Thursday, September 17, 2009

SSN vs SEN

I had a rather pleasant day at work today. SSN Y, my preceptor, was in-charge. SSN R and I were taking teams, near and far from the nursing station respectively. SSN F and SEN L were our respective runners. I had 7 patients, no admissions or discharges during my shift. Of these cases there were 4 on IV drips, 4 IV medications to give, 2 cases of 4 hourly nebulizers.

There was 1 case which required hourly monitoring of a finger's skin-graft post-operatively. Unfortunately due to the child's movements, the protective dressing around the forearm fell off. Thus the specialist decided to bring forward his dressing change from tomorrow morning to this afternoon instead. Thankfully, SSN Y and SSN R were around. SSN Y prepared the dressing trolley. Both SSN Y and SSN R supported the child while the specialist was doing the dressing. I helped with opening of sterile dressing materials. When completed, SSN Y billed the items used.

As mentioned before, I noticed a change in SEN L's attitude. These days, she orders me to attend to patients rudely instead of informing me politely about their situations. In addition, she advised me rudely or wrongly accused me of mistakes.

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After checking with the consultant, SSN Y applied an interim sterile field to the child's finger while awaiting for the consultant's arrival this afternoon. Unfortunately, the child managed to loosen his finger out of the interim field, right after SSN Y had left the room. I put on a plastic sterile glove to re-seal the interim sterile field. While I was doing so, SEN L said sternly, “不要綁得那麼緊” ["do not make it so tight!"] when she herself would not step forward to assist and instead commented as a "back-seat driver". I was not even applying any tension when the re-sealing sterile field.

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When SEN L is assigned the runner's role these days, she functions just like a HCA. She does not flush IV lines, change IV drips or other stuff that an EN can do. Instead, she even tries to push some of her hourly monitoring work to me. Somewhat sad to think about it. We started off so well together.

In contrast, SSN F volunteered to help me out with my medications and other stuff, even though she was assigned to be SSN R's runner. She even ran down to the pharmacy for an urgent order for SSN R when the pneumatic tube was down. Thumbs up for SSN F's humility and dignity. She was an SSN in a Medical/Surgical ward when I was a still a student on clinical attachments. In those days, she would sometimes be the in-charge overseeing the entire ward. Yet, when assigned to the runner's role today, she did not sulk nor acted as a HCA.

Ironically it was SEN L who mentioned the following chinese proverb to me.
“路遙知馬力,日久知人心。” ["One knows of a horse's strength after a long journey, one knows of a person's heart after a long period."]

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