And there endeth my nights

Well you may all be very disappointed to know that I didn't end up writing an incident report. The night after "the incident" I decided I would do it when I got time. That night I did five admission as well as all the usual ward stuff, and at about 7ish when I got a bit of a break, I didn't have the energy or the care-factor anymore. Although every time i went to the particular ward she had worked on the nurse who was her boss was very quiet and avoident of me.

By the next night I was just bored of the whole thing. I didn't work that hard, but at about 6.30 in the morning one of my pts had a code called on them/ By the time I got there the nurses were bagging and masking and doing CPR and the patient had a pulse and had resumed trying to breathe on his own. Then everyone pretty much arrived at the same time so I spent the next hour and a half watching/vaguely helping the med reg, ICU reg, anaesthetic reg, emergency reg and all the other various people doing various things to the patient (like putting them under and tubing them). I think I mostly did things like take blood gasses, check blood results, get cotton balls, get blood tubes, write up xray forms for CT brain and chest xray, swear when I saw that their blood gas showed their pH was 7.01 and lactate was 10 (although that may have been elevated from the nurse giving the pt CPR before I arrived). The funniest part of the code (if there can be a funny part) was when the ICU reg was arranging to tube the patient and one of the administration type nurses said "do you really think you should tube them if there's not an ICU bed available?". Honestly people!!!! Intubating a patient is a clinical decision based on if the patient can breathe adequately on their own or not, not one you decide based on bed availability! The patient was intubated and transferred to recovery in theatre (because there were no ICU beds). Not really the way I hoped to end my week of nights, and certainly not the way that patient probably hoped his post-op recovery period would go for his elective surgery.

Things that happened in my week of nights: one of my patients stopped breathing and had to have CPR and be tubed and transferred to theatre recovery because there were no ICU beds. A patient went into rapid AF because they hadn't had their regular meds written up for them when they came into hospital (because they were taken from emerg to theatre and never had an admission done) and I had to dig load them. I tend to check pts electrolytes before writing up fluids, and two pts who I did that on hadn't had bloods recently, so I wrote them up path slips, they both ended up needing a blood tranfusion because their Hb was less then 80. I cut one ladies backslab off because her hand was swelling up and watched all the veins in her arm fill up as I cut away at the cotton underneath the plaster (I guess it was just a little too tight). Some young guy did an awesome tib-fib fracture that I wished I'd copied the xray and brought it home with me to put on the net - his fibula was in nearly three equal pieces and the middle piece was at an angle to the other two pieces, and the tibia was fractured right through the middle displaced anteriorly and the sharp shard of the bone was only just not breaking the skin, it was right there underneath it (young people - do not play basketball, it is a dangerous sport). One man had to be held down while I put an IV in because he gave me crazy eyes and has a history of hitting the nurses, and he was really angry at me - until I had trouble putting the IV in and was swearing under my breath - then he started laughing at me as I had to try again to put the IV in. One of the patients in short stay unit in emergency (which surg night cover also has to cover) went psychotic and started stealing the other patients stuff and behaving all paranoid - she was 80 and didn't speak english at all (she told one of the nurses who spoke her language she didn't trust us and would only take medicine if her family were here, and that we were always watching her etc). I guess there were lots of other stuff too.

The worst thing was when I was in emergency I saw the most awful, classic, child abuse xray of a little 5 month old baby, with various rib and arm fractures at different stages of healing:( We were looking at it and the med reg was swearing and we were all just in total disbelief about how awful some people really are. I didn't even see the child and it was still probably the most horrible thing that happened in the week. It reminded me of a song that I'm really quite a geek for even knowing. It's a song by a christian singer called Michael W Smith and the first verse goes "What of the children who have never felt a love, Tender as the morning, Nursing the bruises, And the scars that never seem to go away, What of the babies who have never left the womb, Breathing in the lifeline, Angels in waiting gone, Before they could be given wings to fly, Calling heaven, Seeking mercy, Tell me there's a place for these"

After my last night, I didn't go to bed, I went out for the day with Matt and his parents who are down here in Brisbane at the moment. I slept in the car while they went to the diggers nursery (which has all heirloom seeds and breed of stuff which is supposed to be better for lots of reasons). Then I had lunch with them and then we went to a winery and did some wine tasting. The lunch was really yummy, kangaroo loin with a rocket salad and some really yummy crunchy potatoes. All the salad stuff was grown at the garden and had been harvested that morning. I was pretty exhausted by the time Matt and I got home, we had a roast pumpkin soup that we'd half prepared the other day when Matt had made some chicken stock. It was delicious. ummm.. I think that's everything.

Oh, Happy Birthday to Steve. It's his birthday today. Apparently he must be planning a fairly wild night out because today he is at a first aid course. People who know him should email him, you know he'll love that:) I can say anything here because I don't think he reads this:) :)