First day on the job

Yesterday I had my first shift as a healthcare assistant on the Neurosurgery ward at Southmead, 7am-7.30pm! It wasn’t a particularly great day, but I guess that is only expected when starting a new job. As I don't have my manual handling course until later this week, there was a lot of things I am not allowed to do yet. This was really frustrating, as I felt completely useless when I was asked to help with such tasks. The two-week induction and training had not fully prepared me, as it is very different being shown a presentation on something and actually doing it in real life! It's a lot more about learning on the job. When I got home I was completely knackered, but I'm looking forward to when the job is second nature to me. 

Ebola - is a pandemic around the corner?

With an increasing number of cases and deaths of the Ebola virus in West Africa and the recent growing threat of spread to other countries, this post is long overdue. Here is what you need to know about Ebola, how and why it is spreading, and the future outlook for the virus.

What is the Ebola virus?

Signs & symptoms start 2 days – 3 weeks after contracting the virus. Early symptoms include a fever, sore throat, muscle pain and headaches, followed by vomiting, diarrhoea and rash, then decreased liver and kidney function. Internal and external bleeding may also occur. Death usually occurs around 6-16 days after symptoms begin, due to low blood pressure from fluid loss.

Image: Wikipedia

How is Ebola contracted?

The virus is spread by contact with blood and other bodily fluids of someone who is infected. This may also occur indirectly, by contact with a contaminated item.

How did the outbreak start?

The outbreak started in West Africa, with the first case being reported in March 2014 in Guinea. A week later, cases were reported in Liberia and Sierra Leone. In July, the first case was reported in Nigeria after a man travelled there from the Liberian capital. In August, the virus was then reported in Senegal. In the past, epidemics have not become a pandemic, as travel was less frequent. But now, there are around 6 million people travelling by plane everyday, meaning that the risk of a virus spreading around the world is much greater.

Image: BBC

Where has the virus spread?

In August, a Spanish priest died from Ebola in a hospital in Madrid, and in early October, a nurse who treated the priest contracted the virus and also died. In September, the Liberian Thomas Duncan flew to Dallas in Texas, via Brussels and Washington after trying to help women with Ebola in his home country. Days later, Duncan went to hospital reporting of fever and abdominal pain and was sent home despite telling the nurse he travelled from West Africa! After 2 days, he was admitted to hospital with the virus, and died on October 8^th. Since Duncan’s death, two nurses who treated him have tested positive for Ebola, despite precautionary measures. The day before the second nurse was diagnosed, she flew from Ohio to Texas through two international airports, despite having a fever.  Therefore, disease control specialists are being sent to Ohio to help monitor people she came into contact with. However, as the virus is not airborne, the risk to others on the flights is low but officials are trying to trace those on the flight.

How many have died?

The virus has killed nearly 4,500 people so far, with more cases and more deaths than all other outbreaks combined.

Image: CNN

What treatments are there for the virus?

There are no specific treatments available yet. Zmapp is an experimental drug that was effective on monkeys but tests on humans were less conclusive. The UK, US and Canada are currently trying to develop a vaccine, with the aim of 20,000 doses that could be used in West Africa in early 2015.

What is being done to prevent the spread of the virus?

According to an American group who is monitoring the spread of the disease, the UK is the third-most-likely country outside of Africa to “import” Ebola. Although there are no flights entering the UK directly from the worst affected areas of West Africa, there is still a risk. On October 14^th, London Heathrow airport began screening travellers from West Africa, and this will later be extended to Gatwick airport and the Eurostar. Passengers travelling from Sierra Leona, Guinea and Libreria will be referred to health workers to have their temperature taken and be questioned to establish whether they may have come into contact with anyone infected with Ebola. However, as the incubation period for symptoms is three weeks, it will be difficult to detect. The WHO say it may be more effective to screen people on exit from a country. America may take a more extreme approach, as some lawmakers are calling for a ban to travellers from West African countries hit hardest by Ebola. 

