Hello again everyone. This is part four of the series Anxiety Insights. A lot of people suffer from bouts of anxiety from time to time rather than all the time like me and a lot of others. Although their anxiety is not constant, and is not something that follows them around, it is something that when triggered can be detrimental to leading a normal day to day life. This story is written by Beatrice* who is a 22 year old city worker from London...
"My anxiety first started when I got my first job working in London. It was my first proper 'grown up' job, in the centre of London in a big, well known company relating to the media and involved a lot of changes in my life, and a lot of new responsibilities. It was about a month into working there and I started to get an overwhelming feeling of worry and sadness for no apparent reason. I started turning up for work and would get asked to carry out the smallest tasks and I would want to burst into tears. My job role was to organise other people's lives so the overwhelming feelings I felt when asked to literally do my job made me so upset and panicked. I held my emotions in for around 2 weeks until one day after work I came home and it was a beautiful day. So beautiful, my family were having a BBQ, so my mood couldn't be more different. I could hear laughter from them all as I walked through the front door and it was then when the waterworks started and I didn't stop crying for a couple of days.
My parents thought something awful had happened and when they asked me what was wrong, I couldn't tell them. I didn't know why I felt this way and that just made me ten times worse. The fact that I couldn't put it right because I didn't know what was causing it made this time so much more difficult for me. I attempted to go into work the next day however I managed to only get so far on the tube that I had to get off where my mum worked and I went to see her. I just couldn't face going into work. I was scared but I didn't know why. I just couldn't carry out my normal day with this horrible, anxious feeling on my shoulders. My mum decided to take the day off work and take me shopping to cheer me up and we spent most the day walking round the shopping centre. Before I knew it, I had stopped crying and that feeling of panic and worry had disappeared. From that moment onwards, with the help of my Mum and Dad, I realised I needed a distraction to get me out of the claustrophobic bubble of worry that I was in. Once I got used to the change n my life, having to travel into London for my new job, getting to grips with the new job, my anxiety lifted and I luckily haven't been affected since. I still sometimes feel a little anxious when the tube is busy or I feel claustrophobic but nothing like the feelings I felt when I first started this chapter in my life.
To help me control my anxiety, I try and remove myself from the situation that I'm in by reading books on my kindle or iPad or listening to music. I've found that doing an activity which focuses my mind on something completely different really helps me forget that I'm on a cramped train or standing at a rammed station platform, and keeps my anxiety at bay. I also try to think about people less fortunate than me. Putting things into perspective makes me realise that really I have nothing to worry about, however it's still important to recognise that my problems aren't "nothing", it's just my way of picking myself back on and carrying on.
I've now managed to realise what makes my anxiety the worse and that's change. Any form of change in my life can trigger it. From changing my travel plans, changing job roles, changing social plans or plans for the week and having to rush. These kind of things send me into panic mode so when these occur it makes me really emotional and frustrated.
I think if anyone is suffering from anxiety is reading or relating to this, my advice would be to really work hard to use the technique of distraction. Turn your music up, download a new book to dive into or download an addictive game like Candy Crush. Make sure you do more of what makes you happy. Happiness helps you to have a clearer mind and this may lead you to understand why you are feeling anxious, and be able to distract yourself from it."
*names have been changed to protect the identity of the individual
Showing posts with label nurse mode. Show all posts
Showing posts with label nurse mode. Show all posts
Monday, 4 July 2016
Friday, 1 January 2016
Page 365 of 365.
As the clock turned 12 am last night/this morning, I was surrounded by my friends and boyfriend and was honestly happy the 1st page of a new 366 page book was being opened for me. 2015 was a whirlwind of emotions and a big journey for me, and those closest to me too. I thought i'd take the opportunity to use my blog to talk about the highs and lows of my year and why I'm looking forward to 2016. This is mostly for my sake, so I can reflect on the past year, but it may also help others who have followed my blog and supported me throughout to understand a little bit more.
2015 was an odd year for me in that I could feel something inside me wasn't right from early on in the year. I moved out of my second year, privately rented university accommodation into safer student accommodation due to a case of violence and breaking and entering while in the house at the time. My Mum and Dad say that they cannot believe how well I handled this due to the fear and shock I endured the night it happened and for the month following it. Myself and my housemate were sent back to our hometowns by our university 2 weeks early for Christmas 2014 to ensure we were safe and happy which helped a lot, and moving into more secure accommodation really settled us both. Alongside this, early in the year, I was referred to a gastrointestinal consultant for a painful reflux/hiccup/squeak/weird-noise-that-sounds-like-a-dog-toy. I had to have blood tests, breath tests, multiple examinations and an endoscopy.
