not quite a qualified nurse (?)_nurse preceptee

the clock has turned back an hour, dusk starts to dawn upon us by 5pm or 1700 according to my nursing clock. the air has inadvertently turn so wintry, that dull, gloomy atmosphere is just overwhelming...i can begin to appreciate the effect of dementors described by JKR. just so lifeless, well, maybe not quite as dramatic as that but it just sucks out all the life in me; making me lethargic, apathetic and generally tired all the time. i could have stayed in bed all day today if not for a bit of a sheer will power. it's a constant battle against this dark gloomy winter months and i really get fed up and frustrated.

anyway, called mom and found out that today is one of the auspicious days in buddhism (to do with kuan yin boddhisatva). i'm not sure when i started to drift away from religion and start to question to relevance of religion itself at times. anyway, i shall not go into this. buddhism is probably not a religion after all, anyway, not in the theist sense or at least the roots of all evil as described by dawkins

o yes, i woke up in the middle of the nite, well, 0400, the time i'd probably have woken up had i got to go to work this morning but nope, it's my day off. so, i ended going online and blogged my previous post which i can't quite remember what it was about. and then got a skype msg from a friend whom i knew back when i did my first degree in malaysia. she is now in the states, it was about 10pm there. so, we had a bit of a chat and she didn't look forward to going back to malaysia in dec. she is just a bit fed up and frustrated with the current race situation in malaysia. when i enquired further, apparently, some honchos (well not the ministries this time) have been secretly telling MNCs that they've to fulfil a 30% quota of malay/bumi employees at executive level and i take it that she is not happy cos' this might mean she has got less of a chance to get a job when she goes back to malaysia. so i did my usual best, used my nursing, counselling skills to try and reassure her that with her vast experience and skills, it wouldn't be too difficult to find a job back in malaysia. and then we kinda drifted to the discussion about her unhappiness about the race relation (so it's not about her prospect of getting a job after all, ouch..) and here is an example she gave.

a friend of hers who is a design engineer interviewed and shortlisted two candidates. one malay, first class from mara uni, and one chinese, first class from uni malaya. he wanted to employ the chinese bloke and when i asked her how did he come to that decision, i almost fell from my sofa! well, apparently this designer engineer friend of hers felt that it is more difficult to get a first class from UM than from Mara (how people draw that conclusion from, i've no idea; well, i might be a bit misleading here, lets say first class from cambridge and first class from university of loughborough :-), you get the picture). but i don't buy that kinda argument..anyway, when pointed out to her that academic achievement shouldn't be the sole yardstick for employing someone, there was a deafening silence..again i'm a bit overdramatic. but hey, i just cannot believe that things are so race tainted nowadays that people would justify employing someone by just measuring their academic abilities. what about communication skills? life experience? well, to be fair, when i did press on, my friend did say that the friend of hers thought the chinese malaysian bloke faired better in the interview. i'm not convinced that she knew about that. but the fact that she thought i'd agree with her because her friend wanted to pick a bloke who had a first from UM over another bloke who also had a first but from a different uni is just stunning...maybe i've been abroad for too long, i really dunno but if this is how people are employed in malaysia, it doesn't bode well for the future of the country. not to mention there is a hint of race in every aspect of your daily life..

ah well, hopefully i'm doing her friend injustice by being overly critical of his selection rationale as i only received all these info second hand.

right back to me. i'm now reading Collin Abraham's Speaking out - insights into comtemporary malaysian issues which i find refreshing and at least there is an injection of hope in this sorry state birth country of mine...

been busy over the weekend. but was even more busy on the ward on my last day of the week before weekend dawned upon me. but again busy with purpose. worked with this sister wannabe nurse. not one of the people i'd choose to work with if i've a choice as she behaves like she is the manager running the ward reminding me of the things i need to do etc. anyway, in the end, she was full of praises for me! if only she knows what i thought about her, hah!

i really dread people like her becoming a ward sister eventually. she is just going to make people working with her very tensed! it's beyond my comprehension why people think this is the best way to manage people, to be bossed about? nursing is supposed to be caring, supportive but when it comes to treating your colleagues, this doesn't seem to apply to certain people, bizarre!! I sometimes wonder if i should challenge this kind of behaviour but then knowing me and from my limited amount of experience in dealing in this kinda situation, i don't think i'll do a very good job; so, i guess i'll just grit my teeth and maybe blog about it instead. yes, bit of a cowardice act :-( I really admire one of my nursing friends/colleagues who is so assertive that he would pull someone over and `have a word' with them if he thinks there is some bullying going on. bravo!! wish i could be like that, sometimes, not all the time though.

