Uni Bloc Week 3

This week, I confess, I was the procrastination monarch. The sun was shining. My cousin finished college and passed her driving test. There were adventures to be had, iced coffee to be drunk and frisbee to be played. The importance of assignments seemed to fade away. Despite the impending deadlines. Some sensible decisions were made and many less than sensible decisions with them. I would intend to work in the morning and play in the afternoons and evenings, but it took so long just to haul my body out of bed and longer still to put on proper clothes, that by the time I came to do some studying, it was almost time to go out again. Procrastination and the pursuit of happiness won out. Bite me. When you live in the constant shadow of depression, you have to seize any moment of happiness because there’s no guarantee that it will last.

The procrastination of course meant the assignment deadline swept up before I was prepared for it. I was getting work done, but not all of it was for the assignment and most of it was being done at ridiculous hours of the night because my body clock lost track of time. Cue immense stress and less joyful procrastination. I applied for and was granted an extension, thank goodness the university makes reasonable adjustments for those of us with oddly wired brains! I spent time trawling through research on dementia patients and how I could better communicate with them. It was fascinating, but it did bring home how utterly unprepared we are on my placement ward. There’s so much variation in staff understanding and next to no specialist support. In most cases, boredom is the biggest challenge facing our patients and there is nothing being done about it. All of this I tried to word academically and cram into my half-written assignment.

My brain has crashed somewhat. I suspect a combination of lacking routine and the stress of the assignment and not being able to get in touch with anyone in my placement area to organise my next shifts. I missed the last couple of lectures. I managed to do most of the work, but I couldn’t bring myself to get to Oxford for the sake of a couple of hours only to have to hang around twice that long to get the bus and the train back home again. Learning to drive needs to be more of a priority!

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Uni Bloc Week 2

I emailed my lecturers regarding the issues of being randomly assigned to groups. Hopefully that will help somewhat. As it is, I have signed in but not participated in all of this teaching bloc’s seminars. Not the best. Especially as the material is interesting. If only I could be more productive at home I could guarantee that the work would be caught up. As it is I am battling to finish my second assignment.

Unlike the whistle-stop tour of pharmacology, the GI lecture was fascinating. I feel like I learned some new information. I am confident about the structure of the digestive system, which until now was something I only had a rudimentary understanding of. I also learned a lot about inflammatory bowel disease, it’s one of those things that I almost feel bad for finding fascinating.

The one seminar I managed to both be present for and participate in was the one on Learning Disabilities. I did a lot of pre-reading, but I still felt as though I learned a lot. At one point, someone named autism as a learning disability and my lecturer was going to let it slide, so I corrected them. Autism spectrum disorders can be associated with learning disabilities, but not every autistic person has a learning disability, because autism itself is not a learning disability it’s a pervasive developmental disorder. Although I was trembling with anxiety by the end of that little speech, I was quite proud of myself for giving it. I think it would be useful for autism to be covered on its own, since we get seminars on learning disabilities, mental health and dementia.

We had our medication management SBE day. The highlight was officially learning to give injections, although I still think I’m going to need a lot of practice if I want to avoid causing serious injury! Especially giving intramuscular injections in the thigh or buttock. The low point was being taught how to manage oxygen by a mental health nurse who doesn’t have to do it and was more clueless than we were. Well done Uni, F for organisation, as usual!

I had my first nightshift to make up a few more placement hours. Lilo was in charge and took me through the crash trolley. I feel like I have slightly more of an idea of what everything is. I might be able to pass someone the right equipment. Still so much to learn there!

Uni Bloc Week 1

Uni was a culture shock. It was lovely to catch up with everyone and hear about their placement experiences. In my friendship group there was such a mixture, some people were so glad to be back at uni, others were desperate for the learning bloc to be over so they could get back to placement. There were plenty of gripes all round, especially on the lack of organisation, turns out I’m not the only one who has struggled with that. I surprised myself by being in the group longing to get back to placement, I’m rather glad that I’m still there one day a week to make up hours.

The new modules started – creatively named ‘Education in Nursing practice 2’ and ‘Nursing Fundamentals 2’ at least I’m in no danger of forgetting what I’m studying. With the new modules came new module leaders. These module leaders seem to think that despite all of us being legally adults and apparently responsible enough to deal with patient care, we are not mature enough to get into groups by ourselves. In our seminar, we were assigned groups by the module leader giving everyone a number. I think if I had been in secondary school I would have been offended. I mean who needs someone to do that past Year Three? In a stunning display of maturity myself, I left the classroom. Why? Because I can’t deal with the chaos that is 25 people trying to move around the room to get into these randomly allocated groups. It’s a waste of time. Unfortunately it does mean I have some reading to catch up on. Then again, isn’t that the motto of every university student: Must. Read. More.

For once having a biochemistry background didn’t make me feel like a failed scientist, it made me exceedingly glad to be one of the few people who could make sense of the pharmacology lecture. In A level biology, Active Transport is one of the more difficult concepts, by degree level, it’s a simple mechanism. The pharmacology lecturer assumed everyone would have a reasonable understanding of it. Most people were utterly bamboozled. The flipped classroom, do your own learning and consolidate in lectures concept has potential, but there’s really not enough science support for people who don’t have much of a science background. Is it me or is this a cost-cutting exercise at the expense of our education?

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.

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.

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.