I trained to be a nurse once....part II

Ahh 5 months later.

"So what the hell happened??" cried no-one ever. (I've come to terms with the fact my blog is basically an unseen diary).

I will bullet point for effective, snappy communication. But it may fizzle out once I get my rant on....

• I got myself signed off from AMU with the advice that I wasn't ready for such an acute setting as it was causing panic attacks (it turns out random air-choking has a name....)
• My university prepared me for the worst stating they would try to find a replacement placement (inception) but if not then I would have to leave.
• I received the fabulous news that after all their hard work (I should be grateful too) they found me another placement!! I went from AMU to ASU. They took me from the Acute Medical Unit, and re-placed me into the Acute Surgical Unit. I left the ACUTE Medical Unit due to ACUTE setting-induced panic attacks, and they placed me in the ACUTE Surgical Unit. Exactly one floor above the previous ward, with the exact same ACUTE patients. The ward was identical in layout too. I think it was at this point I went ACUTELY insane.
• I lasted 5 out of 6 weeks. My mentor wasn't too bad (absent for the majority of the time, I was tossed between all the nurses) but I did so well. I managed a patient all by myself in the Recovery unit after his observations all started going downhill. I arranged his medications, recorded his notes, called the doctors. Essentially, he was my first ever true patient. And nobody saw. Shame.
• Doesn't matter. I managed a few patients during my time there, overcame my anxieties and started to enjoy myself. It turns out AMU had such a bad reputation that most of the staff were surprised students were even allowed to go there. 

On the final day of my 5th week I had finally booked my flights and accommodation abroad, as I was to study in a different country for the first placement of my final year. I had even handed in the notice on my house. Things were definitely looking up for me, and I was looking forward to experiencing nursing abroad.

I went to placement as usual, and came across a patient in a side room with an auxiliary who required my help. The patient in question was on a commode and couldn't breathe well at all. I was very worried for her and insisted we get her on the bed immediately. We did so, and I went to find a sliding sheet to get her up the bed more and sit her up to assist her breathing. There wasn't one to be found on the ward anywhere (disgusting), and no-one was particularly interested. In the end I was rather stern with a couple of the nurses and insisted they come and help as this poor lady was suffering. They reluctantly came and helped me. After sorting her out on the bed and making her comfortable, the nurse I was with took her observations which were absolutely terrible. The poor love was struggling to breathe. She couldn't have been more than 60, which after you've worked in a health care environment, is actually a very young age.

In the treatment room shortly after, the nurse I had just been with came and informed me that the lady would be placed on the Liverpool Care Pathway. I asked what this was, but deep down I already knew. She said it was basically a pathway that made death as comfortable as possible. I asked to be excused, and she squeezed my arm when she saw the tears in my eyes.

I couldn't believe it. I was in shock - the woman's family weren't even there and a decision had been made to just let her die?? Of course they would be informed (I hoped) but how can the decision just be altered in the blink of an eye? Just like that, the assistance to help someone live is taken away. I don't even know who made the decision.

I went to the staff room and cried, and didn't stop. I couldn't breathe. It was simply all too much. What was the patient thinking? What would her family think? Does the patient even know? How can I nurse someone who is dying? What do you do or say? 

I knew my role was to offer the woman comfort, and help with her pain, and make sure all her needs were met, and comfort her family. But I simply couldn't. Up until this moment I had fought my anxieties, worries and fears. I familiarised myself with so much and I was doing so well, everyone said so, my mentor included.

I had my panic attack and left. The following week my mentor failed me for my entire placement. I was sad and upset that my patient was dying - so I was failed. The injustice of it all is being taken to a panel. The decision to fail me was made without my knowledge, and my university is appealing it. I had to scrape back a mere 10% of my flight costs back and quickly find somewhere else to live. I was jobless, without a university course, and homeless. It was a true slap in the face from the people who were supposed to lead, teach, encourage and support me.

But it doesn't matter any more. I've moved 94 miles away from that town (even over water) and I'm never putting on a nurses uniform again for as long as I live. Not even an auxiliary uniform. In my 5 years in the health care setting I somehow managed to avoid death and all its emotions and trappings. But what shocked and saddened me the most was the lack of support and interest I received. Don't get me wrong, there are some absolute angels out there who deserve to wear those uniforms. Sadly the majority do not. 

The entire feeling of working in the NHS is exhausting. You're not taught to help the patient because it's the right thing to do for them, or because it's kind, but because if you don't then you'll end up in court. We were encouraged to go to the NMC's website to see all the nurses who have had to stand trial because of drug errors or because they've said the wrong thing or they've done something 'wrong'. Of course the council is there to ensure safety and education, but I was taught to fear them and to watch my back at all times. This advice coming from experienced nurses.

