Cracking Knowledge

14th October (Tuesday) - Today I only attended a few patients because I was supposed to complete my clinical performance record, so instead of the usual posts. I'm going to put up a sort of mini Q&A about the things that I had learned in these two months. Okay?

> SAFETY OF PATIENTS

Safety of a patient is actually a wide field. Safety not only means the patient themselves, but it also applies to us. I'll list it down in brief summarized formats with brackets as the rationale/ reason/ my thoughts and views.

Patient:
Orientate patient about the ward surrounding and the hospital system. (This is really general.)
Whenever patient is going anywhere, whether it's just outside the hospital or home leave, make sure they inform the nurses at the counter. (This is something common that patient often does. They leave without telling anyone, or they give us false information. I got a patient last week who said he went downstairs for a while, but when we called him after an hour or so, he said he's in the BANK. Ohhh, how could he...  At least he came back safe and sound.)
Smoking, especially the male patients (I know it sounds small, even I thought it was a small thing until today. But smoking is an absolute no-no because the hospital is full of flammable stuff, especially those who are in oxygen. Fire and oxygen comes together and KA-BOOM. So, take my advice, do not smoke.)

Environment:
Orientation (Again, the most general)
Keep the environment hazard-free. (People thought slippery floor, the odd bit of this and that scattered all over the floor is not a big problem, but it is. I still remember last time I saw a light screen railing nearly dropping on top of a patient (Lucky he wasn't tall, and the screen was hanging on to the other two hinges that weren't loose.) There was an incident where a small slip up involving a hot bowl of porridge also caused a huge drama. The staff brought in a bowl of hot porridge and told the patient that he brought in hot porridge, but the patient and her family weren't listening. The staff set the bowl on the table and left to attend to other patients. The family were distracted by their own chatter that they moved the table roughly and...you guessed it: Hot porridge went flying in the air and landing on a relative. You can imagine the huge scene it caused, which involves X-rays, incident reports, the relative getting admitted and running through the CCTV footage for firm evidence. Sharp objects are also not permitted to be brought. I know patients tends to say, "I brought a knife to slice my fruits." But when a heated argument starts, people tend to grab something nearest to them, whether it's a pair of scissors, a misplaced syringe, fruit knife to name a few. I also once encountered a police bringing his gun into the ward as well. It was empty, but even so, it's also not permitted. We managed to sort it out by asking his wife to take it back home via our Sister's intervention.)

Self:
Protect yourself before you protect others. (This is very true. We had always tend to sacrifice a lot til we all ended up suffering with the common stuff that you often hears: migraine, gastric, deep vein thrombosis, back pain, stress, insomnia... Well, something I had learned when I entered the field of nursing, work smart, not work hard. If you collapse from exhaustion, no one is going to take pity on you, as most people had often reminded me. Proper disposing of sharps are important too. I had come across several incidences where some people cap their needles back, and POKE! Otherwise, another will be putting all sorts of sharp stuff in a kidney dish, and placing a tissue on top. What will happen if people thought it was normal rubbish and then POKE! It's enough to give me a major heart attack or make me cry. Ohhh...)

> In an incident of a fire, will you rescue the patient first or yourself?
Yourself. (No, it's no joke. International protocol says you should save yourself first, but if there are bed ridden patients that needs your help, do your best to save them, but with the blazing inferno heat bearing down upon you, save yourself first. NEVER EVER BE A HERO, a sentence that keeps ringing through my ears ever since I learnt psychiatric nursing.)

> If there's a big fight going on between two patients, what would you do if you were the only staff nurse around, and it was a night shift?
Call the police. :p (I'm joking, the senior staff nurse tried to trick me with this answer and I told her the police will never come. I mean, what are they going to do? Arrest the two patients? Bzzzt.)
Security. (At any event, there'll always be 24 hours security guards to solve this problem. Again, NEVER BE A HERO. If the security of our building is unable, we have to contact the ones from the main building.)

> Safekeeping of patient's valuables. The patient insisted on you to keep his valuables and he hands over to you the following items : A handphone, a ring and a wallet. How do you safe keep them?  
List down every item in specific details and lock them in our steel cabinet. (We don't have a vault. Different hospitals, different style. Anyhow, for phone, write down the colour and brand. Eg : A WHITE APPLE Iphone, A RED ASUS handphone, A BLACK SAMSUNG tab... For ring and various jewelries, write down the colour of the item, NOT GOLD, SILVER, DIAMOND. Eg : A YELLOW ring, A WHITE necklace, A WHITE pendant with a WHITE stone... For wallet, count the money in front of the patient and note down the currencies. Eg : 7 POUNDS, 5000 YEN, 15 USD, 40 PESOS... There are some patients with black hearts who claimed that we cheated of their money... So be careful. And we also have an invoice like book for safekeeping valuables. So seal all the things into a plastic zip bag, label it clearly and pass the invoice to the patient.)

> For a patient being referred to a dietician, what do you do?
Pass over the relevant information and details. Make it short and brief. (Patient's name, MRN, Dr's Name, Diagnosis, and what type of feeding that is required.)

> During blood transfusion, a patient suddenly develops severe reaction. What you should do?
Stop the drip immediately. Take vital signs, check the patient's condition. Inform the prof and get ready some samples. (This is pretty straight forward. Before you call the doctors, always equip yourself with the data that you need, like patient's vital signs and condition. If you call empty-handed, you'll end up with a total bullocking from everyone.)

Alright, I'm beat.