Raising awareness through personal and professional experiences
Mum to two amazing sons.
Following recovery from a lengthy psychotic episode, depression, anxiety and anorexia, I decided to train as a Mental Health Nurse and worked successfully in various settings before becoming a Ward Manager.
I am a Mental Health First Aid Instructor and a Mental Health Awareness Trainer, Mental Health First Aid Youth and Mental Health Armed Forces Instructor.
Just started my mental health from the other side blog.
Another great post by Drtanya at Salted Caramel, who asked ‘what is the cost (not financial) of blogging to your personal life?’
# Cost of Blogging — Questions
Does it infringe upon your leisure time? Unfortunately, yes. I was an avid reader and now I can’t remember the last time I picked up my kindle. Sometimes my partner has to drag me away, kicking and screaming from my laptop. I’ve only started blogging recently and now I’ve got the bug. There’s so many great blog posts to read (such as this one from Drtanya) and I have so much I want to say, so much that I want people to know about mental health, my time as a mental health ward manager…….. I could go on
Worse still, does it distract you from your work/studies ? Unfortunately I am now disabled and unable to work but fortunately, it’s given me time to spend studying online and more time to spend reading good blogs and blogging.
Is it taking a toll on your personal relationships ? Hhmm, well kind of, but not really. My partner and I both have laptops and we both spend a lot of time on them. Him watching or listening to the news and the latest politics and me – well blogging, of course. I suppose that means we spend a lot of time in silence (apart from him who has the tv on constantly too). He often says “Here, listen to this.” Me, eyes rolling “ah ha.” and I listen to his boring facts or figures until he see my eyes glaze over and grunts “Shall I just say nothing then?” We both smile and return to what we were doing.
‘Has your health suffered? Not really but, I suppose because I have Transverse Myelitis which has its own aches and pains, my back often hurts, my arms and shoulder too, probably from sitting in the same position blogging for long periods. My sleep pattern is disturbed by my illness anyway and I can have days where I don’t sleep at all then I start to hallucinate or days when I sleep forever and just get up to go to the loo. This means that when I’m awake for days I can continue blogging – until I start hearing voices, which distract me. So it’s a bit of a conundrum really – does blogging impact on my health or is it the other way round? That all said, perhaps I now have an addiction 😜
Have you gained weight ? Ha, that’s a good one. Of course when I’m blogging I drink endless cups of coffee and I love biscuits. I love crisps, chocolate, sweets and……….. it would probably be quicker to give a list of what I don’t like or snack on. So I suppose I probably do put weight on, particularly as it’s known that we lose weight during sleep. Because of my sleep pattern, on and off for days, it probably balances itself out. I’ve only been blogging for two months and I can’t say I’ve put on weight because of it.
Do you ever get writer’s block? Not yet, because I’ve just started. However, I do lose my train of thought easily. For example, when him interrupts me with his inane utterances or if I stop to take a telephone call.
Have you ever suffered from blog related stress or blogger burn out? Maybe? Not sure if it’s stress but I found it really difficult at first when I was receiving so many emails with blogging post, 180 one day. Then I learned how to deal with this, courtesy of another fantastic blogger. Perhaps, because I don’t really have many other commitments i.e the boys have flown the nest and I don’t work, it’s a bit easier for me. I only have to stop for Dr’s, dental, hospital appointments or when him suggests we eat then I go help him cook 😂
Thank you once again to Drtanya at Salted Caramel# Cost of Blogging. We’d both be interested in your answers to the above questions. You can answer on Drtanya’s blog post or if you do a separate post, please link back to Drtanya and don’t forget # Cost of Blogging.
It’s yet another dull day in London but I have a lot to be happy about. I have an amazing partner who’s really looked after me since I was disabled by Transverse Myelitis in 2011. I’m grateful I have an amazing close-knit family and I will be going up to Scotland in November for a niece’s wedding where I’ll get to see everyone. I am delighted with my two amazing sons; one (Ricci) is currently a Research Fellow in the States and the other (Ravi) is a Physiotherapist in London.
Today I’m going to meet Ravi and his new wife for afternoon tea and I’m so excited. I haven’t seen them together since their wedding and they’re going to bring some wedding photos for me to look through.
