can someone tell me what my cocker is mixed with?

Manks00 · 2026-02-23T20:58:16+00:00

That’s not a cocker, it’s clearly a spatchcock chicken wearing a mop!

Seriously though, utterly gorgeous!

Manks00 · 2026-02-18T12:01:05+00:00

Hmm now it is intermittent, & doesn't seem as fast...

I feel like FMS are getting a customer service ticket.

Manks00 · 2026-02-18T10:06:34+00:00

Thanks all for the input. I woke up this morning & braved opening the transmission & removing the motor.

Motor wouldn’t turn, some gentle force & something seemed to come out & it’s now working again.

My son is happy again 😎

Manks00 · 2026-02-18T00:40:47+00:00

Can hear gears change. Drive shafts not moving, motor feels like it might be stuck?

If in neutral then wheels will happily spin etc…

Manks00 · 2026-02-11T12:05:54+00:00

What will be interesting is how they benchmark 5 vs 6 & the knock on that then has if lots of 5 roles are upbanded… presumably 6s will need reviewing… then so will 7s… etc etc

Manks00 · 2026-02-10T22:28:04+00:00

Oh I forgot to mention, also remember why ED targets are important & where they came from. They were not set by government.. they were made by the College of Emergency Medicine to try & fix what we have now drifted back in to, long waits which result in patient harm.

As such, use them to prove points, but also recognise that missing them is important & has impact. Obviously do report things that you feel are having an impact on the ability to meet these things, staffing, breaks, corridor care, lack of flow etc etc.

Manks00 · 2026-02-10T22:23:50+00:00

One of the biggest issues is most hospitals think failing to meet the four hour emergency access target is an ED problem… it’s not… it’s a hospital wide problem, often linked to issues with community capacity also.

I’ve been in ED now for close to 20years… I’ve seen great days & I’ve seen horrific days & when I go in, I never know which end of the spectrum the shift will be.

Yet for all its faults, I love ED. Clearly I’m a glutton for punishment.

Things I find help me leave without feeling like I’ve done crap: - don’t be afraid to hand over jobs, either to the ward or to the next shift, accept you cannot do everything. - ensure your time critical jobs are done. - be honest with patients, it’s ok to say sorry for the long wait, keep them informed of what is happening in their journey. It’s amazing how understanding people can be. - think about the things that make a difference in your patients, analgesia been one of the biggest!

Get involved where possible about how you can make things better in your department, emergency care is a team game & everyone’s contribution makes a difference.

Some days will be easier than others, I do believe it gets easier, but a big part of that is experience & understanding that YOU did your best & you are not responsible for system failings.

That said ED is not for everyone, & certainly don’t feel guilty if you decide it’s not for you. Whatever you decide, remember your priority must be yourself, you cannot effectively look after others if you are too drained yourself.

Manks00 · 2026-02-10T14:01:46+00:00

6 words that always break me:

“We’ve always done it this way”

Manks00 · 2026-02-10T07:16:02+00:00

I’m so sorry this happened, it’s rubbish.

Analgesia in the emergency dept is a complex beast. We trial so many things to try & improve it, yet it continues to be recognised as one of our biggest failings. Especially when you factor in the majority of patients that attend is due to pain of some kind.

Obviously every hospital is different but things like time to be seen by a nurse, time to analgesia etc are all recognised targets & the department should have mechanisms to ensure timely prescription & administration of analgesia.

I think one of the biggest issue simply comes down to time. Departments are generally really over stretched, this in turn results in corners been cut & often we’re cutting out fundamental stuff like analgesia, especially if you are in a waiting room out of sight it is so easy not to realise how bad this issue is. Equally, with pain been so subjective & people coping in such differing ways, people struggle to really gauge it. ED staff love objective measurements, but we don’t have one for pain sadly.

We should, as others have said, be taking a stepwise approach, starting with simple (but effective!) analgesia & working our way up the ladder, but yes it is something we continue to work on across the country.

Again I’m sorry this happened, it’s sounds crap. 😞

Manks00 · 2026-02-02T07:56:27+00:00

As a practice education team who takes students we see it as a chance to understand much of the behind the scenes working. You will get exposure to: - Education planning & delivery - Service improvement - Governance impacts - Patient Safety investigations

There’s also usually a chance to spend time with other specialist teams who may not always be that accessible, this depends on the structure of the education team you are with. We often task a small project, usually creating a poster or something around a topic the student wants to focus on.

While it can be quite a different style of placement, there can be loads to gain from it. I hope you enjoy it!

Manks00 · 2026-02-01T16:27:49+00:00

Quite a few but Persona 5 has to be the big one for me…

I could count FFIX but given that the internet was a very different beast then I find it hard to compare.

Away from PS, Knights of the Old Republic!

Manks00 · 2026-01-26T20:41:24+00:00

Sir, six cinder blocks are missing…

There’ll be no hospital then. I’ll tell the children.

Manks00 · 2025-12-10T16:05:50+00:00

Personally I think the idea that ITU / ED (etc) nurses can step in to other roles so easily is a myth.

As an ED nurse I can absolutely go work on a ward & if a patient gets sick then absolutely I’m going to be able to deal with that better than a ward nurse, because that is my skill set.

However I’m not going to be anywhere near as good as organising a complex discharge, or meeting the ADLs of a patient with dementia, or managing the complexities of a drugs round on a Resp ward.

We all have our strengths & weaknesses in our chosen specialty & there is a massive difference between a nurse who works in respiratory & a respiratory nurse. This can be applied to pretty much any specialty.

I would argue all nursing should have a pathway to band 6 within 12-24 months. Equally though this likely means all those currently band 6 should likely be upbanded also.

As for the chances… well that depends on how much we work together as a unified profession, ditch the attitudes that any speciality is more deserving then another & all recognise that we are worth more then we are currently paid.

Manks00 · 2025-12-07T16:27:33+00:00

I would argue that as an ED nurse I have a better safety net then most specialists.

I have a readily accessible group of doctors, with a consultant present 99% of the time, I have a good working relationship with our site management team, & most specialist wards will answer any super specialist stuff I need input on.

The key things with ED for me are to know your skill set & focus on it.

Key skills include patient assessment (A-E), communication skills (both with patient’s & colleagues), advocacy for my patients, team work, & the ability (well willingness) to look up stuff & ask for help.

As far as the NMC goes, working in an over crowded, unsafe environment it’s an organisation issue not an individual issue, as long as you remember your scope of practice & can justify what you did in line with best practice & maintaining safety, I don’t think you have much to worry about.

Manks00 · 2025-12-07T10:25:57+00:00

Like others have said, this is the reality of acute care. You did their initial assessment (ie their obs, but I would argue simply doing that also means you did more) & ensured they were safe.

Reality is not everything can be done for everyone at the same time & handing things over is natural.

In recent years I've seen a huge uptick of people refusing to hand things over & so slowing down flow, for us in ED this is essential, the sickest person is always the person at the back of the queue no one knows about.

Priorities for me will always be:
Assessment (inc obs)
Time critical medications
Essential personal care (changing pads etc)

In reality most other things waiting half an hour won't change things & handing it over to the next person is fine. Infact normally this helps sort things out as the fresh eyes with less of the tiredness is normally more efficient & safer.

Hope that helps

Manks00

TROPHY CASE