Placement Week 6

As much as there is so much to learn in terms of skills and background knowledge, predictably I feel like I’m getting to grips with that much more quickly than the communicating with people thing.

Here is an insight into my brain on a typical placement day: okay, talking. I can do talking. I nail talking to people. I can strike up conversations with old ladies and highly confused men with dementia! Well done me. Ten points to Robin! Wait, did I remember to introduce myself?

What about all the other stuff? Should I have held her hand while we were talking? She probably would have liked that. Was I supposed to manually check her pulse as well as using the sats probe? Probably. Yes. I meant to do that before. Must stop being afraid of touching patients!

What about where I put myself when I was talking to him? Should I have been closer? Should I have tried to be more on his level? Did he hurry what he was trying to say because he thought I wanted to get away?

Why do people always talk when I’m trying to count breaths? Always.

One of our dementia patients has taken a turn for the worse, he’s very agitated and needs to have someone with him all the time. I witnessed him having to be pinned by six members of staff to be tranquilised. Sometimes I think delayed emotion processing is an advantage. I could get on with my day without freaking out. It was horrendous. The poor man had no idea what was going on, he was so panicked and can you blame him? In his head, he just wants to go home to his wife, he doesn’t know why he’s not allowed to walk around anymore. He doesn’t know why he’s not being allowed to do as he pleases. He doesn’t know why all these people are suddenly surrounding him. He probably felt like he was being attacked. Dementia is terrifying.

I did see the flipside later in the week, when two of our dementia patients dramatically improved. One went from being non-verbal, agitated and unable to stand when he was admitted, to walking around independently and having a perfectly coherent discussion about cricket. Luckily for me, I can bluff enough cricket knowledge to get by. The other man had been completely unable to communicate and was so agitated he lashed out when we tried to change him. No longer! He could tell Lilo and I to shut the window, because it was chilly. He remembered his date of birth when we asked him on the drugs round, even his family were stunned by that. It was such an amazing transformation!

I know that I don’t want to be on this ward when I qualify, although Lilo has said she’d love me to come back. I also know that I don’t really want to work with dementia patients. But this week was still such an amazing experience, seeing those two men improve so dramatically in such a such a short space of time. It did make me feel certain that nursing is what I want to do.

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Placement Week 5

Tuesday was a disaster – I couldn’t face 12 hours with my mentor, I had a meltdown and went home. I tried using Brain in Hand, thee DSA funded autism app on my phone, but it has a fatal flaw: my shift starts at half seven and there aren’t facilitators to respond to pressing the red ‘I’m in a flap, help me now’ button until eight. Sadly nobody I know is up that early to stress at either. Or if they are, they’re at work. So home I went, feeling that awkward mixture of self-loathing and relief. I made the sensible decision to rearrange my shifts so as not to work with my mentor, since I have a co-mentor now, I don’t need to be with her for 40% of my shifts.

I had a very busy day with my favourite staff nurse – I realise it’s awkward referring to her as that, but this is the internet and names are personal. Maybe I should give her a name. Maybe I should call her Lilo, because she’s very bouncy and excitable and kind of reminds me of Lilo in Lilo and Stitch. It had to be a Disney name, because she spent a good part of the twelve-hour shift singing ‘Not in Nottingham’ from Disney’s Robin Hood. So now I have that stuck in my head. Pity me!

I spent a lot of the morning feeling utterly clueless because I got to help with the drugs round and I know next to nothing, which given that I studied biochemistry for more years than I care to admit to, is embarrassing. I did however pick up on a potential mistake, the medication dose in one of our patients pod lockers didn’t match the prescription, so we couldn’t give it. Ten points to me for paying attention! Fifty points to Lilo for being so strict on paying attention and doing the drugs round properly.

One of our patients died. I helped Lilo perform the final rites. It was different this time. I was there when the lady was admitted, she was quite old and she had a chest infection, but initially the doctors had thought she would go home. Her family stayed with her for a long time to say their last goodbyes, we offered tea (as you do) and gave them space. Because the day was so hot – and this is the UK so who needs air conditioning in hospitals? – the body was still warm when we came to perform the final rites. Lilo, a September cohort first year and I washed her, when we rolled her onto her side to wash her back, she appeared to vomit. I am aware that’s not the technical term. Once we had washed her face and dressed her, we had to call the morgue. Unlike other European countries, we use a euphemism when calling the morgue, in case other patients or relatives overhear. The morgue in our hospital is called ‘Rose Cottage’. I get the logic, but I still think it’s weird.

It was one of those situations, it was fine while I was doing it, but I did feel quite weird when I got home. It was one of those nights I slept with the light on.

Placement Week 4

Despite Monday bringing a huge relief, I spent Tuesday and Wednesday in a distracted state. I wasn’t sure whether Thursday would be me getting back to placement or me having to hurriedly try to rearrange a placement somewhere else.

My Link Lecturer visited the Ward Manager first and discussed my reasonable adjustments. She ten returned to give me forewarning that the Ward Manager and one of the ward Sisters, now my co-mentor would be in the meeting. She also gave me a list of shift dates running until the end of placement, with who I would be on shift with noted down. I marked the ones I couldn’t do and we went into the meeting. The Ward Manager was much more positive and went out of her way to tell me how angry she was with the university for not passing on the information about my adjustments sooner. She even apologised, albeit while absolving herself of any blame ‘I’m sorry things have been so difficult, I’m angry too.’ Still, I will take what I can get. All of my reasonable adjustments were accepted, although most of them required me to give some justification first. Meeting over with and shifts arranged, the only thing left to panic about was how to make up my hours. With a bit of luck I will be able to do a shift a week over the uni block.

I spent my first day back with my favourite staff nurse – but don’t tell her that, she’ll get a big head – so that was a nice way to start. She likes me because I make good tea. The most exciting part of the day was learning to give subcutaneous injections. I’m told I shouldn’t refer to that as ‘I learned to stab people today!’ It makes people question my suitability as a nurse. My first practice patient, a very sweet older lady, said that I was wonderful and that she didn’t feel a thing, so that was reassuring.

I spent half an hour with an awesome third year while we were writing notes. She helped me work out some goals for first placement. That helped a lot with my Initial review, which I finally got around to while spending a day doing admin with my co-mentor. The idea is to get to grips with the basics of patient care in this placement. That and learn get better at talking to people, who knew it would be so hard to remember to introduce yourself? I need a ‘Hellomynameis’ badge. Although most of our patients are over 70 and would need reading glasses to see it, so maybe not.