Image: The Guardian

What does the future look like for Ebola?

“I’ve just projected that about five weeks into the future and if current trends persist, we would be seeing not hundreds of cases per week, but thousands of cases per week and that is terribly disturbing” says Dr Dye of the World Health Organisation. The WHO are estimating 20,000 cases before the end, but this is described as optimistic by some scientists. The WHO are also saying it could be contained in six to nine months, but with 40% of deaths being over the last three weeks and cases increasing exponentially, just 20,000 cases seems unlikely.

Fear of waking up

A few weeks ago, I woke up from a nightmare to see the vivid white outline of the top half of a baby floating on the other side of the room. Naturally, I was absolutely petrified and thought I had seen a ghost. As it was the week before my UKCAT, I knew I needed to sleep, so I slept in another room. Since my test I have been sleeping at my Dad’s house whilst my Mum is on holiday in America. During my two weeks at my Dad’s, I have woken three times from bad dreams to see the face of the baby on the other side of the room. It was not as vivid as when I had seen it at my Mum’s house, so I thought it must just be my imagination projecting the image of this baby.

Image: Deviant Art

Tomorrow, I move back to my Mum’s house, which was slightly scaring me. So I decided to have a quick look on Google about hallucinations when waking, which I found were called hypnopompic hallucinations. These commonly occur when waking from a nightmare. They can also occur when falling asleep, which are called hyponagogic hallucinations. There seem to be lots of stories online of people seeing shapes and colours (see below), as well as spiders, dogs and also people. But when you see a person, how can you really know if it’s a ghost or a hallucination? As the experiences at my Dad’s house did not seem as real, it’s hard to know if these hallucinations are now just happening because of what I saw at my Mum’s house.

Image: No sleepless nights

Research suggests that these hallucinations are linked to sleep disorders, particularly insomnia. Since I came back from university 4 months ago, I haven’t been sleeping very well, but this had never happened before. It’s possible that I had been worried leading up to the UKCAT and submitting my UCAS application, so I had not sleeping as well. It appears that these types of hallucinations are part of everyday life for much of the population, with one third experiencing them at least twice a week. However, I hope this doesn’t become a regular occurrence for me. Next week I am starting the training for my HCA job and when I start work I will be doing 12 hour days starting at 7am – so hopefully I will be tired enough to sleep through the night without these disturbances!

Submitted!

So yesterday I finally came to the decision as to where I was going to apply for medicine, and submitted my UCAS form! In the end I went for Birmingham and Warwick graduate, and Edinburgh and Glasgow undergraduate. I had really wanted to apply for Kings graduate programme, and thought my UKCAT score might just be good enough to be selected for interview, but decided it was too risky. The UKCAT scores are released to universities at some point in November. After that comes the agonising months of waiting to hear back - wish me luck!

Getting ready to start!

Two months after having my interview at Southmead hospital and being offered the job of health care assistant in the neurosciences ward, things seem to be actually happening! For some reason references and paperwork took a while, but last week I was told that I would start my induction on October 13^th.

Today, I went in to meet my ward manager and have a look round the ward. I hadn’t been in the new Brunel building at Southmead and I was amazed at how big it is. The ward consists of 32 beds – two 4-bed bays, and 24 individual rooms. Due to the individual rooms, it means the ward is very big, which I was told makes the job a lot more difficult, with lots of walking around. I had been worried about footwear, but the ward manager informed me that since the move to the new building they had allowed all-black trainers.

I have now received the information for my induction that takes place over a couple of weeks. This includes: two days of corporate induction going over policies, safeguarding etc.; 3 days of clinical induction, which includes patient safety and clinical equipment training; 3 days of Foundation in care; adult basic life support; dementia level 2; and a manual handling training session.

This means I won’t actually start on the ward until near the end of October, but I am excited to get started with the training and hopefully it will make me feel more at ease about the job!