then the weekend came and gone..

well, did a meal for 8 adults and two toddlers was good; did a tapas-like chinese/malaysian/english meal and it seemed to go down well with my guests. the two kiddo were at their best behaviour i must say and rarely played up at all even though their moms were around. they do know when to pic the time to throw their tantrums. but theyn hey, i still love them to bits, they are the sweetest and cutest babies hehe. i'm not just being a biased parent...

cooking for 8 + 2 apparently is quite a big feat, so i was told. i've to thank my experience of malaysian upbringing. saw huge feast during chinese new year etc. and never really saw the cok/cooks fazed by the sheer number of guests esp. if they are just the family members. i put it down to the fact that dinner/meal invitation over here is quite a formal event whereas it is less so in the east or certainly in my family back in malaysia. so, again i received lotsa praises for my `achievement' huh... i can get used to this i think. but then again before i forget, i have to thank my partner for tidying up the mess in the house and doing the once in a blue moon/only when special guests coming cleaning of the house. it's not perfect but hey, at least it is presentable, to my eye anyway. well, if my mom were here, there'll be lotsa tut-tutting around and there will be argument before the meal or after the meal cos' i'd be telling her off at some stage for not being grateful/appreciative of what i've done :-p

digress a bit, just read this newspaper article about the death of one of the brothers of the malaysian first astronaut. not going to talk about our `space programme' nor the astronaut. well, enough critical review as well as heaps of praises on those subjects depending on which media you susbscribe to (or you could stomach rather). well, that poor chap died without regaining consciousness after a fall according to the press but what i find incredible was there was no mention about the cause of his death, well the real cause of his death. was it subdural haemorrhage etc.? not that i know a lot about head injury even though i did one of my placements on a neuro ward before but surely, people would like to know, esp the family and esp the astronaut brother who is a medical doc! i can `understand' why there is no post-mortem (well, it's just not the malaysian/muslim way- i think, not sure why; i'm probably wrong but that's the kinda impression u get). anyway, i also wonder if we've enough brain surgeon in malaysia or if there is someone who knows how to look after head injury patients! has someone been negligient, not doing their GCS on the patient, not keeping a close eye on the patient? i dunno but u would think this is what the press would want the public to know, how and why a fall in a restaurant would take away a young fit healthy life???

anyway, back to my life, enough of my rants about the state of health care in malaysia or i might be put on the list of unwelcome guests (that is if you read malaysia today :-p) so yes, yes, back to my british life...and the long dark winter awaits...xmas is just within the horizon, not that i celebrate it in a big way but then with the kiddies now, maybe it's going to be different...but at the moment, i just want a rest, bit of peace, just be submerged in this cold dark winter months and not to be woken up just yet...

will blog about the expanded role of nurses' in DNAR/CPR next time...

i try not to criticise or rather not to be too critical of the malaysian ministers but sometimes, it really leaves me wondering if there is a single brain cell left which is working when it comes to certain ministers. for eg.: just read a piece of news titled: fewer HIV cases reported and then there is the health ministry very quickly or perhaps too eagerly expressing their non-brainer conclusion that HIV cases are decreasing. what??? hello, knock knock knock!!! could it not just be because there were less people who came forward to be tested due to the stigma etc.? i rest my case when people in power came up with rubbish like that. you don't need to be very clever to even figure that one out, for goodness sake. huh...

i don't know why i'm annoyed or even frustrated with the stupidity of that statement or analysis by the health ministry. not that it affects me directly but the fact that some people can be so dim is just beyond my comprehension especially the ministry ie. government.

anyway, swiftly moving on before i get to bogged down with this `sensitive' subject (well, only sensitive to certain group of people)..

been another busy day on ward. did everything by the book today so the scary bully sister didn't get a chance to pounce on new meat well, she was too busy anyway. so, it's a good day again on the ward even though it's very busy but i like it when one is busy with purpose. and i guess constant praises by the patients helped a bit too :-p. yes, i'm easily pleased. i shall not reveal what i did to get all the positive praises from all these patients, maybe next time :-p

also, learnt about the Z technique for IM injection. heard of it before but couldn't recall what it was so, the nurse i worked with briefly explained what it entails. so now i know. but will look it up again later to see if this is the current best practise for IM injection. learnt my lesson the other day when i blindly followed what my colleague told me was the correct way to give SC clexane and it ended up with haematoma on the poor patient huh..

