Why opting in was simultaneously the best and worst thing I could’ve done

 

September.

It’s been just over a month since I finished my opt in placement, and I still don’t think that’s enough time to process everything. Life has been in the Upside Down since March, and I don’t think I realised then how much this would impact my studies. 

 

So here we are, after 14 weeks on the frontline, and I still can’t say whether it was actually a good or bad thing. 

 

I mean, I’ve come out of it feeling confident about my abilities as a student, and honestly, I have learnt so much. I’ve also found a specialty I love and plan on working in once I qualify. My confidence has grown, I am no longer afraid that people are judging my abilities, and I feel like this has been a definitive period of personal growth. I have been wholly supported and included on placement, I have made friends, and I now work there regularly as a healthcare assistant (let’s face it- who isn’t broke right now?!) because they asked me to come back.

 

But, I can’t help but feel, at what cost?

 

I cannot pretend that COVID-19 happening in the middle of my degree has not had a profound impact on my mental health. It would also be false to say that working with COVID patients has not caused me mental anguish at the risk I might be bringing home to my family. And it would be an outright lie to say that my academic abilities were not compromised, frankly, deadlines were a laughable concept considering I spent a lot of time worrying that I might catch COVID and die. It seems fatalistic, but I won’t pretend I never thought it. 

 

So here we are, again. 

 

Professionally, I am aware that COVID-19 might be one of the toughest things I will ever face as a nurse. I am also aware that it is probably the best experience I could have had during my training, teaching me compassion, resilience, confidence, and so much more. Personally, I have never been so stressed and anxious at the idea of being a risk to my child and partner. The anxiety was all-encompassing, and it’s never left. It’s something I am going to carry with me for the foreseeable future, and it’s up to me to deal with that. 

It’s the choice I made, and I don’t think I will ever know if it was the right one. 

September

This month has been hard. Who knew- things always come in threes?! Unfortunately, I’ve had to take two weeks off placement as C was in hospital. Honestly, he really scared me for a little while. He was seriously ill and at one point they thought he had sepsis. After his brother had it in February after the flu and was in a coma for 6 weeks, I was envisioning a stay in ICU, and if I’m completely honest, my life as a single parent. I know it really scared him as well. I don’t think I’ve ever seen him so vulnerable and it broke me a little bit I wont lie. He’s always the strong one, the baby’s been in hospital a few times and despite the whole ‘training as a nurse thing’ he’s always been the rational voice of reason when it’s happened.

Luckily, he was okay, and it was just a small stay and some strong antibiotics. I mean, I’m lucky we also had fantastic neighbours who looked after the baby the whole time and drove us up to A&E in the middle of the night. But it made me realise a lot, and honestly being in hospital is scary especially if you don’t understand what’s going on. The GP for out of hours was great, C couldn’t really walk or talk and was getting worse, so I walked in with a scrap of paper and 6 hours of obs, she asked me if I was a nurse and I told her I was a student (so no, not really). She pinged it all into the PC NEWS chart, looked at me, and said ‘you know what that score means right?’. I nodded. She phoned for a bed for him straight away. 

Thing is, C didn’t. He had no idea, and because the GP was phoning to organise things, I had to explain to him what was probably going to happen, and what they were worried about. I don’t think that helped really, I couldn’t explain the actual risks and what the likelihood of it being sepsis was- because at the moment I don’t know. We haven’t done critical care and sepsis starts in year 2. All his experience of that had been was his brother- and that was an exceptional circumstance. But again, all he knew was that his brother nearly died and now he thought he was going to as well. 

We were moved to an emergency bed and a nurse came in to cannulate him. Now, I understand that EDs are extraordinarily busy. But not at one point did anyone explain to C what was happening, why they were doing what they were doing, or even what cannulate meant. If I hadn’t had the knowledge that I have, we would’ve both been clueless as to what the situation was.

And that’s not okay.  

My 30-year-old, ex RAF, solid as a rock partner was reduced to a scared boy literally in front of me, and he asked me not to tell his mum because she would worry and said that he didn’t want to die. 

If someone had just talked to him and explained what was happening, that helplessness could’ve been avoided. 

One Down!

So that’s it, placement is finished!

I’ve really loved it. Over the last few weeks honestly it feels like I’ve properly thrown myself into it, and really enjoyed everything that I've been doing. It’s gone so quickly, and I won't pretend it’s been easy- trying to juggle a family life and placement as well as writing an essay and making sure that was in on time- but it’s definitely been worth it. It’s 100% made me realise I've chosen the right career path. 

I’ve done so many different things and met some really interesting and lovely people. My mentor has been absolutely fantastic, and the other nurses that I was working with were lovely as well. I feel so lucky that they were such a lovely bunch of people, and they made me feel completely comfortable and able to be myself around them. I was quite pleased as well that my mentor said my communication skills with patients was really good as well, but I honestly think that comes from years of working in a bar and talking to every kind of person! We’ve had some really interesting and varied patients, which has been really good as I’ve been able to experience a lot within quite a short placement. I think I've grown in confidence as well, I feel like I’m able to talk comfortably to patients now and I don’t feel so awkward and nervous about it. I like community nursing a lot more than I thought I would. 

I’ve found out I’m not as squeamish as I thought I would be as well. 

