I've had a couple of interesting shifts. Yesterday was tiring, both emotionally and physically and I came home feeling rather weary. It wasn't a bad day; I learned a lot but it was demanding.
We had a 13 year old epileptic who hadn't had a seizure in 4 years and had been off her medication for a year. She had a seizure on a tube station yesterday. A lovely family, she was very upset and worried that this would be the start of her having regular seizures and needing medication again. Her mother was being optimistic for her, but I knew she was very shaken by the incident. Initially she had thought she was alone on the station which must have been frightening for her, but some passers by stopped to help. Her mother said how nice and friendly we were, and I think they were both feeling much better about things by the time they left the department.
Last week I held a 5 week old baby for a lumbar puncture, I'd only seen one before and it was my first time holding, with another nurse to give me a hand. Last night the last 25 minutes of my shift were spent holding a 4 month old, my first solo hold as the department was pretty busy. It took 3 attempts, the fist 2 by an inexperienced doctor and the 3rd by her supervising doctor. It was physically very demanding to hold the baby in that position for that length of time and the baby was obviously very distressed and it is very difficult to comfort when you're having to wrap your arms around the head/neck and legs/back to hold them in a curved position. Mum wasn't present, and when we handed him back was very understanding and calm which made it easier, but I came away feeling exhausted, physically and mentally.
We had a toddler who had squirted persil washing liquid in her eyes and needed irrigation. That was another interesting one to watch. It involved swaddling the kicking, screaming child and laying her on a bed with her head slightly tipped over the edge, and running 500mls of Normal Saline into her eyes which we needed to prise open. It is incredible how strongly a person cold hold their eyes closed. It isn't painful, but it is unpleasant, the nurse was explaining she'd had to to do it to a doctor recently who had got blood in her eye and she really struggled with it, so it's much harder on a child who is too young to understand and comply.
We had an incredibly brave 9 year old who had fallen off a scooter and hurt his elbow. When he came in it was swollen and deformed. The assessment nurse called me over to ask what I thought, it was kinda like "No.. that's definitely not quite right, something is going on there" but it was hard to precisely explain. After a while it swelled more and became clearer. He ended up having broken his elbow bone, and bother his radius and ulnar and was going to need orthopaedic surgery to fix it.
The other great case we had was a 5 year old who came in with a petechial rash and a purpuric rash, a great example as I had seen neither before. The purpuric rash is the one commonly associated with meningitis. The child had meningitic symptoms but was very well, obviously it couldn't be ruled out so tests were being run for that. Another differential diagnosis was Henoch-Schonlein purpura Henoch-Schonlein Purpura (HSP). Petechial spots are caused by minor bleeding under the skin, broken capillary blood vessels, I have noticed them on myself occasionally after I've been carrying a heavy bag over my shoulder or my wrist, they are sometimes seen on the face after excessive coughing.
Well this has been a bit of a long ramble. One other thing before I finish. In my second year I worked on a respiratory ward and really enjoyed it. I was told at the time that when I was qualified if I wanted a job the Sister would be happy to have me. I spoke to one of the Sisters yesterday who had mentored me at the time and she said she couldn't guarantee anything but thought they were still under their quota for nurses and that I should email the senior sister and let her know I'm still interested. I've done that today, so as the Swedes say I shall be holding my thumbs.
3 comments:
Glad things are still going well. You're experiences sound really interesting. Thanks for sharing them.
I hope things go well with your job application.
holding a baby for a lumbar puncture must take some balls . i'd have been shitting myself
Hey MMW :) I find my days interesting, though I know they aren't to everyone's taste! I come home every night and bore my parents with my day at work!
Mitch: It's funny you say that, at the time I was really calm and although I lacked experience I felt quite confident, especially as the medical staff were supportive. It was later that night when I lay in bed thinking about my day that I freaked out a bit, and had a "Oh my goodness, what if I'd lost grip and the baby moved and the needle went somewhere it shouldn't" moment.
Post a Comment