MGS RADAR

Today we had a day full of wound care and dressing..the hard basics and we have this with one of our greatest teachers Mrs.K.

Wound care is definetly hard, it is the top of a pyramide built from the basics we did in our first year and if you don’t have these basics (the skin, the cell, the nutrition, the oxygen system) present the pyramide will collapse immidiately.

During a break I spoke with my teacher about some things I saw during the ambulatory care. And I talked about some things I did and how I do it and if it’s right to do this and this.

These were simple things like pulling up a syringe or preparing medications or do a care plan for a patient. In 30 minutes she bailed down everything I did and showed me (in a very gentle and teaching way) what a load of bullshit I did in my practical education. I didn’t really know why I did some things and I did some things because other nurses did this load of fucking bullshit.

Some of the best bits I did:

- Planning a thrombose prophylaxis for a patient who is under high therapeutical heparin dosages with daily PTT lab check. (There is at least 1% - 0% chance that this patient is under a danger of a thrombosis)
-  Planning contraction prophylaxis for the patients legs which is paralyzed down from the waist but mobile in his wheelchair.

- Trying to sold a transfer from bed to wheelchair as a multiple prophylaxis

- Push air through an infusion line in case it’s not running (The whole line is contaminated and there is an imminent danger of killing the patient with air bubbles)

Despite my arrogancy and the knowledge, that I have the potential to become a good nurse with the view of this great teacher I still see a big challenge and way in front of me!

Soo much work to do!

Stephan

["If liberty means anything at all it means the right to tell people what they do not want to hear!"]

Wohlwollend ausgedrückt trifft das auf Berlin, ferner auf meine neue Bleibe (ferner auf mich… höhö) zu. “Very working class” hat der Vermieter es genannt, aber nennen wir das Kind beim Namen: Ich wohne in ‘nem Haus, dass aussieht wie die die Produktionshalle eines VEB (a.k.a. “Das Kombinat”).

Ich hab’ das Schmuckstück mal fotografiert. Zu meinem Erstaunen ist mir gestern aufgefallen, dass das eine oder andere Musikvideo hier gedreht wird . Wer also ein paar bewegte Bilder zu “meinem Block” sehen will kann mit Hilfe des Clips raten wo ich grad sitzen könnte ^^. Ich wurde vor einigen Wochen übrigens auf’m Heimweg von so Hosenscheißern mit Eiern beworfen. Gut verstecken konnten die sich, dafür nicht gut zielen! Können die nicht - wenn mal wieder Langeweile ist - stattdessen so komisch tanzen wie im Kaiser Chiefs Video?

 

Falls “not available” angezeigt wird, hier klicken!

Daniel

Considering the unbelivable level of cost of living in London you could pretty much say only scratching your (own) “arse” is cheap. Yesterday it’s been bar-hopping time right after work. A great opportunity to get to know the people I had been working with the last two and a half werks and try out a couple of new brands of beer, thus widening the cultural drinking horizon. A classic WinWin situation. Apart from the refreshment (I think I preffered Foster the most) and the good feeling of being on the mildly drunk side of life it was the beverage of choice because it offers the most volume for the best price.

You want to hear a neat comparison? I ordered today two flight tickets for a brief home visit in the beginning of December. When neglecting all the additional services a certain Irish low cost carrier offers I am able to fly for the criminally low price of 28GBP - both ways! Now that is only one pound more than the generous collegue paid for a round of Sambuka for nearly a dozen mates.

There you have it: Ordering drinks for yourself and your friends costs you nearly as much as flying from London to Düsseldorf (Weeze) and back! Cheers to that!

Daniel

Well, emergency situations in the ambulatory home nursing care whatever you call it are RARE but if they appear on the daily schedule of doing “something” they come in big masses.

Yesterday I was on tour with my fellow elderly care nurse until we got a call that we had to cancel our current tour and head straight towards a female patient ouf ours which we planned to visit 2 hours earlier. She called with unknown complaint. Well we rushed all our way to her, and she was sitting in front of the TV. We talked a minute, I took out my blood-pressure-bandage and after all of a sudden, she screamed very loud and then she went into a general seizure

Due to the fact, that none of us knew anything about her, we took a quick look to our documentation and then we saw, that she had three seizures in 48 hours. She was a known epilepsy patient and then we both quickly decided to call 112 for an emergency physician.

