Day Case VS In Patient

During my time in practice I’ve had experience of both settings and have heard such mixed reactions from other students who’ve done the same which got me thinking about the pro’s and con’s of both dynamics and why they can bring out such different opinions.

For a student nurse the prospect of both day case and an in-patient ward can be really daunting, especially if it’s your first placement. My first patient on my first day on my first ward told me as I performed my very first ANTT procedure that today she was “celebrating” her 100th day on the ward. This was frankly quite intimidating to me. It might sound odd because she wasn’t staff or a professional but I thought; “She must really know the lay of the land around here”. In fact she was one of many “frequent flyers” of my GI ward, chronic illnesses such as Crohn’s disease or Ulcerative Colitis can see multiple admissions a year for some patients so this gives staff a real opportunity to build some long-standing relationships with their patients. I grew to become really fond of some of our patients, many of which I believe I will never forget.

One should never become biased towards one patient or another and give preferential treatment so it’s important to keep yourself at arms length emotionally. But you do find yourself saying goodbye to patients at the end of a shift and really hoping and praying when you get back next week they’re still there, which unfortunately isn’t always the case.

This close patient-nurse relationship, however, in day case, must be formed in a far shorter time frame. Everything moves a bit faster in day case. I would see up to 40 patients a day and I had to be able to hold the same amount of information about each case in my head as when I had more or less the same 28 patients for weeks. This doesn’t suit everyone. The hastiness of hello and goodbye without being able to really get to grips with the patient holistically and the quick turnover and often the lack of full closure have been reasons my peers have said day case isn’t for them. It’s often the case with day case that just as you feel you’ve got to know a patient, you’re going through their discharge forms.

This is also the joy of Day case though! You’ll never know who you’ll be admitting next, the stories they’ll tell you or how much they’ll depend on you. This is why I loved day case. As one patient leaves and thanks you for all you’ve done for them the next is through the door nervous, scared and you’re the face they can rely on from admission to discharge. I loved having such an impact on that person’s experience and care.

When the patient you’ve seen on and off for 3 months leaves they’ll know a lot more about you and you about them but you’re one of the dozens of faces they’ve seen whilst they’ve been in. When the patient who’s been in for a day comes to leave, they know your name, your face and everything you’ve done for them the whole time they’ve been under your care and that “Thank you” I found to be the most rewarding of all.

For more information on Crohns and Colitis:

http://www.crohnsandcolitis.org.uk

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