I was ignored, exploited, anxious, frightened and belittled. I've read back over my previous posts and I feel like I've truly escaped the twisted, sinister system. 

Every now and then I close my eyes and imagine all those people I could have helped, and it breaks my heart. So I try to think of those people who I did help. 

Once on the first day on one of my placements I put cream on an elderly lady's dry legs. She cried actual tears and squeezed my hand, thanking me because in the two weeks she had been there, not one nurse had so much as spoken to her. 

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We are privileged to have a National Health Service. But it could be so much better. I was only a student nurse for a short time, but even I can see that change needs to be made. More nurses means more time, which means more patient contact and more CARING. 

I trained to be a nurse once.....

I sense I am being strung along a little now.

I'm not returning to my placement as it just plunges me into anxiety and depression. I think my university are trying to drag out my 're-placing process' as a way to eventually force me to 'go back to placement or defer for a year'. Both options will end up in my quitting. Numerous clinical staff have confirmed that the AMU is a very stressful environment for students. I am quite curious to know why 2 previous students have also quit the placement in the past.

I'm just getting a bit low and fed up of this now and have started looking at other jobs, mainly as a trainee graphic designer.

:-(

I would have liked to have had the chance to be a health visitor, but the only way is to qualify as a nurse. It's not fair that my university are so unprepared that they can't even facilitate a swap in a situation such as mine.

I've managed to stay upbeat for the sake of my family and friends and general well-being but this is really starting to take its toll.

All I seem to be getting is 'do as we say or fuck off'.

How very compassionate. I would have thought that as nurses these people would have a little more empathy for my situation.

Nursing eh?

We Can't Help You.....

Every few weeks or so we get to go to uni to meet up with our classmates and essentially bitch about our placements. It's an opportunity to vent, moan, rejoice, and regale everyone with stories from where we've been. We normally carry this out in the traditional 'circular' fashion, and take it in turns. 

It came to my attention in this fabulous 'circle-time' that another student was having a crappy time with their placement and wished they could swap.

ACE. An answer to my prayers!

When it got round to me, I burst into tears and simply said I hated my placement. Smooth.

So after that embarrassment the swapping student and I asked our tutor if this was possible, and she agreed. I immediately went to our course coordinator to get the ball rolling, who left me with a very positive feeling that everything was going to be okay, and that it was quite likely the swap would be approved.

AMEN!!! 

I have felt crap the last few days not doing anything, I just want to get to my new placement and accumulate some hours! But I'm happy, as things are on the up :-D

A few days later and I still hadn't heard anything back from anyone (despite a resolution being promised the next day) so I emailed some people. About ten minutes later I get a call from uni basically saying

'You have two choices. Go back to placement and suck it up, or quit and start again next year'.

And I fall to pieces again. 

So there it is. Shit starts to look up and it gets snatched away, talk about false hope. The choice is now go back or fuck off. There is no way I'm hanging around in this city another YEAR just so I can be screwed over by uni again. Apparently there is no swapping allowed outside of my trust this late into placement because no-one is willing to give me an induction, and there in absolutely NOWHERE for me to go in this ENTIRE city, (and trust me, it's a big city).

To be honest, I don't know if I want to be a nurse any more. If this is the help I get when I'm learning to be a nurse (as a vulnerable, clueless student) then what support am I going to get when I'm qualified? It's not looking hopeful. All my dreams of working in the community are just slipping away, and I'm no closer to experiencing what it will be like at all. 

Right now I fucking hate my life. What a true waste of the last 18 months after all the hard work I have put in, and now I need help I am simply brushed off. 

Grumble

I am angry and jaded that my 'edgy' blog has turned into some sort of self-help forum for myself.

I sort of pictured myself ending each post like Carrie Bradshaw, sat at my desk looking out the window and pondering to the sky, then taking a drag of my cigarette before typing:

Something that ends like this?

(Don't forget you have to read it letter by letter as if it's being typed for you.....)

Truth is I am sat on my sofa littered with empty cups and dishes from my day, wrapped in my throw blanket. And I look like shit. Not the sexy kind of shit, just plain shit.




Aaaaaaand I don't even smoke. The best I could do is seductively chew on a pencil, but that will just end in some sort of unattractive gagging, and it's funny, and you imagine how funny it would be if you were being watched, or if it was on TV, but then you realise you're alone and not being watched and then you feel a bit sad. And then you wonder if you ARE in fact being watched and start to feel a bit creeped out, close a door or two, check the kitchen and maybe flick a few more lights on just for safe measures. Do I do all of that?

No I do not. I did NOT just do that.


And then you read and re-read your post to see if it's any good, and wonder if people will think it's a bit crap, and then correct it grammatically, and then put some italics in here and there for good measure, then wonder if you typed the word measure too much, then realise no-one is going to read this anyways so SEND IT TO THE INTERNETS!