I’ve been up for an hour now and have been going through my posts’ comments and tried to answer everyone. Somewhere along the way I’ve picked up great blog: Crushed Caramel where she’d answered an interesting set of questions posted by another blogger: Salted Caramel so I thought I’d have a go too.
Do you blog to promote your business?
No. I became disabled and regretfully medically retired from my job as a Mental Health Nurse/Ward Manager, a job I truly loved. I also had to cease running my small business where I worked as and supplied Mental Health First Aid instructors to a variety of organisations. We taught MHFA to a wide range of companies, schools and Armed Forces. I was there at the inception of MHFA England and would love to be able to carry out more training in order to raise aware of mental health issues.
Or is your blog a launching pad for your social life?
What social life? Okay, so I’m exaggerating a little ‘cos I’ve already told you I’m off out this afternoon. We went to see our grandchildren on Thursday and got to stay the night. It was sooo much fun playing games like hide and seek, where when you’re looking for a two year old an you utter to yourself “Now, where’s that Ava?” and she shouts “I’m here.” and her four year old big brother shouts crossly “Aaaava! You’re not supposed to tell her! You’ve spoiled the game now!” and off he stomps, sulking and trying not to laugh when I pretend trip and fall onto the sofa “Ouch, Ouch!”
We’re going back there this Sunday and I’m cooking stew and dumplings (a nod to my Scottish heritage) for everyone together with my brother-in-law and his girlfriends. So far my social life’s been all family but hopefully next week I’ll be able to catch up with a few friends.
Does it exist only to complement your Instagram account?
No. I’ve never had an Instagram account. I’m a complete technophobe and not very computer literate, despite having typed and used computers since the seventies. Oops, just given away my approximate age 😉 When my energy levels reach rock bottom, I sometimes find it hard enough responding to my blog comments, Twitter and my emails, let alone having another account such as Instagram. However, I love picking up my laptop and catching up with everyone’s news – it’s my little window on the world.
Is your blog making you real money (if so please let me into your secret)?
No. Unfortunately not and it never will really. I don’t intend to monetize my blog and only set it up because I wanted to make use of my fifteen years of diaries, kept from when I was nursing. Reading through them reminds me of all the good times I had, the amazing inspiring people I met; both patients and colleagues. However, I was also reminded of the poor standards of practice and that’s really what I wanted to highlight in my blog.
I want people (nursing students, nurses, doctors, social workers, occupational therapists, community psychiatric nurses, the public, MP’s, the government, patients, carers or friends) to be informed and make the necessary changes. Tell your care team you are not happy with the standards of care. Tell your boss,manager, team that standards must be raised. I want Doctors and nurses to continue with their professional development and stay up-to-date with current practices. Ooops! Rant over.
Are you blogging because you are so adept at this craft that you want to teach it to others?
No. I wish I was smart enough tho’. I loved teaching and mental health is my niche, so I’ll stick to it. I can offer lots of information, not unsolicited advice, and point people in the right direction if they are seeking support but I can’t profess to being a teacher or instructor any more.
Or are you like me : blogging just due to the urge to write?
Yes. I’m like you. Yay, we have this one in common. I love reading and also enjoy writing; releasing the pent up frustration that’s been raging inside me for so many years. As a mental health nurse I was used to writing ‘in and on reflection’, hence the lengthy notes in my old work diaries.
As I’m disabled I often have time on my hands and can’t believe how many hours I used to spend on social media i.e. Twitter and Facebook, just to see if anyone had messaged me or liked my comments. Now I’m blogging, the likes, the helpful comments and advice I get is both helpful and constructive. I only started blogging a few months ago and I’ve not even finished with my first work diary yet – so looks like I’ll be here for a few more years.
What are your reasons why you put the proverbial blood sweat tears into your blog posts?
I want people to be aware of the poor standards of practice in mental health units. I want everyone to shout it from the rooftops or from the highest mountain whenever they come across poor practice in mental health nursing and care environments. I want to increase awareness of diagnosis (right or wrong sometimes) the signs, symptoms, causes and effects of mental health disorders. And I want to reduce the stigma. I know I can’t change the world on my own but if my little blog is of use to one person and they have the confidence to speak out, it’s a start.
