P4R1W4: Tough Love

On ye bike, it's Monday!

The DHB has two orientation days for all staff. This is very similar to what was done in CHCH for preclinical weeks. Here's an outline of some of the things we sat through for a second time... Health, Safety & Wellbeing, Fire training, Maori health, Infection & control, I.T. training, Policies/Procedures/Guidelines, Patient centred care, Smokefree training... I also went on the tour of the hospital (found that there is an underground passage between the clinical and administrative sides of the hospital)... and I managed to skip the first aid training (and zipped back to AT&R to work through the afternoon). 

"Would you treat them any different?" We should be empathetic in every interaction, whether it be in a healthcare or any other setting. Powerful message. Worth a watch.

So I've now got a @nmdhb.govt.nz email address! When I first logged on, there were emails sitting there from a few weeks back (... 22 emails in total).  There are a few perks to working for a DHB - staff discounts for example! There's a staff gym (with squash court) and pool for ~$100 per year (access is for staff families too!). We have online learning systems which I am pretty sure I will need to sit down some day soon and complete a module on smoking cessation and privacy. Apparently we can hire bikes at a cheap rate and get massages at work (for a reasonable rate). On the intranet there's a buy/sell/swap, a list of continuing professional development courses, and of course a link to our patients notes.

Most of the time we write on lined paper like this...

Wednesday I was full on busy. Starting with hand-over at 8:30, hydro-pool for half an hour (I didn't get in), three patients before lunch, a physiotherapy refresher course on emergency procedures in the hydrotherapy pool (I got to pretend I was having a seizure), I had a brief catch up with the Physiotherapy team leader whom I hadn't met until now, I had a DNA (did not arrive) and an outpatient in the afternoon (plus patient notes... I managed to leave them all for the end of the day). I caught up with my I.T logins and cleared out the unnecessary emails then I was off... by this time it was 5:30pm. It was a pretty cool day - the person I admitted to the ward last Thursday is set for discharge on Friday. I played a bit of Nintendo Wii (bowling) with a patient. And I fitted a boxia ankle support on a patients shoe. Cool eh!

Thursday was busy. We started with a manual handling session at Franklin Village seminar room (across the road from the hospital). Following this we all picked up our NMDHB ID cards / swipe to access cards. Then it was back on to the ward to treat two patients before lunch. I couldn't get a new patient for my clinical educator to watch me assess, so she watched me perform two treatments on patients I had seen yesterday - one was the person with the ankle support (we decided the support was doing nothing, so we discontinued its use). The second person had a code brown when we arrived, so there was a slight delay - bowel motions are a good thing. Earlier in the day I had taken this person to the gym to begin a programme but the person's catheter connection to the bag got caught when they were trying to shift, and it broke free leaving urine on my treatment table. Shit happens. This week my session with my educator went really well. I was challenged to clinically reason, and sure I didn't know some things, but I can now direct my own learning to know more about it. I was buzzing throughout the session, it was great!

 

On Thursday I also recorded my bike trip from my flat, to the hospital. 

Currently there is only one paid male physiotherapist at Nelson hospital (that I've seen). With two male physio students there we have increased the male physiotherapists there by 200%

Tough love is:

• Mobilising (walking) a patient even if they've got severe pain linked to anxiety. 
• Throwing you into the deep end of patient assessments for the growth of your professional and clinical skills.
• Keeping a patient on a walking frame over the weekend even though they might be safe to walk without it.
• Discontinuing an intervention when it's no longer indicated, even if the patient likes it.
• Waking up a patient for physiotherapy.

Quotes & stories from the ward.

• "We're losing fish faster than we're losing patients this week" Referring to the fish tank by the reception desk... " 
• A nurse told me yelling down the corridor was the normal method for finding people (including staff) that you've lost...
• One morning this week we had a laugh during the morning handover about a patient who had emptied their catheter into an empty large can of peaches at the OT's breakfast club...
• A story from an OT about a home visit where they were given drinks of tea in large bowls the patient had provided. The OT apparently commented about the tea being in a soup bowl as 'quite a large drink'. A caregiver was present also, who mentioned that it was probably more soup than tea, given the dirty towel the patient had previously used to clean the bowls.

On Friday after placement I  drove down to attended my friend's wedding in Queenstown (Glenorchy). After a 10h drive (including torrential downpour, lightening, fallen tree on the road and waterfall gushing over the road between Haast and Fox Glacier) I made it by 4am for a few hours of sleep. The weather was perfect for my mates wedding, a stellar day! On Sunday I drove back up to finish writing this blog (final touches). [Pictures are not of bride or groom]. Time for some sleep!!