The first thing I wanted to know when I saw my placement allocation was what on earth being on a ‘surgical ward’ might entail. I had a vague idea that patients would be awaiting/returning from surgeries, but beyond that…
What kind of things would I get to see/do?
What sort of nursing goes on?
What is the day-to-day like?
In this series of posts, I will briefly describe the kind of activities I encountered on each of my placements so far. Although all hospitals will have slightly different setups and slightly different ways of doing things, hopefully this will give you a better mental image of what you will be walking into on your first placement day.
[NB! Also be aware that a bed is sometimes just a bed – a male ward may end up with female patients in the side rooms or you may get a patient who has a completely different condition to the rest of the patients on the ward as they are simply awaiting a bed being freed up on a more appropriate ward. Be prepared for anything!]
Male Surgical Ward:
The ward may or may not have a specialism. My ward dealt primarily with gastroenterology. Anyone needing surgery related to their liver, gall bladder, small/large intestines, stomach etc. would end up on this ward. We saw plenty of gentlemen who had presented with jaundice. Many of our patients had some form of cancer and were either soon to have or had already had radiotherapy and/or chemotherapy.
It was a 21 bed ward and three nurses (band 5/6) would regularly have seven patients each. There would also be two to three health care assistants per shift. During the day there would be a fourth nurse (band 5/6) designated ‘coordinator’ and a fifth nurse (band 6/7) in charge of the unit. The three nurses on beds would attend to patients, the coordinator would -among other things – follow the medical team during their patient rounds and take notes and help out the bed nurses with tasks when necessary. The nurse in charge would primarily remain in the office and complete paperwork.
The early shift began at 07:30 with a handover that took roughly 30 minutes. Nurses from the night shift would discuss each patient in turn and highlight any relevant information such as changes in medication or reviews that needed to be done. Once handover was finished, the nurses would start by doing a set of physical observations (blood pressure etc) on each of the patients and getting prepared for any morning medications that needed to be administered. Both the nurses and health care assistants would try to get as many patients as possible sat out in a chair to eat their breakfast. This helped with the next task which was changing bed sheets and helping the patient with a wash.
You’d be surprised how long administering medication and helping a patient with their wash can take. Some have numerous medications including creams, eye drops, nebulisers, liquids, pills, patches and they may need the assistance of two to three people to wash if they are bedbound. Once ‘meds’ and ‘washes’ were completed, the day consisted of doing any other tasks that were scheduled, for example, redressing wounds, removal/insertion of peripheral cannulae, giving prescribed IV fluids, monitoring drains, meal times (including any nasogastric or parenteral feeding regimes), stoma bag assistance, more obs, completing risk assessments and nursing notes.
On a ward there is also a great deal of patient admittance and discharge home to contend with during the day. When a patient arrives you will have to complete the admission paperwork and when they leave you have to ensure their ‘to take out’ medications or TTOs are ready, they have been properly referred to the district nursing team, the ambulance or their relatives have been called to escort them home, their belongings are all collected and accounted for and that their ‘package of care’ if applicable is active. [A package of care (POC) usually refers to the healthcare assistant visits individuals can receive to support them at home. Currently the maximum is four visits per day of up to two healthcare assistants each visit.]
Again, every ward is slightly different, but in general, these are the kinds of activities that will be going on around you. Be sure to get involved as much as possible!