Ho ho ho

As most of you may be aware Christmas isn't my favourite time of the year, but I know a good portion of you like it. So here is my present to you, I found it online and wanted to share, enjoy.

To those of you working over this silly season, be safe and have a good one.


'T'was the night before Christmas and all through our town
Ambulances sat quietly-call volume was down.
Controllers and medics, without any calls
All settled all cosy within station walls.

The town grew silent as the night grew deep
My partner and I settled in for some sleep.
But no sooner dreaming in our beds were we,
When control awoke us, crying, "Code 1 Hurry! "

The call had come in for an RTA;
Some nutcase claimed he'd hit Santa's sleigh!
"Head trauma," we thought, as we gathered our gear,
"Or maybe a drunk driver - it's that time of year."

As we raced to the scene with our sirens and lights,
We hoped for the best, tonight of all nights.
We had no idea we were in for a surprise
And,on arrival, couldn't believe our own eyes.

I said to my partner, "This must be a trick!
That man in the ditch just can't be St. Nick!"
A smashed-up sleigh! Toys thrown far and near!
And off to the side, a group of reindeer!

The driver of the car, with a bump on his head
Was crying and told us he wished he was dead.
"Oh, why did I have that one extra beer?
Now I've killed Santa - no Christmas this year!"

By now we'd decided that this was too strange,
So we tried to call backup, but were out of range.
"No radio contact," to my partner I said,
"I'll check that one while you dress this one's head."

I approached the man in the ditch with great care.
He was dressed so oddly - he gave me a scare.
He wore a red suit and a strange kind of hat.
I thought to myself, "Who dresses like that?"

Then he opened his eyes and said, "Do not fear.
Just please help me up - I must catch my reindeer."
I said, "The reindeer are fine, but stay where you are.
You've taken a pretty hard hit from that car."

I didn't want to leave him, so I let out a holler:
"We're gonna need backboard, head blocks and collar!"
As we worked, the man cried, "No! Please don't strap me down.
I have toys to deliver all over town!
All the children tonight are depending on me
To get their presents under the Christmas tree."
"I'm sorry," I told him, as I shook my head sadly,
"You're going to the hospital - you've been hurt too badly."

He looked up at me and wiped away a tear
"Then you must bring the Christmas presents this year!"
"Visit every child's home in this town?" asked I.
"Sir, you must think I can make an ambulance fly!"

I thought I had made a serious blunder,
For his eyes grew steely, and his voice was like thunder.
"Now Dasher, now Dancer, now Prancer and Vixen,
Come Comet and Cupid and Donner and Blitzen!

Hitch onto that ambo and take to the sky
For tonight, indeed, an ambulance will fly!"
I just shook my head as we loaded him in,
Then climbed in the cab and I just had to grin.

There were the reindeer, all in a row,
In front of the ambo as if ready to go.
"That's cute," I thought. "I'll just go around."
But then they took off and our wheels left the ground!

Away we went, up over the trees,
Sailing along as light as a breeze.
We touched down on rooftops, delivering toys,
Dropping gifts for good little girls and boys.

We stopped briefly in the hospital's ambulance bay
wheeled him to casualty - and hoped he'd stay.
"We'll call in a report later," we said on our way.
"This man's turned our ambulance into a sleigh!"

Then off we flew, all through the night,
Delivering toys till the dawn's first light.
Finally, at our station, we headed down,
Both of us happy to be on the ground.

Control was mad, but the more we explained,
The less they believed us and the more they complained.
So we sat in our quarters - boy, were we in trouble!
We turned on the news and perked up on the double.

As the tv crew interviewed people around town,
It seems that some very strange things had gone down.
Tyre tracks upon a rooftop were seen.
and children said, "This year, Santa wore green!"

I grinned at my partner and said, "tis no mystery!
This Christmas we will go down in EMS history!"

Gift of giving

As I type this post I'm lying on a rather comfortable bed/chair.

Sticking into my left arm is a needle, drawing blood which is going into a machine and then back into me.

I'm donating platelets.

This is my third platelet donation, I made 11 whole blood donations previous to this.