*Click*

Breathe

I don't want to quit.

I don't want to defer.

After my sobbing-session and a good sleep and a cup of tea I have made myself a list. My list justifies things for me and validates my aspiration to become a nurse, and why by hating this placement does not mean I am a crap, lazy, anxious student.

• There are many forms of nursing. It's not 'one' job with varying degrees of 'how much adrenaline can you handle, if you can't hack emergencies then you're rubbish'. There are loads of different types and they are all valid and useful. Whether you work in the Emergency Department or a Stroke Rehabilitation Unit, or in the community changing dressings and making cups of tea you are contributing to the patient's journey of health, and each of these roles is NECESSARY AND RELEVANT. 
• I do NOT like this type of nursing. I do not wish to pursue this type of nursing. I made this clear when applying to university that I would like to experience an acute setting (which I already have when I was in theatres and recovery) and I also stated that my main interest would be gaining experience in the community. This has not been considered AT ALL.
• I like to know my patients. 3-4 weeks or longer would suit me just fine. I want to be able to detect subtle changes in my patient after being with them for a while. I want to offer my patients a sense of continuity, familiarity, patience and time.
• I prefer patients with long-term issues, or chronic problems. NOT acute or short-term or emergencies. 
• I don't want to be around death, or bad news, or big emotions. This isn't me. Who I am does not fit well with these types of situations. If I can't fix it or make it better or use my humour to make it better, then I can't do it. I choke up and I am useless. I am not prepared to mould myself into something I am not to please people who feel I should be able to do it. Why not utilise me for what I am good at? Distribute me somewhere I am useful. I am not useful on AMU. I am, quite frankly, a quivering wreck. It is affecting me to the point of wanting to leave.
• I have been matched to the perfect opposite of what I want to do and achieve out of my time at university. This placement is a step back for me and a waste of my time, AMU's time, my mentor's time, and my university's time.
• My health is actually being affected by this placement. I am anxious, nervous, scared, terrified, crying, exhausted and drained. All after 3 days work. 
• Today I briefly (for a nanosecond) considered living under the floorboards of my lounge for the duration of my placement. I don't know how that would work out or benefit me in any way, but, I BRIEFLY CONSIDERED LIVING UNDER THE FLOORBOARDS IN MY LOUNGE FOR THE DURATION OF MY PLACEMENT. That is, quite honestly, a little fucked up.

That said, I am going to try my best to get my placement changed (I decided not to do this initially out of shame of failure, but accepting that this is not who I am is so much more refreshing and calming, I can actually breathe without fear of choking). Failing this I will attempt to get signed off if nobody will help me. I am making myself ill doing this, and am likely to end up on AMU as a patient rather than a student.

That is........if they ever do find me under the floor.......

Day 171

I have had a few days off to spend with my family back where I'm from, also visiting some lovely nurses and auxiliaries I worked with when I was a health care assistant (the job that made me want to be a nurse). I forced myself to go into placement last night for my first night shift, and my first meeting my mentor, hoping that I would gain some sense of security knowing that I would have a familiar face from now on.

Try your best, H. Don't give up.

Notable event 1
I spent every second of every minute of all of the 10 hours I was working in a blind panic. I could not see straight for the anxiety. The first 3 hours were the worst. I mentioned I was very nervous, but I don't think those words hit home with anyone.

"You'll enjoy it"

"You'll get used to it"

Maybe I wasn't firm enough? Maybe I should have sobbed? I cried in the car park before I got out of the car, and nearly cried on more than 3 occasions while I was left with patients. I could feel the expression of pain and nervousness on my face, it had to have been obvious? My mentor is alright. I was hoping for someone bubbly and matronly, willing to teach and happy to keep me at her side. But they're busy. They're all so busy, even on the night shift.

Notable event 2
I worked solidly through until 3am without so much as a break. I drank a quick tea while completing forms. I didn't stop. Nothing stopped.  Buzzers and beeping machines went off all night long. Sometimes the nurses responded to the monitors when they bleeped, sometimes they didn't. I tried to sense a pattern of what was important but failed. In the end I ignored them all. I was already panicking that my patient is falling asleep. Or is it into some sort of coma? I don't know. I will 'make her comfortable' to see if she responds.

Everyone is ill. Everyone is ill. But they're not ill with the same thing. All the people in my bay have something different wrong with them. I am unfamiliar with bleeds, cardiac, COPD and anything medical. And they all have one of each and more. I read the nurses pack from front to back hoping it would give me the answers but none of it made any sense.

I would rather be at the dentist's
I would liken my experience to that of having a filling. You're in the dentists chair now, you can't move or just get up and leave, you have to endure it until the end. You have to put on your bravest face and do not crumble. 


The bit that crushes me is that once it is over, I have to come back tomorrow and do it all over again.

