Tuesday, 10 November 2015

Thank God for 'Nurse Mode' | Dealing with Adrenaline Surges.


"Adrenaline is a hormone secreted by the adrenal glands and released into the bloodstream to serve as a chemical mediator. Adrenaline has many different actions depending on the type of cells it is acting upon, however the overall effect of adrenaline is to prepare the body for the 'fight or flight' response in times of stress. It increases heart rate, increases blood pressure, expanding the air passages of the lungs, enlarging pupils, redistributing blood to muscles and altering the body's metabolism" 

Commonly experienced in those who suffer from anxiety, surges of adrenaline are released for no reason at all and can develop into strong anxiety or a panic attack. This weekend, I felt adrenaline being released at the right time for the right reason, for the first time in months. 

I often get surges of adrenaline while i'm on my nursing placement due to the nature of the job. Having to be on the ball at all times, not only to structure my tasks and efficiently working throughout the day at fast pace, but to be ready to react to an emergency situation. I have experienced having to stop what i'm doing and jump into 'life saving mode' many times, with patients who have choked on their sandwich, elderly patients who have fallen and even a patient who went into cardiac arrest, so it is not uncommon for my adrenaline to fill me with the energy and strength I need. 

After having to end my last clinical placement of 2nd year early due to my sickness, I experienced these surges of adrenaline more and more while sat watching TV, while on my phone or laptop, while talking with friends, for no reason, and although I had experienced what I like to call 'unneeded adrenaline' before, this was a lot stronger and a lot more difficult to control and calm down. These surges brought on panic attacks and strong anxiety that became noticeably difficult for me to shake off like I was used to being able to do. So since my last placement, around 10 weeks ago, I had not felt 'needed adrenaline', until this weekend. 

My best friend text me Sunday morning telling me that following 2 head collisions during his game of rugby the Wednesday before (which worried me anyway!), that his nose had started bleeding, that his headaches had got no better, his hearing was muffled on one side and he had bruising behind one of his ears. The nurse in me, using the knowledge I've learnt from lectures and patients I've cared for myself, diagnosed this as a severe head injury - worse than the concussion he self-diagnosed himself with. Of course, I explained this to him and told him to go to his local walk in centre immediately. The walk in centre checked him over and told him he needed to go to A&E as the nosebleed shouldn't have happened under the circumstances and there could be some cranial damage. When he texted me all this, my adrenaline hit the roof. Baring in mind, my anxiety levels have been good for around a week now, it was a shock to the system. While walking down to A&E to meet him so he wasn't alone, such bad, irrational thoughts were crossing my mind. What if he collapses on his way here? What if he's left it too long to be able to help him get better? Should I have made him go to A&E earlier than today? When he got there, alive, I immediately felt better because he was orientated, alert, still able to make jokes and be on Tinder. He checked in and we were told to sit in the Minors waiting area. Surprisingly, over hearing the busy rush of A&E and the hospital in general calmed me and I felt like I was in familiar surroundings. It reassured me that the adrenaline rushing around inside of me was normal and okay and that settled me alot. An hour passed and he was called in by the doctor who told him he needed a CT scan on his head and neck to check for fractures and internal damage to the brain, and this news sent another surge of adrenaline around my body. Of course, I wasn't going to let him know this, but I was scared, probably more than he was, but like my Mum always tells me "Lucy, you know too much when it comes to health". I could feel myself buzzing and my feet were going tingly like they sometimes do when I'm about to have a panic attack. I unconsciously started tapping my feet to get rid of the horrible sensation and remind myself that he was in the best possible place but still I was thinking irrational thoughts. There's going to be something wrong with him. What if he collapses in the waiting area? Will I know what to do? I was scared, at this point that my anxiety I was feeling wouldn't calm down, but it was quite clear that he was in a lot of pain with another headache and although not showing it, must have been worried so my brain rationally clicked into nurse mode and I was fine again. No tingles, no irrational thoughts. I felt these surges throughout the night, sat outside the CT room, waiting for his scan to be finished, waiting for the results of it and finally when the nurse told him what was wrong. "You've fractured your mastoid bone". Now I knew what this was before he did - he'd fractured his skull, just behind his ear. It was big shock as it is very uncommon to break this part of the skull, and again I the adrenaline crept up on me, so much so I ended up almost dancing on the spot to try and shake it off and blamed it on feeling loopy and it being 2am. I was expecting slight bruising to the brain or something like that but not a skull fracture. This was causing the headaches, the bruising, the nosebleeds and the muffled hearing as it was pressing on his ear canal. While she was explaining it all to him, again, I clicked into nurse mode and felt absolutely fine again, like I was there as a nurse supporting a patient. Thankfully there was no cranial damage. 

This time last month, I was so worried about what I'd be like having to walk back onto a ward of patients, many very ill, and have to deal with adrenaline surges again. Would I have to try really hard to direct it where it needs to go? What if I don't get them when I need them? What if I get them when I don't need them and I can't shake it off? After this weekend, I know that I can go back to what I love doing. I can use the adrenaline thrust upon me for a reason and use nurse mode to shake it off. Nurses need it, and I do sometimes wonder if maybe it doesn't help my anxiety that I am so prone to having moments where I need adrenaline fast. It's also taught me that I can handle my anxiety, and I can put others first, put a brave face on and come out with a genuine smile. I am so proud of myself for what I achieved Sunday night and it's shown how much I have developed with my anxiety and panic disorder. I was telling another friend about it all today and she said "8 weeks ago, there is no way you could have handled hearing that sort of news from him, let alone willingly support him through it all, especially with that sort of outcome" and it's true. I wouldn't have been able to, but now I know I can. I know that hospitals and helping those in need is were I belong and is where I feel most comfortable. It's where I can be me.

Love Luce xo

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