There are many different roles within the working environment. This being so, there are many different working relationships, however subtle the difference. When working with another Nursing Assistant there seems to be an immediate understanding of what is required. Although the routine my differ from ward to ward, the tasks largely remain the same and are performed with relative fluidity. When working with a Staff Nurse on something outside of my training, they will take the lead and instruct me in the task. The same can be said for when assisting doctors, physiotherapists and all other professionals. Each has their own role and it is important that they work within the scope of that role, as performing duties not within your skills is breaking with policies and procedures. It is equally as important to be accessible to those who cannot perform certain duties beyond their own remit.
Before going to work (I work mainly night shifts) I dress according to the Dress Code, with washed and ironed uniform, sensible enclosed shoes, nothing below the elbows which follows the Hand Hygiene Policy, ID and name badges present. On arrival I gel my hands, put my belongings in the cloakroom and wash my hands before entering the staff room. Before handover we are read the CUBAN which relates to staffing and patient levels, patients with dementia and/or having special needs or one to one care and falls risks. In handover we learn about what has happened during the previous shift, any changes in condition of patients and about new patients needs. All the information is confidential and so the Confidentiality Policy needs to be adhered to. We are all issued with a handover sheet with these details on and I jot down and highlight any tasks that immediately concern me. E.G. Catheters/measured urine, observation times, pressure care, hourly checklists and blood sugars.
We are allocated which bays we are to concentrate our efforts on and plan the best course of action, which is usually standard routine. We then load trolleys with the necessary paperwork and go from patient to patient, checking which paperwork needs replenishing and noting down what time physiological measurements etc. need doing and tidying the bed areas. We then do a hot drinks round and update the fluid and food charts as necessary. Next we help patients into bed. After gaining consent, we help them wash and get into their night clothes. If they need toiletting, the patient’s preferred way of doing so is used. The Dignity Policy is maintained at all times. If it is documented that a patient needs more than one member of staff to transfer them safely then we help each other to do so., thus sticking to Health and Safety and Manual Handling Policies. Usually at this time the trained nurses are available and are easily approachable and willing to help. After the patient is safely and comfortably in bed, we fill in the repositioning and personal hygiene charts as per Policy.
Usually, we start the observations around 22:00, reporting any NEWS score over 3 or anything untoward to the the Staff Nurse who will inform a doctor who may order an ECG, which I would perform and report straight back to him/her. This is an example of how communication and co-operation is so important to working in partnership. Any missing ‘cog’ in a machine could spell disaster, especially in the care industry. More often than not, we answer call bells of patients requiring pain relief through the night. We take the drug chart to the Staff Nurse and she will dispense it. Unfortunately we quite often need to wash and change a patient after a mishap. The correct PPE is always used and Infection Control policies are observed as are Waste Disposal policies. At around 05:30 we empty catheter bags and document output in the fluid charts. We also tidy the bed areas again. Observations, urine measurements and toiletting continue throughout the shift until handover to the day staff.