Found my bogie....literally!

Every nurse has that one body fluid that they can't handle. I've discovered mine. I have suspected it for a long time, but it's now official - this nurse cannot handle sputum! Hearing a patient with a big productive cough, then hoiking it up and spitting it out makes me gag. And then, sometimes, they'll pass you the tissue to get rid of.......or worse, a specimen jar where you can see it!!!!! YUCK!!!!! I find nothing worse than someone sitting in an emergency waiting room, coughing all over everyone and not even bothering to cover their mouth. Way to spread your germs people!

You can give me profuse diarrhoea, projectile vomit, pee all over the floor......just keep the big wet coughs away from me! (Unless it's a kid - for some reason I can handle paediatric sputum, but not adult. Meh.)  And do not EVER think of giving me a patient with a tracheostomy to look after - NO WAY. I think I would faint if I had to suction a trachy. Ew. Somehow I don't see myself ever working in a respiratory ward! ;-)

Time Management
One of the biggest things a newly graduated nurse may find difficult is time management. You can always get help with a skill if you're unsure, but managing your patients and their priorities is yours, and yours alone. Just how do you decide what is more or less important?

I've found that the team nursing environment here makes that a little more challenging. With allocated patients, I found it a simple matter of using a grid on paper to note down what needed doing at a particular time, such as medications, then fitting in other tasks in the gaps, and this worked well. I knew what needed doing, and when it needed doing. I'd need to think about what had to be done, what should be done, and what would be nice to get done if I had the time. Sometimes I'd need help deciding the priorities, but I was usually pretty close.

So do we give this now or later?

Here however, everybody looks after everybody, so it is a bit different - sometimes I can plan to do something and find it already done, or someone else may say they are going to do something but not end up doing so, for whatever reason. I find we constantly refer to the in-charge, and to the others on duty to figure out who's done what, and what else needs doing. Sometimes the ED nurses will come up and help too, if they are having a quiet day, adding just a little more confusion! There are some nurses who like to get out of doing certain things, and leave some jobs for everyone else, so that also has to be factored in. Some in-charge nurses are very proactive and set the tasks (as well as check up on what's been done), others are more relaxed and let you do your own thing. Sometimes it's tricky if the in-charge is the midwife and she is attending a birth the whole shift - but you find a way around it.

I guess as I get to know everyone's quirks I will be able to plan more effectively. I don't think I'm doing a particularly poor job though, I always seem to get everything done. I know a lot of student nurses read the blog, so my only real advice for you is to never be afraid to ask for help! You soon get into the swing of things, and only time in the job can really give you the insight to "know" what comes next. Make sure you jump in to do things at every opportunity - don't be a wallflower, even if it's a really bad arrest. The only way to learn is to "do" so make sure you "do" whenever you can! You might not know immediately what needs to be done, but even just being the scribe or the gopher makes everyone's job easier, and gives you a bit more experience that you might have otherwise have missed out on.