I started to notice my worrying and panicking over the smallest things was getting a lot worse, very quickly and it got to the point where family members and friends were starting to notice. My Mum recommended seeing a psychotherapist in my local town to see if talking to a professional would help me deal with my emotions better. This is where I was diagnosed with anxiety. My psychotherapist was lovely. I saw her regularly and she helped me dig out the cause of my anxiety which I talk about in this blog post and believe me, working it all out helped so much to not feel stupid and understand it better myself.
I then googled blogs and Pinterest boards with ideas on how to help myself with channeling my emotions, fears and worries in a creative and positive way and I started journaling fauxbonichi style (heres a link to Pinterest posts on the style I journalled in) - writing, doodling, drawing and storing memories. It helped me reflect on what I have done that day and how I feel.
In the summertime, after achieving Firsts in all my assignments and projects (70% or over), I had an exam for my nursing degree which I didn't reach the required mark to pass. This was the biggest shock to me as I have always worked my bum off to gain high grades. I was not expecting it at all and only lacked 2%. I still to this day, along with others (including academic staff!) believe I was unfairly marked, but rightly or wrongly, I decided to go ahead and just retake the exam to avoid any further stress. Things were making me very anxious for no reason now. I asked my doctor for help as it started to really affect my life and was prescribed Propanolol for anxiety to help me keep calm and settled.
4 weeks later, my boyfriend, Ben, sustained a head injury while playing football which ended up leading to an admittance to hospital. This shook me up a lot as I wanted nothing more than to come home and be with him while he was unwell but I was on placement and looking after poorly people in hospital. But it got too much and I rushed home to be with Ben. This was around the time I feel first felt the effects and signs of the panic attacks I have nowadays. The fast heart rate followed by the flush of heat and so on. A few weeks later, while I was on placement, I had my big panic attack that ended me in A&E and had me diagnosed with anxiety and panic disorder (here's the blog post about that).
I was started on Citalopram and was told by my doctor I was too unwell to be in university or on placement as my mental health was too unstable and I was physically and mentally drained. I had to put myself first. I came home and spent 4 weeks getting myself better with the help with my family and was taken on a lovely week getaway with my Aunty, Uncle, Granma and cousins in Fowey in Cornwall, which helped me escape life and relax all day every day. At this time, no one knew about my diagnosis other than my immediate family, my bestfriend and boyfriend, my Aunty and my cousin, so being treated like normal and being on 'holiday' was exactly what I needed. Fowey and the people I had around me will always be so important to me for bringing me out of a dark place and giving me the courage to get up and start again. However, while in Fowey, I was told via email by my university that I wouldn't be allowed to take my resit exam due to being off sick and this may mean I will have to be deferred 6 months in my course, and this news broke my heart. I didn't want to feel like a failure to myself and to others around me. This is when I started scrapbooking with Project Life. This was my therapy and still is to this day. It is the only thing that really allows me to concentrate on happiness and good things in my life.
Luckily, after weeks of stress and anxiety, I was back at university and I was told that due to the circumstances, I wouldn't have to be deferred and would be allowed to remain in the group I started with (and now will be ending with!). I was ecstatic and was told my resit exam would be in February 2016 - plenty of time to revise. I finally felt like I could get on with my life and get myself better with the help of my support network around me.
My motivation to be organised and work hard is now stronger than it ever has been (and I didn't think it was possible!). For Christmas, my cousin bought me the Oh Deer Daily Journal for this new year which is absolutely perfect for the type of organiser I am. I blog on here to release my thoughts and help others, which is therapy for me, more than anyone realises. I am looking forward to starting a fresh page in my journal, and a fresh page in my life. 2016 is the year I turn 21, the year I become a qualified adult nurse, the year I move back home and the year for proving to myself I can do it. I am strong and I have it in me to be anything I want to be. Everyone who has supported me this year, who has written me letters, emails and texts of encouragement and pride, made me personal and special gifts after reading my blog, and those who have shown your support for me by simply liking my blog on Facebook, thank you. Thank you for sharing my story and allowing yourselves and others to learn about my disorders and the way in which I, and many others may work differently. To those of you who feel you share similarities with me, be strong, be confident and believe you can be whoever you want to be. Make this year the year you change things for yourself. Things will get better. Happy New Year Everyone. Here's to a fresh, new year.
