would feel like a very long night. I was right, it felt like the night was never going to end, but it was relatively calm on the ward (sending thanks to the night shift gods). 

The most dramatic moment was when a patient calmly told me his “tube” had come out. Initial panic ensued as he was sitting there quietly twirling his chest drain tube in his hand! Thankfully, it had only disconnected from the ‘tap’ part, and was easily reconnected, and swiftly secured to his side with I.V dressings. 

There was the usual confused patient trying to climb out of bed frequently, and other patients drinking copious amounts of tea throughout the night. But, all in all, it was a good shift. Here’s hoping tonight goes just as well, minus the drain disconnection drama.

The worst part was driving home. I live around 30 minutes from work, which becomes a minimum of 45 minutes after a night shift due to morning rush hour traffic – the bane of my life!

I managed to leave work sharp, and got through the usual slow parts before the traffic started to build up. This surprised me, as I was stuck behind someone scared to get out of 4th gear on a 50mph road. This kind of thing brings out the sweary side of me. (I swear anyway but when I’m tired and stuck behind a tortoise of a driver, it becomes amplified x100!). I eventually managed to sneak past at a set of traffic lights. 

I then ended up behind a large lorry. I don’t mind them so much, unless they are behind me and driving too close. Some idiot in a small white van overtook me, though it wasn’t putting me or other road users at danger. Not until he decided to floor it and overtake the lorry as we approached a bend in the road. The small white van narrowly missed a head on collision with a car coming the opposite way. I felt so sorry for that car driver. I was feeling ill just watching it unfold, so the poor car driver must have thought their days were up! 

The funniest part of this is the small van ended up stopped at a set of red traffic lights as I drew up beside him. I then managed to pull ahead and he was stuck behind me keeping to the national speed limit until his turn off – about 5 miles from where I caught up with him. Made my morning that did! I’ve played with the idea of getting one of those dash cam things, and as time goes on, and I see such idiotic and wreck less drivers, I’m determined I’m going to get one. 

As I prepare for work tonight, after a 6 hour sleep, I’ll leave you with a video of some squirrels playing at work this morning. I know many people don’t like them, they eat their plants or the bird food, and some see them as vermin, but watching these 2 little youngsters was adorable. If you watch to the end (it’s only just over a minute long) you’ll see one squirrel dangling like the acrobat squirrels are. 😊

The difficulty of starting night shifts 😨

Tonight is the first of 2 night shifts. I find it difficult to prepare for the first one. I get up early and try to keep occupied and then go for a sleep in the afternoon. Except it’s not so easy to sleep during the day until you’ve done the first night shift.

With it being summer, the room is light, even with the blinds and curtains closed. The window is open for fresh air, which brings in all the outside noises….the birds tweeting, cars and motorbikes on their way to wherever, the school children chattering and running excitedly down the hill, with parents yelling at them to slow down or wait. I can also hear my husband and one of the kids having a late lunch, cutlery clattering off their plates, their deep voices discussing something, the boiler kicking in as someone runs the hot tap, the dogs paws clicking over the wood floor. I put the radio on low so I have something to distract me from those noises. There was a time I couldn’t get to sleep any time without a radio on low, so having it on now is fine, a bit like a soothing lullaby. 

I’ll drift off into a doze before long, then wake up in a panic, not knowing the time or the day. It won’t have been a proper refreshing sleep, so it won’t help really in preparing for the night shift. But if I don’t attempt to try, I’ll get grumpy too quickly later on. And the husband will nag at me as well, saying I’ll make myself ill with lack of sleep.

When I get up, I’ll chill with a cup of tea while husband makes the evening meal. We’ll eat reasonably early, so I can get changed and get off to work. I hate having to rush for work, so leave in plenty of time. I get there about half an hour early. I prefer to leave the house earlier than needed just in case something has happened on the roads and detours are in place. It’s only happened once, and I still got to work 10 minutes early, but I’d have been quite late if I left when most people think I should leave. I also like to have a cup of coffee (usually the only time I drink coffee) once I get to work. I also check work emails, because there’s often no chance to check during the shift.

I’m hoping for 2 calm night shifts with enough staff, but I’m realistic and know there will likely be some very poorly patients, with some very confused patients too who need supervised at all times. I’m also realistic about the staffing. We usually have the bare minimum needed for nights, but occasionally we manage to get someone extra to help out if we have a lot going on. 

After having a week off as annual leave, I have absolutely no idea what the ward is like just now. It was really nice before I went on annual leave, with a lot of lovely patients who enjoyed a laugh and were very pleasant. It’s great when it’s like that, even when all hell breaks loose with someone having a peri-arrest or respiratory arrest there is still a good atmosphere. The staff know what to do and do it briskly so that the emergency is dealt with quickly and efficiently. But sometimes we have patients who aren’t so nice, some even aggressive. Those patients can make a long shift feel much longer. We don’t get them often, and they are treated the same as the nicer patients, but it just makes things nicer when patients are lovely.

I’ll update next when I can. It could be during the night shift or it may be later in the week. We’ll just have to see how these shifts go. Wish me (and my work family) luck! ☺

A tentative hello :)

I have no idea what I am doing here. In all senses! I’m a WordPress virgin (though I guess I’m not now), which means I really don’t know how this thing works. That, in turn, means there will be a lot of mistakes, potential deletings because I don’t know how to save whatever I’ve written. I’m obviously having some kind of mid-life crisis. Why else would a 40-something married mother of 3, grandmother of 4, be embarking on a WordPress blog thing?

Ahh, so there is a very small intro to my personal life. I’m aiming to remain quite mysterious, though I may throw in some notes about the husband, one of the darling children, or one of the cherubic grandchildren. The main aim of the blog is to give a small insight into the life of a healthcare assistant. We are in the UK, (we meaning me and usually whoever I may (anonymously) mention during my witterings), and I work on an acute medicine ward in a very busy hospital. I’ll throw in real stories, with identifying information witheld, so aliases will always be used to protect those I write about. Any names used in conjunction with a story that are the same or similar to someone else’s in real life is purely coincidental. A lot will be regarding my feelings – frustration, helplessness, weariness, happiness, excitement, confusion, anger, sadness….pretty much any and every emotion imaginable. I’ll also add photos where I can, which will never contain anything that can identify other individuals or the ward I work on. 

As this is a “diary” blog, it’ll also contain life away from work. So basically anything I want to share, from places I’ve visited, to how I feel on a particular day, to food, to serious stuff, and everything in between. I can’t promise to blog every day, as I may simply not have time. It may be one entry a week, depending on what’s going on, but it’ll likely include whatever has gone on throughout the week. 

I hope you follow my journey as I travel it, the good and the bad and everything either side. I’ll try to stick with being light hearted, but there will always be some heavily serious stuff too. You can skip those entries if you like. I won’t mind. But I hope to be able to resonate with some readers as I go along. I’ll never look for sympathy but rather understanding. I am not a literary professional, but I do enjoy writing and sometimes I forget to stop. There will be grammatical and possibly spelling errors – especially if I’m in a very not happy frame of mind! But it’s all real and raw, it’s my life and what goes on. The mundane to many. A soap story to others.

Thank you for getting this far! If I haven’t bored you to death already, then congratulations 😉 (not sure if emojis will work but I’ve just put a winking eye on there lol).