Category Archives: Community Nursing

My Nemesis In My New Job

I have been in this new job for about six weeks now and I have already come across the thing that gives me the biggest headache.

It’s faff.

For those who are unaware, ‘faff’ is the accretion of stuff that protrudes into our dimension after being summoned by excessive paperwork, awkward workflows and all those little things that go wrong and ruin your day.

Let me explain further – let’s say that I have to see a patient in order to dress a leg wound. Now, because of the rules every patient must have a prescription for the thing that I’m going to wrap around their leg, be that a clever hi-tech dressing impregnated with nano-particles, or a simple bandage. This is fine if the patient has a nice big box of the dressings in their front room.

Often they don’t.

So, for one pharmacy I can phone them up and they can order more, for the other two that we use I have to go back to base and order more using the victorian technology of a fax machine. Of course the nurse before me should have noticed that supplies were running low and would have done this previously.

This does not always happen.

It should also be obvious which pharmacy ‘owns’ the patient, but again, if a patient moves then the pharmacy that would logically be theirs, isn’t.

What this means is that I spend two hours running around (some would say ‘faffing around’) in order to scare up some dressings to use. And this is a simple example.

What it means is that a nice easy day turns into a nightmare as I faff about phoning referrals, chasing ambulances, robbing Peter to pay Paul and doing all those other things that are required in order to make sure that the patient gets the right care.

It’s not always incompetence which leads to the gathering of faff – sometimes it’s the pathways which we use. For the example above, why aren’t dressings automatically ordered? Surely we have the technology?

I think some of my workmates have seen that I’m starting to stomp around a bit grinding my teeth and muttering (who am I kidding, moaning) ‘why can’t things be better?’

My plan is to start trying to change things. Let’s see how it goes.

(Also – high degrees of faff from Squarespace v.6. I think I need to go back to v.5 which actually let me do things inside my blog posts)

TV On The Job

I was supposed to be writing more for this blog but a few things got in my way, mum going into and then coming out of hospital, new job, depression and being tired all the damn time. I’m going to try and make a bit more of an effort, not least because I’m supposed to be writing three things as well as this blog…


As I go from house to house visiting patients I catch a lot of snippets of TV. It is interesting to see what this tells me about my ‘client group’ (as is the correct term for patient now – it might be ‘stakeholder’ or some such, I’m afraid I lost track about three terminology changes ago).

The TV programmes that are being watched seem to fall into one of four things.

1) Jeremy Kyle.

2) Repeats of Catchphrase

3) A Bollywood/Asian soap channel

4) A Imaan preaching intercut with Asian political news.

I honestly do my best to not listen to Jeremy Kyle – I think about his show in the same way I would think about bear baiting if I lived in medieval times, its just an evil show. Catchphrase is pretty easy to ignore as he always seems to be talking to the contestants rather than getting on with playing the game. My favourite is the Bollywood/ Asian soap – it’s normally utterly insane. The other day I think someone had been bitten by a snake which had made them revert to childhood – at least that’s what it looked like to me, I’ve not much clue about what they are saying. Finally the Iman preaching is a pretty relaxing background noise unless you get one who likes shouting at the camera. The bonus of this channel is that I can now tell you what each Pakistani political party is now polling at.

Some patients will turn the TV off, others will keep it on and to be honest as long as I can hear what the patient client is saying, then I’m not much fussed.

Why I Changed Jobs

I’ve been trying to put into words the exact reason why I have left the acute services (A&E, Ambulance, Urgent Care) to move into the slower paced world of community care. After fifteen years of acute services you might think that it is because I have some degree of ‘burn out’, and maybe that is part of it. Perhaps it’s because I am getting older and more worn out and so the ‘easier’ work of a community nurse appeals to me.

I was visiting a member of the In-health team today and she asked me that question, why I am going from a band 7 job to a band 5, and why the sudden change of career.

The answer that I came up with while sitting in her office is perhaps the closest I’ve come to putting my finger on the truth. I told her that while in acute services, I may well be fixing people on the day, in this new job I would be able to help them for much longer and in a deeper fashion.

If you come to me with a broken arm I’ll assess you, x-ray your arm, give you painkillers, put you in a plaster and arrange the follow up appointment – I am unlikely to see you again.

Now I am working for the community, I will be coming into a person’s home on a regular basis and I’ll be able to provide a more in-depth service. If they tell me that they are having trouble with the stairs, I can arrange help with that, if they are feeling depressed, I can refer them to the right people, if I can heal their leg ulcer then that will make a massive difference to their life. Heck – if I can make sure that they always have incontinence pads in stock then that will make them happy. Instead of a rapid response I am better placed to provide care in more depth.

I was often asked what about the worst things I would see on the ambulances – people would expect me to talk about car crashes and dead children. Instead I would surprise them by explaining that the worst things that I saw were the old folks being neglected in nursing homes, or the housebound pensioner whose carers would drop their medication on the floor and not bother picking it up.

By moving to the community I will have more power to change that sort of thing for the better, in part because I am incapable of letting bad care continue.

That and I get more fresh air than working in the hospital.