Love Luce xo
2015 was an odd year for me in that I could feel something inside me wasn't right from early on in the year. I moved out of my second year, privately rented university accommodation into safer student accommodation due to a case of violence and breaking and entering while in the house at the time. My Mum and Dad say that they cannot believe how well I handled this due to the fear and shock I endured the night it happened and for the month following it. Myself and my housemate were sent back to our hometowns by our university 2 weeks early for Christmas 2014 to ensure we were safe and happy which helped a lot, and moving into more secure accommodation really settled us both. Alongside this, early in the year, I was referred to a gastrointestinal consultant for a painful reflux/hiccup/squeak/weird-noise-that-sounds-like-a-dog-toy. I had to have blood tests, breath tests, multiple examinations and an endoscopy.
I started to notice my worrying and panicking over the smallest things was getting a lot worse, very quickly and it got to the point where family members and friends were starting to notice. My Mum recommended seeing a psychotherapist in my local town to see if talking to a professional would help me deal with my emotions better. This is where I was diagnosed with anxiety. My psychotherapist was lovely. I saw her regularly and she helped me dig out the cause of my anxiety which I talk about in this blog post and believe me, working it all out helped so much to not feel stupid and understand it better myself.
I then googled blogs and Pinterest boards with ideas on how to help myself with channeling my emotions, fears and worries in a creative and positive way and I started journaling fauxbonichi style (heres a link to Pinterest posts on the style I journalled in) - writing, doodling, drawing and storing memories. It helped me reflect on what I have done that day and how I feel.
In the summertime, after achieving Firsts in all my assignments and projects (70% or over), I had an exam for my nursing degree which I didn't reach the required mark to pass. This was the biggest shock to me as I have always worked my bum off to gain high grades. I was not expecting it at all and only lacked 2%. I still to this day, along with others (including academic staff!) believe I was unfairly marked, but rightly or wrongly, I decided to go ahead and just retake the exam to avoid any further stress. Things were making me very anxious for no reason now. I asked my doctor for help as it started to really affect my life and was prescribed Propanolol for anxiety to help me keep calm and settled.
4 weeks later, my boyfriend, Ben, sustained a head injury while playing football which ended up leading to an admittance to hospital. This shook me up a lot as I wanted nothing more than to come home and be with him while he was unwell but I was on placement and looking after poorly people in hospital. But it got too much and I rushed home to be with Ben. This was around the time I feel first felt the effects and signs of the panic attacks I have nowadays. The fast heart rate followed by the flush of heat and so on. A few weeks later, while I was on placement, I had my big panic attack that ended me in A&E and had me diagnosed with anxiety and panic disorder (here's the blog post about that).
I was started on Citalopram and was told by my doctor I was too unwell to be in university or on placement as my mental health was too unstable and I was physically and mentally drained. I had to put myself first. I came home and spent 4 weeks getting myself better with the help with my family and was taken on a lovely week getaway with my Aunty, Uncle, Granma and cousins in Fowey in Cornwall, which helped me escape life and relax all day every day. At this time, no one knew about my diagnosis other than my immediate family, my bestfriend and boyfriend, my Aunty and my cousin, so being treated like normal and being on 'holiday' was exactly what I needed. Fowey and the people I had around me will always be so important to me for bringing me out of a dark place and giving me the courage to get up and start again. However, while in Fowey, I was told via email by my university that I wouldn't be allowed to take my resit exam due to being off sick and this may mean I will have to be deferred 6 months in my course, and this news broke my heart. I didn't want to feel like a failure to myself and to others around me. This is when I started scrapbooking with Project Life. This was my therapy and still is to this day. It is the only thing that really allows me to concentrate on happiness and good things in my life.
Luckily, after weeks of stress and anxiety, I was back at university and I was told that due to the circumstances, I wouldn't have to be deferred and would be allowed to remain in the group I started with (and now will be ending with!). I was ecstatic and was told my resit exam would be in February 2016 - plenty of time to revise. I finally felt like I could get on with my life and get myself better with the help of my support network around me.