While I was a student on the rehab unit I had to complete my Practice Based Assessments (PBA’s) and I’d chosen four patients that I could work with to meet these over the twelve weeks placement. First there was Mandy who had Generalised Anxiety Disorder (GAD) and next was Sasha, Elsa and Edward who all had a diagnosis of chronic schizophrenia.
I spent many pleasurable weeks working with Mandy, the lady who’d previously screamed for her medication several times a day. She repeatedly said that she could notice the reduction in each nought point five mg Diazepam, which was highly unlikely. However, I appreciate that for her, it was difficult, hence her continuous screeching at medication time.
From my parenting days, I knew that distraction worked well when children were upset so I hoped distraction might help Mandy too. I would offer her a cup of tea and ask what her plans were for the day or about her collection of teapots, rather than have the poor lady screaming and working herself into a panic attack.
It’s a shame that other nurses hadn’t picked this up as it would have been far easier for them in the long run and certainly better for Mandy. However following discussions with her Primary Nurse, the nurse who has overall responsibility for a patient, her care plan was updated and read “When Mandy is upset and screaming her allocated nurse must use distraction techniques.”
Care plans are prepared for each patient and wherever possible, are developed with the patient, rather than for the patient. The care plans are used to guide your practice with patients, to explain what care is required and how to carry it out.
As she got better, Mandy would eventually accompany me to the local Primark to get cheap knickers. Grinning cheekily, she would say the money she saved from buying these allowed her to buy her favourite yoghurts from Marks and Sparks next door. Once I’d left the unit it always cheered me up when I saw Mandy and I loved to stop for a chat.
I had a lot of fun working with Sasha; she was witty, intelligent and was becoming much more cheerful as the weeks went on. Between us we managed to clear all the cereal boxes from her room along with the crumbs and mouldy, congealed leftovers we found in bowls under her bed.
This wasn’t my favourite task but I laughed all the way through it because Sasha was getting really cheeky. When I was busy scrubbing the floor she’d sit on her bed reading or stand at the window waving at random passersby and she’d crack up when I spotted it.
Many of Sasha’s care plans were updated or changed altogether now because she’d made great progress in several areas and some of her care plans were now outdated. One care plan read ‘Encourage Sasha to keep her bedroom tidy and work with her if necessary. If Sasha refuses, staff to advise her that they have a duty of care to ensure her environment is clean.’ It was like writing instructions for nine year olds rather than senior qualified nurses.
Another care plan read ‘Encourage Sasha to spend time off the unit and accompany her if needed.’ I loved spending time with her in the cafe, a local haunt for both patients and staff. I always took my badge off when accompanying patients outside as I wanted them to feel equal in the community. It really bugged me seeing staff wearing badges when outside with patients. It was like ‘them and us‘ and showing the staff member was in a position of authority, which I thought was unfair.
At forty eight Elsa hadn’t aged well at all; she originally came from Greece and her face was craggy from the sun. She had short wiry grey hair which she hacked at herself, staring in the mirror taking great clumps out with almost blunt scissors. These were eventually taken from her as she’d often say to fellow-patients and staff “I will kill you.” She did this with a wicked grin so I didn’t think she was really serious but the scissors might have posed a risk to both her and others.
One of her care plan was updated and read ‘When Elsa wants to cut her hair, a staff member must be with her and remove the scissors back to the office once finished.’ I wanted to find out why Elsa chose to use her clothes as toilet paper but, despite using one of our translators, she just shrugged and grinned when asked. However, it was something we had to work on, we couldn’t just ignore it. I asked several staff nurses what has been tried in the past and what worked but was told “That’s just Elsa. She always does it and nothing works.” Elsa had been on the unit for months and nobody could tell me what had been tried.
When I was on duty as a nursing assistant (NA) or there on my student placement I tried to speak with Elsa every couple of hours to see if she needed the bathroom. I tried taking her to the toilet, getting her to sit for a while to see if she would poop, her favourite word. Sometimes it worked and I had to wait while I encouraged her to use toilet paper. “Too small.” she would grin “No enough.” and she’d try to use her skirt. Ah! Next time I accompanied her to the bathroom I took a roll of the large hand drying paper. Success!
