Monday, 18 August 2014

Stick to the plan - Know your care

One of the things they stress oh so often to the Student Nurse's is the importance of communication. You can understand the logic behind this when you have all manner of specialists taking care of you. However, it is so easy for things to be left out and thus, things can go wrong.

For instance, in a place like an operating room, time is a lot money. Think about it, the wages alone for the nurses, surgeons and anesthetists are the killer. Then you can add in, the consultants, the radiographers, the equipment specialists, then the group of medical students, and, nursing students. At any one time during your procedure you could potentially have up to 10 people in the room with you. On top of all that you have the large expensive anesthetic equipment, the X-Ray, the procedure trays, the anesthetics, the induction drugs, the opioids and, all of the weird and wonderful sterile equipment. Because time is money you don't want patients to be in there for very long nor do you want them delayed. It gets hectic as everyone tries to find out their little bit of info and if they aren't able to tell anyone that information, it falls through the cracks.

So what happens when inevitably none of them know who you are or have ever seen your face before? You have a folder! You also have a number! This wonderful folder filled with all the wonderful things about you is meant to tell every single one of these people how to treat you. If you have been in a hospital and a nurse has been scared that they have lost your folder, that is why. Without it, you can't do much. This is also why most of the nursing job, is paperwork. We aim to check that everyone has told us what we need to know during all of your care. If you didn't write it down, it didn't happen.

Of course, each of the people I listed before will be looking for different information in the folder as well. They also like it displayed in different ways. You can take a blood pressure and have to write it on 3 different forms. Things are changing though so the documenting itself isn't too much to worry about. What this can cause though, is the assumption. Assuming knowledge is the downfall of caring for people in these settings. It is also sadly, something that everyone does. Especially patients.

Medical professionals don't know you. Before you give medications to a patient in a hospital you have to check name, date of birth and their number before you can hand it to them, to be absolutely sure that you are you. With the amount of people seen in a day, it would be hard to remember who had what allergy and what dose of medication. All of the people I have seen working have had amazing memories but seriously, you can't expect remember it all.

Being in a procedure room only to find out as the person walks in that they have a latex allergy is nothing short of frustrating. Not just gloves can be an issue for this case, a lot of medical equipment has latex in it as well, meaning you could potentially get a patient on the table only to find you can't actually go ahead with the procedure. You can't take frustrations out on the individuals though, everyone has their part to play. It could be the student nurse that didn't ask that question specifically, the doctor who assumed people read the note from last admission, the emergency admission papers from the day before having no mention of it, the patient never mentioning it, the handwriting of the previous person making it hard to understand.... you get the idea.

Take home message from all this? Know your stuff. Ask questions. Keep information and documentation with you. Pester people as to what your needs are. People will ask you questions but it is truly important to know why they are asking them so you know how to answer. 4 Important things to know to pester people about:

- Allergies + Reactions

These can be counted as anything from anaphylaxis or a small rash you get from a band aid. Mention what kind of reaction you get, when the last time it happened was. If you are allergic to any foods as well, mention that. Especially things like shellfish as some dyes and contrasts contain it.

- Previous Operations

Usually this is counted as major surgeries. Be sure to mention if you had anything removed or put in. Also, when the operation was.

- Medical Conditions

What have you been diagnosed with? Ever. If you had a condition that was treated, say so. To put it the meaner way, you don't "get over" that Asthma you had as a child. You still have Asthma, the trigger .

- Medications

ANY medications you are on. All of the ones prescribed by the doctor and all of the ones you take yourself. This also includes any supplements. Doses of your medications are also important to note.

I hope this helps give a better understanding to what people who look after you are actually looking for, and helps to make sure that should you need medical attention you will be well looked after.

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