My motivation to be organised and work hard is now stronger than it ever has been (and I didn't think it was possible!). For Christmas, my cousin bought me the Oh Deer Daily Journal for this new year which is absolutely perfect for the type of organiser I am. I blog on here to release my thoughts and help others, which is therapy for me, more than anyone realises. I am looking forward to starting a fresh page in my journal, and a fresh page in my life. 2016 is the year I turn 21, the year I become a qualified adult nurse, the year I move back home and the year for proving to myself I can do it. I am strong and I have it in me to be anything I want to be. Everyone who has supported me this year, who has written me letters, emails and texts of encouragement and pride, made me personal and special gifts after reading my blog, and those who have shown your support for me by simply liking my blog on Facebook, thank you. Thank you for sharing my story and allowing yourselves and others to learn about my disorders and the way in which I, and many others may work differently. To those of you who feel you share similarities with me, be strong, be confident and believe you can be whoever you want to be. Make this year the year you change things for yourself. Things will get better. Happy New Year Everyone. Here's to a fresh, new year.
Love Luce xo
Monday, 23 November 2015
A Day in The Life of a Third Year Student Nurse.
This blog post will be slightly different from my usual blog posts but still related in the fact that it's a true account of my general day working on the ward as a third year student nurse. It also allows people to see that even while battling with anxiety and panic disorder, I can still work hard to achieve my goals in life. Every day is different and each ward is different but this account is for my 12.5 hour shift on my current placement on a busy Surgical Assessment Unit. (Apologies in advance for the length but it's really hard to condense this sort of post down!)
6.20am - Alarm goes off. I take my medication and lay in bed and scroll through my social media, check my emails and texts.
6.40am - Get up, start getting ready.
I have a uniform provided by my university consisting of beautiful grey trousers which fasten above my belly button(!!), white tunic and blue epaulets. The epaulets are different shades of blue for each of the 3 years training to help staff and patients distinguish how far along in your training you are. I wear a fob watch given to me by my brother on my 18th birthday, my 'my name is...' badge and my lanyard with my student ID on. In my pockets I keep two black pens, a small notepad and a lip balm. My phone stays in there as well while i'm on shift due to students not having anywhere secure to lock their belongings away like permanent members of staff do.
I have to have no nail polish, no jewelry apart from stud earrings and my hair up and off my shoulders for infection control purposes so my go-to hair style is usually either a high pony tail or a messy bun. I very rarely wear makeup to work as I am a bugger for rubbing my eyes throughout the day and it would end up all over my face if I did apply it, but sometimes a bit of coverage is needed, especially when not much sleep has been gained overnight!
My shoes were not provided by the university but this pair are from Skechers and are my third pair of nursing shoes. I have previously owned these Shoes for Crews trainer style ones which I do occasionally go back to as it is good to change up shoes for when you have a long run of shifts - apparently it's good for your feet! My first pair of nursing shoes were these Skechers shoes, and they served me through 6 and a half placements but sadly they gradually got too worn to wear. Admittedly, I was able to get staff discount from a friend who works as Skechers but I 100% think they're worth the money. My feet are so thankful for Skechers so I would highly recommend them for those of you who do long shifts and are always on your feet.
7.10am - Leave my flat for work. The walk to work takes 10 minutes but I like to arrive early so I don't feel rushed. It also helps for particularly anxious mornings when I can take those few extra minutes before the shift starts to focus on the day, prepare for it and get accustom to my environment.
7.30am - Hand over. This is the time in the morning when the night staff hand over their patients to the day staff. We are given printed sheets of paper with the names of each patient, their age, why they're in hospital, their diagnosis and their plan for recovery. It is particularly important to pay attention throughout handover as this is where vital information about patients are given to you. For example, if a patient is going for an operation, they will be Nil By Mouth in preparation for their anesthetic (they wont be allowed to eat or drink). If you miss this information, you could ruin the plan for that patient and potentially make their situation worse. Hand over is also a chance to say Good Morning to my patients and introduce myself if I don't already know them.
7.45am - Assisting patients with washing and dressing. I know right! It's too early to be getting poorly, sleep deprived patients up and out of bed to change their bed sheets but it has to be done to allow the day to run smoothly. Some patients are independent and will take themselves to the ward shower when they feel ready to, but for those who need assistance in washing and dressing, this is usually done first thing in the morning.