I like fillings because if anything, they are at least 5-6 years apart, or it may even be the last one.

You don't have to anything. But do this.....
I spent a good deal of the night stopping my hands from shaking, and allowing myself time to slow my breathing down. My heart raced all night long. It just felt like drowning.

"Don't worry, you're not expected to do anything, and if you need any help just ask".

And yet here I am taking observations and transferring patients whose mobility I have no clue about. Why all this guesswork? How do you turn around and say 'no'?

"I'm just nipping to the ward next door, are you okay to just stay with the patient for a little while" they will ask as they are halfway out the bay. They make it sound so simple, I'm a 2nd year student, I can't say 'no'. Well, if they're that confident all is well then they wouldn't leave right? Then they're gone 15 minutes, and the patients machine is going haywire, but is it the type of bleep the nurse would ignore again? I don't know. The sats are lower than they should be. Is that mask on right? I don't know anything about this bi-pap machine.....the whole reason the patient is on it is because they can't have too much oxygen. I don't know how to work it......but I'm not allowed to leave. I grab the nearest HCA who says it's all fine and silences the alarm.

I HATE IT HERE. I hate everyone and their blasé attitudes when I am quite literally shaking with nerves the whole time. 

I don't know what I am doing, and try to stop myself from choking with fear.


Notable event 3
At around 4.30am I finally get the chance to go through my uni checklist with my mentor. My goals are written down. I had scribbled them briefly before I came in, but I don't care really. I don't want to be here.

1. Familiarise myself with the drugs chart and become more accustomed to the drugs rounds.
(So I can stay in the treatment room as long as possible and take sanctuary away from all the beeping and panic-inducing patients)
2. Book myself onto courses so I can be more confident in clinical practices
(Preferably the all-day ones where I don't need to be on the ward, and also so I can at least have the same knowledge as the nurses I am working with, and not learn through osmosis, because that isn't fair)


My mentor makes me add on about 3 or 4 more objectives, none of which I am interested in, and when she suggested I aim to manage a few patients I clearly said 'no'.

"Maybe one or two then?"

"Perhaps one, but that may be unlikely....."

I have been working up to this moment all week - I'd have preferred to say this privately to my mentor but we haven't been alone to discuss anything once because it's been so busy, so the nurses station will have to do, even if there are people around....


"To be honest with you, I am terrified of this placement. I'm so anxious and it's quite affecting me--"

I was about to go on to suggest maybe I have another mentor for when she is off (since she's part time) as I think I could do with a little extra support, but she cuts me off.


"Really though, everyone finds it difficult. You'll actually really enjoy it in the end, you just need to get used to it, but you'll be fine honestly".

The bog-standard 'one-answer-fits-all'. I close my mouth and nod slowly. I so badly want to believe her words, but I have been fobbed off. I don't try to reiterate my point, how more direct can I be than with the words 'anxious' and 'terrified'? It has taken me a week to try and reach out to someone to tell them how I feel (how can they possibly know if I don't say anything), and it has just slipped by.

Notable event 4
I finish. I leave. I get into my car and it all comes flooding out. In the 15 minutes it take me to drive home, the tears do not stop once.

Big fat tears stream down my face and dribble miserably down onto my chest. I have not cried like this in years.

Day 170

Notable event 1
I woke up, but I didn't open my eyes.

I. Felt. Awful.

I sort of hoped I would lapse into some sort of unconscious state where I couldn't be woken, some sort of unexplainable temporary paralyses that no-one could explain, but genuine enough that it would be a great reason not to have to go in today. I stayed that way, awake but pretending to be asleep for about 2 hours and 45 minutes. I have hardly slept at all anyway.

Notable event 2
I didn't go in. Instead I poured my anxieties and worry into an email to my tutor and other faculty staff explaining that I feel nauseous at the thought of going back to placement. I don't want to talk to anyone. I feel so terribly guilty because to look at me there is no reason why I can't go in. I feel like a big fraud. All the other student nurses protest about how much they hate their placements, yet they seem to manage going in.

Maybe they don't go in. Perhaps only 3% of my cohort ever attend placement at any one time, and the only reason there are so many admin staff at uni is to try and deal with the fallout. That would make me feel much better.

How I feel
I feel like a massive failure. I don't want to be with any of the patients because I don't know them. I have no idea if they're going to 'go off', or if this is how they normally are. I can't make anyone feel better with my killer sense of humour because everyone is preoccupied with their pain. If I can't deal with this then how am I supposed to be a good nurse?

I have been fine up until now. Why am I freaking out? Why this placement? I can't figure it. Have I had enough of nursing? I want to be a nurse, and I don't want to quit or defer, I just loathe everything about this placement. If this was my full time job I would quit today.

For now I will crawl into my hole and sob some more about how I am potentially throwing everything away. Could this placement be the end of it all??