I worked in our emergency rooms today.
Recently, swine flu has been spreading throughout the world.
Although no patient who is infected with swine flu is yet reported in Japan, such patients may come to our hospital.
So we need to prepare for treating them.
Yesterday, my superior told me in detail about how to treat patients who are suspected as being infected with swine flu because I would play the role of leader of nurses in emergency room today.
However, no patient who is suspected as being infected with swine flu came to our hospital at least during the day shift.
I'm relieved at being out of danger now.
How to refresh myself|
I read an interesting news article today.
According to the article, one out of twenty-three nurses in Japan has been working more than 60 hours' overtime every month.
It means about 20,000 nurses are facing crises of death from overwork.
On the other hand, I think nurses tend to be willing to work seriously since they choose to become nurses even though it is said that nursing has all three of the following K's:
K : Kitsui（きつい） = heavy work
K : Kitanai（汚い） = dirty work
K : Kiken（危険） = dangerous work
Many nurses do resign every year, and the cause of the resignation is sometimes burnout syndrome.
The Japanese Nursing Association shows the rate of nurses leaving jobs is about 12%.
It means one out of about eight nurses resign every year.
If I calculate back, the rate of nurses not leaving jobs is about 88%.
According to a simple calculation, half of nurses will resign within six years and nurses who remain until retirement are only one out of about a hundred people.
Of course, that is a just simple calculation, but according to that I may not be able to continue my job until my retirement.
In order to prevent getting burnt out and having to quit my job early, I need to consider how to refresh myself.
Absence Without Leave|
Yesterday, I enjoyed my holiday until around 9pm.
And then, I glanced at my duty roster.
At that time, I realized that yesterday was in fact not my holiday.
I was extremely astonished and couldn't believe that the chief nurse did not call me if I didn't go to my workplace without leave.
To make sure, I sent an email to my friend who worked on that day and asked her, "Was today my working day?".
She answered, "Yes. It was your working day. But no one noticed it until the day ended. So no one called you. Your name did not appear in the list of today's workers. Therefore we thought you were off duty.”
Today, I apologized to my boss for not going to my workplace yesterday.
At the same time, she also apologized to me for forgetting to write my name.
I was lucky that my boss forgot to write my name when she made a list of workers.
I worked today instead of yesterday.
That settled the matter completely.
I'm really lucky.
I worked in the department of hemodialysis today.
I generally work there once or twice a month.
Although I have much interest in hemodialysis, I don't like working there.
I get very tired whenever I work there, even if I'm not busy at all.
I indeed felt worn out even though I spent a lot of time just sitting on a chair today.
I hate monotonous work.
Working in the department of hemodialysis is very monotonous and my brain doesn't need to work very much.
I am sick of doing the same things.
On the other hand, working in the intensive care unit (ICU) is full of changes.
So, whenever I work there, my brain works with all its might.
I guess that adrenalin revives my spirit when I work in the ICU.
However, I can't get sufficient adrenalin when I work in the department of hemodialysis.
Maybe, that's why I feel tired when I work there.
A Popular Qualification|
There is a qualification for respiratory therapists named 呼吸療法認定士 in Japan.
That is not a national license, but stupendously popular among medical staff such as nurses, clinical engineers and physical therapists.
To gain the qualification, we need to attend a lecture on respiratory therapy for two days and pass an examination.
The lecture is delivered only once a year and accepts around 3500 participants.
Whether I can attend the lecture or not depends on the order of applications sent.
For this year, the acceptance started at seven o'clock on April 14th.
On the other hand, post offices in Japan usually open at nine o'clock.
Because I heard that it was better to apply immediately after the society had begun accepting applications, I didn't think I should wait until 9 o'clock.
However, because I was on duty at that time, I asked my wife to to send in my application exactly at seven o'clock at the central post office, which stays open all day long.
She arrived there exactly at seven o'clock but there were already some people who had the same application forms and each applicant had a few friends' application forms.
My wife said, "I think about 20 application forms were sent from that post office at seven o'clock.".
Although the city we live in has a population of about 300,000, I couldn't believe that people who were longing to attend the lecture were that many.
Since the population of Japan is about 120,000,000, it is about 400 times the population of my city.
According to a simple calculation, around 8000 people applied at seven o'clock.
