Nurses Rock!
I am very lucky to be able to do a job that I love, and to have invested 23 years into harnessing the skills of caring for and nursing patients. Most days and weeks fly by, with sessions both in the NHS and private sector, filled with a busy flow of patient care. Rarely do we, as nurses, get chance to pause for thought, reflect on our work and praise ourselves for a good job! I work with a team of nurses and doctors, and we provide a great service, even if I do say so myself. On this day at work, the Practice Nurse I work with came to my rescue in supporting a very unwell patient.
Helen has the clinical experience and skills to determine if a patient requires escalation, and she can provide a very quick and effective hand over, to the on call, which facilitates a safe and prompt transfer of care. This was carried out on a routine Thursday, where each of us were working through our full but routine lists of patients.
We were each taking in regular routine patients in a morning and my list for the afternoon focused on anything more urgent (but not usually life threatening). Every now and again, all the organization and planning that underpins a successful and seamless session goes rapidly wrong! When you are dealing with the human condition, both physically and mentally, there can always be an emergency, which throws total chaos into an otherwise innocuous afternoon.
Today was one of those days. I had started my afternoon the usual way, ringing and seeing the patients I had agreed to come onto my list, and signing prescriptions for various team members who had assessed patients and required my input. As I chatted to a male patient, who had been added to my list for increased breathing effort (he spoke fluently on the phone), I had a screen message from Helen, requesting urgent intervention for her 63-year-old female patient. I was able to wrap up the phone call, switching from a non-urgent consultation to a life-threatening presentation within seconds. Helen effortlessly relayed the crucial information that helped to provide the level of urgency for my response; immediate!
Very quickly in this job, you become adept at managing crisis, taking on an almost automatic approach when faced with a patient in a life-threatening situation. This patient had crushing chest pain, fever, an abnormal ECG, grossly elevated respirations, and worrying low oxygen levels. This was relayed to me all while the woman was walking into my room attached to an ECG lead, blood pressure and Spo2 machine. Helen and I went from a routine working day, enjoying the calm pace to full blast eye of the storm. We both remained calm, which somehow allows the brain to adapt to the new rapid influx of information. Rushing into a blind panic to match that of the situation just blurs the concentration, so that you cannot see the wood from the trees. And this patients’ trees were all burning down.
We immediately got her seated and Helen brought in the oxygen and salbutamol (I simultaneously viewed her medical history, while witnessing the audible wheeze and respiration rate). As I connected her to the blood pressure machine and read her pulse of 130, and glanced at her abnormal ECG, the first question in my mind, was whether she had chest pain. She confirmed the crushing pain just as the blood pressure flashed at 203/188mmhg, confirming my suspicion of a cardiac event. My hand went straight to the phone, and before I could write anything down, I was relaying the information to the emergency services.
While everything seemed to happen at high speed, there was an ordered methodology to the care. I asked her if she had a history of chest pain, shed confirmed and got her GTN spray out. As we waited for the ambulance, knowing that they would have a whole list of question for me as the referrer, I continued to monitor oxygen, pulse, blood pressure respirations and her pain. Helen supported me throughout the whole emergency, bringing in the initial high flow oxygen and 5mg salbutamol and a further dose 15 minutes later. She even stayed with the patient while I nipped to the loo!
Luckily the crew attended within twenty minutes, which is remarkable. They were very helpful and accommodating, and soon the patient was whisked off to the A & E department. Soon after, my list and afternoon returned to normal, a moderate flow of patients and phone calls and a pause for reflection. Helen and I might just have saved someone’s life. With the help of paramedics and their the speedy arrival! The NHS, while exhausted and in many ways, incapable of providing effective care, when it really matters, staff come together, focus, and get the job done.
It is these moments where miracles happen that the joy in nursing really comes to life, and we are reminded of why we came into the vocation. Too often, our days are taken up with complaints, of waiting times, of pressures within secondary care and no appointments, that we often lose the pleasure of what we do. But then, suddenly a curve ball is thrown our way, and the universe shines a light on our skills and expertise and reminds us to keep going, to never forget we are born nurses, it is in our DNA! Thank you to Helen, the talented practice nurse, and to the emergency services, who arrived to save our patient promptly and professionally! Just another day in the life of two nurses!
