My memory is poor, but I'm sure that, when I was a nurse, the NMC had it as a condition of being the sort of nurse who gives drugs to people that the aforementioned nurse understand what a drug does and what it's side effects are.
It's 3am in the morning and I'm miles out of my area on the FRU*. I have been sent, as a blue light response, to a nursing home where one of their 'clients' is sleeping.
Yep – sleeping.
I get there and the patient is in the reception area of the home sitting in a wheelchair. He is… asleep.
The 'nurses' at the home tell me that normally he is very active at night and often comes to see the night nurses and sits chatting with them. He's ninety-eight years old and mildly demented.
I bite my tongue and do all the checks that I can to make sure that there isn't anything obviously medical going on. All his observations are fine and he responds somewhat when I try to wake him. I'm sure that if I provided enough pain stimulus I could fully wake him up, but it would just seem cruel.
I look at the patient's drug chart. Two days ago he was prescribed a rather strong sleeping pill.
I ponder, for about 2 milliseconds, if this might be the cause for his sleeping. At 3am in the morning.
I suggest this to the nurse.
The staff don't say anything, but I get the distinct impression that they have been getting tired of this patient being awake while they are at work. If all your patients are sleeping then the night shift has little to do. If this patient has been awake, then they actually have to talk to him. In a lot of the nursing homes that I've been to the nursing staff don't like talking to the patients.
In a fair few nursing homes that I've been to the staff and the patients rarely share a language, and so everyone just 'gives up'. As a digression, the good nursing homes that I've been to have been those where the staff and patients do talk to each other, and the care of the patients is considered to be more of a 'partnership'.
The nurses, who I suspect have got exactly what they asked for, aren't happy. They've already rung the elderly relative of our patient (at 3am!) to let her know that he is heading into hospital.
The ambulance crew arrive and I have a real problem explaining to them why we have been called.
“The nurses wanted this patient to sleep at night. They have given him a sleeping pill, and now he's asleep”, doesn't really seem reasonable for a trip to the hospital.
But the 'customer' is always right – and so the patient is driven off to the hospital.
I talk to the crew a few days later and they tell me that the receiving nurse at the hospital was as befuddled as the rest of us.
I don't know, jobs like this make me despair at the general intelligence of people, not less the intelligence of the sorts of people who look after the elderly.
Oh well, at least one of us had a bit of a kip that night.
*I really need to tell you about FREDA one day – perhaps a joint post with Nee Naw.
I'd like to apologise, blogging has been a bit slow of late. Mostly this is due to working on the sequel to 'Blood, Sweat and Tea' – I'm needing to put some concentrated effort into it. this is not easy with twelve hour shifts accompanied by the utter lack of energy I have at this time of the year.
Medgadget are running their annual Medical Blog Awards – you should go over there and have a look at the nominees, there are some really good ones there. Also there is no other motive for suggesting you visit the link. No. None at all…