Why do YOU want to be a nurse?

Why do you want to be a nurse?

I’m willing to bet that all nursing students, no matter which branch they’re in are asked this question more times than they can count. The NHS is in crisis. Social care is in crisis. Everywhere is understaffed. You could earn a lot more in a less stressful job. In mental health the need massively outstrips demand. There’s no funding. You’ll never do a good enough job.

Why would anyone want to be a nurse in the UK right now?

 

That is not the question I get asked. It’s not the question I get asked because I am autistic. I am autistic and I tell everyone that I am autistic because if I don’t tell people then they can’t reasonably be expected to know that I have a disability. If they can’t reasonably be expected to know that I have a disability, then they don’t have to make adjustments for that. If they don’t make adjustments for that and I have a sensory overload or a meltdown because nothing was put in place, then it’s my fault. So, I tell people, because autism is as much a part of me as my eye colour, only people can’t see it. When I tell people I’m autistic, the question becomes this:

Why do you want to be a nurse?

Suddenly it’s not about the state of the NHS or understaffing or underfunding or pay or working conditions. Suddenly it’s personal. Nursing is about communication and teamwork and interpersonal skills and every day is different. The things required to be a good nurse are anathema to everything most people know about autism. How do you, autistic person, think you are going to cope?

 

There is a video by Tony Attwood that I really love, I’ll link it below. It’s a video I wish that I had seen three years ago when I first started my degree or when I was 18 and wondering if working in a lab really was what I wanted to do. It’s the video I wish I could send to everyone who has ever asked me why do I want to be a nurse. I love the video because it explains something I have known for a long time but struggled to articulate. I am autistic, but I am also a woman. I am an autistic woman who, more or less and with a lot of help, survived mainstream school. I’ve lost count of the number of times people have told me that I don’t ‘look autistic’. I learned to mask. I learned to mask by watching and reflecting and cataloguing turns of phrase and facial expressions and social rules. I learned in order to imitate and although my imitation still isn’t and probably never will be perfect, I have learned to read people. I have learned what body language can mean, depending on the context, depending on the words accompanying it. I have learned to judge when I’ve said completely the wrong thing. I have learned how my own emotions work and how they link to what’s going on around me in ways that aren’t always immediately obvious to me. I became a psychologist because I am an autistic woman in a society that doesn’t make space for us to simply be as we are.

So why do I want to be a nurse?

I want to be a nurse because I have spent my whole life learning to understand people and what is the point of that if I don’t use it to help others? I want to be a nurse because I’ve been a patient and I want to break down those barriers. I want to be a nurse, because who is more qualified to work with and advocate for autistic children than autistic adults? There are some things you can’t learn from reading about. I want to be a nurse because I want autistic children to know they don’t have to accept closed doors. I want to be a nurse, because I love finding that one thing that sparks a moment of connection with another person. I want to be a nurse because what’s the point of looking at the world from a different point of view if you don’t put that to good use? I want to be a nurse because working with children is something I’m surprisingly good at. I want to be a nurse because everyone needs someone who will listen to them and be there for them and fight their corner. I want to be a nurse because I’m better at 1:1 than I am to groups, so I’d be an awful teacher. I want to be a nurse because I am autistic and I’ve found my special interest and for me, that is enough.

 

https://www.youtube.com/watch?v=-n6IWTRVGeg

Letter from 25-year-old Robin

Possibly I will try to write more this year than last year’s two posts. Possibly. 

Dear 26-year-old Robin,
It’s funny how much I still psych myself up to write these letters. In the beginning there was so much uncertainty over whether I’d be there to read them in a years time. In a sense, that uncertainty is still there, because none of us can know when one day will be our last day or what will happen a few minutes down the line. But that heavy grey cloud no longer hangs over my head. There is no longer that sense that if I am not here reading this next year it will be because I have taken my own life. There are still struggles and there are still doubts, but I am more Luna now than I have been since I was a child. My baseline is brighter. Instead of a constant grey fog, my mental skies are clear. Sometimes a pale wintery blue, sometimes a deep, warm summer blue. Sometimes there are storms, but they blow over, they’re weather and not the sky itself. It’s hard to put my finger on exactly what has changed, it’s more that I feel less empty, I feel like I can greet myself as a friend.

