The work experience thread is here:
http://www.thestudentroom.co.uk/showthread.php?t=3546665 I'll go through my day, from waking to finishing. This is my shift from Monday:
0550: I get up. I cycle to work which takes about 20 minutes and shower once I get there.
0730: Our big handover begins. We receive our safety briefing and any key messages, quick handover of all the ward and patient allocation. We then go to receive a more detailed handover at the bedside from the nurse we are taking over. The main and bedside handover is all supposed to take 30 minutes in total, but often runs over.
0800: I've got 3 patients today, and I'm expecting a 4th. - A 4 year old boy with complex needs who I know very well. He's on a fair amount of respiratory support and has no adult with him, so I will carry out all the care. He needed: hourly observations, meds at 3 points in the day, 4 hourly blood sugar and blood ketones checks (If his ketones were high, there was a management plan), a 10 hour continuous feed starting at 9am, which has to be changed every 4 hours, regular turns, as required suction, regular nebulisers, seizure management, strict fluid balance, mouthcare & nappy changes. There are also safeguarding concerns, so we keep a record of who visits and phones the ward about him.
- A 1 year old with a UTI/gastroenteritis who's on IV antibiotics and was on IV fluids. Parents were very anxious. She also had no IV access so the antibiotics would probably be delayed.She needed: 4 hourly obs, two doses of IV antibiotics, and strict fluid balance.
- A 5 year old with a temperature (pyrexia) of unknown origin, but clinically well.He needed: 4 hourly obs & oral antibiotics. 5 stool samples.
- The fourth patient I'm expecting is an 11 year old with Type 1 diabetes who is not managing their blood sugars. I don't know what they need as yet, but there was talk of an insulin infusion which would mean hourly observations & hourly blood sugar checks.
As I'm receiving my bedside handover I write a list of everything that is needed for all my patients. I take a moment after handover to prioritise - the boy with complex needs comes first due to his respiratory support and because I know he has a propensity to deteriorate. The little girl comes second, with the boy who's clinically well 3rd.
I start by doing all the bedside safety checks, introducing myself to my patients/their parents, give them a plan for the day, and checking there's nothing they need initially.
The day goes on from there... I get on with my busiest patient and try to start everything early because I know things take time for him. In between all of this, I check drugs with colleagues and ask them if they need any help. At 1000 my new patient comes in. I quickly do some medicines and obs, so I have a block of free time to spend (About 30 minutes) with them filling out all the admission paperwork and completing an initial assessment. I also let the Drs know they are here.
Also between 1000-1200 is ward round. I try to liaise with all the doctors seeing my patients to ensure I am up to date, and that I have raised any concerns I have. Fortunately today, I have no concerns. I also make a start on my documentation. I review, update and sign the care plans, write my initial assessments, and update the section on our pre-printed assessment sheets where we write in the plan from ward round.
At about 1130 I manage to go for a quick 15 minute breakfast break. I come back to learn my patient now has a cannula so I do their IVs. I also sit down at the computer for 5 minutes and request some of the samples my patients need and print off the labels.
The nurse in charge then approaches me and asks if I'd like to lose one of my patients, as a colleague only has 2 and I have 4. I handover to them the boy with pyrexia of unknown origin.
The ward continues to get busier and as I'm up to date so far, I help out some of my colleagues. My other things to do continue, I also do little jobs like answering other patient monitoring alarms when their nurse is not around, answering the phone and getting my patients a drink. I also have to spend a lot of time answering questions and reassuring the parents who are particularly anxious.
At 1430 I give another nurse a quick update on my patients to allow me to go for lunch for 30 minutes.
The endocrine team have come and seen my diabetic patient. Nothing changes at the moment. The afternoon calms down a little bit - its still constantly busy but not unmanageable. Most of my day has been spent with the boy who has complex needs. I've changed him and done his mouthcare 4 times, as well as given him a little wash.
At 1700 I go for another 30 minute break. At 1800 I sit down at the computer and update the handover sheet for my patients so its ready for the nurse in charge to print.
At 1830 I contact the doctors as my patient with the UTI/gastroenteritis has been continually vomiting/diarrhoea and hasn't been drinking. I put up IV fluids on her, and do her IV antibiotics. 1930 we are due to handover but my patient has pulled his respiratory support off his face. I end up re-sticking it, and am late to handover.
I leave about 20 minutes late once I've documented the last few bits.I get home about 2100. I wind down for about 15 minutes. I eat a quick dinner - leftover pasta bake. I get my bag ready for my shift the next day, set my alarm and go to bed.