1.She has had no rigors or shaking chills, but her husband states that she was very hot in bed last night. 2.Between you and me we ought to be able to get this lady pregnant. 3.She is numb from the toes down!

These are just a few of the ‘funnies’ doing the rounds at our hospital at the moment. Apparently they supposedly are extractions from actual patients notes!

I can’t corroborate that but I have seen a few funny extracts in my time as a nurse. Not as obvious as those above but mildly amusing nevertheless and not of the kind to cause any offence to anyone affected.

It is little things like the extracts from the list above, (stay tuned I will sprinkle a few more throughout this op!) which go a long way to lifting the spirits of the nursing staff at times of considerable pressure and stress in an often highly volatile environment.

I don’t quite remember the exact time of my life when I decided I wanted to become a nurse, like lots of little girls, but I am sure it had something to do with the fact that my Mum was an Orderly (as they were called then) back in the late 60’s and early 70’s and it always seemed such a glamorous and worthy job to go for. Ho ho ho!!

(4. Patient has chest pain if she lays on her side for over a year!)

I kind of fell into it eventually, having been ‘forced’ to go out to work following a nasty biking accident my partner had in 1989.

I started off by joining the domestic/housekeeping service at our local hospital. I had the idea that I would see if I could hack working in this kind of environment and just see where it might take me.

After cleaning and buffing and dusting and being a scrubber ;o) for a few years I decided to take the plunge and apply for the job as a temporary Health Care Assistant on a Care Of The Elderly Ward at one of the local hospitals.

It was a 3-month contract and I decided that while I w
as doing this I would gain some experience and join the nurse ‘bank’.

So that when it did end if I had not secured a more permanent position in the Trust by then I would be able to work as and when I could get shifts with the ‘bank’.

This was April 4th 1994!! By August of the same year I was a permanent part-time member of staff of another CoTE ward and loving it.

(5. On the second day the knee was better and on the third day it had disappeared completely.;o))

Sadly the hospital I was working in was due for closure later the following year but fortunately the ward and its whole compliment of staff were transferred to the newer hospital across town.

By the time this happened I had changed from working part time in the evenings to full time during the day.

What a change that was, not the hours but the hospital environment. We were used to a small ‘cottagey’ type set up when if someone took poorly or who had a cardiac arrest, was usually attended to by just the ward staff and the on-call ward manager and a couple of doctors.

My eyes nearly flew out of my head the first time I witnessed such an event at the other place, the world and his wife appeared from nowhere as soon as the crash call was put out and took over, there was little then for the majority of the ward nursing staff to do, we had to let them get on with it.

No nurse wishes to be involved in such an event but I am peculiarly grateful that I was party to such whilst still at the old place. I was a main attendee to it and was able to perform CPR myself with the supervision and assistance of senior nursing staff.

I would like to think that should I encounter such a critical incident in the future that I will be able to call upon my past experience and be of some use.

All nursing staff are trained to be able to carry out some form of basic life support, as well as attending regular
updates though their employment. I thoroughly enjoyed my placement as an HCA on the CoTE ward but jumped at the chance to become part of the Medical Assessment Unit, which was a newly formed team later on in 1997.

Care Of The Elderly nursing is special, I think you have to be a particular kind of person to be able to work with the elderly and all the age related illnesses that come with it.

The MAU was a real eye opener! Here we began to get used to dealing with a very different clientele. We dealt with any medical admission patient ranging from a suspected heart attack to would-be suicides. This is where you really do have to learn on the job, both trained and untrained staff.

Lots of support is offered to all members of the nursing team be it through formal tutorials and lectures to the more informal support from the varying hierarchy.

However nothing prepared me for the first time I had to sit with an elderly gentleman who had survived a suicide pact between him and his wife, he survived she didn’t. To say that he was bereft is more of an understatement that you will ever get.

I sat for three hours with that man while he pleaded with me not to judge him, and asking me if I thought God would forgive him. Interspersed with being heartbroken that he was alive, and his beloved wife wasn’t.

Even I, who can usually cope with most things that life throws at me had to have a bit of informal ‘counselling’ after that.

I loved my time on the MAU, I can truly say that. We were a great team and all supported each other, in work and out. Boy did we have some wonderful and wild Christmas parties.

I would have said that Medical People know how to party best but since I have been on the Surgical side I think I would have a hard job differentiating!

(6. The patient is depressed ever since she has begun seeing me in 1993.)
(7. The patient is tearful and crying constantl
y. She also appears to be depressed.)

I was given more and more responsibility as my experience and knowledge progressed, eventually leading to me doing an NVQ Level 2 in Care. This didn’t give me a higher grade but it was a pleasure to be able to gain further knowledge in a field I was very interested in.

As well as the theory side of things HCA’s on our unit were encouraged to develop professionally further, as far as their grading limitations would allow.

I can’t comment on wages here as they will differ between areas but I can divulge that when I started I was on just over 9k a year and this was incremented each year until year 5. I left at earning about 10 and a halfK, supplemented with unsociable hours payments as well as night work enhancements.

It is fair to say that the role of the Health Care Assistant, or whatever name they go under in other hospital trusts, can differ from ward to ward. Our unit ‘trained’ their HCA’s up to do the basic admission paperwork for new patients.