Actually, a community for respiratory therapists in mixi shows that almost all central post offices were crowded with people who had the application forms for the lecture.
Moreover, some people said that they had been waiting from 5:30 or 6:00.
What a popular qualification!
I hope I will be able to attend the lecture.
Today, at the end of my work, an epileptic patient was hospitalized in the intensive care unit.
When he was hospitalized, the cause of his epilepsy was still unknown.
However, I noticed a strange smell and said that the smell was abnormal.
Doctors agreed with me and looked for the cause of the bad smell.
We finally realized that the bad smell was coming from his mouth.
Therefore, the doctor inserted a big nasogastric tube into his stomach.
Then, a lot of white muddy liquid effused in the tube.
We couldn't identify what the liquid was but it seemed to be an agricultural chemical or a disinfectant.
We thought the cause of the epilepsy was the chemical he had swallowed.
(We don't know whether he swallowed it by himself or someone made him drink it.)
Anyway, the smell is too intense for me to stay there and some of my co-workers felt headaches.
During his treatment, I put on two surgical masks and sometimes breathed outside.
I got the feeling that work in the intensive care unit was full of dangers.
Today, I worked in the emergency rooms.
Before beginning work, we usually inspect all medical devices such as the ventilator and electrocardiograms.
During this time, I would always examine my own pulse. My pulse rate is too fast.
The normal range of an adult's pulse rate is 60bpm to 100bpm, but whenever I examine my pulse in the emergency room, it is always more than 120bpm.
("bpm" stands for beats per minute.)
Basically, my pulse rate is around 80bpm.
It is within normal limits, even though it is comparatively fast.
However, it is only when I work in the emergency rooms that my pulse rate would increase abnormally.
This proves that I get very tense in the emergency room.
I think this extreme tension is bad for my health.
How To Stop Resignations|
Today I attended a farewell party because six of my co-workers will resign and my superior will also be reshuffled.
I was on good terms with them and their resignations have discouraged me.
I had educated a lot of nurses but most of them had already left my workplace.
Many fine nurses had already left from my workplace, and many young nurses remain.
I'm facing a crisis now.
Because nurses are almost always female, some of them resign due to their marriage or childbirth.
Some of them also resign to go abroad to study foreign languages.
If I were single, I would resign and go abroad as well.
However, because I have a family and a housing loan, I can't resign.
Anyway, I have to continue my work.
I need to consider how to educate young nurses because nurses who are capable of teaching have become less than nurses who need to be taught.
Besides, I want my superiors to find the best plan to cope with the nurses' resignations.
Our hospital may not be attractive. (But I think our hospital is better than most of other hospitals.)
We need to come up with a plan to retain nurses who are married, as well as those who have children to look after.
Or, maybe we should employ more male nurses because they won't resign due to their marriage or childbirth.
Severe Pediatric Patient|
I am exhausted because I was very busy today.
A patient whose condition was extremely serious was transferred to my hospital from another hospital.
The patient is only five months old but he needs a membrane oxygenator (an artificial lung) and a continuous hemodiafiltration (an artificial kidney).
I sometimes nurse patients who need these devices but usually they are adults.
I feel nervous and get tired when I nurse such severe pediatric patients.
I took part in a disaster drill today.
Over 200 medical staff took part in this drill.
(For example : doctors, nurses, medical clerks, clinical engineers and so on.)
By the way, it was not a drill to practice how to escape safely.
Because I work for a university hospital, we have to treat patients who get hurt by disasters like earthquakes.
I had attended a lecture on the disaster medicine once before.
Therefore, I played the role of group leader of the nurses.
I had thought that it was too hard for me to fulfill the role, but now, I'm satisfied with my job because I did it better than I expected.
Usually, we divide patients into 4 groups when a disaster happens.
The 4 groups are as follows:
Green group :
-> Patients who can walk.
(It doesn't matter whether patients can walk by themselves or not.)
Yellow group :
-> Patients who can't walk but whose vital signs are stable.
Red group :
-> Patients who can't walk and whose vital signs are not stable.
Black group :
-> Patients who are already dead or almost dead.
I was stationed at the green group.
It was fun because it was just training.
However, if a disaster actually happened, we would probably panic.
We have to repeat this drill over and over again.