The process is a bit mote complicated donating platelets, but equally, if not more rewarding.

On your first visit you go through a donor assessment, which includes all the usual checks and questions, followed by a quick platelet count blood test.

If all is well you go into a clinic area, sit on these very comfy chairs (might get one for infront of the tv) another couple of checks and the needle is in before you know it.

Depending on your platelet count and how many units you want to donate the process of the donation can take from an hour to 90 mins. Today I'm giving 3 units, total time 78 mins, Ive 27 remaining.

Understanding the process takes some getting used to, there are times to squeeze the stress ball and times when you shouldn't, but all the staff are extremely friendly and helpful.

After its all done there is a lovely seating area where you rest and have drink in a bite to eat, before making and appointment for your next donation......don't forget to pick up a pen on the way out ;-)

I encourage each and everyone of you to make either a whole blood or a platelet donation, a short space of time from your day could mean all the difference to someone else.

Academia (Research Part A)

I know a fair few of you are interested in the recent topic I brought up about nurses preforming BLS, a lot of you offered me help and guidance on twitter, which is very much appreciated.

Here is the 500ish word Part A of the assignment I submitted, for your reading pleasure.

Research Enquiry:

Part A: Identification of a problem and development of research question

The problem identified for this piece of work relates to the ability of nurses to provide effective Basic Life Support (BLS) to patients suffering an in-hospital cardiac arrest in an acute general hospital.

The reason this particular problem was chosen is that for every minute BLS is delayed the patient’s chance of survival drops by as much as 10% (Koster et al. 2010). Basic Life Support refers to maintaining airway patency and supporting breathing and circulation (Koster et al 2010), including cardiopulmonary resuscitation (CPR). CPR refers to providing chest compressions to pump blood around the body and ventilations to breathe for the patient (Pre-Hospital Emergency Care Council 2011a). In a hospital setting staff nurses are often first on scene of a cardiac arrest and as such, their ability to perform effective CPR is essential in maximising the patient’s chance of survival. The chain of survival is a series of steps in maximising patient’s chance of survival. The steps are: 1: Early access, 2: Early CPR, 3: Early Defibrillation, 4: Early Advanced Life Support, 5: Early Post Resuscitation Care (Pre-Hospital Emergency Care Council 2011b). Nurses can implement the first two or three steps depending on training. Literature shows nurses often lack confidence in performing BLS (Kakora-Shiner 2009) and skills are not practiced nor perfected often enough (Krahn 2011). The author is a fourth year general nursing student, who has been involved in the pre-hospital emergency care as a volunteer for six years and is also an instructor involved in teaching CPR to fellow volunteers and lay persons to deal with Pre-Hospital cardiac arrests and this area is of particular interest to him.

The question that this piece of work aims to answer is:

“Are nurses trained and able to effectively perform cardiopulmonary resuscitation to patients experiencing an in-hospital cardiac arrest?”

The proposed search strategy will involve use of the authors own personal text books as well as searching a number of academic journal databases including but not limited to, CINAHL, ScienceDirect and Wiley Online Library. The keywords “Cardiopulmonary Resuscitation”, “CPR”, “Basic Life Support”, “BLS”, “Training”, “Nursing” and “Cardiac Arrest” shall be used. Articles identified in the search will be reviewed for their reference to the question; also their reference lists will be reviewed to identify applicable secondary references which may help in answering the research question.

The themes I expect to identify from the literature review are:

• The training nurses receive in CPR and BLS
• The measurement of the effectiveness of training nurses receive
• CPR and BLS skills retention in nurses
• Nurses impression of their ability and willingness to preform CPR

When I've finished part B I wont bore you with 1500 words of academic writing but will post the findings of my literary review for you reading pleasure

Tis the season for a ronnie, fa la la la la

The most wonderful time of the year is almost upon us again, I know what youre thinking where did the year go?

We've seen the ad's, the special offers, the stock in shops changing....but ignore all that as it has nothing to do with Movember!

I'm pretty sure most of you havn't spent the last few years living under a rock and are well aware this is a charity event, where men begin Nov 1st clean shaven and then proceed to grow a moustache for charity.

