Kick starting at 8:30am, the medicine nurse team convene in ‘Pet Exam’, which is our main communal area that is first stop for patient’s coming out of consult and heading towards wards. Our team leader who is responsible for the organisation of the day, delegates any early morning admits while the rest of the team meet with the clinicians, residents, interns and students in a meeting room upstairs.
There, each inpatient in discussed in detail with the whole team to analyse their progress, and as a team decide which patients require further investigatory procedures or blood analysis. Our team leader then will discuss each of the appointments arriving throughout the day, and the clinicians will request what procedures should be reserved for each patient.
Once the morning rounds are complete, the team leader will head towards the imaging and anaesthesia departments to reserve procedure slots, while the nursing team collect any requested blood samples, and submit to the lab. Once again re-convening in pet exam to liaise with our team leader, each case is assigned to a nurse, and as a team discuss the overview of the day to ensure we are all aware of any procedures that might require assistance.
Morning is the time we aim to perform any procedures on our inpatients, as we wait for our new patients to be admitted. Failing that, we assess the situation in wards to lend assistance in busy areas; or focus on hygiene and stock control in the areas we commonly utilise, such as; pet exam, consult rooms and endoscopy. When a patient come through from consult, we place an intravenous catheter, take any blood samples requested, we ensure all necessary paperwork has been completed and hand the patient over to the wards nurses by giving them a brief overview of their condition, any concerns, and what the plan is for the patient.
In the instance our patient is undergoing a sedation, the clinician will request which drugs they will require and the dose rate, we calculate the dose to each patient’s body weight and prepare the medications required. If the patient is undergoing an anaesthetic, the anaesthetists at Pride will assess the patient and examine the patient’s history before designing an anaesthetic plan, which the medicine nurse will draw up and prepare the equipment required for inducing and maintaining anaesthesia.
The types of procedures commonly performed in the medicine department are; abdominal ultrasound, radiography, placement of feeding tubes such as; naso-oesophageal (placed by the nurse) or oesophageal (placed by a clinician), bone marrow biopsies, arthrocentesis, CT scans, fluroscopy, faecal transplantation, the collection for donation of both feline and canine blood and transfusion medicine, radioactive iodine treatment and a variety of endoscopy; gastroscopy, colonoscopy, rhinoscopy, bronchoscopy, cystoscopy and otoscopy.
Internal medicine is a very busy but rewarding discipline that encompasses a wide variety of case presentation and diversification.
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