A Moan

This is a moan.
And not one I will apologise for.

In one hour
I will monitor oxygen saturation levels, take blood to assess arterial blood chemistry and make sure the patient's entrotracheal tube is situated appropriately.
I perform tracheal suction and note all settings on the ventilator are written down carefully..
Measurements of heart rate, rhythm, blood pressure, blood sugar, central venous pressure are monitored and infusions of insulin , noradrenaline, potassium and fluids are titrated accordingly.
There are three infusion pumps and six syringe drivers all working together.
Antibiotics have to be retrieved, checked, made up and given.
All fluids entering the patient via vein and nasogastric tube are measured carefully
Everything leaving the patient is monitored too.
Pupils are checked for a reaction with a pen torch and sedation levels assessed.
Visiting family are supported and a plan of care discussed .
The nurse looking after the man in the next bed is helped to turn her patient.
Another nurse asks me to check their drugs before they can be given.
I have not even started to look if paperwork such as the moving & handling assessments or the nutritional audit has been completed and I need to organise help to turn my patient in the next hour.
I also need to brush my patient's teeth but as yet have not had the time to do so.

All this in one hour, of an eleven and a half hour shift.

The day before Yesterday, a chirpy electrician fixed our water heater. The part he needed cost about 25 quid
His invoice for part and labour was £82. It took him an hour to drive to the wholesalers to retrieve the part, fix it and have an animated chat about his bad back.
Don't get me wrong I was grateful he came so quickly.

Winnie was in the vets literally a couple of minutes. She had a painkiller and an assessment
£40.00 quid! Again I was grateful for the input.

The electrician's labour cost ...fifty pounds for an hour's work?
The vets? .................................Thirty pounds perhaps for five minutes.
A band 5 nurse on intensive care? .........£14 an hour.
14 pounds!
Go figure

Winnie's First Trip To The Vets

On the way to the vets this morning

Winnie fell off the bed this morning and banged her mouth on the ancient floorboards of our bedroom   floor.  It sounded as though the roof had come in but she did nothing more than half knocking out one of her stubby canines. Winnie seemed unconcerned with the whole thing even though the tooth hung over at a crazy angle and after a few minutes of trying to free it
I thought it prudent to take her to the vets.
I need not have bothered for as we sat in the crowded  waiting room, she nonchalantly spat out the offending tooth in front of an over friendly jack Russell.

It was Winnie's first trip to the vets, and as usual she took the whole thing in her stride.
It was the Spanish vet who was running the clinic and she took one look at Winnie's over serious face and lisped " Is she aggress-ive ?" 
Winnie opened up her mouth to show the vet her bleeding gum.
" Help yourself " I told the vet, " she won't bother you "

Bulldogs intrigue people. 

With their over serious faces that can effectively mask any emotion , they often wrong foot people that cannot read the more subtle signs that flag up bulldog happiness.

Old Bulldogs don't generally wag their stumpy tails in greeting. 

They don't lower their heads, or pull forward in a playful acquiescence when they want to say hello.

They just stand, and they watch, and they snort like bullocks do when they meet you at a farm gate

I love watching the public reaction to Winnie when we go walking along the local public walk and cycle way, for it's very like watching a tense gunman standoff from a very superior Western. 

Winnie will amble alone and at her very own pace.

When she spies a stranger off in the distance. She stops for a moment with her head held high and she will stare at the figure carefully. 

This can be somewhat disconcerting to those of a more nervous nature.

Then, rather slowly she will line herself up with the stranger, and stop again, her change of position meaning that the stanger's path, if continued, will coincide with exactly with hers.

It's this behaviour that gives her the look of a gunslinger.

Think Yul Brynner from Westword with Buster Keaton's face and you'll get where I'm coming from. 

