A day in the life of a nurse

Helen Baker Staff NurseHelen Baker is a Staff Nurse in the Coronary Care Unit at Great Western Hospital.

I have been with the Trust for five years now, having qualified in 2008 and work in the Coronary Care Unit (CCU).  Nursing care is dynamic and as a result, days vary greatly. I get involved in lots of areas related to my role, both as a Nurse, Steward, ward link for musculoskeletal disorders and clinical educator - working in the Academy here at the Trust and at Oxford Brookes.

My clinical shifts are predominantly late-shifts and nights so a typical day for me might start with meeting a RCN member in the morning and advising or representing them within the workplace. All kinds of issues come up and so being up to date on policy, practice, guidelines and the law really helps in being able to work with colleagues and the Trust to resolve concerns and develop strong working relationships.

Going on shift

When I come on to my clinical shift there is a safety briefing followed by handover of patients. CCU is high dependency and patient needs vary from the relatively straightforward to the very, very complex.

During the late shift, we get patients going to and coming from the cardiac catheter labs. This means that we have to do a lot of patient movements to other wards to create beds for those that need to be in CCU. Lab patients need careful and frequent monitoring for several hours post procedure.

I care for patients who have experienced an MI (heart attack), may be suffering heart failure, sepsis, arrhythmias or other cardiac issues requiring intervention. Most patients have other medical conditions that impact on their cardiac care, so nursing care can quickly become very complex and some cases will clearly be more urgent than others, so close liaison both within the cardiology team and the wider healthcare setting becomes vital.

Urgent transfers to other cardiology centres happen regularly and emergency care, such as a cardiac arrest needs to be handled in a calm and controlled way, with everyone in the team playing their role.

Simple things

I find it's the simple things that mean the most to my patients. Treating them as individuals, maintaining their dignity, taking time to answer questions - prompting them to ask the questions in the first place! Patients often don't like to, "trouble the nurse, because she's so busy", so being able to interpret the non-verbal cues that tell me someone is distressed or needing support becomes second nature.

It's the things we take for granted that patients appreciate and miss the most - being able to have a wash, go to the toilet, eat a meal, have a drink - when they want to and in a way that is acceptable to them. It's during these times that I can really get to know someone and work with them to improve their experience whilst in my care.

People get really frightened when it comes to conditions relating to their heart, so a big part of my role is offering reassurance and information that can lessen their fear and build their confidence and resilience.

It's not about giving false hope, but it is about being honest and providing information at a level comfortable to my patient, in a way that allows them to feel able to make informed decisions in a safe and supportive environment.

Always learning

Towards the end of my shift I will ensure all my documentation is complete. When I hand over to the next shift I do this at the bedside and where possible and appropriate include the patient as part of that process - it's a good way to include the patient in their care and gives them an opportunity to clarify any outstanding points.

The key thing for me is that all of my roles are aimed at improving patient care. I learn something new every day.

When I go home, it's not the chest pain or fluid balance that I remember. Instead, it's the hand I held, it's the hard and difficult conversation I had, it's the box of tissues that I might have shared with someone. It's the joke shared while giving someone a wash - that made them feel human and included and as a result made me feel human and included.

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