DILP Week 3 – A&E lessons learnt

This last week has absolutely flown by!! I’ve kept myself very busy both in and out of placement which has been tiring but so rewarding!

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Scans following the admission of a lady with drowsiness and weakness following loss of consciousness

I can now run triage efficiently and effectively on my own and have been working with some really great nurses for the last two weeks who have taught me a bit of singhalese in between tasks. Key phrases you need to know as a tourist e.g. What’s your date of birth? What is your pain scoring between 0-10? Etc.

I’ve managed to get all the nurses to ask the patient for pain scores now which is a really vital thing. I only realised they weren’t asking properly when a woman who couldn’t speak with the pain in her abdomen or open her eyes fully had a 5/10 for pain written on her triage documents.. I’m in no way saying this is the only time I’ve come across falsified pain scores, unfortunately. It wasn’t at all rare to see Ward rounding forms where all patients conveniently had a pain score of 0 on my first placement in the UK. It wasn’t the case of course but writing this down meant less paperwork and less hassling the already over worked doctors. So it was sort of left unsaid and when I did rounding a and was accurate with pain scores it was met with a general groan from the staff because they had to chase up altering patients analgesia.

Pain is such a vital symptom to understand – this should be evident by the fact that all of our hospitals have a devoted “Pain Team” of specialist nurses that are like ache whisperers.

Changes in pain, not just the score but the type or the frequency can be the biggest clue you get about what’s going on with your patient and if their records aren’t accurately reflecting this evolution of their pain then we have failed that patient. For example, a headache.

It can be cause my 101 different things but if the patient is complaining of a sharp throbbing headache associated with noise or lights and also has a rash on their abdomen.. This could be meningitis. This patient might require urgent interventions. Equally, they might be having an allergic reaction or be dehydrated. However, without going into the details, we are pretty much running blind.

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This is not where anyone wants to be is it?? 

Literally 3 hours ago as I write this a woman who originally came in suffering from loose stools for 4 days arrested! She started coughing up frothy pink sputum then her heart failed, I was lucky enough to assist in giving chest compressions and ambu-bagging her to keep oxygen pumping around her system.

I had no idea what to expect from the other staff members in such a high-pressure situation but the respect and trust they showed me was pretty moving.

Having the doctors from CCU direct their questions at me about the patient, as a humble Nursing Student, was really empowering. I’m also very pleased to say that the patient’s vitals were stable when she left our care to recover in CCU.

Experiences like that today just remind me how privileged I am to be able to not only be a Nurse but to have this opportunity to travel half way across the world and still be respected, trusted and appreciated for all the hard work I have put into the degree so far. Nursing has always been a great passion of mine and it’s a truly wonderful thing when you can see that that passion exists in Nurses across the world who will work tirelessly next to you for the good of each patient that needs our care.

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