right too tired now to continue with my other reflection activities on what went on the ward today. just tired after work + workout ..maybe will write more tomorrow..watch this space! (a popular quote by the ward manager in my last student placement :-p)

what a wonderful day at work today turned out to be! the `bullying' Sr wasn't working, wasn't on the ward, wasn't in charge. so, no telling off for forgetting to fill in your charts etc. what an a......e.

it is kinda a strange day. wasn't really not feeling up to it this morning. weather was cold, it was sunny but i could feel the short day looming and my mood was pretty low in the morning to be honest. and then tried a few things on way to work, listening to a couple of CDs, then ran through my mind the things that i could do to make my life easier on the ward, remind myself to be objective about things the next time i'm told off. and then got to work and wow, what a fab day it turned out to be!

anyway, today is perfect. the whole ward was just perfect. even patients were super duper. no problems at all! and it's fair to say it is a quiet day, yes, the `q' word is out. and all the nurses got a chance to talk to their patients and the patients really appreciated that. what a change from an understaffed, busy, Sr. breathing down your neck ward a couple of days ago.

lets see what changed today: well to start with, there were quite a few empty beds, so, on my bay, there were only 6 patients to look after between myself and the other qualified nurse. so this anecdotal evidence really support the evidence that higher staff to patients ratio really bodes well with everyone, staff morale is high, patients are extremely satisfied, what more can i say? anyone listening out there!! i know money is always the problem, limited resource - management/financial speak but hey, what about prioritising? and i would certainly think nursing care is one of the top priorities if not the top, don't you think so, people at the top??

anyway, also learnt a few things today with regard to nursing:
1. no clexane at least 2 hrs post epidural removal - well this is obvious but it's only obvious when u think about it, i think.
2. no opiods if patients are on PCA/PCEA
3. can't remember the third thing i learnt now :-p

lets hope next week is going to be better!

o yes, a few things to note down before i forget:
1. i must arrange to have a chat with the ward manager re:
a. my preceptorship booklet
b. my contract
c. her expectation of me etc. (am i still supernumerary? till when?)
d. my personal development plan (study days? courses?)
2. contact Occ Health aout NHSP job

and there are a few more things on the list which i'll list down once i get those two done.

i'm watching the world cup as i'm writing this well, hoping that england wins :-p but really wish the commentators would just shut up. they can be a tad over the top with their commentaries at times. it'll be a good game regardless.

back to nursing, found out about contraindications for PCEA; according to the royal marsden, if opiods is given as epidural, no other systemic opiods could be even in any other routes. not sure what the reason is but perhaps respiratory depression etc. anyway, that's what i'm going to tell my preceptor when she comes back from her holiday.

ok, finding it hard to write this while watching the telly. so, will stop this and get back to rugby proper.

the weather is getting so cold now that there was a layer of frost on the car windsreen this morning! it's going to be a severe winter so i've been told. definitely not fancy leaving so early in the morning for work when the road is icy and frosty and then have to park miles from the hospital (can't afford the car parking charges at the hospital - yes staff have to pay to get to work! and the government has the cheek to even deny us a decent pay rise!!).

walking in the cold, dark winter morning is definitely no fun. wonder if i can sue the hospital if i slipped on black ice??

been off for the past few days, so nothing exciting to blog about with regard to nursing really. received my copy of NT yesterday morning. so i guess the postal thing is back to normal now. o yea, have just been told that we could check if we are on the NMC register now. will do that after blogging. knowing my luck, i'm probably not on the register yet as the NMC has probably not got my cheque etc. yet. anyway, patience...

o yes, had a chess game this morning. it's part of the club's annual tournament cup thingy. did a rook for bishop exchange and won bit lucky but then thought i had more active pieces after the exchange anyway. and also thought i might have a bit of a psychological edge after the sacrifice :-p

nothing on the telly; should probably do some further reading on the nursing topics that i'm not good at. actually borrowed a couple of books from the local library. it's quite a good library i think, bit of a pleasant surprise that they actually stock up to date nursing books. hurrah! three cheers to my local library.

ok, better get back to doing some proper reading (just started on patrick gales' my lifetime - or something like that, yesterday nite and as usual, i read the end bit and then back to the middle after i've read the first couple of chapters so, i more or less know what the book is about now, lol.

