So, I spent much of the week with this vague intention that I’d make a post. It started early in the week when, as one of the nurses trained to take the head during log rolls (having done the trauma course), I put gloves and an apron on and we log-rolled this chap to get him into our CT scanner. Then back again to get him off. Halfway down the corridor he vomited.
Now, when you’re in 3 point immobilisation vomiting is a bad thing. I grabbed the suction from the bottom of the trolley, and found that it was disconnected in three places. Finally I got it working, but thankfully the individual in question had managed not to inhale the vomit. And we trundled back to A&E, where he felt better. Unfortunately a little while later he did it again, this time I was in the right place, at the right time and whacked the head of the bed down, this prevents someone inhaling their vomit, but is also fairly horrendous for them. Suction and back to level he went.
Finally, the spinal bed arrived and we prepared to send him to the ward. I stuck on gloves again and put my arms either side of his head, coating them in vomit. And then we spent a happy 20 minutes sorting out lacerations to his scalp (mmm, mixed vomit and blood all up my arms) and rolling him back and forth as people failed to make decisions about what we were going to do.
Finally we got him on the bed. The interesting outcome to this is that the next day, on the ward round, having reviewed his Xrays and noted his C2 (C2 is one of the bones at the very top of the spine) fracture, the consultant took off the three point immobilisation asked him to move his head side to side and pronounced him fit to go home.
I spent about 20 minutes trying to make myself feel clean again…
Having dealt with people who really are sick, we moved on to far too much of people being abused. I spent a lot of time dealing with social services, or thinking about ringing social services, and having discussions with people about the fact that I’d be ringing social services. I did my best to repair a very nice woman’s face after her partner took a dislike to it. I did a mound of documentation on an older person who’s husband has ‘been a bit of a sod’. The bruises on her arms and legs a testament to his unpleasant nature.
While the nights themselves were much better in numbers of people than most of our night shifts of late, and we avoided having any of the hideous snow-related trauma I expected to get, we did seem to get more than our normal level of abused people.
Or maybe it just felt that way to me.
Of course, it’s a funny situation you’re in, as an A&E nurse, with these insights into people’s lives. They let you in a little, and you catch a glimpse of the pain, and then they’re gone.
On the other hand, we did, of course have our usual fleet of ‘I’ve not registered at a doctor because I’ve not needed one’*. Of 2 and 3 month histories of problem X (painful arm/hand/leg/nose/thought process) which is now worse, but has never been investigated. You sit there at 2am and think: Surely there’s something better you could be doing, like, for example, SLEEPING. WHY ARE YOU HERE?!
For some reason I had no patience for that last week. I was doling out the ‘this is not an accident, nor an emergency; we will see you here, but it’s not an appropriate use of the service and you need to see/register with your GP’ lecture to virtually every patient who walked through the door.
Anyhow, on with ILS.
*The corollary to this is, of course, well you need one now.