Ten shifts doesn’t sound like much, does it? Sounds easy, doesn’t it? Sounds too soon and like I don’t really know if I want to leave, doesn’t it? Sounds like, actually, I’m leaving work really soon and it hasn’t sunk in and I don’t know if I’ve really thought it through?
I’ve found it helps reinforce my faith in my decision to think of it in terms of medication rounds. That’s twenty-seven. I’m also going to write it out in words, rather than numbers. ‘Twenty-seven’ is about a hundred times as many as just ‘27’, surely? It’s also twenty-seven of something unknown and unpredictable… will it be:
- twenty-seven drugs rounds where every patient on the ward has a complicated diabetic regime involving bizarre super-strength non-formulary insulins (not available anywhere in the region except, currently, the patient’s kitchen cupboard, in their locked house, to which no-one has a key)?
- Twenty-seven drugs rounds where each patient is on forty-three different tablets, each of which needs to be considered, withheld, delayed or adjusted depending on their blood pressure or kidney function or whimsy?
- Twenty-seven drugs rounds where everything will just be prescribed a little bit wrong?
- Twenty-seven drugs rounds where every patient’s usual routine (which really we should let them stick to in hospital unless there’s a good reason not to) is to have their medication at slightly different times to those the new electronic meds chart allows?
- Twenty-seven drugs rounds where everything needs to be second-checked?*
- Twenty-seven drugs rounds where every patient hasn’t got a cannula and really really needs some IV anti-emetics RIGHT NOW because they’re vomiting all over you? And they’re really scared of needles. And they’re angry. And they’re big and scary.
Twenty-seven drugs rounds suddenly feels like a hell of an undertaking. It’s only ten shifts though. And that’s somehow even more terrifying.
It’s a funny old thing, though; the things that are off-putting about work are the sort of institutionally boring bits. Tedious tech-wrangling. Trying to make sure our workload isn’t so procedural and task-oriented that we bulldoze over people’s usual routines (I’m thinking of the diabetics who’ve managed fine for years, who come into hospital with something completely unrelated, and are completely thrown off kilter because we fiddle about with something that was just fine). There’s a balance to find – we need to be flexible around the lives and daily routines of our patients, but have enough of a routine of our own that everything gets done, you know? And so that everything gets done even when a couple of things make it trickier, like that fighting vomiting needlephobe, or someone who needs extra attention because they’re getting sicker, or crying, or dying, or because they’ve just told you there’s no one looking after their dog (/fish/cat/wife/child/geranium) or any of the reasons people need a bit more time. Or someone tries to jump out of the window. Or someone tries to smash the doors with a fire extinguisher. Those are the bits that aren’t boring, aren’t off-putting, and can be an absolute joy. I’m really going to miss nursing; people are endlessly varied and fascinating.
*Apparently in paediatrics they second-check everything, even Calpol and stuff. Questions for paediatric nurses: (a) before you started, did you know that all the medication you give would require a second signature? (b) Would you still have gone into paediatric nursing if you’d known you’d have to chase other nurses with iPads and expiry dates every time you saw a fifteen-year-old asthmatic surreptitiously use their blue inhaler?