One of her care plans was updated to read ‘Encourage Elsa to use the toilet throughout the shift and have hand paper available.’ though I know this rarely happened as I never saw it documented. The Nursing & Midwifery Council (NMC) Code of Conduct states that ‘nurses should respect, support and document a person’s right to accept or refuse care and treatment.’ It did not say ‘if patient refuses support, just leave it at that.’
Once my placement ended I would later hear that Elsa had reverted back to using her clothing to wipe herself. I was truly mad that the nurses had allowed this to happen. It was like they’d given up caring and they were just passing time until retirement. However, I did learn how not to nurse and their disassociation made me even more determined to be a good nurse. Our patients deserved better.
Edward had long been on a medication called chlorpromazine, the first antipsychotic which was widely shown to be significantly more effective than later antipsychotics. However this drug had a range of distressing side effects, one of which Edward had was the shuffling gait known to nurses as the ‘chlorpromazine shuffle.’
He would also complain of constipation and impotence. He was prescribed a regular dose laxatives and he often requested Viagra but would talk about not being able to get rid of his erection for hours. You had to laugh with him, his tales were hilarious. He told me about one time when he was on the bus returning to the unit and the movement gave him an erection just as his stop was coming up. It was summer and he was wearing just shorts and a t-shirt so he had no way of covering the erection. He had to stay on the bus and went miles out his way.
My main task with Edward was to get him to take better care of his hygiene. He was physically fit and more than able but he really needed a ‘kick up the backside with my tiny size three’s’, I’d tell him. He also picked his nose and would later want to shake my hand. This was one habit that would have to go and I told him I would never shake his hand unless he hadn’t washed it. I also said I wouldn’t accompany him in the community if he was wearing his usual attire of stained tracksuit bottoms and a dirty old t-shirt. I often used my sons as examples, telling Edward that I wouldn’t go out with them if they weren’t clean.
One afternoon I arrived on the unit and there was Edward, spick and span. He was clean and reeking of cheap aftershave. His receding hair had been carefully dampened down and he wearing mismatched clothes but they were spotless. He’d been waiting for me since after lunch. How could I not take him out to the local snooker hall? This was his favourite outing as the voices he heard were much quieter and encouraging when he was concentrating. It became a weekly treat while I was there but I later saw him shuffling along the street, head down and miserable.
I don’t know why the nurses on the rehab unit ignored any improvement or the hard work that was done. They scoffed at his updated care plans, saying – it won’t last! Why did they think it was okay to let patients revert to their old habits.
Conclusion—Rehab does work — but only if the staff do!
*The Purpose of the Written Care Plan is to ensure continuity of care. The care plan is a means of communicating and organizing the actions of a constantly changing nursing staff. As the patient’s needs are attended to, the updated plan is passed on to the nursing staff at shift change and during ward rounds. http://www.rncentral.com/nursing-library/careplans
As I parked up my first morning, even above Slade’s Noddy Holder screaming “It’s Chriiiiiistmass”, I could hear a female screeching “Medication. I want my medication. Where’s my medication? I need my medication.” The poor neighbours either side of the building must have been well p’d off. It was six forty-five, pitch black outside and the streets were eerily quiet — other than the high pitched screeching coming from the Mental Health Rehab Unit piercing the air.
Someone in the office by the front door pressed a button to let me in and I was greeted by this tiny little lady who grabbed both my hands and panted “Help me. Help me please. I need my medication. You’re new. Are you an Agency Nurse?” Will you help me? Please?”
I spoke calmly but firmly, “Listen to me, I can’t help you right now…” I was trying to placate her enough so that she could hear me and take in what I was saying. At the same time I was trying to get her to take a breath as she was panicking and was as white as a sheet. I really felt for her.
“Please, please. I’m begging you,” she continued to screech, now in my face, as I tried to disentangle myself from the tight grip she had on my wrists. The office door opened and a nurse yelled “Cindy, stop it, leave her alone. Cindy!” I’d now managed to get myself free but Cindy had grabbed the nurse and was pulling on her cardigan, all the while screeching “You’re a bitch. You’re a fucking bitch! Get my medication you fucking black bitch.”
The nurse eventually pushed me into the office and she followed, turning to slam the door in Cindy’s face with a kiss of her teeth “Oh Lordy Lord. That Cindy. She will be the death of me. I am Ayo. Who are you?”