not that the three are related whatsoever in this post that i'm going to write about...just thought it's kind of interesting to say it when i hear people talk about their PPE degrees from oxford, ahem... :-p

politics
well, i shan't comment too much on the british front apart from the minging old man resigning from lib dem. personally i think it's a shame and he deserves better really. i cannot see what chronicle age has got to do with someone's ability to govern but obviously the media and the british public can be a bit shallow it's a great shame really, anyway, i'll still vote for lib dem in the coming general election which will piss my partner off if word comes round to him lol.

but hey i actually want to blog about malaysian politics in this particular post. not that i vote in malaysia, well there is an obscure law/regulation making it so difficult if not impossible for malaysians residing in foreign countries voting in GE unless you are willing to travel back to register and then go back again to cast your vote. yes, postal vote doesn't work as far as i'm aware of unless you are in the army. anyway, this is not what i want to blog about either today.

i just couldn't believe what i read on thestar online about this `allegedly' corrupt to the core politician in selangor who just organised an open house for the eid festivals in his RM8 million mansion. well, that's £1 million folks. not that i'm jealous, well, just f"£$%^&* jealous. he was investigated earlier and cleared of illegally building this mansion in the first place (by paying the fines etc.). and i'm furious the local press, media, NGOs, ordinary people weren't as furious as they should be. what's going on for f.... sake?? how could a state assembly man afford £1 million??? how? other malaysian political bloggers questioned if he paid his income tax at all? and the sad and depressing thing is not one so called clean politician commented on this either. why?? is malaysian politics really that corrupt? it really really frustrates and angers me seeing people in power getting away with corruption and why are the public still supporting him is beyond me. you don't need an accounting degree to be able to tell that state assemblyman wage cannot possibly afford that kinda palatial mansion -16 rooms, jacuzzi, mini gold course etc.. wow...how and when did malaysian politics go down to as low as that??

and then i couldn't sleep yesterday nite busy thinking about how on earth he still gets support from the public? o yes, before i forget this chappy name is zakaria mat deros or zak in short.

philosophy
why do people support evil dictators? people who plunder, massacre? hitler et al.? how could these people garner support? i suppose not everyone is pure evil, how do you deal with people who are 30% good and 70% evil for eg.? apparently this zak guy then invited 100 orphans for a free treat and stay at his ill-gotten mansion. u think, would the orphans be grateful to him? yes of course they would. would they care that he is possibly a corrupt politician when they grow up? well i dunno frankly. perhaps some of them would, perhaps some of them might think this is how life should be? what can the public possibly get from supporting corrupted politicians? are we public really dumb?

but then i thought about one unrelated event. the war in iraq; had a big row with partner when i found out that he actually supported tony's ridiculous idea of war/invasion to birng democracy and peace to iraq and o yes, to fight terrorism, to prevent WMD being deployed etc. i was an ardent fan of hans blik and preferred to let him finish his job first before deciding on the next course of action. and i thought this is the most logical sensible answer to the problem with saddam then but apparently not. my partner who has got a phd (just to add to the point that maybe academic achievement has nothing to do with being intelligent and sensible) was so adamant that that's the solution to the iraq problem, f!"£$%^ war!!

i've never been through war but am intelligent enough to know that it's going to be hell for people on the street like you and me. i find it very hard to justify the use of force in any circumstances but then i'm naive, maybe that's why i become a nurse. maybe i should take up psychology and try and work out why people act and think the way they do??

nursing
i should really be seriously thinking about doing a course in psychology or i'll go insane getting up at 5am on my day off thinking about why and how we could still allow and sometimes support corrupt, insane, mad, stupid people to represent us? why? why? why? how can people not be mad about the pay nurses get?? and the union accepting the government's staggered pay award and ended up with 1.9% pay increase? are they mad? are we mad in still supporting them? why aren't we boycotting? why could the postal worker union do it and we couldn't? why are we even on Afc when the medics aren't? and asking my ward manager about Afc is just as good as telling her `mama is not coming home today'....well, no, this is what i want to put forward, just like the sound of the phrase and thought i 'd throw that in and see what it looks like in that sentence :-p yes, going mad i know...how can i not??????

maybe it's the winter blues; probably need to start having light therapy soon. not kidding. got this white lamp which seems to ease the SAD a bit but then hey, not sure if it's EBP? but what the heck, if i feel good about it and i can afford it (not that NHS will or should pay in my humble opinion), i don't see why not. just like CAM...

