Wednesday, July 8, 2009

Physical exhaustion and a bit ansy.

Is life Jim..... but Nursing is physically demanding shit!

Wow, 3 day's down, 1 and .8 to go. Or whatever the friday's worth.

I am exhausted. My shoe's, are not the may west, so the sole's of my feet are aching, my ankles have scabby ulcers and even my calluses are throbbing. I ache all over, i'm generally tired and intermittently sluggish. And my moods change very frequently. This is the price i pay for a massive increase in physical activity coupled with lack of sleep. It's a shock to my unfit system and it's nay fun i can tell you that.

My rash is still semi-present. My hands have been washed so many times, and rubbed with alcohol gel so often that the skin is visibly dry and bath wrinkles are appearing. I try to moisturise them but it doesn't help when you wash it off minutes later. My rash has run and hid on my hands and feet. This means as well as the swelling soreness of standing on my feet in small tight shoe's all day, i also have a constant nagging itch that i can't scratch in any way. It's only small red spots but it's a constant burrowing itch that just won't fuck off.

I'm showering every day, but the physical activity and this mild humid weather means i'm sweating a lot, and i usually don't sweat. This means i'm getting chaffing around the groin from pool's of sweat. This is possibly one of the worst as it's the one that i notice most while at home.



As for my mood, it can be circumstantial. I was relatively happy with my nursing actions today. It was quiet, "touch wood", and not much had to be done. This meant i got everything i needed to do done. Fluid balance's, a couple of walks of the patients, so on and so forth. I even had time to loosely pre-pare for whenever my cpc would come around.

This involved a quick scribble of the basic's i knew she would ask me about. But i was busy and walking up and down with a slight limb, throbbing feet, sweating my ass off and generally knackered. I didn't have the time to look after all the patients i was assisting in the care of and also learn. When i was home the night before i wasn't arsed. i was too tired. MJ's memorial made my eye's well up and Torchwood was nice escapism. I had few hours of sleep and rest to recuperate, studying was not on my agenda. So when then CPC did finally catch me, in the middle of a task at that i wasn't exactly happy.


I was trying to get a patients weight. The first weight i got was grossly underweight and obviously wrong. She then asked what it was in Imperial, and so did a nosey former Nun in the next bed. As they chatted about that i kept trying to amend the result and get it again. But the damn scales wouldn't switch back to Metric. And i was stuck with senseless weights, in the sense of what i was looking for. Stone's are all well for conversation but they're fucking useless for medical purpose's. I failed to get it. My CPC arrived mid task and started to chat to the Nun. Fed up and aware i was basically being summoned and watched i stopped and put the lady back into bed.


I was then brought to talk about what i had "studied". Here came the shit part. I'm not stupid. Okay, yes, i failed exam's for second year twice but that's lack of study and emotional failure's such as being a fuck-wit selfish twat who only Care's about self-pity. But when on placement i do what's asked of me and generally get by well enough. I was on-top of a lot of things today. I was almost on a roll, apart from a large spillage early in the morning. I was dreading the cpc, i was tired and exhausted from actual work. I didnt expect this time owing to include being expected to self-educate to the same standard. Obviously that is not so.

So being put on the spot. I struggled to string a sentence together. I was pissed not only with the idea of being pulled aside for inquisitive learning, but i was even more pissed that i couldn't even talk. I actually stuttered. I know this stuff, the words may not be perfect, it's not clear in my head, but i don't see myself as thick or anything. It may be an over-confidence in what i may know but when i Stuttered and couldn't say what i knew i SHOULD KNOW, and expected that i could talk about i just stammered and fell short of my intended words. It was beyond frustrating. It was unbearable. I just wanted to blurt it all out in academically perfect explanations. I wanted to look at the notepad in my hand with the answers. But i was all over the place. I couldn't even say the words my eyes snatched quickly.

I then had to read through the software guide to explain it all i was still flummoxed and stammering. It was on the screen. I rolled my eyes and squirmed every time her eyes weren't on me. I checked the clock in the corner of the screen every time i could.