I breathed a sigh of relief and introduced myself as the Student Nurse. “I don’t know. See how it is here. I pray to God for her sins,” humphed Ayo. “Hmmm. Take a seat. Ah! Here come the staff.” and I turned to see two females and one male puffing away outside, the ciggie smoke belching through the office window. “Tsk, Tut. I don’t know. Smokers, heh!” moaned Ayo as she reached to slam the offending window shut.
Seven o’clock on the dot the three members of staff traipsed in, throwing their coats on top of a filing cabinet. Lisa was first to introduce herself as the RMN, the shift coordinator and my supervisor, and said “That’s Lorna, she’s a qualified (RMN) and that’s Graham the NA (Nursing Assistant).” Where’s the fourth member of staff? I thought to myself.
“Okay.” started Ayo, above Cindy’s screeching. “The lady herself. Cindy, she slept and now she has been shouting before six thirty. Lord help me! Everybody still in bed. Only Sasha, she awakes all night but she stay in her room. Somebody needs to clear her room. I saw the mouse there.” My feet moved on their own, up off the floor as I sat on a desk, and I shuddered involuntarily when I was looking around for the said mouse.
Ayo continued and ended with “Moses needs to see a Doctor and his toenails need to be cut. It’s in the diary for this morning. Now I’m going home. Goodbye!” She pulled off her slippers and put them in her bag then huffed and puffed as she bent down to put her shoes on. She grabbed a large woollen blanket and shuffled out of the door.
Lisa went through the diary, handed out tasks to the other two and said she was doing medication and that I should shadow her. Lorna went off to wake up the other nine patients that lived in the ten bedded unit and Graham wandered off to the kitchen to prepare for breakfast.
With our coffee, Lisa and I went to the medication room, we were met with Cindy who was still gulping in great lumps of air, wringing her hands and saying “Thank you Lisa.” and “Thank you nurse.” to me. Yes, I could get quite used to being called Nurse.
“Right Cindy. You know we start titrating down your Diazepam today.”
“No, please Lisa. Not today. I can’t cope. I can’t cope!” Cindy screamed.
“Nought point five milligrams Mandy. You won’t even notice it.” Lisa tutted and turned to me. “She’s been on thirty milligrams three times a day for years and you can see it doesn’t reduce her anxiety. So we’re going to try titrating down while she’s in Rehab.” Cindy lived in a one bedroom flat and had apparently relapsed over a period of six months prior to admission to an acute ward. Once stabilised she was transferred to rehab.
Cindy had generalised anxiety disorder (GAD) which is a long-term condition that causes you to feel anxious about a wide range of situations and issues, rather than one specific event.
People with GAD feel anxious most days and often struggle to remember the last time they felt relaxed. As soon as one anxious thought is resolved, another may appear about a different issue. Titration looked like it would go on forever, reducing her Diazepam by nought point five mg three times a day. However, Cindy eventually accepted the reduced dose and greedily swallowed down all her medication, followed by gulps of water, then scurried off to the dining room.
We continued until each patient had had their medication then joined everyone for breakfast in the dining room because, on rehab, we were encouraged to eat with the patients each mealtime. Lisa waffled something about nurses having a responsibility to role model table manners and eating with the patients was supposed to encourage healthy eating. I wasn’t sure that this was an evidence-based intervention but I went along with it anyway.
Coffee and toast with jam was just what I needed but as I sat to eat I was immediately struck by an offensive odour. One older lady to my left had obviously not washed or brushed her teeth, yet there was another disgusting smell.
Graham screwed his nose up and said “She’s just sat there and shit herself and carried on eating!” to nobody in particular. “That’s Elsa.” he whispered with an Aberdonian accent. “She normally goes to the toilet but she uses her clothes to wipe herself and then hides them down the back of the toilets, eh Elsa?” he now boomed. “Elsa, say hello to Nancy, she’s our new student.” Elsa’s face was buried in the huge breakfast she was picking up with her teeth. She raised her head and gave me a toothless grin.
None of the staff got up to help Elsa so I offered, but Graham told me “No. Wait til after breakfast!” And this is rehab? I wondered — does it really work?