now, enough said, going to badminton soon and see if i can release some of my build-up tension on the court and according to EBP (i think), the melatonin should help with the winter blues

had about 7 games of singles badminton in oxford. was totally exhausted after. but felt good; hadn't played singles like this since y moved down to oxford. still feeling the effect of the game. feeling tired and hungry all the time. deadly combination really. when you are tired, you don't feel like doing anything but then the hunger is still there. this is the time when you think it's good to be rich, just press the buzzer and someone will come over and present you with a tasty perfect dish.

talking about food; spent quite a bit eating out whilst in oxford. went to quod. very expensive food, pretty posh i think but then i suppose everything is a bit posh in oxford :-p had a nice walk back after.

before leaving home this afternoon, went to the head of the river pub for a pub meal. long queue, food was ok. but quite an expensive meal too. walked along the river and it's a nice walk, with nice weather

i think i'm writing for the sake of writing at the moment. waste of time and space...writing blog is much difficult when there is not much to write about. maybe my life is not very exciting after all.

anyway, it's my blog, i can do whatever i like, can't i?

back to nursing, been told to look up contra-indication for PCA/PCEA. think i'll ask some friendly colleagues for the answer

o yes, well done england!! looks like SA is going to be their opps in the final. it'll be nice for england to win again but then i wish the commentators could just shut up and don't go overboard with their antics. just so annoying.

anyway, back to rugby on telly..

i have lost count which week this is now since i started my preceptorship. or maybe more aptly lost the will to count

well, things are not too bad after all i guess although i hardly spoke to the ward manager yet and i have so many things which i wanted to ask her. she did spare me a couple of minutes the other day to discuss my annual leave and ksf and afc but hey, the ward hasn't implemented the new pay scale yet so, no ksf. wonder if that will affect my salary now when i finish my preceptorship eventually.

i'm so tired. worked long day on the ward. up since 5am and then played in a badminton match after 9 hrs work and i'm shattered. didn't win any games. feel abit sorry for my new partner. he must think i'm crap in the game lol. i was ust so out of focus and just wished that the game ended quickly really. can't be arsed nah, it's not true. i did try and my partner kept making mistakes and serving into the net! and with the new point scoring system, that's just disastrous as every point counts!!

i'm grumpy, cos' lack of sleep, lack of rest. shouldn't have agreed to the badminton match really but then was told that they couldn't find anyone...pathetic or what :-p oooo, i'm real mardy...

thought i felt better after talking to my sister on skype. it's great cos' it's free (well in a way).

right before i signed off, i thought i ought to recount what i did on the ward.

drug round, obs, care plans, and o yes, did a toe to knee bandaging. hope the bandage stays till tomorrow. remember when i did my community placement, did a bandage on this old gentleman and it dropped off and this lovely old couple panicked and started contacting the evening DN team! huh :-o

and was told off well, maybe not, a bit of good advice from Sr. xxx (one of the sisters who insisted on being called a sister, i think, well didn't dare to go against the norm about being extra vigilant on hourly fluid balance chart. well, i did wonder if she was just picking on me cos' i was working with another nurse and i didn't see the other nurse got told off. i was probably just being sensitive, i'm sure the Sr meant well :-p to my defence, they were thinking of taking the catheter out for that particular patient in the handover, so it's just logical not to be too `worked up' about the fluid balance chart. anyway, i just kept my elegant silent, no i lied. i actually nodded to the Sr and took in what she said and told her ok, (i'll pay more attention to the hourly fluid balance chart). i do think she meant well coming to think of it and not just picking on me cos' i'm new :-p

anyway, it doesn't matter, i feel better about myself today on the ward. trying to imagine how i'd cope if i were to be left on my own to look after a team of patients. i think i could just about cope :-p i know some friends of mine are a bit worried about being left on their own. i actually think it's a good way to learn as long as patients' safety and wellbeing is not compromised (had to throw that in, don't I :-)

o, dear, it has turn out to be much longer than expected post.

ok, that's it. stop writing now.....zzzzzzzzzzzzzzz

#
"Hi mom

thanks very much for the message. it's great to hear from you and that you are more used to the email technology now

i'm sorry if i've caused you undue upset when you were here. i cannot apologise enough for my outburst but i think i've explained to you the reasons and the misunderstanding.

i'm afraid i'm pretty sensitive and i don't take criticism easily. I'll try and take your `jokes' in a more light hearted way next time

i don't think you need to worry about my friends as they are all too polite to criticise me. hehe. i think i'm so used to being away from you and other relatives who are more outspoken and less subtle. so it takes some getting use to when talking to you. as i've said before, my friends and the people i know are all much too polite although there are a few that can be a little bit abrupt sometimes

one thing which i'd like to point out to you though is that you need not `give in' to us and there is nothing for you to `give in' to either when it comes to our lives i'm afraid. i know you might not like to hear this but all of us have our own families and lives now and i'm afraid you'll have to accept that whether you like it or not. i wish i could put this in a less direct manner.