In the past more intimidated walkers have become all a bit of a dither with the thought of a confrontation so now I am in the habit of calling out " the old bulldog is friendly" when people appear. The word " old" seems to placate nerves more than the word "friendly" and the subsequent crossing of paths when seemingly miserable bulldog strains her head up to a stranger to be petted or preferably kissed, always feels rather sweet

The Walking Dead ( spoilers)

For seasons now humanity has taken a true bashing in The Walking Dead.
Even Rick's group, now devoid of the moral compasses of Hershel, Dale, Deanna and Tyreese and with Maggie and Glen incapacitated by pregnancy, is finding it hard to keep a civilized community going in a world filled by fortified townships ruled over by leaders with their own agendas and way of managing a frightened new world.
The new baddie in season 7 is a real psychopath. He is also clever and uses proven psychological and physically terrorizing ways to control his environment.
Negan is modern day ISIS personified, and in that way, his retribution on " Team Rick" with his barbed wire baseball bat  is even more sickening than it could have been. 
Terror is king, it would seem.....its parallel with the middle east's medieval war all too apparant
And It's all too much.....
Having said this Jeffrey Dean Morgan is quite amazing as chilling and psychologically savvy Negan

The Walking Dead, is essentially an adventure story and adventure stories should be entertaining.
Overkilling two lead characters in such a bleak, violent way is not quite entertainment...but it was bloody powerful television
We shall see where season 7 goes eh?
" suck my nuts" 

Monday, Monday

I'm too busy to blog today.
Workmen have to be organised, revalidation paperwork for of my nursing qualification completed ( we nurses have to justify our practice by evidence and pay 120. £ a year to work after we do!)
Albert has the shits after eating a dodgy mouse and the water heater is on the blink again
Hey ho
The Walking Dead  is on later...perhaps I can have a big smile then......perhaps not"

In the meantime

Snippet

At 4pm Mrs Trellis could be seen tottering through the village holding a heavy saucepan.
She was somewhat red faced and puffing like a steam train when I passed her on the opposite footpath of the main road
" Is the Prof in? " she gasped " I've made you both a rice pudding"

The Affable Despot

I know that some people out there think that the characters I often describe in Going Gently do not, in fact exist! Mrs Trellis, Pat the animal helper, Harmonica, Gay Gordon and fat Mary....I have often had a barbed comment outlining that they are, in fact, a product of my imagination
I guess I can't blame people......there are always disbelievers wherever you go.

Last night, Claire, the wife of affable despot Jason, facebooked that she had been married now 9 years.
She posted this photo which I asked to share, as I know he has quite a following .....

See......people....real people DO exist in Trelawnyd!
Hey ho

Wedgie

The Prof was in a strangely uncharacteristic playful mood today
When I bent down in the bread aisle of Waitrose
He grabbed the band of my underpants
And in front of a dozen astonished shoppers
Gave me a huge and exceedingly painful wedgie ! 

Travelling Alone

Rachel has impressed me.
The thought of travelling alone  around a vast country like Russia, would have filled me with paralysing  dread.  even the thought of it has me sweating like a Hooker in church! So the fact that she is presently crossing the frozen wastes by train in nothing but a fur hat and the faint smell of vodka fills me with awe.
I couldn't do it.

I have only been away by myself once.
Years ago, after one of several messy break ups with a psycho boyfriend, I took myself off into Sheffield city centre in order to buy a vacuum cleaner. ( like you do) I ended up buying a cheap ticket to Seattle and just a few days later, I took myself off to the city of fish, clouds, rain and frazier without really knowing just why I was going.

It did me good for Seattle is a friendly city.
I mooched around the harbour and the antique shops, drank copious amounts of coffee, had a wet and rather eerie trip on the Puget Sound Ferry and visited the cinema time and time and time again.
I talked to people daily, had a chance encounter with a Japanese/American lesbian called Hisoka who gave me a gift of Alan Bennett's book " Talking Heads" and I recharged my somewhat frayed psychi which had been battered somewhat by a relationship that was in essence ....shit.