Day 168

It's 6.45am and it's raining and dark and cold, and I have just parked my car in the staff parking zone with my little 'student note' on the dash stating I'm awaiting my student permit. I am raring to go on my first day, and I purposefully arrive 15 minutes early. I am a student nurse.

I make my way to my designated ward with a bounce in my step. I didn't want this placement, my previous placements have been on two wards and in theatres. I would like to experience a community placement, but you can argue until the cows come home with the university allocations unit - you get what you get, and you like it. So here I am, bouncing down the corridor, eager to please. I find my ward and am the first person in the staff room. I make myself a coffee and introduce myself to all the nurses and auxiliaries who begin filtering in over the next 15 minutes. What a nice bunch of people and what a good start to my day. I love a bit of friendly banter, I'm so glad I took the initiative to come in early and I feel a rush of relief as I sense this placement may not be so bad after all.

I am happy and it's going to be a good day. At 7:15 a very friendly nurse is going through the fire procedure with me when it suddenly hits me. I am on the wrong fucking ward.

Ten frantic minutes later I arrive on the ward I am officially designated to, which happens to be laid out in the complete opposite fashion to the ward I just made myself at home on. (They seemed genuinely sad to see me go). After walking into the sluice, the day room, the kitchen and the 'unlocked' toilet (sorry, Sir), I eventually tumble into the staff room. Which is very small. And very full.

The eyebrows raise and the chests sigh, and in the space of 4 loud, crashing seconds I have become 'that' student. Dishevelled, out of breath and......late. Balls.

All the chairs are taken, and the room is SO small in fact that I appear to be leering. I am leering on my first day, and I don't have a coffee or a friend to my name. I am assigned a nurse to shadow for the shift since my mentor is off, and I begin my day.

Notable event 1:
I have just met the nurse I am shadowing today called Lara. After handover we pop round our bay to see who is who. Gentleman No.1 is okay in my book. He can talk, he's compos mentis, and he can even wash himself. Bonus. I'm not lazy on any account, however after working as an auxiliary nurse for 3 years I would rather spend my time doing the things that freak me out, like drugs and CPR, because once they don't freak me out then I know I'll be okay. NOBODY wants a freaking out nurse.

The next patient, freaks me out. 3 minutes into my day, we're asked to quickly draw the curtains around Gentleman No.2. There are 3 nurses in the bay, all discussing the resuscitation status of said Gentleman (he's not for resus). They are saying they can't wake him, and they are saying they might just leave him.

'Excuse me? What's that now?'

The first thing that rushes to my mind is that it's all wrong. I can't experience my first death 3 minutes into my first shift, I'm not in the right frame of mind! Surely I need to see a decline in a patient first, maybe know their name and things. Do a few chest compressions, you know? Not just casually trot into a bay and watch a dude take his last few breaths. It all seemed so rude. 

Luckily Gentleman No.2 reacts very quickly to something one of the nurses injected into his canula, and he promptly woke up and demanded his breakfast.

Notable event 2:
The shadow nurse asks me to dispense 40mg of medication into a pot using tablets with 5mg strength. I pop the blister pack 8 times into the pot. She looks into the pot, then at me expectantly, which turns to frustration and then some sort of acceptance. I look in the pot confused. What? I discover there are seven tablets, not eight. This woman thinks I am a jackass. Frig. I add an eighth and she scurries off. I then discover after she has left that one of the tablets didn't pop out of the blister pack when I initially added them. I wanted to run after her and show her that I wasn't a complete imbecile and that my basic mathematics skills exceed that of a 9 year old. But it was too late. In her mind I was shelved with the other dimwit student nurses who would be better off suited to looking after plants rather than humans.

Notable event 3:
Gentleman No.8 wanted something 'strong' to help him with his bowels. Lara told me to offer him a soluble laxative. He declined and asked for a shower attachment, some tubing, hot and cold water and a 'receptacle' of some nature. Deep down I knew he wasn't joking, and not wanting to come across as judgemental, politely informed him that due to infection control procedures and NHS cost-cutting we didn't supply use-once-only shower heads. He appeared to take it well. Lara walked in on us when he was describing in great detail the finer points of his DIY shit-retrieval methods, and swiftly removed me from the situation. Apparently I was not to engage in such discussion in case other patients overheard, but the gentleman was so animated and innocent with his descriptions, that I couldn't help but be captivated. I told Lara I thought he deserved a Blue Peter badge. She didn't laugh.

Notable event 4:
I escorted a gentleman from our bay to his CT scan. We had a nice chat as the porters transported him from the ward to the scanning suite. This gentleman (we'll call him Bob) needs oxygen all the time. When transporting patients like this they require a mobile oxygen cylinder for obvious reasons (when they can't be connected to a static O2 supply, usually mounted above hospital beds). In the CT suite his O2 cylinder was taken away by the porters and Bob was attached to the static O2 on the wall.

I stood in the computer room watching him through the window while he was being scanned. There were 4 members of staff in this room, not one of them spoke to me, and they all chatted away to each other about the annual leave someone didn't get, and how disgusting it was, and that so-and-so was still off sick, and how disgusting it was, and how they went on a staff night out, and how disgusting it was. Etcetera. Do you know how it feels to be completely ignored in a room full of people? It's as if you don't exist, and sadly I am used to it. As a student nurse I am ignored by the following people: house officers, senior house officers, consultants, physiotherapists, occupational therapists, surgeons, anyone who doesn't wear a uniform, ANYone who has ANYthing to do with radiology equipment, ward managers, modern matrons, ward sisters (now and then) and cleaners. I am a very confident and sociable person, I smile at people who pass me.I ask questions, I try to engage in conversation. But to these people, I am worthless.

It's exhausting.

But I digress. Once the scan was complete one of the radiology staff, a woman possibly in her late 30's, who had completely ignored me until now, disconnected Bob from his O2 and without making eye contact demanded I open the door for her. I asked her if there was a portable O2 cylinder nearby, and she said there was oxygen in the waiting bay out in the corridor. Fair enough. Bitch. The whole process of getting Bob into the bay was agonisingly slow, and she didn't seem to care that he clearly couldn't breath very well. Sure enough there was a pump on the wall and I waited for her to attach it as it was at her end of the bed. She just stood there for a while looking questioningly at the pump.I stared at her in disbelief. Bob was clearly getting more and more agitated (as was I) then she casually asked me in her uninterested, monotone voice where the connector was. I said I didn't know what a connector was and queried why she couldn't just shove the damn tube on the pump. 'It needs a connector'. Bob's nose and mouth were beginning to show a grey tinge and he was gasping more and more for breath.

Naturally I was very frustrated. The basics of the problem were as so: the woman wanted to connect Bob's white oxygen mask tube to a green tube, then the green tube to the pump. But there was no 'connector' to connect the green tube to the pump. What confused me was that the white oxygen mask tube could just bypass this green tube bullshit and connect straight to the pump. I am usually very calm and collected, but this woman didn't seem to understand the urgency of the gasping grey man and his need for the oxygen and preceded to ask me to 'look over there for a connector'. For the first time in my life I heard my own 'professional stern voice'.

'Listen to me. I don't know what a connector is or looks like, so there is no point in asking me. This gentleman needs to be connected to oxygen now'.

She scuttled off into the the CT suite to look for one of these connectors. I was at the end of my tether and just as I was fitting the white tube to the pump she appeared with this stupid piece of plastic announcing to her colleague that it was the only one in the whole CT suite. I refrained from telling her where I thought she could shove that plastic.


Notable event 5:
I return to my car after my series of unfortunate and events and encounters to find a parking ticket slapped on the windscreen.

WELCOME TO PLACEMENT.