Some go for handlebars, others a black and white movie villain narrow moustache.......me I'm going for the "skanger tache" or the "giveus 10 jonny blue ronnie" (hey I know my limitations, bit of bum fluff on the top lip will be the height of it)

Why am I concerned about mens health?? And why am I donating my top lip for charity? Heres why

*1 in 8 men will be diagnosed with prostate cancer in their life

*This year more than 2000 new cases of the disease will be diagnosed

*1 in 3 men will be diagnosed with cancer in their lifetime

*In Ireland only 26% of men attend their GP for regular check ups

Funds raise will help make a tangible difference to the lives of others. Through the Movember Foundation and our men's health partner, Action Prostate Cancer, an initiative of the Irish Cancer Society, Movember is funding world class awareness, research, educational and support programmes which would otherwise not be possible.

Find out more at http://ie.movember.com/?home

Or visit my Mospace to donate http://mobro.co/theSmurse

Or is you're old school, send a cheque payable to "Irish Cancer Society Movember" reference my name and Registration Number 1552614 and send it to: Movember, Irish Cancer Society, 43-45 Northumerland Road, Dublin 4, Ireland

Please donate and spread the word, stay tuned for Tachetastic updates

The Fighter Part 2

17th May 2011 The Fighter finally gives up her good fight......not without a struggle mind you

Admitted a number of days previous, following a rapid decline, she still fought the whole time

Because that what she was like, if you were in the wrong she was the worst person in the world to cross, but if you were right shed back you to the last stand.

On Monday afternoon, Dad, Derek and Myself were called in for a meeting with the ICU Consultant, he lay out the hard facts, facts that we knew were coming, but yet did no want to hear, you had a cardiac arrest that morning and they had brought you back, but for what? The inevtiable was just being delayed.

There was nothing anyone could do, other than to let you go, Robert was away and couldn't get home until the next morning, so we asked to keep you going until then, then we'd let you go. It was the only humane and fair thing to do.

The next day your treatment was wound down, medications were stopped other then pain relief.....yet you still kept fighting! Vital signs that would signal the end for most, yet you kept going....for many hours!

Tears were shed, final words were had, we urged you to go, to end your suffering, but like everything you were doing things on your time.

Eventually all treatment was ended and finally, for the first time in your life, you backed down. You never lost a fight in your life, even when you did, you wouldn't admit it.

We had your wake and people from all over came to pay their respects, people I hadn't seen in years, or people I'd never seen before. Afterwards we went for a drink, my mate bought you a vodka and coke and left it at the head of the table, he was scared you'd haunt him as you never paid for the vodka, you always brought it with you.

The following day we had your funeral, even that you had planned! The priest was your friend, the music was of your choosing. The church was full, the crowd spilled outside, such was the effect you had on people.

As we carried you outside to the hearse my colleagues formed up in a guard of honour, perfect uniforms, standing bolt upright at attention, officers saluting you, that really effected me, the pride I felt cannot be explained in words.

As my O/C said "You may not have been an official member, but you supported me, you ironed uniforms and missed out on my company while I was on duty."

We buried you in a quiet graveyard you picked out yourself. A family friend is behind you and the chap next to you had "I told you I was sick" on his headstone.....you'll get along with the neighbours so.

Don't mind us, well get along just fine, you made sure of that! You had everything sorted before you went, new kitchen, new car, affairs put in order, you must have known, yet wouldn't tell us.

Not one person thinks you lost you'r fight, a former teacher and a personal friend of mine said "Alan, I know where you get your stubbornness from now, she was one hell of a woman"

"That she was Conor, that she was"

R.I.P. Joan McGee

12th June 1953 - 17th May 2011

Love, Eamonn, Derek, Paul, Robert, Alan and Duke

Revulsion

As I'm sure you're aware on Saturday a callous attack by some narrow minded neanderthals resulted in the murder of Police Constable Ronan Kerr, if you're not, read this then come back to me.

P.C. Ronan Kerr PSNI

Murdered 4th April 2011

As usual I first heard of the attack on twitter, immediately I was shocked and my stomach started to turn.

