Night 1

Jun. 14th, 2021 02:25 pm
whitewriter: lun (Default)
I was reading on fanlore about Crackvan - - and thinking mildly about how I came to find LiveJournal in the first place.

I have 4 x12 hour night shifts in a row this week.

Kill me now, when did I ever agree to this?

Despite it all here I am, 1/4 and determined not to call sick (unless I've got vomiting or diarrhea).

Ridiculously long rambling reminiscing about how I found fanfiction and what it gives me )

Short ramble about my pt tonight Mr bed 27 )

Oh and Happy Birthday Pete - your gift is coming in the Mail on Tuesday. He wanted a weighted blanket. I think it's a gimmick but the woven one does look really nice (so even if it is a gimmick it's a nice looking blanket).
whitewriter: (coffee cups)
Wednesday )
At 04:00 there was an email from the big boss to say all nursing staff were not to use their phone on the floor.

I've been keeping it in my locker anyway due to all that stuff with This

Someone wondered out loud in the tea room if anyone ever failed their IP. And I could think of a few that had "moved on".

If you want to stay, and no one wants you - you can always go to neuro-ICU, they'll take anyone. Thing is, most people don't want to work in what is sometimes considered a "dead end ICU" for being "much too specialised" (which I disagree with and that's another topic for another day). I loved my 4.5 almost 5 years there.

I left that shift forgetting to put my name on the 2 person list and wondering if I'd get 2 pt 2 days in a row again.

Thursday )

Friday )
Now I'm all caught up.

Long weekend full of absolutely f-ing nothing in particular (for once) lays in wait.
Oh the things I want to do *cough* read *fanfiction* cough.
whitewriter: lun (Default)
I've been rather slack on blog posts as of late due to prioritisation of sleep and rest which whilst it improves my work day, reduces the quality of categorisation and reflection of my experiences.

My perceptions and thoughts have evolved in 7 days, and feelings are never as strong as they are ATOR.

These now serve as memories rather than daily updates I suppose but I am determined to keep up the momentum that was raised during the painful (and thankfully short) period that was "new graduate midwife" or was it just the pain of being in a new hospital and not knowing who you can trust and who you can't trust to help you through the transition.

I had been burned more than a few times as a new graduate nurse and again in my transitions program so it wasn't like the first time when I had no fear.

Plus the stress of being paid as an RM 8 without the RM 8 level of experience.

This is how they reward you for jumping off the cliff into a new field, I suppose.

How I came to do a pre-planned 16 hour shift came to be )
The little malteser baby )

Woman 3 who became woman 2 )


After afternoon tea induction )

It's surprising the amount of detail I remember when I bother to sit down and go through it properly. Offloads the brain.

SRES 2021

Apr. 11th, 2021 09:40 pm
whitewriter: (coffee cups)
I realised why I stuck around with SJA for all these years.

That reason, is the Sydney Royal Easter show (SRES) (free entry, interesting people, good food, crazy happenings).

Also, it looks good on your resume- they gave me a lot when I was a student in terms of experience and references - and I want to give back to my community.

Unlike my parents who never did community anything (in their jaded migrant ways) - I would have loved to have been a cadet as an 8 year old. I knew about them in my teens but didn't really "get" what they were all about - until I hit uni. I was super flaky for the first two years but when I committed to doing it properly and aiming to get my ten years service award. I committed hard core.

That 10th year is this year. Did SJA keep proper records of 2010-2014? Shockingly, no.

But I kept my own very specific written records of those years. I listed every duty, location and length of time each year at the back of my diary and ensured I hit the minimum hours to be considered efficient.

So on the background of me having to put in a stat dec to prove my 10 years of service, I gave up another 3 days of paid work (approximately $750 AUD after taxes) or 3 days of relaxation to attend the SRES.

This year, was the first SRES they put me onto transport and I had a ball. So much so that I signed onto a 3rd day after the 2nd.

Wednesday )

Thursday )

Friday )

Being on transport meant that I was kept out of feet of the ancient M. Vincent.

SJA takes me out of my comfort zone.

People don't realise that when you specialise in nursing; you really do specialise. I don't assess 8 yr old children in my day job. I'm used to my trolley, and my equipment and my bedspace. But at SRES - you are expected to assess (and potentially refer) anything. Keeps me on my toes.

Hope that kid was okay and that my assessment was correct. On my way home I thought of other reasons why she might have fainted. VSD came to mind. You'd think by 8 yrs of age it would have been picked up already...
whitewriter: lun (Default)
Mr 27 IVDU T1 respiratory failure from last week passed away.

I used to be on the end of life care committee before I left for midi and they never took me off the mailing list.

