Friday, 26 July 2013

How loud can you ask if they want tea / coffee

These past 2 days / shifts have been exhausting, and yet I'm almost looking forward to my next one. Working on the wards has been a completely refreshing experience, re-instigated my drive to apply for medicine, and also a complete laugh. My first shift I arrive, looking for An who is another HCA and is going to show me the ropes on how to do things.

First thing is the handover - as a HCA, nearly everything the handover nurse is saying is irrelevant to me. What I want to know is how much assistance the patient needs, whether they have a catheter, are they able to sit / stand, have they opened their bowels last night, are they on a fluid balance chart, etc. This is all stuff that you'd know if you knew the patient, or you'll find out when you first meet them. I.E. Check the chart etc. So when the Nurse is talking about this drug and that drug, I can switch off An assures me.

Then, we serve breakfast.
"Morning TOM! Would you like a HOT DRINK?" An asks the first patient.
"Eh? Can't hear ya love," comes the slow, quizzical reply.
"HOT DRINK. TEA? COFFEE?" An yells again, motioning with her hands the movement of drinking from a cup. A couple of other patients look over.
"Are you speaking French?" Tom asks, utterly convinced.
An sighs. A few patients giggle. D (fellow HCA) comes over. Plonks a cup of coffee and a cup of tea in front of him waving sachets of sugar.
Suddenly Tom gets it - "Oh! Tea please! Why didn't you just ask?"
And I am in hysterics - this would be the first time of many to come over the next few hours.

We, the HCA's as a team go around the different bays serving cereal, toast, tea. More than a few patient ask for things that aren't on the menu. "How kind of you to ask, I'll have a full English please. Warm sausages and all,"Alan replies with a twinkle in his eye (he becomes my first favourite patient). "Yeah - whisky would be great," - says Ken. And it's nice because we get to banter with the patients, have a laugh and get them a decent breakfast.

Next An makes me and her a cup of tea of our own. "Follow me," and she winks. We go to the non-clinical store cupboard. "Now this, is the most important room of the ward," she says. I look around and it really doesn't look like it. She puts our cup of tea on the shelves. "We're not really allowed to be seen drinking on the ward. So we hide in here - the manager hates it though...anyway, I really needed this..." she takes a sip from the cup, and does the "Oooh," of relief. I nod sincerely, and gulp mine down. We hear a knock on the cupboard door, my eyes widen - I don't want to be caught on the first day.
D barges in with her own cuppa. "That was the secret knock by the way," leaning back against the wall.
Let me tell you, this storage cupboard is not bigger than 2 square metres at the most, packed with loads of things patient needs. Me and An soon feel we are out of oxygen and have to step out.

Next I am shown how to empty catheters and wash patients. We have a breakfast break for half an hour - me, al, an and Ram, all in the staff room jokes flying quicker than I can bite into a biscuit. At one point, I am crying in hysterics. "I am glad Z (manager) isn't in today anyway," Ram says rolling her eyes, "I was dreading having to tell him I'm not fasting today,"
"Why?" I ask
"Because last time, he sat me down and asked me if I was pregnant - do I look PREGNANT?" She points to her stick thin frame. "And then I had to tell him I was on my period, and he was all, oh so now you can eat...drink...and you know and then he raised his eyebrows to say sex..."
"Oh Z!" Say both al and an in unison laughing.
I am both shocked and laughing my head off.
Ram catches this, "Oh yeah he's always like that. He's like one of us ladies, so laidback and is all about cracking jokes..."

I wash my first patient on my own, (Tom actually - others were in fits of giggles listening to me trying to communicate clearly so he could hear me) and feel success. It is weird at first; one minute I'm just girl serving beer at a cricket match, the next I've seen more penises than a big time hooker. And there's no room to be cowardly here, you have to do the best you can for that patient. No-one else is going to clean them, or make sure that they're not sitting in their own faeces. No-one else is going to make sure that they're not getting sore from the pressure on their bottom, and apply cream to help. No-one else is going check for pressure ulcers on the heel of their foot. It's all down to you, and so you suck it up, get that clean wipe, and make sure they're backside is cleaner than a sharks tooth, and their penis hasn't twisted the catheter around and is still in a normal place. I feel privileged to be in such a position of responsibility for these patients.

After that you just get on with it. Some patients are independant, some patients need help getting to the shower, some patients need you to wash them. You adapt as you go, make their beds, and feel accomplished when your bay is done, and all your men are looking smart, shaved, and clean. Then pop back round with the drinks trolley, asking if anyone needs tea/coffee. I came across my first patient that soiled themselves too - that was difficult. An was there obviously, I helped roll him but she did all the major wiping off all the poo. Poor guy. This guy needed all care, and was pretty much bed bound and all we could do to help was make him as comfortable as possible. He was in a side room too, so didn't interact with anyone but staff.

We also saw to John too, to make sure he was OK, if he wanted his bed to change position. He was aggressive, telling us to piss off and get out. And we would have, but the fellow was choking on his own mucus. "I'll be out as soon as I can clear your throat for you!" An said readying the suction, but he wasn't having any of it. "NO! I don't want it!" Said John from what I could make out under the bubbling of his mucus in the chest. I was about to gag, that sound was just too much. I didn't want to look unproffessional so I tried my best to hold strong, look down, and assure John that we'd be real quick. "NO!" He said, with a slightly different choice of words. The bubbling of mucus in the way of his throat got too much, and I had to step out before I threw up. Yes, it was unprofessional - but I think throwing up in this infected guys room would have been more so. An stayed a bit longer trying to bargain with him, "You'll feel so much better if you let me try?" but eventually even she retired.

I'll leave you with my final thoughts: It's difficult because we didn't act in the best way for the patient, but the patient didn't want it any other way. He's never had anyone visit him either and hospitals can be lonely scary places.

So these past 2 days:

  • I have had to look at faeces and determine the consistency of it to write in the notes.
  • Sometimes in the concentration of making sure some guys catheter hasn't twisted his penis around, you get a bit too close...
  • I am now a frequent weigher of urine
  • I am 4 pounds heavier than I thought according to the patient weighing seat thing
  • Alan got his full English breakfast as a treat one morning
  • It's such an awesome feeling when you get praised for your can-do, just-go-for-it attitude by staff and patients
  • I get my kicks out of pausing at a patient's bedside to have a chat. Most like to talk about their children, the pride beaming off them. Contrary to this, you get good at talking about anything - me and paul had an in-depth discussion as to who's smartphone was better. 
  • D once got poo in her hair when a patient released wind a bit too vigilantly
  • I am assured frequently by agency staff that have worked everywhere, nurses that have come from other hospitals/wards - that this is the best ward, and is unique in that all the nurses and HCA's work together and have a really good laugh.

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