We were also shown how to do BM’s (the measure of blood sugar levels in diabetic patients), remove Venflons (the plastic catheter tube that is sometimes inserted into a patients vein so that the trained nurse and doctors can administer medication) as well as remove urinary catheters.

We are not trained nor indeed permitted to put in a Venflon or catheterise a patient. These are among the many things the trained nurses train very hard to do.

The catalyst that brought me to the decision to become a HCA was seeing things that HCA’s were doing on the Ward where I was a domestic and knowing that I was more than capable of doing the same things. Coupled with the desire to have more ‘patient contact’.

(8. Discharge status: Alive but without permission.)

It is the ‘more patient’ contact that keep HCA’s in that position, I think, rathe
r than going on to do their training. Patient contact is sadly lacking for the most part with the trained staff due to the ever increasing and overwhelming amount of paper work that they are now required to complete.

Our Trust encourages HCA’s to undertake their qualified nurse training by supporting them with further education and seconding some HCA’s to do their training whilst still on an HCA salary and with the added option of returning to their own ward once they have qualified.

Hence HCA’ing is an ideal step up to the heady height of RGN.

To briefly summarise the ‘average’ duties of a Health Care Assistant I will give you an outline of the jobs that I undertook whilst I was one.

Assisting the patients with their ADL’s (Activities of Daily Living) as the name suggests this is the usual thing of washing, dressing, feeding etc. The extent to what you will do this obviously will depend on the particular speciality of nursing you go into.

For apparent reasons the critical ill patient on an Intensive Care Unit will not need much of the above help and duties within this department will vary, as in A&E. Colleagues I know who work there tend to do a lot more cleaning up and running around and more closely assisting the trained staff.

On our ward, elective orthopaedics, (mostly hip and knee replacements) the HCA’s are extremely well valued and are competent in wound dressing changes and the like.

Surgical wards need a lot of observations done on the patient, i.e. blood pressure, temperature and respirations following surgery, sometimes as often as every 15 minutes post-op.

Medical wards tend to keep patients for longer while investigations continue. This is nice for the staff as they can get to ‘know’ various patients and a good deal of trust can be built up between both patient and nurse.

Departments also employ HCA’s such as O
utpatients and Day Care Units. Our HCA’s in out-patients are quite prominent in assisting the clinicians in getting outpatients ready to be seen.

This can in itself be a highly charged atmosphere due to the sheer size of some of the clinics, in patient volume.

(9. Patient has left his white blood cells at another hospital!)

Most larger hospitals will have an assortment of specialties and if you are interested in becoming an HCA it might be well worth checking them out to see which would, or in some cases would not, appeal to you.

For instance you might not be able to work on an Oncology (cancer) ward had you lost someone to this condition.

From personal experience I can tell you that I found it very hard to deal with patients that we sometimes had come onto the MAU who had suspected brain tumours after I lost my Mum to one in 1996.

I also knew that I would never be able to work in the SCBU or maternity. Not because I don’t like babies or because I have had a sad experience with them.

More like because I was very broody at the time and I would have gone all gooey over the babies, came home and jumped my husband! Either that or been tempted to walk out with one!
*Tongue in cheek*!!

I can highly recommend a spot of agency HCA’ing with your local nurse bank. It is a superb way to get to work on an assortment of wards and discover first hand which speciality you prefer, on top of that you will get a whole load more experiences and confidence.

(10. Patient’s past medical history has been remarkable insignificant with only a 40 pound weight gain in the past three days!)

As you might have gathered by now, (unless of course you have scrolled down to here without reading the rest..tsk tsk! as if!) this op is mainly concerned with Health Care Assistants within the hospital environment.

HCA’s or Care Assistants as I believe they are more co
mmonly known do work in nursing homes and the like. That is something I am not going to elaborate on here, as although I have done that work myself it is something that I choose not to remember.

One day I might do an op about my ghastly experiences, but not here.

HCA’ing within a hospital is a brilliant job. You will be a close and valuable part of the nursing team and assisting them, as well as the doctors, I have seen some very interesting things done to patients by the latter.

Yes you will see sad things, yes you will be expected to administer the last care to a dying/dead patient but you will learn to deal with this.

At the end of the day you will go home knowing that you have a made a world of a difference to any patient that you have ‘touched’ that day, be it by hands on care or simply by just being there to listen and comfort.

Gosh…2077 words, best I bring this to a close pretty sharpish then!

I do hope that I have given you a bit of an insight into some of the ‘qualifications’ of which I had none when I enrolled up as an HCA, and whetted your appetite had you been thinking of pursuing this career pathway.

I can highly recommend it and most definitely would have gone on to do my nurse training if I hadn’t been given the chance of doing a spot of Ward Clerk work. But that is another op for another day!!..watch this space!!

I will leave you with a final couple of ‘funnies’ and urge you not to take them too seriously. No offence whatsoever was, or is intended.

(11. Healthy appearing decrepit 69 year-old male, mentally alert but forgetful.)
(12. Since she can’t get pregnant with her husband, I thought you might like to have a go)
(13. The patient refused an autopsy.)

The End.......quite appropriately!!

Have a nice Sunday!
Kazz x