Police Constable Ronan Kerr had only been on the job three weeks after graduation from the Police Service of Northern Ireland's training centre.

Ronan was one of a new breed of catholics joining the PSNI ranks to serve and protect his community, his reward to be murdered for doing so.

"Dissident Republicans" or as I like to call them low life, scum of the earth oxygen theifs planted a lunch box with is what is estimated to be 500g of semtex linked to a mercury switch and planted it under his car.

When Ronan got into his car it exploded, his neighbours rushed to assist the young officer, one of whom was heard screaming for a fire extinguisher while Ronan was heard moaning inside the vehicle as his life was slowly taken from him.

P.C. Kerr's Ford Mondeo after the blast.

The young man who I'm sure felt so proud to put on his uniform and felt a sense of duty to serve his people, like so many of us do, was targeted because of his these scumbags not wanting catholics to join the PSNI.

The whole country, north and south has been united in disgust, I'm sure a few bar stool provos in some dive of a pub arnt, but to be honest their opinion is about as useful as a handbrake on a canoe.

The country has moved on, weve all moved on. After hundreds of years of violence we all got tired and wished to move on. Why can't they??

I can assure you one thing, Ronan was not murdered in my name.

He was not murdered in the name of my country.

He was not murdered in the name of Northern Ireland.

He was not murdered in the name of the honest, decent people of both countries.

He was not murdered in the name of the people of Omagh who have been struck by tragedy too many times.

He was murdered in the name of violence & in the name of criminality.

May Ronan's murder not be in vain, may his perpetrators be brought to justice swiftly and may no other member of police, army, prison service etc North or South have to live in fear of one of them being next.

P.C. Kerr, your duty is done, you may stand down. Rest in Peace.

"True heroism is remarkably sober, very undramatic. It is not the urge to surpass all others at whatever cost, but the urge to serve others, at whatever cost."

The twitter hashtag #notinmyname and the facebook page R.I.P - Police Constable Ronan Kerr show just how people from all communities and backgrounds abhor what has happened. Add your messages.

The Fighter

She feels a lump.

She puts it out of her mind.

It doesn't go away.

She goes to the G.P., then sent to the specialist.

The results comeback, the fear is realised. It's cancer.

"No problem" she says.

"Surgery, chemotherapy and radiotherapy".

"Right let's do it".

And it gets done.

10 years pass.

"It's back" she tells her sons when she awakes in ICU. "I'll never be cured but I'll be well managed, we have time".

Affairs are put in order, they come to terms with it.

Gradually it spreads, gradually it gets worse.

Yet somehow she goes on. Beds are to be made, shopping has to be done "because my husband and the boys will only make a balls of it".

There is work to go to, college to go to, friends to be seen, dog to be walked.

She goes on. Strong. Stubborn. Determined. Making sure everyone around her goes on too.

A fighter. A daughter. A wife. A friend. My mother.

Looks are everything

I hope you did your homework and popped over and read http://insomniacmedic.blogspot.com/2010/12/boots.html

I'm sure my twitter followers will be well aware that both I and @insomniacmedic1 have a thing about polished boots.

I'm a firm believer in "if you look the part you'll act the part" and I try to bring other people round to my thinking.

On a duty recently with a new member he was looking through my kit bag "how much did that cost" pointing to my pulse oximeter "where did you get that" looking at my glucometer.

I explained each one and then told him not to bother buying any of them, he looked at me and said "yea I know I can’t use them now but when I get more training, I'll need them"

"You need to start with something else first" "What?" "An iron and a tin of polish"

You know that look dogs make when they turn their head to the side trying to distinguish where a noise came from, that’s what I was faced with.

I had to explain that to be honest......he looked like he was dragged through a hedge backwards!

The rest of the duty was spent explaining how the first impression is everything and that it’s usually made up of what the person sees.

I hope next time were on duty together his boots will at least be black and not a scuffed grey, his trousers look like they've at least seen a hanger and he isn't doing a rabbit impression.

