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Wednesday, April 25, 2007

Hooray for the NHS Trust

There is not a single bag of normal saline to be had in this entire hospital. Saline is the most basic, cheapest solution used for intravenous fluid replacement. And we have Run Out.

In the ward I'm in, they have 2 dextrose-saline 500ml bags and about thirty 100ml bags of 5% dextrose solution. That's all there is left. There are probably about fifteen patients up here who need fluid replacement overnight. The nurses are desperately ringing around all the other wards to borrow saline, but there is none to be had. Except in ITU - they prefer to use Hartmann's solution there, so they had a few bags of saline in storage.

The ability to acquire goods from other wards is requires the use of high level bartering skills. The chief nursing sister where I am working is especially good at bargaining, having had much training at the local fish markets and carboot sales.

Ward nurse : I'll swop you one bag of normal saline for 2 packs of paracetamol and a banana.

ITU nurse: Are you kidding? A bag of saline is going for at least 3 packs of paracetamol, 10 teabags and 4 apples!

Ward nurse : I'll throw in the use of our healthcare assistant for 1 hour, and 5 teabags but no banana.

HCA (in the distance): HEY!

ITU Nurse: Fine. It's a deal.

Ward nurse: It's a pleasure doing business with you.

But after all that, she only managed to acquire 3 bags of normal saline. This is just great.

Maybe, we can get all the nurses to squirt 10ml saline tubes into the patient's lines every two minutes. Or maybe we can do it Catch-22 style - just attach one bag to the arm, one bag to the urinary catheter and do a switcheroo every eight hours.

Or maybe the NHS Trust will just order in more saline, like the nurses asked them to 3 weeks ago, Instead of spending the money replacing all the
'Handwashing is great!' posters in the hospital and repainting the managers' parking spaces!


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