Placement Week 3

This week was the epitome of mixed feelings. Monday morning started off disastrously. I went in and was told my mentor wasn’t on shift…despite her telling me to come in on Monday. At first, I panicked and went to hide in the staff room. I called my mum and she was angry on my behalf, but helped me talk myself into going and finding out if there was anyone else I could work with. I spent a few hours with a lovely deputy sister and the rest of the day with quite possibly the bubbliest staff nurse ever. I had an amazing day! I started learning more about the medications and where to find them on the trolley. There are two draws, which are for different types of medicines, but inside the draws, there is no logic at all. Fortunately, my temporary mentor was patient with how long it took me to find things.

 

I saw my first body today. I had met the lady and her family in the morning, so it was very strange going back into the room and her body being there completely still. I kept half expecting her to breathe. This time I was there to observe while a staff nurse and a Care Support Worker performed the final rights, dressed and wrapped the body and made sure the right paperwork was prepared. It turns out quite often doctors don’t officially document time of death and have to be chased and pestered about it.

 

Tuesday I was with the staff nurse again. After practicing doing obs on Monday, I was allowed to do a few patients independently. I felt like I got the hang of it, but I probably should practice doing manual blood pressures more. It probably comes as no surprise to anyone that communication is the hardest part. Some people are good at chattering away to patients the whole time, I still sometimes forget to introduce myself. I have now written a note of what to say when I first meet people and things to talk about. Most patients do seem to like it if you keep talking to them, even if it’s just explaining what you’re doing – which is good, because when I’m doing obs, I need to talk myself through it!

 

I had Wednesday off and spent an embarrassing amount of time sleeping. Sleep schedule needs work, that was predictable. I had a couple of wobbles at ninja class, I think because it takes so much energy keeping myself together when I’m on shift. I feel like there’s a very fine line between being okay and having a meltdown at the moment.

 

Thursday was a complete and utter disaster. I had a meeting with my link lecturer, I thought I was going to discuss the problems I’ve been having with my mentor, but apparently not. Since it has been resolved now, I will cut the rant and give the short version. It turned out to be a meeting with my link lecturer, a ward sister and ward manager in which I was essentially being pushed out, told that my brain ‘wasn’t working the way I wanted it to’ and I wasn’t well enough to be on placement. The basic message was, go home and think about whether you’re doing the right thing, while heavily implying that I wasn’t. I didn’t meltdown then and there. I did exchange a flurry of emails with my academic advisor to arrange a meeting with her. I did still have to miss two of my planned shifts, which has messed up my hours for this placement. Oh well, who needs a summer holiday?

I took my mum to the meeting, which was on Monday, but I’m writing about it now. My link lecturer was in that meeting too, but she didn’t have too much to say. The placement lead and my academic advisor more or less said that the meeting on Thursday shouldn’t have happened and that my mentor wasn’t fulfilling her basic responsibilities. It turns out that my occupational health review has gone walkabouts, so the placement wasn’t made aware of my reasonable adjustments. Had my link lecturer and my mentor done what they were supposed to, it wouldn’t have been a problem. Now everyone has a copy of my reasonable adjustments, which the placement lead said were very reasonable and most of them were basic things that should be done anyway. The short version is, Uni fucked up and it’s not my fault.

Placement Week 2

I went to my GP, she’s a big, bubbly, super expressive woman who has a son with anxiety. She told me I had low blood pressure, but unless I collapsed while I was exercising, I had nothing to worry about. Then she confirmed exactly what I had thought – going in was the issue, I needed to do it as soon as possible. I have been back to the hospital, mum took me up there just to sit for half an hour while she went shopping. I could do that without panicking. I set a target for my next shift: Follow my mentor around like a little lost sheep and don’t worry about anything else.

 

I was very anxious, but I coped. We did the drugs round and I didn’t faint, it was already better than day one! I was also on the lady’s bay and some of them were quite chatty and very sweet to me. One woman was very upset, I went over to her, held her hand and let her talk. She told me I had nice eyes and I would make a good nurse. It made my day. I was feeling so lost and uncomfortable. She made me feel like I had potential and didn’t need to run away and give up now – thank you brain for the ever useful advice.

 

My mentor is hard to work with. I don’t know if she’s had many students before, which is difficult because I don’t have a clue what I’m doing. She doesn’t explain things or tell me what she wants me to do or make time to do my paperwork. If I was someone else, I would probably have the confidence to bring that up. But I’m me and I feel like I’m barely staying afloat as it is. I do not have the spoons to have an awkward conversation. I feel like she thinks I’m fragile and totally incompetent. Maybe I’m just projecting, I don’t know. We haven’t had a chance to go through my paperwork, which explains my reasonable adjustments, so that is only making things worse.

 

Conclusion: My mentor sucks, but I love nursing.

Windows and Domes

It has been a while since I have written about the snow globe. At the moment, it feels like the snow globe is in a constant state of thawing and refreezing. Sometimes the glass is as thick as ever and so frosted I can barely see the world outside through it. Other times the glass is more of a shimmering bubble and it’s all too real, too intense, too much. Sometimes, the river running through my snow globe swells, overflows and crashes over me. My skin starts tingling, my throat closes, I feel sick. The tears I haven’t shed over the last five years have finally found my eyes. On the days when the snow globe walls are thin, I am constantly on the edge of tears. The tiniest things tip me over the edge. I am either utterly detached or constantly a breath away from meltdown.