I was trying to talk about Pressure sores and the assessment tool's and so on. Frankly even when i do encounter them it's second nature to use the various treatments we use. Such as barrier cream's, positioning, pressure relieving cushions and mattress, diet, hydration and so on. We do that as basic care as it is. Actually summoning up the rationale was escaping me. And for someone who usually over thinks and drifts off on trains of thought, not being able to express what i knew or could say was just awful.

I was so focused on all my physical demands and physical pain that i couldn't kick my brain into gear and catch up. My higher functions we going no further than what had to be done.

It may be trying to excuse my inept and glaring failing, but i just was NOT in the mood to dredge out education and knowledge when i couldnt even say the words articulately or at all.

Yes i am far behind of where i should be. Let's face it, after 3 years i really am worse at this than i should be. I got lazy, i became complacent, i became indifferent and cock sure of my own abilities, which is a lack-there-off. My academic rationale is seriously lacking. This is due to a large lacking in work. My physical care is usually hap-hazard and messy.

Basically i don't think i really am of the right mind set most of the time to be a Nurse. I'm a walking disaster. I may be a caring person but i am to all over the place to do anything competently. I, knowing myself, would not trust ME to care for ME. Not at my current level. I really wouldn't.


In my pissed off state i just smiled and agreed with the rest of what the cpc said. Trying to get rid of her. But then came a fact of documentation and care that is a glaring omission of how bad it really is within our health service. We are meant to "Think Discharge". From the second someone comes into us we have to have a minimal idea of how they will be managed after they are with us and so on. Well ALL of my patients were post surgeries and varying stages. And out of 6 only one had a mention of Convalescence and discharge in the near-by future. 1 out of 6.
My CPC quoted an audit of a ward of 25 where only 4 had preliminary plan's for discharge. We only started talking about it when all issue's are generally resolved and taken care of. Once people are generally well then we start planning discharge as the last few tasks like additional scans or removal's of drains and dressings and so on. Most of ours it wasn't mentioned, and considering how fucking busy we were for just a "QUIET" day it was fucking woeful how little i really knew about the over-all picture of our patients. I know i'm not the nurse but most of what i did was tasks, tasks, tasks.

No big picture. No Care Plan. No documentation past Vital Signs, Input and Output/fluid balance and stool charts. I've been doing that for 3 years. The clerical stuff has been intermittent at best because the nurse's, my preceptor's are always doing that as i do the tasks for them and us as a team. That is a glaring sign of my lack of assertiveness in showing that i am very far behind on knowing or having any experience with the clerical side of nursing.





Celebtastic:

Soon We Bury The 2nd King.

It is a staple of human society that once and a while someone great come's along. Someone so special that they eclipse all others. They are a jack of all trade's and capable of anything. From Gospel we are told of Jesus Of Nazareth, From history we know of Issac Newton and Shakespeare, From science we know of Edison and Einstein, from Politics and civil rights we know of John F. Kennedy, Bobby Kennedy, Doctor Martin Luther King Junior and Nelson Mandela, and from film we know of Charlie Chaplin, James Dean and Marlin Brando.

From the World of Music we know Of Elvis Presley, and Michael Jackson.

I have to say a few words here and there. I welled up at the footage of his memorial yesterday. I cried when His brother sang Charlie Chaplin's Smile. I especially cried when his daughter said her first public words.

That memorial may have been a show worthy of Michael Jackson, but it will also live in Infamy. Hundreds of millions of people worldwide watched in unison the passing of a Legend.



On The Box:


I'm currently loving TORCHWOOD.

The first episode was great fun. The second a bit weak and contrived, tamely just another episode despite it's dark undertone's.

Tonight however was just amazing. It all came together. The slow and never full reveal of the 456 was well done. The use of a "middleman" to absolve world leader's of culpability is a great plot point. And the terrifying use of children, and request for 10% of them is brilliantly played out.

Jack's involvement in their last visit is a great twist, and i can't wait to see where it goes. I hope it doesn't go down hill from here. Dr Who would. It's in it's nature in recent years, to give a soppy cop out that the children can buy. Torchwood is less forgiving. They did after all kill off 2 permanent characters at the end of their second season. The less said of their Dr Who cross-over the better.

I'm loving it and can wait for tomorrow's episode, but i don't want to.






P.S Stuff came out in my nursing rant that i didn't even realise. I think it shows how therapeutic and helpful just writing this blog can be.

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