SIP: Nursing Staff

Without nursing staff, patient care could not reasonably be expected to occur. Besides the usual recordings, drips, bloods, drug calculation and administration, the nurses are the first people to note when a patient needs medical attention.

Like any other profession, the individuals in the nursing profession run the gamut of competency.

Fortunately for J., the nursing staff of the Gastro/Endo ward of SGH have been nothing short of outstanding.

A few things performed by them: administering insulin, monitoring capillary blood glucose, restraining patients, feeding patients, inserting NG tubes, arranging for follow-up clinic sessions, calling people for updates, inserting IV cannulas (on upper limbs), labelling tubes, drawing blood, filling out forms, arranging for transport, calculating medication, chaperoning, translating…

And saying some of the darn funniest things around.

These nurses are downright amazing. The experienced nurses are competent and understanding. The newer nurses are earnest and hardworking.

However, there’s just this one older nurse who irritates the heck out of some of the medical staff. To illustrate the issue, J. will bring up classic incidents regarding capillary blood glucose.

Case scenario 1 – Morning ward rounds (competent staff nurse):

The gastro team has taken the case files, Inpatient Medicine Record (IMR) and clinical chart of the patients under their team. The capillary blood glucose is recorded in the IMR (along with the subcutaneous insulin administration).

Patient: “Oh I’m feeling very good. But just now, er, 10min ago they say my blood glucose 12+ eh.”
MO: “Hmmm, the last record was 4.6 mmol/l, but we took the IMR away 45min ago. Go check with the nurse what his blood glucose was, will ya?”
J.: “Right.” “Excuse me, K (the nurse in charge of the room), what was the hypocount of 234/43?”
K: -looks at his sheet of paper- “It’s 12.3 mmol/l. Heh, if you’re holding on to the IMR, can help me write it down also ah?” -carries on with administration of medication-

Case scenario 2 – Afternoon ward rounds (incompetent staff nurse):

Consultant: “Let’s go see the 4 patients at 245.”
-team walking out of room 234 towards 245-
S (the nurse of this shift in charge of same room): “Eh doctor right? Where’s 234/12 IMR? (patient under Endocrinology)
MO: “Nope, not with us.”
S: “I don’t have his IMR. His hypocount is 12.4 mmol/l.”
J.: “Okay. Write it down on a piece of paper, will ya?”
-hurries to catch up with consultant for round-

K is a young, tanned man fluent in Hokkien and efficient in nature. He takes any bloods the nursing board allows them to take (i.e. excluding Arterial Blood Gases [ABG] and blood cultures). He sets intravenous cannulas on patients who have accessible superficial upper limb veins. He reminds the medical team appropriately and not excessively regarding things that need to be done.

This is true for almost all the nursing staff J. has been exposed to on this SIP posting. Efficient and helpful. Truth be told, the ward rounds the medical teams keep doing at different times is very disruptive to the running of the ward by the nurses, yet the nurses continue to manage to do a fantastic job.

S is the bad egg in the lot, a middle-aged, dour-faced lady who keeps asking the medical team to do things the other nurses can do by themselves. She continously reminds people of things with nary a smile or a joking, “Aiyo… why all the PSY patients come to my room?” She’s not as competent or as friendly as the other nurses.

Maybe J.’s just spoilt rotten by the high quality of nurses in the SGH gastro/endo wards.

Big thank you goes out to the nursing staff. They’ve made 3 weeks (with one week to go) a lot easier and more enjoyable than expected.

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