Wednesday 22nd March will be remembered in a lot of different ways. As a Londoner, I’ll like to remember it as diverse people coming together in adversity. For me it began as a “typical” day in the small island of RAID within A&E. A bit of banter was exchanged by my colleagues with one of their friends, a senior nurse from ‘outside’ as to why she wasn’t in her scrubs – there was a seniors meeting taking place so it was an ‘off’ day for her! Then it was into looking at the caseload handed over from the night shift and looking at the new cases being presented. Just another day … Lunch came and went and as we went into the early afternoon, the mood changed. All of a sudden, the typical day became one in which the hospital went into preparation for dealing with a major incident. Our colleague on her off day, was seen (in her scrubs) rallying her staff in an aim to clear A&E of the non-critical cases, and prepare for any casualty overflow. In a sense it went well, casualties were absorbed by St Thomas’ with only the HEMS cases brought to us. Working here over the last 10 weeks showed me how well integrated the teams are and how well we all work together. What Wednesday demonstrated is that there is actually capacity to up gear and perform even higher than what I thought of as daily exceptional work! This is possibly the lesson I leave with, no matter how good something is, there is always capability for better!
A week ago I said farewell to A&E. It is a now a fading memory but overwhelmingly it gave me perspective of where I am in my training. The Liaison Nurses are all seasoned professionals in mental health – none has less than 10 years of experience in a variety of areas – Acute Wards, Assertive Outreach, Drugs & Alcohol, Forensics. Each shift was spent with often a different member of the team and this allowed me to see different perspectives on similar issues and the complexity of assessing someone you were meeting for the first time. The reliance of the nurse in this area is on using a combination of experience, Nice guidance and institutional best practice. One of the opportunities I had on this part of my placement was an opportunity to work with the Drug and Alcohol Addictions team. My main learning point is that behind the substance misuser is a story, one that is quite sad and has led to this unhappy ‘ending’, which for a very few becomes the beginning into recovery aided by the very small team at the Royal London. Where once I had entertained ideas that liaison was an area I would like to work in, now I realise how much more experience I need to gain before I entertain this idea gain! Thank you RAID, I enjoyed every minute and challenged me in my student role!
In the last week, I have managed to complete 40% of my checklist to graduation. The five items on the list were: the management essay; OSCE; simulated practice; dissertation; and final placement. The first two are now done and echoing in my head are terms like, “CPA”, “coproduction”; “leadership vs management”; “transformational”; “treatment oriented approach”; “recovery model”. If you are reading this and start your course in September, just take down these terms, they’ll be useful in three years time. Yesterday was OSCE, where I had the pleasure of teaching a first year student how to take an oral temperature reading and pulse. Memorably, I made a faux pas and told the student that in addition to oral temperature checks we also do tympanic, axilliary and anal readings. The laughter of my course mates at the Narrowboat Pub is still ringing in ears – we do not do it anally anymore and the correct term is “rectally”. Looking forward I have a short break, start my last ever Sim Prac session while juggling my dissertation on menopause. What I don’t know as yet is where I’ll do my final placement, I have asked for CAMHs or PICU which probably means I’ll end up doing a community placement – only joking! The allocations team at City are probably one of the hardest working teams with true Harry Potter powers! There hard work over the last few years has allowed me to undertake some really rewarding and challenging placements. And it is something they will continue to do well long after I have graduated!
Roll on final placement …
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