Maybe reading letters from my past selves is trepidatious because they list hopes I have since dashed. I couldn’t cope with the long shifts on Ambulatory assessment. Nor could I cope with the heat of Day Case Unit through the summer heatwave. I failed a placement and at the time it was heartbreaking and a part of me is still angry about the way it happened. But it made me make the decision I had been toying with all year: to transfer to mental health or not. I transferred. I still have nearly six months left of Second Year because of it. I’m no longer in the cohort with my friends. It doesn’t matter. It was completely the right decision, so in a way I am grateful that those events transpired. I have forgiven myself for what feels like giving in, because I am on the right path.

My first mental health placement was CAMHS. I have found what I need to be doing. I have found what I am good at. To say I enjoyed it would be the understatement of the century. I wanted to get up and go in. I looked forward to work the next day. I felt so appreciated. There were moments when I was genuinely asked for my opinion on patients by other clinicians including the psychiatrists. Suddenly being autistic was an advantage, because it meant I got it. It meant that all these years of struggling with mental health, of researching and learning obsessively could be put to use. I did over 100 extra placement hours. I missed it when I left. I hope you still have that drive. Being back at uni is hard. I am still so nervous about my next placement and placement 5 because I know deep down that I don’t want to be on a ward and I will struggle with it. But I am determined, because I know where I want to end up.

Over the last year, that subtle change has spread. I stopped tracking meals because when I track I know I start to obsess. Over the summer there were moments when I caught my reflection and realised not only do I look like myself, I like the way I look. At the beginning of the year I started doing RED January. When I signed up, there was a part of me that was thinking about getting abs. Getting fit. Getting my body lean and perfect. When I started doing yoga in the morning, I realised I was wanting to do it for longer not for my abs, but because I loved it. I could relax into poses because my mind was calmer. After January, I hit a stumbling block with the usual Pre and post menstrual stress. I am trying to get back into it, because it helped. On the subject of exercise, I got my brown belt at Jado and it was one of the biggest achievements of my life. I have since taken a break because I struggled with getting to Advanced class, I struggled with the change and I struggled because my one track Aspie brain had focused on nursing and not ninja class. I do intend to get back to it, because I do want my black belt and for so many years I have held onto Jado as something that I haven’t quit before the finish line. Talking of reaching the finish line, on the 24th of August last year, just after I turned 25, I passed my driving test on my first genuine attempt. I still don’t enjoy driving, but I feel more confident now. I know that I can drive and I know that nobody is perfect.
In some ways I have been more creative over the last year with altering clothes and making puppets, but I have written less. It isn’t so much that I lack the muse, it’s that I lack the motivation to sit down and write. My mind has been so wrapped up in other things. Even in my endless daydreams I am a nurse now.
Socially I am much more relaxed, and my relationships are stronger. Narnie is not my only port of call. Twice last year I had the pleasure of seeing Willow, I hope there will be more occasions in the year to come. There are still times when I feel like I’m sitting under a harsh spotlight watching myself from the outside over analysing what to say and how to say it. Those times are becoming rarer and I am becoming better equipped at navigating them. I have learned to take myself as I am.
Hopes for the year:
I hope you’ll have stuck out mental health nursing
I hope you’ll be doing placement 6 with CAMHS (and maybe even have a job lined up!)
I hope you’ll be back at Jado
I hope you’ll be doing yoga everyday
I hope you’ll have written a short story or maybe more
I hope you’ll have completed the DBT course
I hope you’ll have done some ACT training
I hope you’ll be writing a sentence a day
I hope you’ll have moved to Appletree
I hope you’ll have stopped picking your skin

I look at how far we’ve come and I am so proud. I do things in my own time at my own pace, as Luna would. I hope I will only continue to live, learn and experience the ocean of life.

I love you,
Robin

Act Now

I am a mental health student nurse in my final year. Last week, as part of one of my modules we were asked ‘should nurses’ be political?’ My opinion, one which is increasingly shared by the RCN is yes. Yes, nurses should be political. We are our patient’s advocates, we are one of the most trusted professionals (Ipsos Mori, 2018), surely it is our duty to be political, when doing so improves patient care? Surely it is our duty to use our position of public trust to speak up for things that matter?

