5 posts tagged “ward”

the ward party will be on 6th of August 2008 from 2pm to 5pm at the KTV lounge (blk 6 level 9). AG_NC Mina is getting people to perform, so far there are ballet dancing, indian and malay dance and people singing. everyone attending must dress up in ethnic dresses/ clothes.

on the flip side, those on the evening shift will be unable to attend but i suppose sanna's cooking will somehow still make it to her GI tract by ways and means. =P

(ps- i am willing to change my D to E shift if anyone wants to)

wat a crazy day! so many send for procedure, fetch from procedure...somemore these involve some DIL pts! thankfully HO was nice enough to help past her standard 5pm. =)

GIST finally went to another ward. her suctioning was still drawing dark brownish fluid (aka blood) today, O+ve blood was still pumping into her veins. she looks still so yellowish and seriously ill but her spirits are still up and chirpy. what an amazing lady!

just when rm28 seems settle AM decided to "collapse". full story got to extract from Syida. i only got in after the trolley was pushed to the pt's bedside. amazing enough pt's SPO2 was 100% without bagging and pulse was 108, BP 80+/60+. err...i don't know if that was indeed a collapse. her ecg wasn't too pretty though, seems like she had gone into an AMI. without a DIL status she was placed as max. ward management.

but... today's story's leading "actress" i am to mention is her "neighbour" aka Mdm Deaf. aiyoo... Mdm Deaf was so excited (or nervous leh?) that she kept talking non-stop, LOUDLY some-more!!! when the trolley was pushed in and while we were hooking up the leads, checking this and that, Mdm Deaf was annoucing to the whole world that "inside got someone dying!" and she was LAUGHING! *faint* i think she is really crazy!

hC's family (actually kampong) was there so Mdm Deaf spoke in malay + hokkien regarding pple dying and stuff. but the way she said it was as if she was happy that AM was going to die or something. since things were rather settle in there, i came out and started to serve dinner. i wanted Mdm Deaf to sit on the high chair for dinner but AM's pillows were previously placed there Mdm Deaf shouted "crazy ah you? that pillows belong to that dead person one, you want me to sit there?" ok, so Mdm Deaf had her dinner on the bed. while i tried to tell her that AM was fine, she (Mdm Deaf) insist AM was dying. *faint*

when everything was settled. AM's curtain was opened. Mdm Deaf got even crazier by saying "CB" (sounds like cheese pie) and stuff like that sort. i was thinking inside me "aiyo.. is Mdm Deaf taking over AM's role in sputting vulgarities?!" even Syida got frustrated by Mdm Deaf crazy behaviour!

since my name was under Rm27, i went back there and rooted myself to the chair. but that doesn't stop Mdm Deaf to keep trying to get me to her side. i refused and she walked over! *faint x 10* she said "can i come over to this room, cuz she is going to die. i scare. don't want to sleep there." i ensure her that AM was fine, no problem already. but Mdm Deaf is DEAF mah... so she didn't seem to hear what i said even though i was shouting! *faint x 20* i brought her back to bed and instructed her to stay on bed. but it seems she "wayang" a few more times after that. *faint faint faint* i bet Syida *faint x 50* liao... by the end of the shift. poor her... still need to be i/c tomor.

finally, got the time and the attention span to read the article "recruitment and retention strategies: a magnet hospital prevention model" posted on w53 group vox. interesting topic- talking abt depleting nursing force and how to prevent high turnover rate. i wonder if it was my selective reading or what but i think the report was covering more on retenting than recruitment. but wat the heck lar. i am not very interested in the recruitment part anyway.

1 suggestion that i agree with is the involvement of nurses' input in decision making. our company is already doing that with nurses accompany team on dr round, specialized nurses referals (eg-wound/ breast care/ etc) and i heard that icu nurses are key decision makers in the absence of drs. but... how are nurses using this power given from the top? rather minimum, i think.

most nurses don't proactively express themselves during the dr's round unless asked. when consultants do ask, nurses normally stop short at giving the answer to the question rather than exploring possibilities to improve/ eliminate the problem. those that do are normally seniors staff or NC. can't blame the nurses actually for not being participative. cuz nurses are so busy and often distracted by pt's needs/ calls during dr's round, less experienced nurses are unlikely to be able to come up with suggestions to improve pt's care since they might not know what is available or should be done. for a small fraction, they may not be even interested, they rather take orders and do the just the needful.

so it seems we have 2 broadly grouped pple. 1 the keen to contribute but face difficulties in doing so, another not keen. hmm... given 2 fishes-1 sick and 1 dead, which will the vet try to save? heehee... not need me to say lar.

for those that are keen to contribute group. they have been given the 'power', the opportunity but they may lack the knowledge and perhaps courage? knowledge can be obtained by learning- self learning or structured learning in form of weekly talks, ward-based case-studies, competence checklist, bcls/ CI courses, degree, adv dip, etc. these will give us wonderful head-knowledge but application-wise can we really do it? i can read and research on how to insert a ngt and even practise it on a dummy but come to an actual human can i be 100% sure that i can do it? err.. not really lor.