Around the table, there was belching, farting and one young chap was trying to snort back the snot that was threatening to hit his top lip. He eventually gave up and wiped a huge glob on the sleeve of his t-shirt leaving a silvery snail-like trail.
Coffee finished and my toast in the bin, I helped clear the table and took my time in the kitchen. I was hoping someone would deal with Elsa, as I was already feeling queasy. Fortunately, she’d gone by the time it took me to do the dishes but she’d left wet poop dribbling down the chair legs. Gloves and apron on and ten minutes later the chair was scrubbed and left outside in the back garden to dry.
Activities of daily living
To the bedrooms on the first floor now where I tried encouraging patients to wash and dress before attending any appointments or activities. Oh my word! I’d knocked and opened the door to Sasha’s room and was aghast at the cereal boxes piled as high as the ceiling. At a guess I’d say there must have been over two hundred boxes and the only other floor space was filled by her bed and two or three black sacks.
“Get out of my room.” stormed Sasha as she pushed me and slammed the door. I stood for a few seconds, stunned, then knocked and called out “I’m a student nurse Sasha. Is there anything I can do? Would you like me to help you clean your room.”
“Get lost.” Sasha muttered. I went to find Lisa and asked what I could do to help Sasha. “Not a lot,” Lisa laughed. “Her room’s been like that forever. She won’t let us in.” That can’t be right. Surely we have a duty of care? I went to the office to look through Sasha’s file and her painstakingly completed but outdated care plans to see if I could find ways to engage her.
I read that she was single, had no children and had been in care since the age of eleven when her mother couldn’t cope with her chaotic behaviour. She was thirty one and was diagnosed with Schizophrenia at eighteen. Sasha heard voices and was often heard talking back to them when alone in her bedroom. Apparently Sasha had no insight and didn’t believe she had a mental health problem. She’d been on the unit for six months and was awaiting housing but it was proving difficult to find a place that would meet her needs.
I decided then that I’d be really firm with Sasha right from the start, telling her that we have a duty of care to ensure that her environment is habitable. If she wouldn’t clean it herself, then we would have to do it! It annoyed me that staff had let her live like this for months. Even if Sasha had refused to let them clean it, surely the staff could have come up with a plan between them.
It was exhausting and often thankless, but I worked hard with Sasha for the next twelve weeks, updating her care plans and engaging her in meaningful activities; things that would both interest and help her rather drum banging or painting by numbers. I appreciate that one of her care plans previously stated ‘Engage Sasha in activities.’ But, while these particular activities may help with dexterity and fine finger/hand movement, I wasn’t sure they would support her development. It was clear that certain staff had intermittently tried to push Sasha into any activities and wrote in her notes ‘Declined to attend.’ I wondered why!
I’d eventually learned more about Sasha, along with the other patients on the unit, and had managed to form a professional bond with each of them. As I got to know them better, often by engaging them in friendly banter, I was better informed about their likes and dislikes. It was easy to see they weren’t interested in particular activities and that they had their own ideas about how to spend their time.
Mark liked football so I’d have a kickabout with him in the gardens – he was quite good – so encouraged him to attend the local leisure centre where he could access different types of exercise and look out for a local football team to join.
Jenny loved knitting so we bought her knitting needles, a few patterns for baby clothes (that she requested), and some wool. She wasn’t great, dropping more than a few stitches, but that wasn’t the point. She enjoyed it. Other staff who could knit helped her unpick and start again. Eventually, with the help of staff, she started her own small weekly knitting group on the unit.
We also got a group of patients to go swimming once a week, with a member of the team. We also went to the local pub once a week so that some of the young lads could have half a pint and a game of pool. They’d never felt comfortable going into a pub previously, because they were worried about what other people thought. We quite often did get some odd looks but as a rule, the regulars were great – helping the lads with their game and showing them trick shots.
At the end of my placement I loved seeing Sasha and the others laughing, smiling, engaging and growing in self-confidence and once again, I was sad to leave.
I would later bump into some these patients in various settings i.e. in the community or on the wards and I was either saddened by their relapse or delighted by their continued improvement.
Note to self: “Public service must be more than doing a job efficiently and honestly. It must be a complete dedication to the people and to the nation.” Margaret Chase Smith.