The ambulance crew and the physician arrived soon, I knew the doctor on duty, he was an internal & general medicine attending physician. He reviewed the patients charts and we (Both nurses, the physician and the paramedics) decided that it was too dangerours to let her home. The seizure stopped and she went into a terminal sleeping state and then she was extremely desoriented (which is normal for epilepsy patients). So they took her to intensive neurology care unit
Today I was called off duty, half an hour prior my late shift…a patient had high fever which was not responding to antypyretic medication (Metamizol, Aspirine & Acetaminophen/Paracetamol are the most common). Upon our arrival we measured a rectal temperature of 41,8°C degrees. I said let’s call the general practicioner on duty, my fellow nurse said let’s call HER general practicioner and ask for a telephone order . The GP on the other side said, that we should start an I.V. drip of Perfalgan (which is the intravenous brand-name for paracetamol). He was a hack, because we had no Perfalgan and no I.V. set on-scene (despite the fact that I’m able and have the balls to puncture a vene and start an I.V. after order, but let’s just put that out of the line) so he was out of tips for us. We asked him if we’d do a controlled fever compress on the calves and the lower abdomen. (@Arteria illiaca) and he said okay do it whatever this is.

Well if you put down the temperature with wet towels around your ankles and calves, you must be aware of certain risks. The patient must be monitored frequently (Puls + Blood pressure) and you need to stop if he shows any sign of new discomfort. The german “Wadenwickel” can lead to a “general failure” of the cardiac system, I only use them as a last resort.

The temperature went down, but she had to go to the hospital for pneumonia.

FUN FACT

The old lady with the seizure complained about our treatment. She said she never wanted to go to hospital and that we are idiots, the next time we should let her lay down on the floor.

Stephan

["If liberty means anything at all it means the right to tell people what they do not want to hear!"]

With international capital markets under heavy pressure and in desperate need for liquid funds mgs-radar contributes in its own way to recent money injections, brought on the way by numerous governments. In an uncoordinated action with G7 leaders I opened a bank account here and deposited the equivalent of two months’ rent.

I might withdraw some of the money though – and maybe I’ll try out something equally exotic, as from my continental European point of view, also outdated method of doing payments: The issue of checks. I just received this fine booklet… don’t really know how it works yet, but I guess as long as I don’t sign as “Mickey Mouse” financial institutions will accepts it.

Daniel

Again some bitter response to my regular topics that I encounter in my daily swell as a Nurse Student and loyal jerk.

The last school-time (4 weeks after my holidays) was a haze, I mean it was really intense and I have to say the kidneys really fuck up even the anatomy and physiology lovers like me. I really had to learn for the test because the anatomy was so fucked up and the kidneys are a bunch of fuckers Beside the fact that I finally did not manage to properly catheterize a male or female without getting unsterile, I just faced the fact again how dangerous it could sometimes be to do something you haven’t really learned yet. Pushing a catheter in an uthetra is far easy, but working completely sterile and having your mind set up for working proper.

The first time I assisted in catheterizing a patient (it was four years ago during my first surgical nursing internship), the nurse screwed up completely and we had a massive ammount of blood flashblack which is a sign for a perforized urethra. The man needed a surcigal reconstruction. This was the lesson for me not to push the catether further into the bladder if you have a resistence.

Also the school time was sick time again. I went sick and had a nasty flu , I even had to take a day off because I was so sick. I hate the flu because it fucks me up completely with back pain and having the feeling of drowning in my own snot. The whole flu thing was an epidemy, maybe a pandemy in my nursing class…from 20 people over 16 got sick and it started with one girl who catched up some multi-resistant bastard virus from a patient in ambulatory care. One day only half of the class attended the day, which was kind of relaxing.

Since I started my job and work with infectious patients on a daily basis, I went aware of my own immortality. I got infected 4 times (two times with a diarrhea-vomiting-combination virus and several times with a nasty flu) from patients and all these diseases were heavy. I don’t think that my immune system is weak, I just started to think that I got exposed to bacterias and other bastards which are part of the elite force.

Back to work in ambulatory care and driving around from patients residencys is kind of…not challening for me. The whole thing is fun though and the patients are nice (most of them) and I appreciate the very good nursing they do with the patients, but I quickly realized that a hospital is a better place for me to be. Same work in a different backround, of course you can take an idea of lessons.

The part of my work that sickens me the most is the lack of energy, the all-the-time tiredness, the lack of sleep, the disturbed sleep pattern and the feeling that you got after you finished your shift. You are just empty and your body feels like you just did a marathon. After the thrilling drive home, you go to bed and cannot sleep because you had very much changes in your shifts. Shit game!?

