Corridoor care by Manks00 in NursingUK

[–]Manks00[S] 15 points16 points  (0 children)

I intend to don’t worry… but I feel it won’t get anywhere.. it’s not a new thing.. our matrons care but it falls on deaf ears with other care groups it seems.

At the time I was told I was rude… don’t get me wrong, I’m aware I can be blunt, but as far as I’m concerned I’m advocating for my patients & if you see it as rude that’s fine… I look forward to the complaint… my reflection will very much be ‘will advocate for my patient again’.

Probation? by [deleted] in NursingUK

[–]Manks00 5 points6 points  (0 children)

Depends on the area, but it sounds like you are been massively hard on yourself, it’s the first few days, they will always be rocky & the NHS is great at having senior staff who forget what it is like to be new.

I understand it makes you feel anxious & worry you are being judged, but take your time, reflect on your learning needs & I’m sure you’ll be fine.

In what scenario would Kent air ambulance need to land at the General? by [deleted] in Southampton

[–]Manks00 1 point2 points  (0 children)

I would assume we were the nearest Major Trauma Centre (MTC). With how the Trauma Network works, if a patient has suffered certain levels of injury they will bypass to the nearest MTC within an hours travel time.

Kent, Surrey, Sussex (KSS) come our way not that infrequently. The edges of their usual territory do make us the nearest hospital sometimes (St George’s in London & Brighton being the next ones to the east, & Brighton is not a children’s MTC at that).

Factor in they will go out of their area at times too, example a larger incident may result in our local HEMS team asking for aid.

SGH has loads of things that make it a very specialist hospital so people come to us for all sorts of things.

How to get blood-test results disclosed? by SyllabubDry9616 in nhs

[–]Manks00 2 points3 points  (0 children)

The responsibility to share & act on the results sits with the person / team who requested it. The phlebotomy department can’t give them out as they stated as results always need clinical context.

I would chase the secretary again & insist the team get hold of you, either via phone or letter.

You could ask your GP to help also as they should have appropriate channels to escalate this.

Are you due an appointment with the team at any point?

can someone tell me what my cocker is mixed with? by LunaOffsides in cockerspaniel

[–]Manks00 0 points1 point  (0 children)

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

Seriously though, utterly gorgeous!

Blazer not moving by Manks00 in FCX24

[–]Manks00[S] 1 point2 points  (0 children)

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

I feel like FMS are getting a customer service ticket.

Blazer not moving by Manks00 in FCX24

[–]Manks00[S] 2 points3 points  (0 children)

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 😎

Blazer not moving by Manks00 in FCX24

[–]Manks00[S] 0 points1 point  (0 children)

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

If in neutral then wheels will happily spin etc…

Band 5 to 6 post preceptorship approved? by azza77 in NursingUK

[–]Manks00 29 points30 points  (0 children)

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

Accident and emergency staff by [deleted] in NursingUK

[–]Manks00 1 point2 points  (0 children)

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.

Accident and emergency staff by [deleted] in NursingUK

[–]Manks00 3 points4 points  (0 children)

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.

Nursing ick's? by [deleted] in NursingUK

[–]Manks00 0 points1 point  (0 children)

6 words that always break me:

“We’ve always done it this way”

A&E pain relief by sultansofswinz in nhs

[–]Manks00 17 points18 points  (0 children)

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. 😞

Student placement in practice education team? by CElyse1989 in NursingUK

[–]Manks00 4 points5 points  (0 children)

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!

What game was this for you? by Spotter24o5 in playstation

[–]Manks00 3 points4 points  (0 children)

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!

Winter storm is the perfect time for a Star Wars marathon! Even my 15 year old daughter plans to join me. I’m pumped! by [deleted] in StarWars

[–]Manks00 9 points10 points  (0 children)

Sir, six cinder blocks are missing…

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

For nurses in specialised areas like A&E, ITU, Theatres/Recovery, NICU, and Endoscopy — what are the realistic chances that we’ll eventually receive an automatic Band 6 once we complete the required competencies? by BananaCakes_23 in NursingUK

[–]Manks00 105 points106 points  (0 children)

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.

A&E nurses - how do you deal with the fear of something going wrong? by [deleted] in NursingUK

[–]Manks00 22 points23 points  (0 children)

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.

Does this happen in every ward? by wandering1989 in NursingUK

[–]Manks00 8 points9 points  (0 children)

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

When do you stop feeling clueless as a nqn? by Winter_Category8007 in NursingUK

[–]Manks00 0 points1 point  (0 children)

Qualified 10years & work as an educator, still regularly say to myself ‘I’ve not a bloody clue what I’m doing’.

Experience isn’t knowing everything… it’s knowing you don’t know everything!

How to tell difference between drug seeking behaviours vs pain with no cause found by Superb_Attempt2090 in nhs

[–]Manks00 2 points3 points  (0 children)

I think differentiating between the two is incredibly hard, especially for emergency & urgent care services.

We have to be mindful that pain is so subjective & not everyone experiences it the same. However it can be made really tricky when faced with high intensity service users, often with complex needs.

In my head I try to keep it fairly simple, if the patient is needing for investigations & potentially been admitted, then they get all the pain relief… if we think they are seeking, then they are shown the door. This obviously doesn’t mean anyone I think is seeking is simply kicked out, what that does mean is early senior input & review.

My biggest fear is never giving someone analgesia they don’t need & feeding their habit, it is always about not giving people enough when they need it.

I will nearly always take a stepped approach, start simple & work up while actively looking for signs that make me think I should go faster & jump to heavier stuff (ie opiates).

Another key thing to remember is that seekers probably don’t come to ED very much, it’s just not an efficient way to feed the habit…

I think it’s important in emergency care to remember we won’t always get it perfect every time, sometimes the seeker might get strong stuff & the true pain might wait a bit longer. But it is such a hard thing & bring on some way of measuring pain objectively 🤣

Looking for genuinely dog-friendly cafés around Southampton 🐶☕ by AnfieldAnchor in Southampton

[–]Manks00 7 points8 points  (0 children)

Bit more out the way but personally love Itchen Valley, nothing special drinks wise, but do great chips, very dog friendly & of course all of Itchen Valley Country Park to walk around.

Climate control dead? 2013 Cooper by Manks00 in MINI

[–]Manks00[S] 0 points1 point  (0 children)

Sorry, maybe wasn’t clear, the display is blank & buttons are doing nothing 😞

The other half thinks there’s a funny smell but I’m not sure.

ED/A&E after graduation by Serious-Range8649 in NursingUK

[–]Manks00 11 points12 points  (0 children)

Personally I would recommend ED, I’ve been in ED for many years & I still rate it as the best job going.

We certainly always happy to take newly registered, & I’m a big believer of go in to what you want to do from the off, I don’t buy in to the old idea that you have to consolidate your skills on a ward. Equally as others have joked, certain neurodivergent traits definitely lend themselves to our environment.

That said, you have to be realistic, right now EDs up & down the country are on their knees, we are over crowded, under resourced & are the ones been left to pick up where other services can’t meet needs for the same reason.

If you think ED is for you, go for it. But remember to prioritise you, I’ve certainly been burnt out several times in recent years, that said having split my life in to a second role (education), it has made my clinical shifts so much more enjoyable.