If you walked into a restaurant and the waiter was covered in stains, he looked scruffy, his shirt was undone. Would you be happy he was serving you food?? I wouldn't. If you see a pilot walking into the cockpit of the plane you're about to travel on, wearing a pair of jeans and scruffy trainers would you be happy he was flying? I wouldn't

You can be the best at what you do, but if you don't make the effort to appear professional I won’t trust you as far as I can throw you.

Why should the people who look after you when you're sick or injured be any different?

I think it's a shame that on a duty recently two people commented on my polished boots, one a Garda (police officer) and the other a paramedic. It should be that comments are only passed on scruffy attire, that everyone is properly turned out and the ones who don't meet the standard stand out not the other way round.

Put the effort in, little and often makes all the difference. I know sometimes situations beyond our control get in the way, like c-spine control on a person who's fallen off a horse into a muddy ditch, but if you start off with the work done sorting it out after will be a lot easier.

First impressions are everything. Get the iron out, and don't forget the kiwi polish.

Remember if you look the part, you'll act the part!

Homework

Right listen up. Pop on over to the Insomniac Medic and read this blog post http://insomniacmedic.blogspot.com/2010/12/boots.html

Pay attention, take notes. I'll be posting about it tomorrow about it shortly.

Pro tip: get the kiwi polish out

Why do it? Part 2

"What ya mean you don't get paid?"

"I don't get paid, it’s voluntary"

"Are you mad? Why do you do it then?"

That is the conversation I seem to have with most people when I explain I'm a volunteer medic.

On the 24/01/2006 I went to my first meeting of my local voluntary ambulance organization and it went from there.

Why did I go?

Emergency medical care has been something that always interested me; my lifelong goal from an early age was to become a Firefighter/paramedic with the Dublin Fire Brigade, so becoming a volunteer medic was a step in the right direction.

I did my basic training, got my uniform and started going on duty.

Initially it was daunting, despite not treating a patient for who knows how many duties, I was in uniform and on an ambulance. Even though I was always accompanied by senior members anytime I treated a patient my adrenaline went into over drive accompanied by sweat and tremors.

But eventually I settled. I felt comfortable; I started treating patients with less supervision, I was no longer just doing task after task, I was looking at the bigger picture, thinking two steps ahead. I had found my niche. This was for me.

Initially when asked why I do it, my reply would be "Ah sure someone has to" "Or there’s a job that needs doing". I always tried to avoid the cliché "To help people".

I didn't want to be a cliché.

So I had to spend time thinking. Then it clicked. On the first day of a course the instructor asked us one by one to introduce ourselves, state our unit and say why we were on the course.

"To increase my skills" "The duties we do require a certain level of skills" "Because it’s the next step" A sample of the answers others gave.

All very relevant reasons I thought and probably would have said the same if they hadn't have said it before me.

Then it was my turn "To give me a greater knowledge and skill set so as to provide the best possible care for my patients, to maximize the best possible outcome for them".

It was completely off the cuff, just got a lot of thoughts floating about my head and mashed them into a sentence......and it worked!

That was it! I want to do the best for the people in my care. I am not the be all and end all, there’s usually a long road ahead of them when they leave my care. But I know I'm a cog in a big machine. If I can get the ball rolling in my patients care the outcome will hopefully be better.

So now when asked why I give up my free time to stand beside a football pitch in the rain, babysit intoxicated punters at a concert as they fill sick sack after sick sack or be deafened by motorbikes as I sit in a lay by at a road racing event I answer "Just in case, to do what I can for who I can"

That’s the simplistic version. I'm not going to lie, I still get a buzz from it, I still get satisfaction from a job well done and boy do I break out into a small grin when a patient or relative says "Thank you" and genuinely means it.

I really could go on forever talking about the things I enjoy, but I'll elaborate in posts at a later date on some of them.

theSmurse, Out!

P.S. All comments and feedback much appreciated on here or on twitter. Thanks for reading

Why do it? Part 1

This is a question I get asked a lot "Why do you do what you do?"

Up until recently my answer was a cliché or just whatever random thing popped into my head. Then it got thinking.....(its ok the pain has gone now!)

First off I'm going to deal with the nursing.