I look kind of retarded when I start my shift in the morning. I pass the death-hall, go left and then I’m in this shithole of dressing room which is in the most cases cold like a fucking refrigerator. When I’m finished scrubbing, you walk the way to the hall and you listen to the noise the fans outside, the cooling system of the cafeteria and the isolated sounds of elevators and automatic doors. It’s a silence you percept every morning. You enter the ward and the workload begins.
Despite beeing VERY bored at the home nursing care time I have to spend I had a sense of archievement today. I stated in my nursing plan that a female patient with severe contractions was able to stand with aid of kinaestetic movement of a nurse and that she was able to wash herself. An elderly care nurse with 20 years+ experience said that this would be impossible but I said try it out, and I WAS FUCKING RIGHT. The training and my sharp eye in assesment and nursing diagnosis led to the great event that a women was able to wash herself the first time again in two years! These rare events are the reason for doing this!

Today I remembered a time far far away, where Daniel and me were dependend on bicycles and we met in the middle of our ways which was Hostert and we drove around with our bikes and did a lot of shit. Also the time we met in the middle of nothing with some friends and drank cheap alcohol, nothing compared to the ammounts we stuff in ourselves today. I remember where an old colleauge of mine, Padde and me went drunk in Waldniel and we brought up the idea of jumping into the garden of some poor guys and doing a run. We started our ways through the backyards and this quickly became a pursuit. At one fence, Padde jumped against it (it was kinda high ya know?) and the whole thing fell down…the owner saw this from his TV-chair and went fucking mad. Without orientation where we exactly are we rushed over the next way and ran into the industrial zone and rushed into some bush where we stayed the next 20 minutes. We then quickly disappeared into Paddes summerhouse, where his father a high-ranking police officer showed up after some hours. With bruises and some left bushes in our hair we had to tell him, that we had nothing to do with some “backyard-harvesting”

I don’t know exactly what pushed the button back in the days were I was in the 11th grade and did my school-orientation-internship at a hospital, but as I was allowed to stay one day at the Surgical Intensive Care Unit and watch the work done there, I was fascinated. Others feel a great ammount of fear when they see the ventilators, the perfusors, the ECMO’s but I was fascinated. I saw what 1 to 1 nursing really means and the endless possibilities and time you got left for your patient. I really like working on the floor wards and despite beeing very challenging I can’t imagine myself in 10 years….beeing a floor nurse and end in a burnout or back pain hole…I always thrived to Intensive an Anaestetic care and I have very little to zero experience in Intensive and Critical Care but I know that I have the potential, the willingness and the philosophy of doing it. I have seen many others doing it, and when they do it I can make it.

Yesterday I found some “old” pictures from good old times. I remembered how easy going it was and that you didn’t have to worry about some things. School was a fun-place, where learning should but never stood on the top of our priorities. We had fun, we acted stupid like lunatics, we were idiots and together we experienced a lot of things. Even in the Oberstufe and in the Abitur time, it was so funny and “loose”. Nobody really cared as much as he should do, and everybody was doing it at the same time. Today I see it as a privilege simply not going to classes like German with the retard fucknut Hr.Osten, today I just can’t stay away from work if I tend to sleep longer. If anybody had told me in the 8th grade I had to get up at 5 o clock to be at work, I’d laugh at him an and tell him to fuck off. Now I’m the fuck-off!
One day in 9th grade, our class (we were the elite-force of troublemakers, and I really mean it we were tough shit for every bloody-beginner teacher) was re-assigned to a new classroom in the second floor. We entered the room the first time in our life and the chaos started. Some guy named Risch****** set some paddings on the wall on fire with new-years-eve firecrackers and Marc and Mueller threw the trashcans out of the class two stories down. After this the trash in the remaining can was emptied on the floor and the broom was destroyed with much energy. We then went to our class-teacher Dr.Ohlemüller and complained about the status of the room and that the other class didn’t managed to clean it up. What bastards we were….

Some weeks ago I had to put out my physics book from 12/13th grade basic physics course. I had to clear something up for me…it was frightening. I sat 1+2 years (1 year pre-course in 11th grade and 2 years in basic course 12/13th grade) for three hours a week and lets say for 40 weeks per year in this old fashioned physics room which makes up  a number of 360 hours which are 15 complete days in my life and learned nothing but building a small bomb out of a lighter, building a very good paper-plane and “how-to-conceal-that-I’m-just-about-doing-other-homeworks”. Something is and maybe was completely wrong with the school system.

Having or doing something very often is a mechanism of compensation, not having enough or the dicsability of doing something often enough is a reason to compensate⁽¹⁾

Stephan

["If liberty means anything at all it means the right to tell people what they do not want to hear!"]