Whilst the emails are annoying, they do give closure if I see a name on the list that I've nursed.

We are generally not informed regarding outcomes. Mostly its word of mouth "so and so went to the ward did you see?" or "so and so passed away, so sad". But if they got better or went home or went to rehab, we wouldn't have a clue. So sometimes when patients or their families ask me how long they may need to stay in ICU, or how long their recovery will be, I genuinely tell them I have only ever worked in ICU (pretty much - one track career girl.... it has it's downsides ) and therefore have no idea. Once a year a patient will come in to thank us (and you'd have to be lucky to be on) and then you can see how well they're doing or their family will email our manager with an update and that gets passed on.

But otherwise when someone dies, it's not something that gets broadcasted. You'd have to ask (or be on the end of life committee mailing list).


There's a new Miss 27 and she's pretty cool even though her story sounds chilling )

I've negotiated her wash time (she prefers morning) and she'll tell me when she wants to roll.

I've been reading articles on breastfeeding and how covid-19 has impacted it; and figuring out her history; and now I might do some HETI. It's only 22:30...


It's going to be a long night.


Miss 27 is currently on a video call with her family at the moment and there is a lot of gesturing for someone who is on a ventilator. Certainly no one sided conversation going on there. I'm trying not to eavesdrop and allow her some privacy.

Imagine being her family. You've taken care of this child whom is now a toddler - for 2 years. They became unwell quickly and life and death decisions leading to limb amputation and transplant decisions being made over a 2 year period. It quite well may have taken over their entire lives for the last 2 years. If one parent was working; they may possibly have had to quit in order to keep up with all the decisions and treatments being made. And after all of that; you are left with a child with no legs, and 3 stumps on either hands for fingers, a lot of scarring all over her body and who knows what other damage - psychological - and to her future options are left.

It makes me think of friends whom I have felt have pushed me away after they had children. Or perhaps it was I who pushed them away. If their child went through an event such as meningococcal septicemia would I return? Would I offer to help out? Or would I just leave it be and remain in my bubble. Where I am me. With my cat and my Pete. And I just observe the lives of others. Taking care of them for a shift or two, and going home and just writing about what I think from afar.

I know that wouldn't be me. But I'm not an initiative taker - I offer help; and if they ask I'm more than happy to pitch in and provide, but if they say thanks and don't actually ask; or; if they do ask and I find it doesn't seem genuine I get the shits and feel used.





non work related random updates )
whitewriter: (coffee cups)
It had been described as "feral" during the day but by the time the PM staff came on, we managed to clear the place out and it stayed comfortable for the rest of the shift.

Women of MAC )
whitewriter: lun (Default)
1. Family hierarchy and cultural norms are revealed

There are generally 4 types of chair in the birth room. Who sits on which chair denotes hierarchy/status and role for the day.

Type 1: A big high backed chair which is typically for the woman.

Type 2: Waiting room style chairs that look finished in carpet and are generally unpleasant to sit on for more than an hour (and birth generally takes much longer).

Type 3: Plush leather look recliners that have a foot rest, lean back into almost a bed with large soft arms.

Type 4: the stool (sometimes a saddle stool) the midwife or HCP sits on, which sometimes looks like this:
saddle stool

Women (pre-covid) usually had two persons accompany them (sometimes three). The dad, the mother in law or their mother - and perhaps a sister for a time - who then usually leaves when it gets late.

Leaving the Dad and mother in law or mother to sort out the seating arrangement.

From what I have observed:

​In lebanese families, it's the Dad who sits on the comfy recliner, and the mother or mother in law who is in the waiting room chair.

In Indian families, it's the opposite: grandma sits prime on the comfy recliner and the dad is in the waiting room chair.

In other cultures it really just depends. Sometimes they take turns.

If the dad is super dooper keen on being right there, he sits on the saddle stool like he owns it and he's going to be the midwife today!

2. Midwives wishing the baby a Happy Birthday!

I found this really cute when I first started and it hadn't even crossed my mind until the first time I heard them say it myself as a student midwife and I realised yeah! yeah baby. Today is your first birthday!

3. Women and their families expect the epidural to work every time and mean zero pain.

As one anesthetist puts it: 80% of them work and 20% of epidurals give trouble. They have 2 choices when it doesn't work:
fiddle with it; perhaps resite it - or accept that it doesn't work and your in that unlucky 20%

Furthermore, today's epidurals are supposed to allow you to feel when to push. This means some amount of pain, especially down where the head is coming out. It's much better for the woman, and for the midwife too - if they don't have to guess when it's the "right time" to push by feeling your abdomen.

4. Consultants act weird and the women seem to love it.

Some private doctors do surprising things. One of them likes to make the baby "shake hands" with Dad and generally waves the baby about a little after it comes out and all is well.