To be honest I fell into nursing, I was at a loose end when I had to fill in the form listing my preferences of university courses....what to do? Since as there isnt a degree in becoming a firefighter/paramedic here and having been a couple of months too young for the latest fire brigade recruitment I needed something to keep me occupied!

Business??? Nope cant deal with 9-5 and I hate ties

Engineering? No chance I cant make a sandwich that doesn't fall apart

Languages? Maths? Geography? No, no and no

I want something with a nice dose of practicality, I had a moment of enlightenment one day driving to school "What about nursing?........ermm ok that'll do" So it went down on the form, knowing very little of nursing bar working in hospitals taking handover from ambulance crews and making sick people better. Thats where it began and ended to be honest.

Then I did my end of school exams, getting middle of the road results which in turn were converted to points, college courses allocated depending on how you scored, I didn't do too great...or so I thought.

My #1 preference course lowered its points requirement before I knew it I was sat in the back of a lecture hall surrounded by 300 or so other people, most of the female persuasion, any mans dream you say.....I would have too only I was too shit scared it took me months to get comfortable with my surroundings.

I've often asked myself "why in the name of all thats holy do I do this???" Granted thats usual at 6:30am as I'm on my way to placement, usually looking down the barrel of a 13 hour shift. But I have thought about it properly. To be honest I've always known nursing will not be my career for life, I wasn't really sure I'd see out the degree at times.

I've learnt a lot from nursing, I feel very comfortable interacting with people from all walks of life, thinking on my feet and planning care. I also now look at the big picture "what medications should they be on?" "What assistance will they require?" "What specialties do I need to refer them too?" "How will they cope at home?" "How did this happen, how can I try and prevent it happening again?"

This experience has helped me a lot in the pre hospital field, when I started if they lived until we got to A&E well I'd done my job, now as soon as a patient is in my care, nearly subconsciously I'm doing a nursing assessment on them and only stop short of discharge planning!

As for why I do nursing, to be honest it's a means to an end, I've no doubt learnt a lot, am still learning everyday, being exposed to everything from out patients, public health, theater, A&E, medical wards, surgical wards you name it I'll be sent there. But its still not for me, it has a routine 07:30-08:00 Handover 08:00-09:00 Patients breakfast, washing etc then staff go on break. Everything has a time and has to be done on time. That doesn't suit me, I like somewhere where I dont know whats coming next, whos next? Whats their illness or injury etc.

Thats why I liked A&E so much. Cublicle 7: 90 y.o. Female with a UTI. Cubicle 8: 22 y.o. Male with a GSW's to R Leg. Mad place, but even that didn't quite satisfy me.

Me I want to be out there on the streets responding to calls for assistance from here there and everywhere. Everything from stubbed toes to life threatening incidents. One day I will be. You have been warned!

Hello there

Welcome to my blog, see this is what happens when I get bored and should be doing college work. Lets see how it goes.

The about me bit:

I'm a Student General Nurse studying in a Dublin university working mostly in a large acute general hospital

I am also a volunteer with a voluntary ambulance organisation and I've recently qualified as an Emergency Medical Technician. Ive been a member for over 5 years starting off as a basic first aider and gradually working my way up. Our work mainly focuses around event medical cover but also includes more community based work such as transporting elderly and disabled people from healthcare facilities back home etc.

Outside of that as I said I'm a guy in his early 20's so make of that what you will. My loves in life are caffine, nicotine and rugby.

Right the introduction bit:

The name of the blog, the three T's reflect me.

Tea....I love the stuff, would drink it all day everyday and have been known to do so!

Triangulars is the slang term for triangular bandages one of the most versatile pieces of kit for any medic, one of the most simple but very handy piece of kit

Tunics, nursing ones to be precise, I hate mine with a passion, I find it hideous and impractical, but alas it must be worn......plus you know it gives me something to give out about. Happy days!

As for what this blog will contain, will itll just be about my random thoughts and experienced. The people I meet, the things I see, the thoughts I have....and well whatever else comes to mind.

You can follow me here and also on Twitter, find me @theSmurse

Thanks for stopping by, comments and feedback always welcome