"Philosophical rhetoric when not grounded in reality is nowt but sophistry of the most facile variety." - DeeDee Ramona
You are currently browsing the monthly archive for May 2007.
Here is one version of a conversation:
Daughter: How has my dear frail sweet natured mother been getting on ? Did she sleep well last night ?
Mental Nurse: Oh fine. She is lovely. A little bit unwilling to go to bed last night, we convinced her in the end though. A little bit out of sorts in the morning, maybe from not getting the best nights sleep possible.Daughter: That is good. She always was a bit stubborn.
Mental Nurse: She is a strong minded lady.
There is another hidden conversation.
But there was the issue that previously, before the Korsakoff’s and the brain injury, he apparently had a conviction for a sex offence.
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Similar to my previous post, we are not collaborative with patients that want to have the freedom to smoke, we are not collaborative with those clients who want to sleep all day and wake at night, we don’t tend to be accommodating and collaborative with patients who like to sleep until midday, as it doesn’t fit with our view of what is deemed acceptable. we might collaborate with them in terms of sitting with them and writing a care plan, but is that care plan a product of what we want it to look like, or do we really write what the patient thinks is important, and in their own language.
Just to recap on previous events I’m now in the final phase of the nursing degree, known as the “management placement”. This involves 12 weeks on a ward where I’m expected to run around acting as the nurse-in-charge. This is to jolt the lazy-arse student who stands around picking his nose into the role of a busy staff nurse, running around dealing with all that takes place on a hectic psychiatric ward.
My ward manager has been piling work onto me as part of this. I arrive on shift at 7.30am; the nurses and support workers need to be allocated to various patients, there’s a pile of full sharps boxes cluttering up the office, there’s a great big heap of old furniture cluttering up the wall outside the ward and attracting vermin, there’s a patient who is heading off on overnight leave at 11am and although the psychiatrist filled out his medication chart to request meds to take home, the med chart wasn’t taken to pharmacy and the patient can’t leave until he’s got his supply of meds. Oh, and all these have to be sorted by 9.30am because that’s when I’m supposed to be heading into the ward round.
Here’s how I got on:
On the wards among the nurses, there is a similar gift economy in action. However, instead of circulating necklaces made of seashells, the commodity is pens.
Well, it looks like I stirred up a bit of a hornet’s nest with Dr Crippen and co. Slip a truth serum into my tea and bourbon biscuits and I might be forced to admit that the nest-stirring effect wasn’t entirely unintentional on my part. Give ‘em enough rope etc.
Still, a day on, I feel it’s now time to munch on a bourbon and reflect on yesterday’s blogfight. Here’s my observations.
1. The argument over on NHS Blog Doc has pretty much settled into the usual screaming match between doctors and nurses over nurse specialists/practitioners/consultants. The usual arguments are being wheeled out. Doctors aren’t good communicators, nurses aren’t intelligent enough, yadda yadda yadda. This argument will probably continue for some time, and probably all be repeated again verbatim next week.
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Thank you for all the wonderful things you do for me. Without you I would not get paid, have a job or have the pleasure of working with some of the best nurses I have ever met. I love you all, dearly. After many years nursing I am almost convinced that not all of you are idiots all the time.
I do have some questions though.
The current array of advanced nursing roles - clinical nurse specialists, nurse practitioners, consultant nurses - are a frequent target of Dr Crippen aka NHS Blog Doctor. He accuses them of replacing doctors, of “dumbing down” healthcare, of taking nurses away from patient care, pretty much of being representative of just about everything that’s wrong with the NHS. His opinion matters, because he’s the most popular British medical blogger out there. His castigation of the “nurse quacktitioners” has been echoed by other blogging doctors, such as Shiny Happy Person and Dr Rant.
So, nurse specialists and nurse practitioners. They’re useless, they’re destroying the NHS and all doctors hate their guts. Right?
You don’t currently see all that many of these roles in psychiatry (though there seems to be an increasing amount of nurse therapists delivering CBT interventions) so I took advantage of a sojourn over to the world of “proper” medicine and nursing to find out more.
A sneak peak at the ICD11 and DSMV.
We will start with something easy. Major and Minor Tranquilisers.
Help Noreena Hertz get every premiership footballer to give up a day’s wages for our nurses by the last day of the season.
The money raised will go into a hardship fund for nurses.
The awareness raised will hopefully make the government give nurses their due.
This is a 12 week placement in which the student nurse starts to take on more and more of the responsibilities of a staff nurse - acting as nurse-in-charge of the ward, delegating tasks to HCAs, organising rotas and so on.
The initial shock is pretty jarring, as you start to realise you’re not in the relatively cushy life of a student nurse any more. Which of the arcane forms of the Mental Health Act have got to be completed correctly unless you want the Mental Health Act Office to ring you up and start screaming at you? How do you organise the rota so that all the requests are taken care of and the HCAs don’t start screaming at you? If you have to send a HCA off on a patient escort, have you left enough staff on the ward? It’s a juggling act.
I learned a salutory lesson the other day about the Mental Health Act, and relations between doctors, nurses and managers.
azazel : Hi..I stopped lurking and decided to join :-). In my first year of training now and going to a PICU for my next placement. What can I expect ?
azulinebloo : That sounds unusual for a 1st year. I am in 2nd year and we can do PICU as an elective (I think) but that’s it. Good luck anyway azazel.
oldschoolbaby : Azazel, PICU nurses are all lazy and spend their days playing games on their mobile phones. A few of them are good looking thgough. Take it as you find it.
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