 

My library is going up haphazardly, the shells are built, the interior is empty. I’m upstairs in the Creativity block, the ceiling is a glass dome. Some days I feel like hiding in here and letting the world disappear. Some days I am so afraid that depression is returning. Some days I want to sleep and hide and dream and do anything to avoid having to be. Maybe I’ll leave this room bare, have a role mat on the floor and an assortment of blankets, so that I always have somewhere to hide.

 

When I fainted a few weeks ago, something very odd happened. I suspect that it was my half-conscious brain misinterpreting people talking around me, but I felt like I went somewhere else. I was here, then I was not here. It felt like falling through a window into another world. The only thing that stuck with me was that I didn’t want to come back. I think I need to write more. Even when I’m tired. Even when the blank page or the blank screen is terrifying and turning on my laptop or picking up a pen is too much effort. Sometimes that helps. Even if it doesn’t help to trap the dreams words, there’s always hope that one day I’ll write something that has enough potential that I can get it published. Then maybe I will let the world outside the snow globe go, for the most part, and live in a shed in the garden and write. At least then I would feel safe. I wouldn’t have to rely on the fragile glass of my snow globe to keep me safe, I would have real walls to do that. I would have a pass to be as eccentric as I please.

Placement Week 1

In my head, I have built up my first placement into a do or die challenge. The deciding factor. A confirmation that I made the right choice or the epitome of poor judgement. In my head it could mark the beginning of a life’s work or it could be another dead end. When I’m anxious, my head becomes a very dramatic place to be. Sleep becomes something I used to do. Ah 3am, my old friend.

As it turned out, true to myself, the first day was an utter disaster. What did I put on my to-do list for the day? Survive placement. Seriously Robin, you had one thing to do. One thing!

FAIL

I passed out on ward rounds. My mentor left me with the drugs trolley for five minutes while she helped transfer a patient and I started feeling a bit sick. I tried deep breathes, my vision blacked out. I blinked and all I could see was black. I crouched down to get my head low. My vision cleared. Thinking it might be that the bay was hot, I got out into the corridor and sat down, head on my knees. My head was still spinning and my vision kept blacking out. The ward sister asked if I was okay, I told her I was blacking out, funny, sometimes when I’m really overwhelmed, my fear of people evaporates. She and another nurse helped me to the medication cupboard because it’s cooler in there. I collapsed as we stepped through the door. I can’t have been out for more than a few seconds, I came round while they were putting me in the recovery position.

The nurses took my blood pressure, it was so low the machine alarm went off and I had to go to A&E on a trolley and have a heart trace. Fortunately, it didn’t show anything wrong. I was however told to go home for the day. I went back to the ward to collect my bag. The ward sisters and my mentor were very sweet about it, mostly they were just worried about me. I suppose now I can ask all the stupid questions, because nothing is going to be more awkward than collapsing on shift! Placement literally cannot get worse.

I’m not sure what lead to the collapse, possibly a combination of heat, anxiety and possibly anaemia. The main thing is, it wasn’t anything serious.

Unfortunately, fainting on shift wasn’t something I could have prepared for. I had prepared for all sort of stuff, I had prepared for not getting on with people, people dying on my watch, not knowing what to do, not knowing where things are, feeling shy, feeling lost, constant noise, almost everything I could think of. But that is something that hasn’t happened to me before. Over the next few days it built up in my head, until, on the morning of my next shift, I got up, got dressed, even got out of the front door and then had a panic attack. I couldn’t leave the front garden. My legs turned to led and I could not stop sobbing and saying ‘I can’t’. My breath caught in my lungs, my teeth were chattering in spite of the warmth and my whole body shook. I ended up calling the ward in tears and trying to explain what happened.

I know my brain pretty well at this point. I know the problem is getting to placement, once I’m there, in all likelihood I will be fine. My link lecturer disagreed. She wouldn’t let me go in for a short day the following morning, which was the one day I could easily get a lift in. I felt so frustrated. Not going in only made the anxiety worse, because now I have to worry about making up hours.

Nursing Week Eight

A word of advice, if you happen to have a skills day which involves personal care, do not look at the online training manual in a public library. Anyone who happens to glance towards you will see you looking at detailed diagrams of how to clean a penis. If those people are fellow nursing students, it’s all cool. If, on the other hand, they’re doing maths, it can get a bit awkward.

The SBE day was the last day of term. I was tired and stressing about having an essay to write. I’m still not used to essays. The morning session was quite interesting, using unwieldy manikins to practice helping patients use a bed pan, was and how to change the bedding of an immobile patient. When we replaced the manikins with each other, one key point became apparent, we all needed to communicate with the patient more. When the bed has been raised to a good height for the nurses and you’re being rolled on your side towards the edge of the mattress, the floor is a long way down and it is terrifying. I will try to bear that in mind when I’m on placement! I will also try to remember the point about bringing the bed up to around hip height, it does make it easier. I should try not to take my back for granted.