8.30am - Alongside a qualified nurse, I will assist in administering the morning medication to the patients. These are all the tablets that the patient would usually take in the morning if they were at home, plus any medications that the doctor has prescribed for their recovery process while in hospital. They can be all sorts of medication from tablets, injections, liquids, IV medication (or drips) or nebulisers to be breathed in. Some patient who have nasogastric tubes or PEG feeding tubes may also need their medications crushing and administering through their tube. Similarly, some patients may need assistance with physically taking their medication, and I will assist with this. On admission, all patients are also prescribed a bottle of Stelisept body wash and a tube of Bactroban nasal ointment which both help prevent the spread of MRSA in hospitals, so during medication round, I ensure my patients have used both. Before all medications are given to the patient, I have to ask the patient their name and date of birth to ensure I am giving the medication to the right patient and ask if they have any allergies in case something has been prescribed that they are allergic to. I have to ensure the medications are in date, are prescribed by a doctor, are being given at the right time, are the right dose and are being given the correct way (e.g. tablet or injection). The medication round usually takes 30-40 minutes depending on the amount of patients and complexity of their medications.
9.20am - This is usually the time I spend doing any tasks that need doing. In handover, the night nurse will share information given to them by doctors over night to help with the diagnosis and treatment for a patient. Especially on the ward I am on now, there are a lot of patients admitted throughout the night from A&E and so tasks such as urine dips, stool/urine/sputum samples, wound swabs and wound dressings are usually done at this time. I use a tick box system in my notepad to ensure I get all my tasks done. I will also assist patients to the toilet, support anxious, worried patients, patients who are in pain or patients who are vomiting, as hospital can be a very lonely place, especially when you're feeling unwell. Paperwork is also completed throughout the day, including bowel and bladder movements, the changes in position of a patient (even if they're only minor as it helps regulate the risk of the patient developing a pressure ulcer), fluid input and output, and general nursing notes.
10.15am - This is usually when I get my first break. Sometimes it is earlier, sometimes it is later. It all depends on how hectic the morning has been or how hectic the late morning is expected to be. The good thing about a surgical assessment unit is we have a running update of how many patients we are expecting to be admitted so we can prepare for the amount of work we will be faced with. On my break, I usually have a bag of crisps and a piece of fruit and a cup of tea while flicking through my phone or a magazine.
10.45am - This is usually the time for admitting patients. The patients presented in A&E this morning will be coming up to the ward around this time and so if there are enough beds, I will begin admitting the patients. The admission process involves asking the patients a series of questions regarding their Activities of Daily Living or ADLs and how they may have been affected by their illness. These include things like whether they can wash and dress themselves, their mobility, their eating habits etc, and the answers they give us help us care for the patient in the best way possible using a personalised care plan. If the patient states they are usually independent with walking but is a bit wobbly since their accident, I will refer them to a physiotherapist who will be able to review and assist the patient. Other information such as past medical history, allergies, regular medication and main personal details are all noted down too.
Helping patients to the toilet, completing any tasks left to do, or new tasks given will also be carried out throughout the morning. Liaising with other members of staff such as dietitians, occupational therapists, physiotherapists, doctors, specialist nurses etc also takes place throughout the whole day.
The doctors and consultants will also have a 'ward round' whereby the consultant teams for each specialty (Upper GI surgery, ENT, Plastics, Lower GI surgery, Vascular etc) will meet with their patients and the nurse in charge of the ward and discuss the plan with them on what they think would be best. As a student nurse, luckily I get to be a part of the ward round and have the task of jotting down the new plan of action for each patient. The doctor will usually discuss with the patient how they feel, they will inspect the body part in question and will decide on what would be best, whether that be prescribing a medication, referring to other specialisms or surgery. I will then update the handover on the computer with the new plan for each patient ready for the night staffs shift.
12pm - Lunchtime medication round. This is where the patients receive all the medications they are due around lunch time. It is the same process as the morning time medication round but usually there are less medication so does take slightly less time. Antibiotics and other IV medication are usually made up and administered on lunchtime medication rounds too, so I am often found in the treatment room mixing us powdered antibiotics with water for injection too -which is one of my favorite things to do.
12.30pm - Helping patients with needs, advice, help or education on anything. It is also worth mentioning that there are usually a lot of discharges made throughout the day on a busy ward like this and so I do have to discharge patients ready for home too. This involves ensuring they have the relevant medication they need at home, giving advice on how to behave at home (e.g. how long they shouldn't drive for), arranging a sick note from the doctor, and educating them on taking their medication or changing their dressings. Referrals to community teams are also made for discharge to ensure the patient is assisted with any further care needs they may need when returning back home.
3pm - Lunchtime! I usually go down to the hospital shop for a meal deal as my choice of food changes everyday and previously when I would take in ready made pastas or sandwiches, I would end up not enjoying my lunch as I wouldn't fancy eating it. I flick through my phone again and reply to any texts or emails I've had and chat to colleagues.