you and dad have done marvellous job in raising all of us and i think you should try and enjoy your `reward' now you should sit back and relax and let us do the hard work and stop worrying about us. pls remember that it's our lives now, not yours, not daddy's. we choose to lead our own way of life whether it's to or not to your liking. my advice again is sit back and relax and reliquish your parental responsibilities. you can let go now (of being a parent to us). i think (i might be wrong) that you'd be much happier if you see us as your good friends now than trying to still `parent' us i.e. telling us what is right or wrong or what needs to be done etc. remember, it's our lives, and how we lead our lives (rightly or wrongly in your opinion) is still our lives.

of course i'm not asking you to be just our friends, but our very special friends. someone who will not desert us when we make mistakes, when we are in trouble etc. and someone who is constantly there and around when we need them. that's the kind of friends that i'm talking about before you start thinking i'm asking you to abandon us as parents hehehe...you can't get rid of us so easily just yet maybe what i'm asking is for you to change your parenting style now that we've all had our own opinions about things, own way of life etc. before i get too philosophical (well, i'm a doctor in philosophy after all :-p), i just wanted to say that not everything is black and white or right and wrong in this world, dearest mommy

whether you are conservative or liberal is not a problem with me (or my sister or brother i think . everyone is entitled to their own values and opinions. it only becomes a problem when we try to impose our values and opinions on other people. again, going back to the fact that not everything is right or wrong /white and black, what you think is right might not be so with other people and vice versa. i'm sure you know this but you probably need to realise that your children (now all with their families) have their own values and opinions which might differ from you. there is of course room for discussion/debate but pls don't be disappointed or hurt if we don't share your values or opinions. this is the way of life; we are only going to make ourselves unhappy if we cannot accept that there will be times when people just simply refuse to agree with us (no matter how right we think we are!)

i don't think either myself or my sister or my brother doubted your love. so don't worry about that. remember we are parents now ourselves! we know how you feel :-p

ok, i think i better stop here before you think i'm going to start another round of lecture with you. my experience tells me that when you think that i'm starting my lecture, it's not very likely that you'll take in what i say hehe...

so, till another lecture, oops...time

take care and lotsa love"

#

morning routine:

handover
get patients out of bed etc.
obs, BM etc. - delegate to HCAs (?)
drug round (not allowed to do it without supervision yet)
prioritise: 1) who is going to theatre, get them ready (shower/wash, theatre checklist etc.)
2) rest of patients - eating/drinking, hygiene/washing etc., change beds - delegate to HCAs (?)

coffee break

wound dressing
getting updates about patients from ward round
any discharges, TTO, DN referrals
filling in bits and bobs; care plans, all sorts of paperwork eg moving and handling, waterlow (if daily)

afternoon routine:

patients lunch - any help with eating and drinking - delegate (?)
lunch break (if long day)

patients siesta
writing up nursing notes

home (if short day)

visiting hour

carry on with the above tasks eg. preparing patients for theatre (afternoon list), more wound dressing, drug round, care plans cont', talking to relatives/patients etc.

home (long day)

n.b. other things to do throughout the day: updating fluid balance chart (possible delegate), putting up IV, pain assessment/control, nausea/vomitting assessment/medication etc., CD checking etc., answering buzzers, getting doctors to write up drug card etc.

Did not get to finish Dawkin's book. The book couldn't be renewed and had to go back to the library as someone had requested it. ah well..

on the work front, things seem to be getting better at times. yesterday was very busy. buzzers were going all the time towards the evening and i think i'm begining to suss out where things are etc. and the nurse that i was down to work with had started to trust me and let me do things

one of the things that came out of the training session i had with my preceptor the other day was checking BM. i hadn't realised that you are not supposed to put pressure on the thumb before taking blood from the patient, i.e. no squeezing as that would damage the capilaries and hence affecting the blood sugar result (?); not sure how true this is but it sort of make sense so, now, i've changed my practice

i've also started doing discharges, DN referrals and care plans for the patients. so i'm feeling a bit more like part of the team now.

i also learnt some new stuff recently:
Whipple procedure = pancreoduodenotomy
ITP = idiopathic thrombocytopenia purpura