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Tuesday, 30 June 2015

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Nurses are the glue that holds FGH team together

TODAY marks International Nurses’ Day, a date set by the birthday of pioneering nurse, Florence Nightingale.
In the second of a series of articles during which health reporter EMMA PRESTON is given exclusive behind-the-scenes access at Furness General Hospital, she visits the Accident and Emergency department to meet some of those serving on the front line of medical care today.

WATCHING Accident and Emergency nurse, Julie Weatherburn, in action, it dawns on me that her role in a medical team is reminiscent of that of a mother in a family.

Kind and calming, yet firm and completely in control, Julie is the glue that holds everyone together – doctors, paramedics, support workers, and of course, the patient.

She seems, somehow, to address every person in the room simultaneously – reassuring the patient, swapping information with the paramedics and discussing action with the doctor all at once.

The man they are treating has arrived at Furness General Hospital by ambulance, after falling 10 feet off a ladder on to a slate patio, and the team is working to get him off the stretcher without moving his spine.

It is Julie who takes control – sending for additional help, instructing everyone where to stand and issuing the call: “Ready, Brace, Roll”, at which point they all ease him onto the bed.

The nurse seems to predict the doctor’s actions before even he decides on them, and is swift to explain what his happening to her patient, at the same time discussing his allergies, pain relief and details of the accident.

She makes notes throughout the doctor’s initial examination and, after he has left, files more paperwork and arranges X-rays.

As Julie works, A&E senior sister, Judith Walmsley, explains her nurses’ roles.

“We can almost pre-empt what the doctors want before they ask us”, she tells me, “because we almost know how things are going to pan out.

“We work closely with all sorts of different people within different departments, including pathology, physiotherapy, occupational therapy, intensive care.

“I wouldn’t say we’re a hub, but everything’s funneled through us and we filter it out to different areas.”

As well as being a connecting force between hospital staff and departments, their most important task, Judith says, is to communicate with the patient.

She says: “We’re the patient’s advocate.

“We’re here for them 24/7, whereas a doctor is more of a transient figure.”

Fellow A&E nurse, Howard Rand, chips in: “I used to work in customer services, and I always think that’s a big part of what I do.

“There’s an element of just slowing everything down, talking to people, explaining what’s going on.

“It’s about being the person who can translate what’s happening for them.”

As the nurses show me around A&E, it quickly becomes clear how varied their day-to-day life can be.

On arrival at work, they are assigned to “majors” or “minors”.

Today I am in the minor side of the department – and a triage nurse is assigned responsibility for seeing patients on first arrival.

The triage nurse works out what checks or X-rays they need, organises these and arranges pain relief for those who need it.

It is then up to him or her to make the tricky call of deciding how urgent each case is. Howard says: “We’ve got to think, is that patient going to stop breathing, or can they wait while we see someone a bit more poorly?

“You’ve got to be able to prioritise, and that’s the difficult thing, especially when it’s busy.

“We understand there’s different levels of illness, but we also understand people are worried about their loved ones.”

No two days in A&E are ever the same, the nurses tell me.

They deal with a range of tasks, including providing pain relief and first aid, doing ECGs and administering fluids.

They are also responsible for filling out patients’ paperwork, carrying out ongoing assessments of them and screening those who are being admitted for MRSA.

Nurses work with social services wherever they have concerns about patients, and they regularly advise people on their general health, wellbeing and lifestyle.

In what increasingly seems to me an unlikely situation – that they find themselves with a spare moment – they check if there is any cleaning or re-stocking of medication and equipment to be done.

Today, our next stop is to see a builder who has got plaster in his eye.

Julie uses saline solution to wash the eye and, as she does, notices more plaster, calling the doctor back to try to remove it while she rinses.

As they work, it is she who reassures the man whenever he flinches in pain, offering him the chance to stop and rest and asking him questions to keep him occupied.

Julie tells me this quite a common injury – something she has dealt with countless times – but her job will always find a way of surprising her.

“That’s what I like about it, the variety”, she says, “it’s very, ‘Expect the unexpected’, from a minor thing like a splinter in a finger to people being in cardiac arrest.

So how does the approach of a nurse change in those more major emergencies?

“The fight or flight mechanism kicks in”, Julie says, “you function at the time, and you function well – it’s only afterwards that you feel deflated.

“But we have a really good system here.

“We have a resus officer who we can talk to about how it went, how the team supported each other, and how we can learn from the experience.”

The hardest part of the job, Howard adds, is when the A&E team is unable to help.

He says: “One of the things that worries people most is the bereavement side - explaining to a family the patient hasn’t made it.

“No amount of training or courses can prepare you for that, it’s just something that relies on instincts, your human nature.”

Next week, Emma spends a day with an FGH clinical site manager - the person responsible for organising hospital admissions. Find out how she fares in Saturday’s Evening Mail.


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