The Lancet referred to the Climate crisis as “the greatest threat to human health of the 21st Century” (Watts et al, 2018). Surely then, as a future nurse it is my duty to take action. The RCN position statement on Climate Change states that nurses have a duty to protect and promote health and adds that “Their expertise, diverse roles and the trust invested in them mean they can be leaders in protecting the health of the public from the consequences of climate change.” (Royal College of Nursing, 2019).

I will be travelling to London to take part in the International Rebellion. It’s my final year, this isn’t something I wanted to have to do. But it’s something I feel I must do. The Climate Crisis is the biggest crisis of our times. According to the Intergovernmental Panel on Climate Change (IPCC report) unless Global Warming is limited to 1.5˚C, we will reach a tipping point where ecosystems will be lost, food supply will be hugely reduced, natural disasters caused by extreme weather events will be increased and the amount habitable land will be hugely reduced (IPCC, 2018). Heatwaves such as the European Heatwave of summer 2019, which is thought to have caused the deaths of 1500 people in France, will become at least five times more likely (Oldenborgh, 2019). To prevent Global Warming exceeding this 1.5˚C tipping point, we need to reduce carbon emissions to net zero by 2050.

Extinction Rebellion has three demands:

Tell the Truth – partially achieved in May 2019 following the International Rebellion in April, demanding that the Government tell the truth about the Climate crisis

Act Now – Government must act now to halt biodiversity loss and reduce greenhouse gas emissions to net zero by 2025. Why 2025 when the IPPC report says 2050? If we aim for 2025, we have a chance of achieving 2050.

Beyond Politics – Government must create and be led by the decisions of a Citizens’ Assembly on climate and ecological justice. A Citizens’ Assembly involves a representative group of the public being selected to hear evidence from experts and discuss and agree on a way of responding to the Climate Crisis.

Non-Violent Direct Action has a long history of success, from the Civil Rights movement to the Protests in April. Personally, it is the only way forward. I am one person and I care about the environment, but I still have to use my petrol car to travel to university and placements. I still use electricity generated from the burning of fossil fuels to light my home. I can make changes in my own life, but unless the Government Acts, the changes individuals can make won’t be enough. We need Government policies and investment in green energy to make this possible. That is why I am going to London. That is why I am willing to risk arrest, even if it means never getting my pin and the last three years having been for nothing. This is more important.

 

For more information about the Climate Crisis and to find out about Extinction Rebellion visit: https://rebellion.earth/

IPCC, 2018: Summary for Policymakers. In: Global warming of 1.5°C. An IPCC Special Report on the impacts of global warming of 1.5°C above pre-industrial levels and related global greenhouse gas emission pathways, in the context of strengthening the global response to the threat of climate change, sustainable development, and efforts to eradicate poverty [V. Masson-Delmotte, P. Zhai, H. O. P.rtner, D. Roberts, J. Skea, P. R. Shukla, A. Pirani, W. Moufouma-Okia, C. P.an, R. Pidcock, S. Connors, J. B. R. Matthews, Y. Chen, X. Zhou, M. I. Gomis, E. Lonnoy, T. Maycock, M. Tignor, T. Waterfield (eds.)]. World Meteorological Organization, Geneva, Switzerland, 32 pp

Royal College of Nursing (2019) Responding to Climate Change RCN Position Statement: RCN

Van Oldenborgh GJ et al (2019) ‘Human Contribution to the Record-breaking June 2019 Heatwave in France’ World Weather Attribution Science Available at: https://www.worldweatherattribution.org/wp-content/uploads/WWA-Science_France_heat_June_2019.pdf [accessed: 10/10/2019]

Watts N et al. (2018) ‘The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health’ Lancet. 391 pp. 581-630

A letter from 24-year-old Robin

Better late than never. I feel so much more positive than this time last year.

Dear 25-year old Robin,

Wow. A quarter of a century. Who saw that coming?

