Jan. 18, 2009


Greetings to all!!! It is hard to believe I have been here over 2 weeks! The time has gone by so fast. I am finding that the days are not long enough for everything I want to get done, be it do laundry, or exchange my television antennae for the fourth time.
I had coffee the other day with a woman who I met in induction. She is a neonatal nurse originally from Scotland, and just changed jobs. She had lots of good tips regarding housing, neighborhoods, the work atmosphere, and other topics. I enjoyed her company, and we plan on going out on the town later.
Dow, my husband, arrived yesterday. He came while I was at work, so managed to take the tube from Heathrow and come up to my ward. I took him over to the dorm and showed him how to use the three systems to access the room, two different key cards and a key. His directions are to act like he knows what he is doing to blend in, as technically, he is not to come in unescorted, let alone, stay the night! I had seen in the hall an extra bed, mattress and frame, so we have decided to borrow it for a while.
Today I showed him some of the ropes of my routines, starting off with coffee and a free croissant (before 12pm!) and shopping at Tesco for 1 pound dinners. We went to Argos and bought a coffee pot, then treated ourselves to the movie “Slumdog Millionaire”. For those who have not seen it, it comes highly recommended by me. Very intense!

Back to the work environment. Except for the fact that the shifts are brutally long, I am thoroughly enjoying them. I learn so much every day, and I am so intrigued by how things are done at this particular hospital.
The morning starts out with “hand over”. It is 745am, and all of the lights are turned on. The nurses are divided into two groups, each group is assigned to two bays of patients (each bay consists of 6 patients), and those nurses work as a team. The team then goes from bed to bed of those twelve patients, and the night nurse for that patient gives report. As us nurses know, everything is discussed during report, and this is also true here. We stand at the foot of the bed and discuss all issues about this person as the whole room can listen in. Some patients impress me, as they seem to be able to sleep through this process, but they are definitely the exception.
There is a route for morphine that I have not seen before. They call it “sub-cut morphine”, or rather, subcutaneous morphine. It is a subcutaneous needle access that is put usually in the upper arm, and then used for morphine injections, and in the case that I observed, the volume was 2 mls. I am told that this is a common form of pain administration. The access looks just like an iv site.
For post op pain management, the preference for the first administration is iv paracetemol, which comes in 100 ml bottles. The order read, paracetemol (acetaminophen), iv, pr, or po. I made comment that I would have probably gone the po route (oral), but apparently, that is not commonly done. I still want more information on this.
Nurses mix all of the antibiotic bags. Phlebotomy comes in once a day in the morning, except not at all on weekends, for draws, if more are needed the doctors do them.
Visiting hours are from 11am to 8pm, but visitors have to leave from 1-2pm, when the lights are turned off for quiet time. Actually, that seems to be a good time for all patients, as they then have a time of day when the ward is not full of people and the noise level comes down.
I had a most charming patient yesterday. He was a 95-year-old gentleman who had fallen and hit his head, and was sent over from another hospital. He had had some confusion earlier, but that had cleared. He took care of his wife and would drive 100 miles to visit his son. He was hungry and it was past time that the kitchen was open, so I warmed him up a fish pie from the refrigerator. As I brought it to him I said something to the effect that he would need to sing for his supper. At that he said, “I used to sing in the choir”, to which I said, “Well then, what would you like to sing?” The answer was Ave Maria! He started singing in a beautiful, old 95-year-old voice, and sang well into the evening, changing over to love songs. I believe all of us, patients and all, had our hearts well warmed.
Until later.