It reminds me of Michael Jackson and the balcony or Steve Irwin and the crocodile. Put. The Baby. Down. Fellas, it's not a toy.

5. Dad thinks he can deliver the baby.

I hear this all the time. I've yet to see it happen. I have worked with dad's whose heads were basically right beside mine the whole time, watching everything. Similarly I've had others who stayed well back in the corner and left as soon as the child was out. The mother cited he can't deal with blood and cut her own cord. You go girl!

6. Men watching their partners go through the experience and saying that if men were pregnant they'd do the whole process better.

Seriously. Just, get out. You clearly can't see how unsupportive and douche-like you sound when you say that.

7. Women are surprised that their waters breaking feel like their peeing themselves and are shocked at how much liquid comes out.

Studies say that in a normal pregnancy about 700mls of amniotic fluid surround the baby.

The water can either leak out slowly or in a spurt - it comes it fits and starts often.

It probably feels worse because they're often sitting in bed when this happens- and no one likes to pee themselves and feel out of control, feel wet constantly- and have someone change the pads underneath them all the time.

Even women who have had multiple babies seem surprised and seek reassurance about this.

8. Women (and their partners) beg the midwife for the epidural

I can't speak for other midwives, but when you've asked me - and I've said I've called them, there's a reason why I don't tell you exactly what time the anaesthetist is going to arrive. If they're in the middle of a procedure with another woman: they could take anywhere from 10 minutes to 45 minutes sorting out a previous woman. There could have been complications during their epidural, may need to attend to other emergencies in the hospital - these factors are things I cannot control. Therefore, if i said they're coming in 10 mins and their more like 1 hour, you're going to call me a liar and I'm going to feel bad.

If you want that epidural immediately, perhaps you should investigate with the hospital your intending to give birth at: how many anesthetics they have available on the day; and if they are exclusively only to service the birth unit or if they have to also service the emergency department or emergency theaters and the like.

But somehow; this is not something people investigate pre- pregnancy or pre booking in.

The anesthetist can be 5 mins, or they could be 2 hours. I can't control the universe. I have been known to stalk the room where the anesthetist is known to be in; doing the previous woman- because it's hell/worst part of the shift - being in a room with a woman who is begging you for the epidural; and knowing there's literally nothing I can do to speed things up.

9. Someone always asks the midwife what time the baby is coming out.

Honey, if we knew, we'd tell you and this would make both our lives much easier.
I feel like you know that we don't know - but you ask us anyway. If I had a dollar for every time I got asked this I wouldn't have a mortgage.

10. Ordering Mc Donalds.

The second thing women (and their partners) do after they ask us how long until this process is over - is order a burger from Mc Donalds. Once they have adequate pain relief, they realise they're super hungry and it's a special day. No one is interested in the snacks they've packed into the hospital bag so Uber eats for a maccas order it is.

Especially if it's 2am.
whitewriter: lun (Default)
Today in ICU

tt's quiet.

It's boring.

It's rainy and humid and windy outside and the only way I know this was because I walked in it at 0700 to come here, and there's a little window in my patients room and I can at times see the rain and wind whipping about.

I remembered to bring an umbrella with me today. I've lost so many. This one's a freebie from the dumpsters outside Sallys apartment where hoards of international students have returned home, leaving their not worth it items behind.

My patient is in bed 24. )



Melbourne is back in lockdown as of midnight on Friday due to 8 cases from the Holiday Inn.



A man who flew in on Tuesday to visit his mother; was locked outside the hospital whilst they sorted out a rapid covid test for him.



Meanwhile, the rest of her family from Sydney were all inside; whilst she was very close to passing away.



The managers were seeing what they could do to expedite his entry.



Despite this; he remained outside - and the family used video call so he could at least see what was going on.



By the time the result came back (pretty quick, 4 ish hours maybe?) she had passed away but as it was negative, they let him in (that result isn't 100% - and what about all those family members that would have been considered close contacts of him: or the fact that he's been in to visit every day since Tuesday...)



Rules are rules but I did feel rather sorry for the family. We're not even in the affected state and our visiting policy just changed to reflect how well NSW has been going overall (unlimited visitors but everyone has to wear a mask and check in). - And it's not like he hasn't already been there and visited for the past 4 days (meaning that if he did have it, we were all in trouble...).
whitewriter: lun (Default)
Yesterday I was babysitting an AIN-able pt (Val)

Today I am babysitting what will be, and is currently, a palliated gentleman.
rambles )

My shift ends with me running up hospital road and then cursing when the bus I was aiming for drives past. I'm sure it left early. So I walk the 2km home.

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