I loved the optimism in the letter form 23-year-old us. I was so sparkly with the thrill of starting something new then. To my past self, you are incredible. Taking that gamble was so brave. Much as this past winter has been hard and I have felt lower and less in control than I have for a long time, it is worth it. It was the year I finally learned to stop running away. I pushed through every set back. I pushed through the first placement being so difficult. I persevered when second placement wasn’t what I wanted. I learned to cope better with group work – I’m still working on that, maybe 25-year-old Robin will have it nailed. I am in my second year, about to embark on placement three – Ambulatory Assessment Unit. I’m terrified. After week 1, I will have to do three long days a week for five weeks to get my hours in, while doing Fridays at uni and trying to juggle all my assignments. I feel I have improved my organisational skills, but I have a way to go yet. Those tentative friendships of a year ago have strengthened and expanded to include Eleanor, Lyndsey and Helen.

It’s funny, reading last years letter, I thought my progress had slowed somewhat. Writing to you now and looking back over the last year, I have realised I was wrong. Once again so much has happened. I have stuck with Nursing, I passed first year with As and A+s. I built friendships. I found a whole other side to myself. A side to myself that loves music. A side that can dance for hours. A side that wants to run wild and make crazy puppets and be a pixie child.  I went to Boomtown Faire, I had an incredible time, I spoke to so many fascinating people and felt so inspired to embrace my creative side more. I went to SolFest and that feeling was only reinforced. I met so many people that I would like to forge friendships with. I hope that you have gone some way towards that. I hope that you’ve found the courage to message people, to spend more time with people, to push yourself that bit further. You are awkward, but awkward is okay, it’s part of who you are. If you can accept that part of yourself other people will too. Unless a lot of people are bullshitting you, you’re more likable than you think.

Binging is less of an issue. I have got the hang of tracking meals. Admittedly it has taken the best part of the year to get to this point. I have finally started PIIT, I hope that you will have stuck with it. I hope you will have done one round of BBG by now. I hope that you will feel comfortable in your own skin and love your body for what it can do. I hope that you’ll have your Jado Brown belt. I am grading on the 25th February. I hope you will look back at the fear that made me put off grading with the rest of my group and smile. I hope that you’ll be going to Advance classes. I hope that you’ll have started being an assistant instructor. I hope that you’ll be more confident with sparring. You know what to do, you just have to breath, relax and let yourself, don’t over think.

I hope you are embarking on the third year of your Nursing degree. I believe in you, I know that you can do this. I hope you’re building on the friendships you have and making a point of talking to other people. I think your optional module will be good for that. I hope you give placements your best, make a point of asking silly questions, when you think of something you’d like to do, make it happen. Talk to people. Practice your skills. Remember what Jess said to you: you’re going to make an amazing nurse. I hope that you’ve started your job, I hope it’s everything you want it to be. I think Mental Health is the direction I want to go in, are you still on board? Have you started looking for graduate jobs yet? I hope you have. I hope things are coming up in Mental Health. I hope that having done an Adult Nursing degree hasn’t held you back. I hope that Placement 4 and 5 have been different to what you’ve done before.

I may not have found Luna last year, but I caught more glimpses of her than I have in a long time. I hope you’re that much closer. I hope that you’ve learned to let go of the residual fear of saying the wrong thing or not being good enough. Everyone feels like that sometimes. Nobody gets it right all the time, it’s okay. You are allowed to ask for help, you’re allowed to lean on your friends. If there’s one thing I hope you achieve over this year, it’s reaching out to other people, Narnie can’t be your only go to person.

Pearl and I have grown closer. Arlo has grown so much stronger over the past year. I hope you can tell me the same in a years’ time. Family is important. For the most part we’re a socially awkward bunch who have problems showing affection. I hope you learn to let people know how much you care about them. It’s worth the effort.

To my future self, good luck. I’m looking forward to seeing where you are and what you’re doing. I hope you’ve embraced your creativity. I hope you’ve written something. I hope you’ve made a puppet. I hope you’ve had moments where you feel completely freed.
I love you,

Your 24-year-old self

Brain Glitch

Is it any wonder that only 32% of autistic adults are in paid work compared with 80% of the non-disabled population and 47% of the disabled population? There are obvious barriers, like the fact that social communication is an essential skill regardless of your job role. People who can’t play office politics are automatically on the backfoot.