so.... as much as the need to empower the staff with knowledge, impartation of experiences is important too. i remembered following 1 morning round with the team and NC. the NC taught me things that i had never been taught in classes and books! her mannerism when talking to the consultant (firm but not aggressive neither did she present herself as intimiated) wow!! she was damn cool, in my view. the small suggestions that she gave were impressive! it can be as simple as referring pt to rehab care, doing oral hygiene or even inserting an IDC but it managed to solve the problem, which otherwise the dr may be ordering something else more invasive or troublesome. seeing how and what the NC did, taught me how and what i too should do. learning by observation. that's how experience get imparted.

i was told to be a good coach to someone involving leading the person by the hand into the unknown(to that person lar, not the coach). 1st time, i do and u see(observing). 2nd time, i and u do it together(guiding). 3rd time, u do and i see(assessing). finally....u r ready to do it on ur own! then depending on the needs, reassessment may or may not be needed. of cuz i am not saying literally by the 3rd time the learner will be ready to be on his/her own lar. having a role model/ example to follow is essential.

then the next problem is distraction. call bells and pt/ families calling, requesting for this and that. possible resolutions:

1-more staffing. to settle the outstanding iv meds/ to attend call bells, then the staff following round can really drop everything and concentrate on the following of round.

2-standardise morning round timing. showering/ bath sponging can be done before and after that time. basic toileting needs attended to. resulting in more staff on stand-by to fulfilled pointer 1 and staff following the round will not be struck doing other tasks.

3-practise the "no visitors allowed during round policy" STRICTLY! not just for privacy but to miminize distraction. most of the time its the pt's family calling for this and that rather than the pt lor!

i can understand the family wanting to be updated of the pt's condition. so... the team could explore setting aside a fixed time to see pt's family- eg. 10 to 11am, 3 to 4pm. the pt's family members don't have to come early early at 7 to wait for the dr to come, worrying that they may miss the dr round. neither will the family keep pestering the nurses for pt's update at the most ungodly time - eg, serving meds time!!- knowing for sure that a slot is already allocated for dr to meet the concern family. any adhoc request for updates/ family members can't avail themselves during that slots will be update accordingly over phone or pre-fixed appointment. oh gosh!! imagine the amount of distraction that will be reduced?!?!?!?

of cuz... these are the ideal situations but if we don't dream for the 'impossible' we will never progress beyond our present isn't it? afterall who would had thought of man walking on the moon, if not for the dreamers who think they can make it possible. =)

a frd of mine always remind me never to get too involve in our patient's life. they r patient, u r nurse..FULLSTOP. if not eventually u will get all emotionally drained. i never agree with her reasoning. faith without action is dead. action without love is rubbish! (my theory)

a patient who had somehow weeded her way into my heart was ah heng jie. i no longer call her mdm so and so or miss so and so but simply that. she sort of recongise me but can't remember my name (always one leh!). she is 1 sweet thing. no matter how painful or unwell, she won't mention it or make a fuss. she will only tell, if we ask. and even so she will not demand us to do things. however its her humble and lovable spirit that makes us all want to do something for her. seeing her wither away, makes us sad. yet there was nothing anyone of us can stop it. its the act of nature, so be it.

heng jie recently passed away. i am hoping to visit her for the last time. this time not to ask her if she is in pain or not, not to inform her of the upcoming ngt feeding or iv drip but to whisper a prayer to her. telling her "its alright. its all over now. u will be well, painless and full" how i wish she had knew Christ before she leave. at least i may see her again?

though i am sad that she had left. i somehow wished she would had left earlier. when she was a little more prettier, when she was a little better. then her suffering will had been shorter and her sister less 'depended'. i wish them all well at home. God give them rest ba! =`(

today is sunday, a great day to work esp. in the afternoon shift. generally sunday is slower pace and quieter. that's what i like about sunday. we can get to talk to patients more and do more TNPR (theraptic-nurse-patient-relationship) plus we can arrange the casenotes and blah blah blah blah. today is just one of such sunday, with the rain softy humming at the background. it was just the perfect setting for a peaceful ward's drama setting! heehee...

thanks for people who helped me with some of my work and the reduced in IV drugs ordered we managed to have a happy smooth sailing shift. although there were 2 admission, i didn't get all crazy (CUZ IT WAS CLERKed ONLY @ ~8PM!!) come weekdays, admission will be flooding in again, cuz lots of d/c!! aiyoo...

but 1 thing interesting today... we saw geraldine's mummy. she looks just like her photo!! and and and... i heard geraldine called her mummy "mum....mm...yyy" wow!!! so sweet!!! haha... they must have very very very close mother-child relationship. my crazy brothers nowadays sometime call my mother "yo..boss" guys are weird!!! o_O?!