3.30 onwards - Again, just assisting with patients needs, talking to patients, updating notes, answering call bells, learning new things from doctors and nurses. Sometimes I will be asked to chaperon patients down to X-Ray, to inpatient clinics such as ENT clinic and fracture clinic and sometimes even get to watch operations in theater. It not only relaxes the patient by having someone familiar with them, but it also allows me to learn more about different specialties and follow the patient journey.
5pm - Teatime medication round. Same as the morning and lunchtime medication round. There are 4 medication rounds a day and three of them occur during the day shift. The night time medication round is carried out by the night shift staff.
Answering call bells, assisting patients on their travels around the ward or hospital, updating the nursing notes, ensuring all tasks for the day have been completed and assisting patients with their food and drink. Generally just making sure my patients are as happy and as comfortable as they can be.
7.30pm - Hand over. This is when the day shift staff will hand over the updated plan for each patient to the night shift. Same as the hand over process we received in the morning and usually from the same people we are handing back over to, but with new information on what has been done, what needs to be done and how the patients are.
8pm - I say goodnight to my patients and colleagues and walk home. I usually ring my mum or boyfriend on my walk home as I hate walking in the dark on my own! It also gives me a chance to tell them about my day. Whether it's been calm, happy, stressful, upsetting, difficult, easy, rewarding, boring. It allows me to reflect on it all and release emotions which is a massive part of being healthy and stable within my mental health.
8.10pm - I get home and shower. I make myself some tea and get straight into bed. Usually, I am shattered and my feet ache. I put on Netflix or some catch up TV on my laptop and watch it until I fall asleep ready to do it all over again the next morning!
I hope this was a helpful and interesting insight into my busy day as a student nurse. Every day is different and because of the nature of a surgical assessment unit, we may have 12 patients one day and it be very calm and not rushed at all one day, and the next there are 30 patients with 6 in A&E needing a bed and you have a list of 18 things you need to get done. Cardiac arrests, falls, patients suddenly deteriorating and the like can also shake up the flow of the day too but I am fully trained in being able to deal with crisis like these and have done many time in my training already. Nursing brings out the best in me and when I am on the ward, I find it easy to put others first and for a moment forget my anxiety and panic disorder. As I spoke about in this post, when I am in 'Nurse Mode', my adrenaline is being used for the right thing at the right time, and I love it. Even though sometimes I can finish a shift feeling very emotional or very drained and tired, the majority of the time I finish happy and proud of not only what I have achieved for myself but what my patients have achieved too. Writing this has even allowed me to reflect on how proud I am to be able to handle the amount of things I do each day even when spanners are thrown in the works, which they frequently are. It really is my dream job and helping poorly people is my absolute love in life. I am so excited to qualify in 10 months time and get my blues!
Love Luce xo
6.20am - Alarm goes off. I take my medication and lay in bed and scroll through my social media, check my emails and texts.
6.40am - Get up, start getting ready.
I have a uniform provided by my university consisting of beautiful grey trousers which fasten above my belly button(!!), white tunic and blue epaulets. The epaulets are different shades of blue for each of the 3 years training to help staff and patients distinguish how far along in your training you are. I wear a fob watch given to me by my brother on my 18th birthday, my 'my name is...' badge and my lanyard with my student ID on. In my pockets I keep two black pens, a small notepad and a lip balm. My phone stays in there as well while i'm on shift due to students not having anywhere secure to lock their belongings away like permanent members of staff do.
I have to have no nail polish, no jewelry apart from stud earrings and my hair up and off my shoulders for infection control purposes so my go-to hair style is usually either a high pony tail or a messy bun. I very rarely wear makeup to work as I am a bugger for rubbing my eyes throughout the day and it would end up all over my face if I did apply it, but sometimes a bit of coverage is needed, especially when not much sleep has been gained overnight!
My shoes were not provided by the university but this pair are from Skechers and are my third pair of nursing shoes. I have previously owned these Shoes for Crews trainer style ones which I do occasionally go back to as it is good to change up shoes for when you have a long run of shifts - apparently it's good for your feet! My first pair of nursing shoes were these Skechers shoes, and they served me through 6 and a half placements but sadly they gradually got too worn to wear. Admittedly, I was able to get staff discount from a friend who works as Skechers but I 100% think they're worth the money. My feet are so thankful for Skechers so I would highly recommend them for those of you who do long shifts and are always on your feet.
