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Please refer to my disclaimer before reading any of my Nurse Boo categorised posts
As I touched on in part one – my experience in the Theatre admissions unit confirmed my initial thoughts about the direction I would like to go in my nursing journey. I was lucky to have my first placement and my longest placement in a place that I really wanted to be. In three months, there I experienced so much, it was my first taste of hospital life and it was a nice introduction, not being ward based and patients coming in for elective surgery, so they are mostly not severely ill, they are coming in for non-emergency procedures, including hernias, urology procedures, teeth extractions, eye surgery and various ENT procedures ranging from simple manipulation under anaesthetic or more complex Rhinoplasty. Then there are the bigger procedures requiring overnight and/or extended stays with orthopaedic surgery ranging from bunions to total knee replacements, higher risk procedures like laparoscopic cholecystectomy (gall bladder removal) Then there were also breast patients, so you are dealing with highly sensitive cancer patients who are often about to lose a breast and I feel those patients teach you a lot about gratitude and compassion, perhaps more than any of the others. So, a great start to learn a lot about a big range of conditions and ailments. There are no drug rounds, no night shifts, no weekend work, but nevertheless such a broad range of aspects to learn and experience.
During the three months, I rotated around the unit allowing me to experiences the entire ‘patient journey’. Firstly there is pre-assessment, that appointment you wait ages for the letter for and then it comes and it suddenly all starts to feel real, you rock up to that appointment slightly nervous, probably having a long wait because your appointment is just a time slot rather than an actual time and you are often unsure what you should tell them and what is not really relevant – I had a bead stuck up my nose as a child – does that count as a previous surgical procedure for example, or will I just amuse the nurse with it? I will have to admit that I found my stint in pre-assessment pretty boring an uninspiring – nice hours and nice staff, nothing to complex if you are looking for an easy life? But, having said that, when you then work in other areas within the unit you come to see the value of the information collection at pre-assessment more and more, and the job the person in pre-assessment has done on completing a details assessment impacts everyone else down the line in the patient journey (because some do it great and some do it badly!) You use that information and the tests performed at that appointment to help you admit the patient, be able to assess any risks and to be able to understand your patient better, you use it again in theatre and again in recovery. It is almost like your patient’s manual.
Pre-assessment taught me how to perform and ECG and take MRSA swabs for the first time and also do basic measurements like height, weight and calculating BMI. All straightforward and become very repetitive but are very basic things that you have to have in your repertoire, and things that I will use over and over again throughout my career. The best thing about pre-assessment was hands down the amazing Health Care Assistants who work there and how they all supported me and made me laugh. On day one when they were asking my back story I began to tell them and one of them jumped in and it turns out that her and her friend had come for tea and cakes to bake-a-boo – strange small world we live in. She was younger than me by probably a fair bit, but she knew her stuff and also knew how to stand her ground, I picked up many words of wisdom from *Martina, even though on the first day when she asked me to do something and I asked (probably in a slightly flappy way) – if could I watch her do it first, for the simple reason that I had never done it before and this was all so bloody new to me. I guess she misconstrued that as I was busy doing something else and therefore couldn’t complete her task. She looked at me sternly and said “If you wanna be a nurse you are going to have to learn to multi-task” – now I can’t lie I was slightly taken aback – without wanting the words ‘do you know how I am???’ to enter my head I was a little bit like – sweetheart I ran a business for 10 years, and have been in far more stressful situations than weighing an height measuring a few patients, for many MANY more years than you – I’m perfectly capable of multi-tasking!! Of course I didn’t act on my inner monologue and horror and instead swallowed my words and accepted the situation for what it was – that’s how she saw the situation and me and I wasn’t in a position to tell her otherwise – I may have life experience, but I don’t have hospital experience, and this kind of scenario is clearly going to play out several times in several different ways for as long as I am the student, or the bank HCA or the new nurse or even if I make it to matron – I’ll still be below someone and someone will always think I could or should be doing better.
Admittedly I went home narked by that comment that day, but this was so very early on in my experience and I continued to work with *Martina, not just in pre-assessment but in other departments and I came to have a great respect for her, and I felt that she very intentionally set that harsher stance with me from the beginning for my own good. She didn’t bubble wrap me, she told me things how they were and pushed me to do things even when my face clearly said I didn’t want to – and in hindsight I really appreciate her pushes. She smirked at me when I said I didn’t know how to do something and she probably unknowingly helped me to be better with those smirks. She has a sarcastic and abrupt charm, but she was good at her job and worked hard. She always said that how well a day goes at work is not about what’s happening or the work load, it’s the people you are working with and how good a team you are, and she is absolutely right about that.
I saw softer sides to *Martina throughout my time in the department and when I returned after some time away she greeted me with a huge hug and said I had become part of the furniture. She also went out of her way to photocopy some of the patient feedback forms where patients had specifically mentioned my name in their positive comments – she said – I know this will be good for your book and I wanted you to see them anyway. That made me feel like I had got Martina’s approval and her harshness was really only to push me to the limits she knew I had in me to stretch. I know she wants to go on to do her nursing and I really hope she succeeds.
So all in all I heard and saw a lot in pre-assessment and heard the same questions asked over and over again but came to understand to value and importance of a patients back story and vitals. It was the most I got to sit down throughout all my placements so that’s a bonus, it was where I felt most stupid because it was all so new and as well as the Martina comment I got my coat and all my belongings locked in a cupboard on day one and the senior nurse who had to help me find the key-holder was NOT amused! But I know when I moved to pre-op I appreciated the efficiency of how well a patient had been pre-assessed…..
….Next time – Pre-op theatre admissions……
Image by wokandapix
Affectionately known as Boo to my friends, I opened bake-a-boo in 2006 and after 10 years of making cake dreams come true, hosting fabulous tea parties and releasing a cookbook I have now closed the doors of the tea room. Plagued with severe endometriosis and several food allergies I’m turning all the bad into something good and after being a great patient, I’m now training to hopefully become a ‘great’ nurse! Here I’m sharing my journey, and talking health, my inspirations and life after bake-a-boo…..and of course CAKE! You can take the girl out of the cake shop but you can’t take the cake shop out of the girl so find out here how I can still help you with cakes and treats and parties galore x