Patients loved good student nurses cos we had time to chat with them
Good student nurses might not be as skilled or knowledgeable as the professionals, but they’re very much loved by patients. They’re a breath of fresh air. Most of them want to help, whether it’s plumping up your pillows or making you that longed for cup of tea.
Have you ever been in hospital, maybe bursting to go the loo and you couldn’t get the nurse’s attention? Or your chin was on your chest and your neck had locked because your pillows were skew-whiff? Hmm, me too, on more than one occasion. And I get that nurses are really busy, I know, because I was one. But manys a time I could see them huddled round the nurse’s desk, laughing and stuffing their faces with chocolates.
Seriously, some general nurses work really hard, running up and down their wards, trying to fit in everyone’s needs. And it seems impossible some days. But Hallelujah, several times a year, they get a group of student nurses, many of whom want to learn. Woe betide if you just want to hang around looking like a nurse. You had work to do, and nurses couldn’t be bothered with hangers on.
I’d wanted to become a mental health nurse and thisgeneral nursing wasn’t what I’d signed up for. However, if you were a good student, willing to learn and share the teams’ mission, they’d support you, which made it easier. You’d help them with most anything they asked, within your capabilities. Even the most dreaded tasks.
Me and patient’s bodily functions
I wasn’t looking forward to this particular placement because, not only did I dislike East London and that hospital, it was also a general male ward. And generally where you get all men, you get burps, farts, snot and phlegm, in no particular order.
I gagged when I was asked to collect mucus — just at the thought of it. But actually holding a sputum cup half-full with sticky green bodily fluid had me dry-retching and reaching for the ladies. I dreaded the day I had to hold male poo samples.
A lovely elderly chap called Derek was the first patient I saw. He had prostate cancer along with other age-related ailments. Derek chuckled and winked at me when he saw me screwing my nose up. I couldn’t help but show my disgust at the foul smells of half-full bedpans and commodes. I realised I was being unprofessional, and it didn’t take long for me to become accustomed to the odour on the ward.
Patients I adored
Derek loved telling me stories about his life during the war and how, once home with his lovely young wife, they’d never spent a day apart. He also told me that his wife was on another ward down the corridor and he missed her terribly.
Before I went off shift one day, I managed to get Doris’ bed wheeled right next to Derek’s for the afternoon, despite moans from the nurses. I got to see why they never spent time apart; holding hands, whispering and giggling like teenagers and dipping custard creams into each other’s tea. I felt so proud that I was able to help in some small way. I’d honestly never had such a humbling and emotional experience.
Ah! Derek’s bed had been moved the next morning. I asked a male nurse where he was. With a nod and eyes rolling upward, he said: “He’s gone upstairs.” Oh, I thought and before I asked anything more, the nurse said “He’s dead.” Just like that!
I dashed the ladies to dry my eyes before looking in on Doris and her family, to pass on my condolences. I wasn’t sure I was at the right curtains when I heard laughter. So, I stood for a while, then Doris noticed my tiny shiny shoes and called me in. The family thank me for the humanity shown the previous day, and told me how much it had meant to both parents. They’d had their final chuckles and they were both at peace in their own way now.
Students have the time to listen
Most patients love good students on the ward because sometimes they’re the only ones who have time to stop and chat. They’d ask patients about their needs and wants, and try to help. Sometimes patients just wanted someone to listen to them, and students fitted the bill. While nurses ran ragged. They’d administer medication and attend ward rounds, while writing notes, and updating no end of needless care plans.
Phones rang out, begging to be picked up. It might have been someone wanting to speak to a poorly patient, or results from other departments?
Patients had many needs
See, most patients had more underlying health problems than just the issue came in with. This tends to happen unfortunately, particularly in large cities like London. It then becomes difficult for care teams to discharge patients in a timely manner because:
patients who didn’t speak or understand English needed interpreters
some patients needed support with housing and benefit issues
other patients couldn’t go home because their accommodation had to be repaired of adapted prior to discharge
often we had homeless patients who required a lot of input
others — just didn’t want to go home either because they were lonely or didn’t have any family around them
at least 25% of general hospital beds are occupied by people living with dementia. On average people with dementia stay more than twice as long in hospital then other patients aged over 65, said the National Audit Office, 2016.