7.10am - Leave my flat for work. The walk to work takes 10 minutes but I like to arrive early so I don't feel rushed. It also helps for particularly anxious mornings when I can take those few extra minutes before the shift starts to focus on the day, prepare for it and get accustom to my environment.
7.30am - Hand over. This is the time in the morning when the night staff hand over their patients to the day staff. We are given printed sheets of paper with the names of each patient, their age, why they're in hospital, their diagnosis and their plan for recovery. It is particularly important to pay attention throughout handover as this is where vital information about patients are given to you. For example, if a patient is going for an operation, they will be Nil By Mouth in preparation for their anesthetic (they wont be allowed to eat or drink). If you miss this information, you could ruin the plan for that patient and potentially make their situation worse. Hand over is also a chance to say Good Morning to my patients and introduce myself if I don't already know them.
7.45am - Assisting patients with washing and dressing. I know right! It's too early to be getting poorly, sleep deprived patients up and out of bed to change their bed sheets but it has to be done to allow the day to run smoothly. Some patients are independent and will take themselves to the ward shower when they feel ready to, but for those who need assistance in washing and dressing, this is usually done first thing in the morning.
8.30am - Alongside a qualified nurse, I will assist in administering the morning medication to the patients. These are all the tablets that the patient would usually take in the morning if they were at home, plus any medications that the doctor has prescribed for their recovery process while in hospital. They can be all sorts of medication from tablets, injections, liquids, IV medication (or drips) or nebulisers to be breathed in. Some patient who have nasogastric tubes or PEG feeding tubes may also need their medications crushing and administering through their tube. Similarly, some patients may need assistance with physically taking their medication, and I will assist with this. On admission, all patients are also prescribed a bottle of Stelisept body wash and a tube of Bactroban nasal ointment which both help prevent the spread of MRSA in hospitals, so during medication round, I ensure my patients have used both. Before all medications are given to the patient, I have to ask the patient their name and date of birth to ensure I am giving the medication to the right patient and ask if they have any allergies in case something has been prescribed that they are allergic to. I have to ensure the medications are in date, are prescribed by a doctor, are being given at the right time, are the right dose and are being given the correct way (e.g. tablet or injection). The medication round usually takes 30-40 minutes depending on the amount of patients and complexity of their medications.
9.20am - This is usually the time I spend doing any tasks that need doing. In handover, the night nurse will share information given to them by doctors over night to help with the diagnosis and treatment for a patient. Especially on the ward I am on now, there are a lot of patients admitted throughout the night from A&E and so tasks such as urine dips, stool/urine/sputum samples, wound swabs and wound dressings are usually done at this time. I use a tick box system in my notepad to ensure I get all my tasks done. I will also assist patients to the toilet, support anxious, worried patients, patients who are in pain or patients who are vomiting, as hospital can be a very lonely place, especially when you're feeling unwell. Paperwork is also completed throughout the day, including bowel and bladder movements, the changes in position of a patient (even if they're only minor as it helps regulate the risk of the patient developing a pressure ulcer), fluid input and output, and general nursing notes.
10.15am - This is usually when I get my first break. Sometimes it is earlier, sometimes it is later. It all depends on how hectic the morning has been or how hectic the late morning is expected to be. The good thing about a surgical assessment unit is we have a running update of how many patients we are expecting to be admitted so we can prepare for the amount of work we will be faced with. On my break, I usually have a bag of crisps and a piece of fruit and a cup of tea while flicking through my phone or a magazine.
10.45am - This is usually the time for admitting patients. The patients presented in A&E this morning will be coming up to the ward around this time and so if there are enough beds, I will begin admitting the patients. The admission process involves asking the patients a series of questions regarding their Activities of Daily Living or ADLs and how they may have been affected by their illness. These include things like whether they can wash and dress themselves, their mobility, their eating habits etc, and the answers they give us help us care for the patient in the best way possible using a personalised care plan. If the patient states they are usually independent with walking but is a bit wobbly since their accident, I will refer them to a physiotherapist who will be able to review and assist the patient. Other information such as past medical history, allergies, regular medication and main personal details are all noted down too.
Helping patients to the toilet, completing any tasks left to do, or new tasks given will also be carried out throughout the morning. Liaising with other members of staff such as dietitians, occupational therapists, physiotherapists, doctors, specialist nurses etc also takes place throughout the whole day.
