Foot loose

I don’t know what’s up with me these days. Can hormones make you assertive? When I think back to six months ago when I had just qualified as a nurse and first went to Sunshine Retirement Village as an agency nurse, I wouldn’t argue with anyone. I’m even a bit ashamed to say that I probably didn’t stand up for my nursing residents very well, when some of them only had me to speak up for them.

But I’m not like that now. I think I’m positively bossy but I like to think that I do that because I have learnt so much about the residents and I know that if I don’t speak up then they might not get what they need.

Take today for example. I’d forgotten we had a massive safeguarding meeting being held at the home. Apparently, a social worker had reported the home for mismanagement of a pressure ulcer and the lady resident had been taken to hospital and had her foot amputated, poor lady. 

The safeguarding had come out of nowhere. We had every professional input into that wound including the GP and the Tissue Viability Nurse. We had even documented and photographed the wound at every stage. We had done everything we possibly could for the patient and yet we were still getting blamed for when it went wrong.

Welcome to nursing.

Anyway, I got to the meeting and the world and his dog were there. There were social workers, GP, a Consultant from the hospital – even a police officer attached to the safeguarding team. It was this that really made me nervous, even though I knew I had no real reason to be. Then there was me. The Manager was on holiday (or at the hairdressers) and had left me a few scribbled notes that I’d tried to decipher. From the looks on their faces the only way I was leaving that meeting, was after they’d chewed me up and spat me out. I was more than a little nervous. 

The paperwork at Sunshine hadn’t always been the best and I had spent a lot of time with the other nurses trying to improve things. They didn’t always get why we had to document everything but I think the message was starting to sink in, that the paperwork is often the only thing standing between us and losing our PIN or even worse, facing prosecution.

I was praying that they had done enough to show that this wasn’t neglect on our part.

I opened the file and was relieved to see the pictorial story of deterioration. The wound care file was immaculately documented with attached photographs and the professional visits notes were full to the brim. There were files full of re-positioning charts and diet and fluid balance sheets. Calls to doctors had been recorded, as had the conversations with the tissue viability nurses.

Not that that mattered ... the goons around the table had it in their heads that I was personally responsible for the foot dropping off. 

And at that point I got mad. 

We had cared for Mrs C diligently; re-positioning and dressings had been completed by the book; concerns had been raised with the GP and Tissue Viability throughout the last 3 months and everyone had done what needed to be done. That didn’t seem to matter to these people, they were looking for a scapegoat … and apparently I have horns and make good cheese. No way Jose … I wasn’t having that! 

So I mentioned that Mrs C had diabetes and that her previous GP had diagnosed Osteomyelitis. I also spoke about her having a Sinus and that Tunnelling had been indicated through probing by the TVN. That meant that despite the wound appearing to heal on the surface, underneath a whole load of issues were occurring. 

Then I dared to mention that if there were issues that could have been spotted and prevented, why had none of the multitude of professionals who had been seeing her constantly for months, raised any concerns at the time? 

I was met by a sea of gormless faces. They clearly hadn’t considered this and had taken it for granted that we at the nursing home had failed Mrs C. On the contrary, we had done all we could but weren’t able to see beneath the surface, x-ray eyes not yet having been invented. 

The Consultant finally woke up from his temporary coma – I’m sure he only came for homemade cake, and conceded that this could have been the case and that from what he had seen, staff at the home had done their best to look after Mrs C and would not have been able to prevent this. I couldn’t believe my ears. Why was I feeling so light? Was this blame being lifted from my shoulders?

Following this revelation, the safeguarding was soon closed. Although the accusing social worker had to have the final word and told me I had better not let it happen again! Was she for real? I am not in the habit of willing feet to drop off!

I do feel proud of myself. I didn’t even know that I knew that information; and a few months ago I wouldn’t have had the confidence to fight my own corner.

I’m starting to feel like a real nurse now. I know I have a long way to go but the world is my oyster… after all, I am foot loose and fancy free (I know, I know, that was a bad one wasn’t it)! 

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