Bed-blockers (hospital speak) are a huge problem for the NHS, and I can’t see it being ‘solved’ any time soon. Patients still need care and support from our busy nurses, while multidisciplinary teams scratch their heads. They too have large caseloads, and no doubt it’s hard to put systems in place so that patients can go ‘home’.
In the meantime, nurses made hundreds of phone calls to the various support agencies and social services, while still caring for patients. This take them away from the very job they trained for; looking after patients. No wonder both patients and staff loved and appreciated good student nurses on their wards.
Over to you
What’s your experience, if any, of student nurses? Do you think nurses have a tough time on the wards? I’d be interested to hear what you think, and I’m looking forward to your comments or questions.
I hadn’t studied for over twenty years and now I was about to begin studying to become a mental health nurse! Let me share my experiences with you and show you how not to study!
Within weeks of starting Uni, I learned just how stupid some people are! It was clear that many lacked personal insight, and had no idea of personal space, or people skills.
I studied my fellow students as they barged their way through the doors and jumped in queues to get the seats at the front of lectures or lessons.
Now, I was really skinny but still, trying to get two people through the narrow single doorways at Uni was nigh on impossible. And, if they thought I wanted to bring attention to myself by sitting anywhere within a ten-foot radius of any lecturer, they were sadly mistaken. Those lardy arses who bulldozed past me, snorting, kissing their teeth, or tutting were welcome to their prime seats.
My own mental health needs
Having only recently recovered from a lengthy psychotic episode, I still felt really shy, nervous even. I constantly prayed to someone who’d help me hold off the ever-impending anxietyattacks. I’d sit somewhere in the middle of the halls and quickly avert my eyes or pretend I was taking notes if I thought the attending lecturer might question me.
I was so busy monitoring my pulse and breathing, I probably missed half the lectures anyway. Still, most of the lecturers appeared to be reading straight from books, which meant I could catch up by going through the same book or reading any handouts during breaks or at home.
Various ways in which we learned
What I hadn’t bargained for was the seminars and classes, which normally lasted between one and two hours. For the first eighteen months, the lecture halls were filled with some 250 students. This included mental health, general, and midwifery. students
In study lessons, we were in smaller groups, normally around eighteen to twenty students. Following the lesson, we’d be further split up into around 2-4 people. We’d have to discuss some topic or other, then complete a written task before presenting our understanding back to the group
However, because of the sweet/crisp packet rustlers, the stupid questions, and other disruptions, we’d often run out of time and had to complete the task at home. Once done, we’d meet with our small groups to finish the task and then feedback to the larger group.
I panicked at the thought of presenting to my peer group
Oh, my word! If I’d known that I would have to stand up! In front of everyone! And speak! I would never have applied for the course. I managed to dodge this one as a couple of the others were happy to do it — this time.
After that, there was no way was I making an absolute arse of myself in future presentations. I practised for hours in front of a full-length mirror at home, where I’d present my findings calmly and with a flourish, maintaining good eye contact and waving my hands theatrically. Cracked it; I could do this.
Huh! For all that, the first time I presented to the class, I dropped the acetates I was relying on to distract my peers as I spoke. Taking in huge gulps of air as I bent down to retrieve said slides, I could feel the heat rising up my neck and hear my heartbeat pulsating in my ears.
Then I swayed and felt dizzy, increasing my anxiety tenfold. ‘Please do not let me have a panic attack’! Though not sure who I was asking. By now, I could see my heart leaping out beneath my clothes like Jim Carrey’s character in The Mask and felt sure everyone else could see it.
It felt like an age as I raised my head and saw my well-meaning contemporaries smiling, encouraging me, willing me to get over the finishing line, so I began. With trembling hands, a fake smile and what felt like a massive boulder in my stomach, I managed to stutter my way through my presentation and answer some easy questions.
There was no theatrical waving and no calm, just relief when it was over and I was able to watch my peers presenting. Not sure I should be glad but, I could see I wasn’t the only anxious student in the room. Those following me muttered, mumbled, lacked eye contact, had hives creeping up from their chest and for some, their presentation wasn’t even relevant.
Note to self:“Today I will not stress over things I can’t control.”