1. This is my fucking qoute, I hope nobody steals it without my name written under it! [↩]

Who would have thought: I got successfully onto the very first bus today! Yesterday’s post appareantly helped . I arrived even some 15min early, which balances my late arrival on Monday out quite nicely. Actually this was a perfect fit as I attended my first general meeting right after the office day began. Another intern and me were briefly introduced by the moderating senior manager… when he asked about the first day’s impressions I of course told everybody about my success at the bus stop this morning. Gosh, it must have sounded like rubbish what I said

I celebrated this commuting success with a first attempt to “cook” tonight… resulting in chicken that was still rough on the inside.

Daniel

After sleeping in hallways (at least temporarily in the shared flat of a fellow intern), after getting acquianted with new collegues and office routines such as getting a cup of coffee (as an intern I actually have to make it only for myself ) and after buying missing basics (a brand new iron at Argos for 4 Pounds - I am tellin ya! It’s like the first minutes of playing the Sims when you need all kinds of things but don’t have the money) I am slowly moving past the “just arrived” state. I settled down in the illustrous area of Elephant & Castle, which is from what I have been told not the most dangerous part of London but belongs to one them. Still, the folks with whom I share this place are a friendly mix from all around the world and the room I got is actually not too bad either.

The streets around the apartment complex - whose buildings by the way rather resemble former socialist factories than places for living - are unfortunatly a different story. I hope putting a mean face on keeps the bad guys away…

I personally think the London public transport branch of busses is eager to contribute to my angry expression. After being forced to wait for the next bus due to overcrowding last Friday I decided to leave 5 minutes earlier this Monday morning. And what did it help? I stood there, half an hour at the bus stop because not one, not two, not three but four busses stopped, left people out, but no new passangers in! It was not after I virtually pushed myself through the half closed doors that I got in. Shortly before boarding the bus driving lady simply stated that it is time for a “No more passangers!”. Screw that! But there is one good thing in this whole mess. My one week Oyster card has expired this morning without my notice. Before “my” bus arrived I wanted to get into the wrong line. I had not seen that before the “63″, there was another three. The machine blinked red when I held my card to have it scanned. I told the bus driver to wait a second and rushed back to the station, baught a single drive ticket at the vending machine and ran back. As that is appareantly everyday business for the driver he just took off. I even knocked at the door. I was actually lucky he professionally ignored my plea. Back to the dear bus driving lady: As she would do it to punish me for my illegal move she demanded to see my ticket and carefully examined it. Tomorrow I am ready for a new round! I’ll leave another 5 minutes earlier. Eventually I’ll find the right time to catch the bus.

The final outcome was: Me arrving not 5mins late like on Friday, but whopping close-to-20mins. Luckily the office atmosphere is pretty laid back, following the model “as long as your work gets done”. London is challeninging my inner German sense of duty to be always punctual. London bus drivers: You make nearly four times (on many busses you’ll find search advertisements for new drivers) more money than I do… please be at least so kind and take me with you!

Daniel

…wie man die Anordnungen von Hausärzten verstehen lernt.

…wie man mit begrenzten von Hausärzten verordneten, festgelegten und ach ja sehr begrenzten Ressourcen klarkommen muss.

…wie man lernt, nebenbei noch Sozialarbeiter zu sein.

…wenn man die Vorstellung hat, alles wäre zeitlich festgelegt und engmaschig geplant ES aber in der Realität so ist das man sich WIRKLICH Zeit lassen kann.

…wie man solche Dinge wie Ganzkörperpflege in Badewanne oder Dusche pflegegerecht durchführt.
…wie Pflege nach AEDL richtig aussieht.
…wie Pflegeablaufpläne das Leben erheblich erleichtern können.

…wenn Hausärzte selbst zugeben, keine Ahnung von Wundversorgung zu haben aber Wundversorgung anordnen die absolut inadäquat ist.

…wie familliäre Fürsorge aussehen kann.

…wie durch “Abwaschen mit Essigwasser” eine schicke Dermatitis entstehen kann

…dass man Nitrolingual-Spray nicht als “Süßigkeiten” nehmen sollte

…dass man im Krankenhaus teilweise 3x schneller arbeitet (und das ohne Grund!)
… wie pingelig und exakt (cm/mm) genau die Standorte von Handtüchern, Waschlappen, Waschlotionen und anderen Dingen bei älteren Menschen im Haushalt angeordnet sind.

Insgesamt machts Spaß, aber…Krankenhaus ist doch was anderes;)

Stephan

["If liberty means anything at all it means the right to tell people what they do not want to hear!"]