 

Then there are more simple things. Like the lack of understanding. Or even more than lack of understanding, the refusal to listen. The dismissive attitude. The problem with “everyone is on the spectrum somewhere” is that it justifies this ignorance. One of the best analogies I have heard is that autism is a different operating system. Autistic people are Apple Macs, neurotypical or non-autistic people are PCs. Most of what you can do on a PC, you can do on an Apple Mac, but sometimes the way you go about it is different. You often need to download operating specific versions of programs or apps; a PC version won’t work on an Apple Mac and vice versa. There are some things that PCs are better for than Apple Macs and some things that Apple Macs are better for than PCs. If you’re used to a PC, you might find an Apple Mac hard to navigate. Expecting an autistic person to process things the same way as a neurotypical person is like expecting a PC program to work perfectly on an Apple Mac. It’s not going to happen.

 

Let’s extend the analogy and imagine that all the processes that go into day to day life are programs on your operating system. Some are functional programs like ‘sociability’ and some are stressor programs. For example: I am a student nurse. I have been on placement on a ward with no central air conditioning, the ancient ineffectual unit and many fans do little more than blow hot air around. The ward is incredibly hot, sticky and close. Imagine that ‘it’s hot’ is a simulation everyone is running. For most people (PCs), ‘it’s hot’ is processed into feeling uncomfortable and more irritable, but it doesn’t have a huge effect on their processing power and they can run their other programs as normal. For me ‘it’s hot’ is processed into feeling claustrophobic, dizzy and uses so much processing power that my other programs start to glitch. I recognise when I am glitching and there are a few tools I can use: I can take rescue remedy, I can drink water, I can take myself away for a few minutes and breathe, I can take some pressure off by reducing some of the other programs I am running and if it gets too much I can remove myself from the situation.

 

The problem is that PCs attitude is we are all experiencing ‘it’s hot’ and everyone else has to deal with it, therefore I should too. Even though my experience of ‘it’s hot’ is different to their experience of ‘it’s hot’. This is what I was told when I requested to leave because I felt that ‘it’s hot’ was affecting my processing powers to the point that my other programs were glitching too badly to function. As a result, I pushed myself to lower the power on some of the glitchy programs, I was less sociable, and I volunteered for less in order to continue to function while ‘it’s hot’ was running. This was manageable until other power draining programs came online too. At this point, I was in a difficult position, because I knew I was glitching, but I also knew that if I asked to leave, that would be considered unprofessional. I took breaks. I shut myself in the toilet and sent out SOS messages to friends to try to pull myself through. I ultimately decided I still needed to leave because the glitching wasn’t improving despite my best efforts. As I was going to have that conversation, I was asked to do something. I foolishly thought I could hold of any major glitches until after I had completed the task, having already been pulled up on not doing things when I was asked to. If I had been allowed to carry out the task without interruption, I might have. Unfortunately, I was interrupted by a PC correcting me on a petty thing, which triggered a major glitch.

 

A glitch is a reasonable analogy for a meltdown. When a computer has a glitch, it freezes or shows a blank screen or flashes lines of colour. When I have a meltdown, my rational self freezes and no amount of clicking is going to bring it back until it’s had a chance to switch itself off and back on again. When I have a meltdown, I am not in control. In this particular incidence, I said I was going home and proceeded to leave. My patient was safe, the PC nurse was with her. I didn’t swear, but I do appreciate it was unprofessional. Hence why, if it had been acceptable, I would have left earlier or not gone in at all.

 

What has now happened is I have probably failed placement and I will probably be suspended from my course. Because all people see is the major glitch and the major glitch counteracts every good quality I have because it is dramatic. Nobody wants a perfectly useful Apple Mac that will suddenly show the blue screen of death without warning. My mind has the processing power that its got. There are some environmental influences that can take the pressure off and free up more space, like an external hard drive for an Apple Mac, but ultimately once the limit has been reached, my mind will glitch.