The second part of the day was more practising observations, mostly blood pressures. I still need more practice! There was also a lot of talking. In theory, I learned how to bath a baby. In practice, I didn’t get to touch the doll and I would probably still be terrified of picking up a wet infant in case I dropped them. Funny thing, I never had that fear when my siblings were babies and they’ve all turned out fine. I would like to do a spoke placement with babies at some point. I am an adult nurse, because I want to keep as many options open as possible, but I do wish we didn’t have to specialise so soon!

Nursing Week Seven

I had a practice session on manual blood pressures with a second-year student, he taught me a very useful trick. If the Korotkoff sounds are too quiet, or it’s just really hard to distinguish between them, look at the needle gage. When the needle starts bouncing, you have the systolic pressure (top number), when it stops bouncing, you have the diastolic pressure (bottom number). It is suddenly much easier! Although, finding the brachial artery is still hard. I just need to be less nervous about poking people. There was a point, I think sometime in 2011, when I understood blood pressure in scientific terms and knew what those two numbers meant. It’s slightly embarrassing to admit that I have mislaid that information.

Two key things happened this week. The first was I got to wear my uniform officially for the first time. We had our Trust Induction. Finding a bathroom to change in and coming out wearing the turquoise trousers and trying to make my collar lie flat was pretty terrifying. We walked as a huddle towards the conference room all desperately hoping nobody would collapse in front of us or even just expect us to know anything. A neon sign saying, ‘I know nothing!’ would have been useful.

It turns out that one symptom of anxiety is not being able to shake the feeling of hundreds of money spiders crawling over my skin. I never noticed that before, possibly because always wearing long sleeves deadens the sensation. It was distracting. Distracting from PowerPoints. PowerPoints are hard to pay attention to at the best of times. I came away knowing that once upon a time, student nurses had to starch and sew the weird little hats they used to wear. I’m quite glad we don’t have to do that, I would probably be kicked out for having a wonky, grubby hat.

Halfway through the day, the information we had been waiting for dropped. Placements. I can’t tell you exactly where mine is, but it’s in a hospital not in the community and it’s close to home. I was so excited! As was everyone else. Concentration dropped further. I think taking a notebook and actually writing notes might have been sensible. It would have helped keep my brain in the room. The main thing being drummed home was that we must get changed on site. No walking to and from placement in uniforms. If you ask me, the infection control reasoning is a bit questionable, I have seen the inside of my rucksack! The more convincing reasoning was: if you’re in uniform and someone collapses in front of you, people will expect you to know what to do. Right, well, leaving a bit earlier and getting changed there it is! There is a reason I am still a student.

Nursing Week Six

Despite the fact it has been an uncomfortably long time since I finished school, I think I am still stuck in the mentality that a term is about 6 weeks and then you get a week off. I get to this point in the term and I’m tired. My motivation is curled up in the corner like a cat and sleeps for sixteen hours a day. Lacking motivation and high anxiety because we had a debate lead to the closest I have come to a meltdown. I didn’t have a meltdown and I did go into the seminar. I even explained to the seminar leader what was going on and that I wouldn’t be taking part in the debate because I can’t deal with it today.

I’m not sure how much I got out of listening to the rest of the class debate aside from some people don’t understand the concept of a debate. You listen to what the other side has to say. You then get your chance at a rebuttal. A good debate does not involve talking over people, shouting people down or degenerating into insults. That is a social media debate (and pointless. And frustrating). I don’t know if it’s an age thing because the people shouting other people down tended to be the younger members of the group or whether it’s just thanks to the internet and the way politicians tend to debate, peoples understanding of the concept has warped.

The one day I managed to poke my motivation into semi-wakefulness was Monday, because we had our second SBE day. The main discoveries of the day were 1) caffeine improves everything and 2) manual blood pressures are hard. We were doing observations. The point about caffeine was an ‘observation’, but not a clinical one. Finding a pulse I can do, keeping track of it is, for some reason, much harder than it has any right to be. Maybe my body is just weird. You are supposed to count pulse rate for a minute…. In all the times someone has checked my pulse, I don’t think they have ever done that and I would know, because I did used to count to distract myself from the fact that someone is touching me. Maybe if someone had ever tried to count for a minute, they too would have lost my pulse at random points. Or maybe that’s just me.

Once we had practiced finding the pulse at various points on the body and listening to the apex beat of the creepiest dolly ever – the thing breathes, I don’t like it – we moved onto blood pressure. I think the person who invented the blood pressure machine is a genius! My dead arm is not the biggest fan of manual blood pressures. Finding the brachial artery and keeping track of where it is when you strap a blood pressure cuff on someone is harder than it has any right to be. Also, using a stethoscope while anxious had the obvious flaw of hearing your own blood rushing and not being able to distinguish that from Korotkoff sounds. It’s also hard to find a balance between getting it within two mmHg and not cutting off the other person’s blood supply for so long that they lose feeling in their fingers.

I have got myself a practice cuff. Beware people!