I'm back again (part 2)

Well it is the morning after the wedding, everyone who stayed in the hotel meets up in the restaurant for a champagne breakfast, we all chat and remember the occurrences of the previous day and one by one the group gets smaller as we all drift off home. It was such a nice day; Kal and I set of and stop on the way so that I can take pictures of the countryside for Nursie999 (she forgot her camera the night before). Kal and I arrive back in Edinburgh and he starts packing for college, I head home and get an early night for my next week in Theatres.

Monday morning arrives and I’m back in theatres, I meet up with J and we both head into our allocated anaesthetic room to set up, now by this stage she is expecting some help, so I ask how many patients and what procedures etc so that I can gather up the necessary equipment, we are ready by 0845 so it's coffee and bacon rolls. This is our routine for the remaining two weeks, set up coffee, patients, getting the consultants to sign me off on my various required procedures on the way!

Week 3 arrives and this is my final week to make sure I am happy with my new found practical skills (totally different on a real patient). I had been working at T in the Park over the weekend and chat to some of the staff about the event and the workload etc. The patients start rolling into the 9 main theatres, consultant surgeons and gas men (anaesthetists) all arrive and we begin again, now over my last two weeks I have received comments of praise from some of the staff etc but now it comes to the final day and I have to see the senior Operating Department Practitioner (Manager) and await my feedback, now this guy looks frightening, but he is very pleasant and gives me my certificate of competence and tells me that should I ever wish to come back into HIS department then I am more than welcome!!

Week 4 sees me moving departments and I am now working in the Coronary Care Unit (CCU) of the Edinburgh Royal Infirmary, which is a busy 10 bedded unit with a ward attached when patients are deemed as fit to be prepared for rehab prior to discharge. I arrive and meet up with the Ward Manager (Senior Sister in old terms) who I know fairly well. I am given my tour and follow the ward round, where the new team headed by Prof N reviews the patients.

I have various skills and procedures which I must have signed of as competent in their appliance and I start these straight away by going on the "Bloods round", this basically means taking the requested samples of blood from the patients as discussed in the ward round for analysis at the lab to see how well the patient is responding to treatment. I assist in making beds, toileting the patients and providing general care with the nursing staff.

Day 2 sees me in the theatres following various procedures including a pacemaker insertion and the cardiac catheter labs where patients are taking to have their coronary arteries either expanded with a balloon or strengthened with a wire mesh tube called a stent. Back on the ward after lunch and I am half way through some paperwork when the "Arrest" bleep blips into life, telling me and the other staff that somewhere in the hospital there is a patient in cardiac arrest and we have been summoned to assist in their resuscitation, now not knowing the hospital that well I drop 2 steps behind the Registrar and the staff nurse as we sprint along the corridors to get to the patient. We arrive along with the rest of the "Arrest Team" and start working on the patient, now bearing in mind normally you are lucky to have 3 people helping at an arrest when out on the road I am a bit shocked to see 14 staff (including myself in that number) all around one bed doing various tasks. We are successful in getting this patient breathing and their heart beating and it is decided that the patient does not need to go to CCU (as it turns out to have been a respiratory arrest) so we 3 all leave the rest of the team with the patient and return to the ward to cool down (27 degrees C outside and ward with arrest had not air conditioning!)

Day 3 begins with hand-over and ward round, then down to the catheter lab again for a more challenging procedure on an elderly male, unfortunately it is suspended due to his condition worsening suddenly. The consultant who is carrying out the procedure decides to reschedule for Thursday, as he will then be able to get a colleague to assist if the patient is stable enough. So back to the ward with the patient and watch as his condition bounces up and down like a rubber ball, eventually he stabilises after much hard work on the medical and nursing staff side. We receive a new patient onto the unit and they are clerked in, I assist with bloods and ECG etc and even teach a student nurse how to use the ECG machine!

Day 4 I arrive onto the unit to begin and there are new patients, some of the others were transferred to the attached ward as they were more stable than the new admissions. The unit is now full and there are numerous tests and examinations requiring to be carried out so I ask the Charge Nurse if I can help and I am allocated the bloods and ECG's for all the necessary patients in the unit along with assisting the staff nurse and student I'm working with for that day. Just as lunch arrives "blip blip blip ... Cardiac Arrest on ward..." yes you have it, the arrest bleep so off we go like a well oiled team sprinting into action and sprinting along the vast corridors to the correct ward, we arrive, with the other team members and begin to swing into our allocated roles, orders are barked out and equipment is brought... unfortunately this time we could not save the patient and it is agreed after a considerably long time that we have tried everything and we should now stop. So back to the unit, feeling low, but knowing we did everything we could do for the patient. As we arrive back on the unit the staff nurse and myself go for some water to cool us down as the Dr had remaining on the ward to complete the necessary paperwork certifying death has occurred. Blip blip blip "Cardiac Arrest.... ward...." I look at the staff nurse and she and I are off again, sprinting along catching up with our Dr (who was closer because of the previous callout) and the full team swing into action again, orders are given, equipment brought, more orders, more equipment and with each new item another team member arrives until the room is filled with medical, nursing and associated staff making 19 of us in total, once again I think back to my last arrest on the road when there were two of us!

We are successful this time, the patient is stabilised and transferred to the Intensive Care Unit (ICU) for further treatment. Back to the unit again, lunch for us and time to relax. The afternoon finds me catching up on my outstanding procedures and getting them signed off by the Charge Nurse. I finish earlier that evening, as it is Kal's end of course drink, which I head down to.

Kal is now 7 weeks into his 9-week technician course; having completed his Ambulance Aid (the care side of things) he now only has his 2-week driving to go... The whole group are found in the bar of the college, I bump into some old friends who are there for various reasons, chat, drink my diet cola, chat some more and then head off as I have an early start the next day. I give Kal a small gift and card to congratulate him and leave him to his party.

Day 5 sees me back on the unit, after having called Kal to make sure he was up, even although unknown to me he had been woke at 6am with the fire alarms, I wished him well and let him get back to his "Long lie"

I now only have one week to go, I walk onto the unit thinking that I will miss the staff, as they have been very friendly and helpful. I am not more than 5 minutes on the unit when the ward manager calls on me and tells me that we have a shout in A&E for a fast track chest pain patient who needed to come up to the unit, so we take the equipment and go down with the Dr. We arrive and the patient is post cardiac arrest, now with classic signs of an MI. The patient is prepared for transfer to the unit and off we go. Back on the unit I am in time for the start of my final ward round and Prof N once again carries this out (as he has for the last 4 days), meeting the patients and putting them at ease with his manner and tone, I am then invited by him to come back to A&E to review a patient with him and the other Specialist Registrar (SpR). We wander down and assess the patient and it is decided that he does not need to come to the unit and can go to the ward for further care.

It is now lunchtime, I have completed all my necessary procedures and had my training record signed off and I bid my farewells to the staff and leave then with the thank you card and a box of chocolates.

Well one more week to go and I will be finished...