 

Glitching is not going to go away, as much as I wish it would. Therefore, it becomes a matter of working with the processing space I have to avoid glitches. It’s worth keeping a perfectly useful Apple Mac which you know glitches when it has 6 applications open at once, because you know you can run fewer than 6 applications and avoid glitching. I would make a perfectly good nurse and with the right adjustments, I won’t glitch. I don’t expect neurotypical people to know what is an isn’t going to make my mind glitch. What I would like is to be listened to and respected when I tell them. At the moment all I get whenever I ask for an adjustment to be made or to leave early because I can feel myself about to glitch is ‘how will you cope when you qualify?’. Then when my mind glitches: ‘your mind glitches and that is unacceptable. You must stop your mind from glitching.’ But equally ‘everyone else is running all these programs without their minds glitching, I realise your operating system is different, but we are all different makes of laptop (even though we use the same operating system) and everyone else manages so you should too.’

 

As a student, I have no control over where my placements are. When I am qualified, I will choose a job in which the environment maximises my storage space. The more storage space I have, the greater capacity I will have for dealing with stressor programs. However, as a student, the environment is entirely outside of my control, so I have much less control over outside influences on my storage space. That means even if I do as many things as I can to maximise my storage space, it is still going to be more limited by the environment that I am in. Therefore, adjustments are more necessary to prevent mind glitches than they will be when I am qualified.

 

I don’t expect neurotypical people to understand how my mind works. I expect them to accept that I do understand how it works and to respect my needs without judgement.

Memories of Glass

The snow globe is different now. The glass is no longer opaque, much of the time it’s merely an illusion, one that will disappear if touched. There are still days when the glass keeps me trapped, but more often now, I trap myself in the memory of glass. I tread familiar paths around the edges of the snow globe because they’re well worn. Safe. Easy. On the days when the glass is an illusion, it’s only my fear of pushing against it that keeps me stuck.

Change doesn’t come easily to me, the familiar is safe, even if it isn’t what I need. Breaking patterns of behaviour is difficult, but it’s worth it for the moments I realise I’m out of the snow globe. The moments I feel real. The snow globe will always be here, it’s the walls my mind puts up when it feels threatened. It’s a safe numb place. It’s now longer the dark landscape it once was, my library is there as a work in progress, the woodlands stretch around it and the weather is warm more often than not. Luna, the person I am inside my head is here. Now she’s not only inside my head, sometimes, when I break through the walls of the snow globe, she’s me. Most of the time the only thing between us is a remembered glass wall.

In a lot of ways my room is the physical manifestation of my snow globe. It’s the place I go when I want to hide from the world. It’s hard to focus or be creative in there. It’s the place I sleep, the place I daydream, the place I shutdown. Getting out of my room and making a connection with another human being helps me get out of my head. I need to remember that’s the key to getting out of the snow globe. I need to remember most of the time those walls aren’t real, in acting like they are, I’m giving them power.

Dear Anxiety

 

I wasn’t sure about putting this up. It’s not a wander through the snow globe. It’s something I wrote while the glass was frosted up and I was ready to turn my back to it hide. I was tired and running away from scary things has always been my preferred method.

Dear Anxiety,

How many things do you get to take before I say no? How much of me do you get to erase, to steal, to break, before I stand up to you?

You are not stronger than I am. You do not get to silence every positive thought and every aspiration I have. You don’t get to drown me out, because I will learn to master every one of the tricks you through at me. I will find new ways of balancing. I will find a way around you. I will not drown. I will not sink and wait for someone to pull me out. I am stronger than I was. I am stronger than you will ever be. Eventually you will run out of curveballs to throw. But I won’t. I have more imagination than you do. I will not let you take any more from me. I will learn to regroup quicker. I will learn to strategize more thoroughly.

I am more than you. I am not just a body for you to inhabit. I am not your puppet. I will get up, every time you knock me down. You don’t get to flatten my thoughts, put my dreams into greyscale or silence my emotions. I don’t have to lie back and listen to your narrative of what makes life easy.

I won’t let you take any more. These thoughts are mine. This life is mine. You don’t make the rules. I do. I do and I am telling you no. I’m telling you I won’t give up. I will find a way around this. I won’t give up this placement. I will find a way to make the next placement easier. I will pass my driving test. I will get my brown belt. I will write a novel. I will stand up for myself. I will make puppets with Pearl. I will finish this degree. I will be a nurse. I will travel the world. I will live independently. You can’t stop me. I won’t let you.

Robin