Saturday, 21 December 2013

36 hours. 3 shifts. 3 nights.

Sorry guys, prepare yourself for an extremely long post but I promise it ends with a bang (almost literally). 

My first nights on this ward were… exhausting, eventful and eye-opening. Don't get me wrong, they don't have to be that bad and actually the work load is much much lighter than the days but throw in a few difficult patients and suddenly the will to live is sapped out of you.

Night 1 :
I have Charlie (one of my favourite staff nurses) and a student nurse working with me. This first night really showcases how good a shift can be if you have staff of real excellence to work with. I make the tea's, I hand them out, I clear up, I do the toilet checks and care rounds, and then I make a brew and do nothing from 11pm-5am. May be change the bins, obs on any new admissions, keeping the care rounds up to date and a tiny bit of filing here and there - and that's the work bit of it done, aside answering buzzers. 
So the next 6 hours consist of the 3 of us behind the nurses station having a really good ol' laugh and natter and because it's Charlie, I end up crying in hysterics more than once. Every story she tells makes my insides hurt from laughing so much. 
When we got a little bored we'd have a little fun. One of my favourites that night was using the CCTV to our advantage. When someone walks through the corridor by our ward entrance, we can see it on the CCTV. There is a little speaker phone thing for when people buzz the ward, state who they're here to see or whatever and we buzz the door open, and more than once, when security passed or something, we'd pick up the speaker phone and just whisper, "We can seeeeeeeeeee you. Put that phone away. Your hair could do with a wash," and watch them panic and look all around before realising it was us and we'd be in absolute pieces. It's like staying up with you friends after a night out and just laughing and talking till the late hours of the morning. Didn't even bother having a break. [It is worth mentioning here that  I am on the lightest end of the ward.]
From 5am, do the pre-breakfast checks, clear all that stuff away, get the breakfast on. Hand out breakfast, and then it's time to go home.

After that, I really felt like I could do night shifts forever. 

Night 2:

I knew I was going to miss Charlie. I always do after working with her - I really enjoy watching and working with people who are good at what they do... and Charlie is phenomenal. I cannot sing this woman's praise enough. Basically, I wannabe her. Anyway, if the first night had me sailing through the sky, the second night was me crashing right back down to rock bottom of the ocean. 
I was put on the heaviest end of the ward. I was working with a nurse I have never worked with before (she was perfectly nice, although could have been friendlier) and 2 agency staff to special a 4 bedded bay. It was hell all because of 1 patient, only having slept 3 hours in the day and not knowing many of the staff that were on making it quite lonely. There was no chatting till 5am in hilarity this time.
Some people say, that they couldn't possibly do my job, which I understand because it can be tough in many ways. But most of the time it is actually the easiest thing to do in the world so long as you are a caring person. My theory behind this is that if you are a caring person, you naturally want to look after people who need your help. Thus as a HCA, I am doing nothing more than what comes naturally to me in looking after people who are genuinely grateful for my time and care. The difficulty then, is looking after people that don't give a flying fuck, either about you, other people - be it staff or patient, or even themselves. Caring for nice patients is easy. Caring for irascible, demanding, and down right disrespectful patients, is not. 
All it takes is one of those patients to make or break your shift. My agency staff were done. 1 was ready to walk by 3am. The other was on the verge of tears. They told me that they've been doing this job for years, and they've never met a man like it, that they did not sign up to this, and they have had enough. I understood them completely but then I really surprised myself. I stepped up. I got that wandering patient's backside back into bed, had a few very stern words with him and got him to settle down and actually go to sleep for a few hours much to everyone's relief. Pat on the back I say.
It was a very tough shift. I was not pleased to be coming back later that day.

Night 3:

I was actually quite well - rested for this shift having come home, (after sleeping on the bus) gone straight to bed and slept for 7 hours unlike the previous day. I was at the heavy end of the ward again, but we had 3 agency, myself, and same staff nurse. However - and this is a big un', there were some of my favourite staff also on the ward, just on the opp end, and this makes a huge difference. The pain-in-the-backside patient was being much better well behaved, and the agency staff were able to handle the bay much better this time. By 11pm, checks had been done, care rounds done, teas done, obs done, we were on a home run. One of the patients, we were told needed specialing, was a wanderer, but so far had been fine. Occupying himself just sitting down amidst his own thoughts. He didn't want to get into bed, drank his coffee, made conversation whenever i popped my head in, although rather absurdly got confused and put his oxygen up to 10L but we brought it back down, and seemed perfectly fine. Rang his daughters from his mobile when he got a bit bored, all was well until he started getting a bit agitated. 

He suddenly wouldn't allow the agency nurse into the room. He strongly held the door shut with his whole body after pulling his cannula out. He was very confusedly saying we had been bribed, that he would be ringing the police etc. He definitely seemed to be using his mobile with his free hand to make phone calls. Staff Nurse made us pull up a chair next to the room, and as long as he wasn't harming himself or others, let him get on with blocking himself in, hopefully to get tired and go to bed. 
After an hour or so, he still wouldn't let anyone in, everyone had tried, so we got the nurse in charge to have a try.
"Hallo mate! Let us in would ya?" She said, big grin, happy face - what was not to love?
"No. You've taken someones money. I saw it happen. What do you want from me?" He shouted through the door.
"Just want to make sure your OK! I won't stay if you don't want me too, but I promise it'll just be me!" She said happily.
"NO. I want the police. Give me police's number. I don't have any money to give you!" He shouted again.
"That's alright, I don't want your money. Let me in, and we can just chat?" sweetly said - I think if she ever approached me, she was so nice and happy-faced, I would give her my house and soul if she asked.
Then suddenly, the fire alarm went off. Doors shut. Our light was flashing. Where the fuck was it? Nurse in charge ran to the fire box. Bed 30. OUR bed 30. We glanced into the confused patients room, his room was filling up with smoke, fast. Was his oxygen on too? He managed to whack it up once, was it on again? Were we about to blow up? Me and Aide who had been watching from the sidelines, barged the door open with a few forceful shoulder pushes. Staff Nurse ran in, to see where the fire was whilst Patient 30 made a run for it knocking everything out the way. Aide runs after him. 
"Get me some fucking water!" Staff Nurse yelled in Bed 30's side room having clocked there were several papers and the curtain was on fucking fire. Before I could even grab a jug, Aide tips the patients jug of water onto it and put it out. "SECURITY! WHERE THE HELL IS SECURITY?" Came shouts from somewhere or other.
Next thing I know, i've got half a dozen Band 7 Nurses on the ward, security have managed to drag the patient back to this side of the ward, three firemen have arrived, the fire alarm is still wailing waking the rest of the ward, and the patient has a lighter in one hand and is on the phone in the other.
Eventually his wife and son in law arrive, (the rest of the family unwilling too come in) where it becomes very clear that this man should be on a psych ward. Lots of other interesting patient history no-one was aware of came to light. The Popo did ring the ward to double check what was going on, and make sure we weren't taking the piss, but it was a mad few hours. All of that before 0230.


All in all, if you have staff you know and like on, it can be a really easy shift, but going on this week - or the past 2 nights, I hate it. On the other hand, if the patients are difficult, extremely poorly, or don't have anyone you really know on, it can be quite lonely and challenging. The workload isn't exhausting, but trying to adjust your sleeping pattern is. It's surreal having all of your shifts together anyway, but having 3 nights together, where you go home and come back on the same day is proper mind fuckery (to use the technical term). 

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