Day 3 of my Acute Care Placement saw a complete shift from yesterday, there were two RNs on Shift, plus the Nurse Unit Manager (NUM). It made life so much easier for skills, assessments, medications, procedures and patient care. I was free to do more with the patients as I had the supervision I needed to legally perform the tasks. I seem to be learning more and more everyday, which I expect to do for the rest of my career, and it seems that no matter how much I seem to learn, it still seems I don’t know enough.
Unlike yesterday, I started on the floor. We completed handover with the evening staff, then dove straight into the morning routine. Wakes, observations, showers and 0800 Medication Rounds. In School we discuss polypharmacy and its impact on patients, what it is and how it occurs. Today I witnessed polypharmacy and how much harder it can make your job. Two patients had over 12 medications, just in the 0800 medication round and nearly 20 different medications by the end of day. It stretched my mind to remember all of the classes of drugs and which ones I was giving out, what they were for and looking up the ones I hadn’t heard of before. It was time consuming and very rewarding, and I am eternally grateful for the very patient RN I had supervising me.
I was given two patients for the shift that were my responsibility, in some ways I felt I did quiet well, I stayed on top of observations, preparations for theatre, discharge preparation, medication administration and personal cares, but in other ways I felt I was inattentive. I am sure it was either my own mind wanting to give them my undivided attention, but as the ward was as busy as it was, and there were blood transfusions, Vac dressings, subcutaneous injections, and other complex or rare procedures to be completed and experienced, I felt I was abandoning my patients. But I know that if at any time I was being truly neglectful the RNs on duty would have curtly reminded me of my duties, or prompted for me to ask for assistance… read You have forgotten this would you like me to do it for you.
I completed my first Fleet Enema on a live patient, vice a latex manikin, which was both interesting and far less daunting then I expected. I am finding the more skills I perform on actual patients, injections, suppositories, assessments, or otherwise, the more I feel reassured that I am actually helping them and not infact inflicting discomfort, pain or general unpleasantness upon them. It is nice to know that what you are doing is having a positive impact.
I experienced my first interrupted meal as a Nurse, even if I am still a student. I was taking the opportunity to take a lunch break between 120 Medications and the afternoon activities prior to handover. I make it to the break room, make a coffee, finally get to the front of the microwave queue and then another staff member comes around the corner and says Medical just called and they are about to start the Blood Transfusion. The blood transfusion I have been waiting for all day. I take my lunch out of the fridge, place it and my coffee on top of the fridge, and race back to Medical. Some 2 hours following the procedure, the myriad of observations that need to be done following and the satisfaction that my Patient is not indeed having an acute reaction to the blood, I return to the lunch room…. Two hours later.
Outside of placement, after clocking off at 1530, I raced home to cook dinner for the family, showered and changed into another Uniform for Scouts and left again by 1730. I returned home, tired, sore and sweaty at 2030, where I now write about my day in my Blog for you the reader to enjoy, it may take a while to get used to regular 14 hour days.
All in all though, it was an amazing day. I learnt a ton about procedures, skills, medications, diseases and conditions, but I also learnt more about myself, my place in the world of Nursing and the same constant reassurance I receive knowing that I am where I am supposed to be.
Until tomorrow, Maintain the Rage