Saturday, 12 January 2013

Domestic handover

One of my favourite parts of each shift I do at the hospital is the first and last 30 minutes, when we hand over responsibility for the patients to or from the next shift.  It goes something like this:

"In Bed 1 we have A, a lady admitted yesterday following a fall at home.  Her sodium levels are low, she has diabetes, and we need to monitor her fluid balance very carefully today.  She is restricted to 500mL fluid intake a day and someone needs to bleep the pharmacist because we're running low on the anticoagulants she has been prescribed.  The physio's coming to see her later because she's rather unsteady when she walks.

In Bed 2 we have B, a gentleman transferred from ITU yesterday following abdominal surgery.  He has very high blood pressure, and desaturated overnight.  The on-call Doctor came out at 2am and prescribed anti-hypertensive medication.  He is receiving IV antibiotics."

I love this part of the day because it is fascinating.  Each patient is a complex person with many needs and problems that need to be solved.  The handover sets the agenda for the day.  We find out who is deteriorating and what the plan is for them, who can go home today, who is going for an X-ray or an MRI scan, and who is due to come in.

There's still masses of terminology I am not sure of, but I'm picking it up steadily.  In a year or two's time, I'll be the one giving the handover.

Graham and I now have a similar sort of domestic handover when I'm about to embark on a couple of days of long shifts, or I'm about to have a couple of days off at home.  It goes something like this:

"We caught another mouse in the trap behind the cooker last night, but I haven't emptied the trap yet.  Olivia came home from school today with a note about a school trip next week; I've marked it on the calendar, and she'll need three quid spending money.  Cam's done his maths homework, but still has geography to do.  The chickens have eaten all those cabbage leaves and you owe me fifty quid because I had to put petrol in the car this evening."

Cinnamon rolls for Cam
"I made cinnamon buns, they're in the Union Jack tin on top of the fridge, and there are only three left"

I like this domestic handover as much as I do the nursing one.  It helps me concentrate on one role at a time - either I am at home and I know what is going on, or I am at work and someone else knows what's going on and I don't need to worry about it.  I am starting to realise that I can't (and shouldn't) be trying to do everything.  It's a wonderful thing to be able to hand the domestic sphere over to someone else for a couple of days, while I make sure I understand the difference between MRI, MRSA and MIBG.

(...and I do: MRI is magnetic resonance imaging - a 3D image inside the body; MRSA is methicillin-resistant staphylococcus aureus - an antibiotic resistant infection; and MIBG is metaiodobenzylguanidine - a radioactive chemical used to treat certain types of cancer)


  1. So that's what MRSA is. Thank you! Nancy I am so enjoying hearing about your new life. It is absolutely fascinating and so REAL. Also you make me feel incredibly idle.

  2. Ooh, I love all those big words!

  3. Love the comparison between work and domestic handovers. It sounds as if you are having such a wonderful experience with your nursing training - you sound so excited and alive!

  4. Sooo impressed with it all! K x

  5. terribly impressed with the handover strategies, and with the application of them from all parties. it would never work here, the message from Mr Driftwood would be more along the lines of " I didn't buy the marmite" even though there were only two things on the list........

  6. Love the parallels between busy work and busy home. Well done on it all :-)

  7. It's really amazing following you on this journey! I think you are doing incredibly well! Also can't believe there were any buns left in the tin at all...

  8. Hi! Ive just found your brilliant blog and I look forward to popping by from now on. It made me laugh about handovers...we have to do them at work as well and the same goes on in our household as we both work shifts and it is almost one coming in the door and one going out. It seems like we have the same love of cookery books as well although I have yet to buy a Nigel Slater even though he's one of my favourites. Best wishes Claire


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