The doctors and consultants will also have a 'ward round' whereby the consultant teams for each specialty (Upper GI surgery, ENT, Plastics, Lower GI surgery, Vascular etc) will meet with their patients and the nurse in charge of the ward and discuss the plan with them on what they think would be best. As a student nurse, luckily I get to be a part of the ward round and have the task of jotting down the new plan of action for each patient. The doctor will usually discuss with the patient how they feel, they will inspect the body part in question and will decide on what would be best, whether that be prescribing a medication, referring to other specialisms or surgery. I will then update the handover on the computer with the new plan for each patient ready for the night staffs shift.
12pm - Lunchtime medication round. This is where the patients receive all the medications they are due around lunch time. It is the same process as the morning time medication round but usually there are less medication so does take slightly less time. Antibiotics and other IV medication are usually made up and administered on lunchtime medication rounds too, so I am often found in the treatment room mixing us powdered antibiotics with water for injection too -which is one of my favorite things to do.
12.30pm - Helping patients with needs, advice, help or education on anything. It is also worth mentioning that there are usually a lot of discharges made throughout the day on a busy ward like this and so I do have to discharge patients ready for home too. This involves ensuring they have the relevant medication they need at home, giving advice on how to behave at home (e.g. how long they shouldn't drive for), arranging a sick note from the doctor, and educating them on taking their medication or changing their dressings. Referrals to community teams are also made for discharge to ensure the patient is assisted with any further care needs they may need when returning back home.
3pm - Lunchtime! I usually go down to the hospital shop for a meal deal as my choice of food changes everyday and previously when I would take in ready made pastas or sandwiches, I would end up not enjoying my lunch as I wouldn't fancy eating it. I flick through my phone again and reply to any texts or emails I've had and chat to colleagues.
3.30 onwards - Again, just assisting with patients needs, talking to patients, updating notes, answering call bells, learning new things from doctors and nurses. Sometimes I will be asked to chaperon patients down to X-Ray, to inpatient clinics such as ENT clinic and fracture clinic and sometimes even get to watch operations in theater. It not only relaxes the patient by having someone familiar with them, but it also allows me to learn more about different specialties and follow the patient journey.
5pm - Teatime medication round. Same as the morning and lunchtime medication round. There are 4 medication rounds a day and three of them occur during the day shift. The night time medication round is carried out by the night shift staff.
Answering call bells, assisting patients on their travels around the ward or hospital, updating the nursing notes, ensuring all tasks for the day have been completed and assisting patients with their food and drink. Generally just making sure my patients are as happy and as comfortable as they can be.
7.30pm - Hand over. This is when the day shift staff will hand over the updated plan for each patient to the night shift. Same as the hand over process we received in the morning and usually from the same people we are handing back over to, but with new information on what has been done, what needs to be done and how the patients are.
8pm - I say goodnight to my patients and colleagues and walk home. I usually ring my mum or boyfriend on my walk home as I hate walking in the dark on my own! It also gives me a chance to tell them about my day. Whether it's been calm, happy, stressful, upsetting, difficult, easy, rewarding, boring. It allows me to reflect on it all and release emotions which is a massive part of being healthy and stable within my mental health.
8.10pm - I get home and shower. I make myself some tea and get straight into bed. Usually, I am shattered and my feet ache. I put on Netflix or some catch up TV on my laptop and watch it until I fall asleep ready to do it all over again the next morning!
I hope this was a helpful and interesting insight into my busy day as a student nurse. Every day is different and because of the nature of a surgical assessment unit, we may have 12 patients one day and it be very calm and not rushed at all one day, and the next there are 30 patients with 6 in A&E needing a bed and you have a list of 18 things you need to get done. Cardiac arrests, falls, patients suddenly deteriorating and the like can also shake up the flow of the day too but I am fully trained in being able to deal with crisis like these and have done many time in my training already. Nursing brings out the best in me and when I am on the ward, I find it easy to put others first and for a moment forget my anxiety and panic disorder. As I spoke about in this post, when I am in 'Nurse Mode', my adrenaline is being used for the right thing at the right time, and I love it. Even though sometimes I can finish a shift feeling very emotional or very drained and tired, the majority of the time I finish happy and proud of not only what I have achieved for myself but what my patients have achieved too. Writing this has even allowed me to reflect on how proud I am to be able to handle the amount of things I do each day even when spanners are thrown in the works, which they frequently are. It really is my dream job and helping poorly people is my absolute love in life. I am so excited to qualify in 10 months time and get my blues!
Love Luce xo
Tuesday, 10 November 2015
Thank God for 'Nurse Mode' | Dealing with Adrenaline Surges.
Adrenaline
noun
"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
noun
"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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