There’s been so many interesting patients. We had one wound which had to be packed daily. Originally it was thought it was an abscess which the patient had had lanced, but it turned out to be a fungating tumour. We had asked plastics to reassess them and they had taken biopsies, and the medical diagnosis was non-Hodgkin’s lymphoma. The patient had deteriorated over the 3 weeks we were seeing them, and we had to phone an ambulance on our last call to have them taken to hospital. So it was good to see why accurate nursing notes are important to keep as it means that when different nurses visit patients, then they can see if there’s anything unusual going on. 

I’ve been able to give some injections as well which was good as I was quite nervous about that for some reason! They were mainly tinzaparin ones as I had built a relationship with that patient, so she was comfortable with me giving them. I’ve learnt a lot about wound-care as well and the different types of dressings/packing, and why it’s used, which I know is going to come in useful over the next few years. I also got to see male, female, and suprapubic catheters being changed, and did a number of palliative support visits as well as helping set up syringe drivers. We also did one bereavement visit after a palliative patient had passed away. I was a bit nervous about that call because I didn’t really know what to expect, but I think the family were prepared for it, and they were happy that he was comfortable in his last few days more than anything. 

Over the last few weeks I’ve really familiarised myself with all of the paperwork required for community nursing, which has involved a lot of different care plans, initial patient assessments, patient notes, skin bundles, nutrition pathway documents, syringe driver documents, and risk assessments. It’s been good because I’ve been quite confident in filling these out as well, and even got together a few new patient notes folders myself. My mentor was really helpful in showing me how to fill them all out correctly and got me to do it for a number of patients as well, which I definitely think boosted my confidence. She also showed me how they order patients equipment as well, like the EHOB cushions and other pressure relieving equipment. It’s a little bit like online shopping ha!

I think what has surprised me most is that my mentor trusted me with a lot. I’m really grateful for this and it gave me confidence in my own ability. She would ask my opinion on things (I’m sure she already knew but I feel like it was to build me up) and trusted me to prepare dressing packs for patients we were visiting the next day, as well as doing a lot of complicated dressings myself. She also got me to phone GP surgeries and patients about prescriptions and things. It might not seem like a big deal, but it feels like it to me. We had quite a complicated patient about half way through the placement as well, they had Huntington’s disease and really struggled to communicate, and his condition had recently deteriorated quite a lot. A family member of his had LPA, and he was being referred for a capacity assessment and CHC, as he was not engaging with care and it was becoming detrimental to his health. It was really interesting to see the entire process of this, and it was good to develop a relationship with the patient, as his communication needs we’re a lot different to other patients I had met, so I feel like I definitely learnt something. I got to sit in on the CHC meeting with my mentor as well, as they were trying to move the patient into a suitable placement instead of having him live alone. This was along with family members, a social worker, and a Huntington’s specialist nurse. It was a really good experience and seeing how different teams come together for the good of one patient was really eye opening. 

I’ve managed to get quite a lot of my competencies signed off, which has been great as we don’t find out what our next placement is until mid-August, but it takes a lot of the pressure off as well. I managed to get my dignity essay finished as well, which is great, I just did a bit every evening and managed to finish it the week before the deadline. 

So, all in all it’s been really good. 

I got my mentor and the other nurses a card and some chocolate when I left because they genuinely were really lovely to me. 

Community Placement and New Experiences

Well, the first two weeks of placement have been absolutely packed full of new experiences. 

I took a notebook with me, so I could write down the main things that I’ve done, and I tried my best to keep a diary but honestly keeping on top of it was impossible! Working with the community nurses has certainly been eye opening, I don’t think you realise how many different things they do until you’re out there doing it. My mentor was off for the first week on annual leave, so I was with a few different nurses until she returned, but it was actually really good to see how a lot of different people worked. Everyone has their own way of doing things, but the outcome is the same which is good. Every patient is so different as well, so I got the opportunity to see and do loads of different things. 

Over the past two weeks I have done a lot of wound care, mainly venous leg ulcers, lymphoedema patients, wound packing, I got to take clips out of a few hip and knee replacements, and stitches out of wounds- which I really enjoyed. I’ve also seen quite a lot of palliative care patients, which has involved syringe drivers, PICC flushes, and PEG water changes. It was really interesting to learn about the different medications used in end of life care. 

I tried to get stuck in straight away.

Mainly because I was really quite nervous about it, so I thought that would be the best way to overcome any fears. If I’m honest I’m not really that confident about my abilities, and I really struggled the first few days. It was difficult feeling comfortable walking in to patient’s houses and introducing myself, and I felt really out of my depth. I got into my own head about it quite a bit and thought that the nurses would think I was stupid because I didn’t know anything, it did make me quite upset for the first few days. I’m not sure why, I think it’s just because it’s all so different from anything I’m used to, and I was really aware that people might be judging me on my knowledge (or lack of it). 

After a few days that passed though, and I got really involved with the wound care, and we saw some really interesting patients. By the end of the week I was able to give the nurse the dressings she needed for particular patients who were in compression, and I was able to remember what we used for them on previous calls without having to ask. So that boosted my confidence a bit. I've seen a few palliative care patients as well which has been really interesting. I was quite pleased that I actually managed to do the medication calculations correctly- the nurse let me figure it out (before she checked it) as we were drawing it up- which was good as it gave me a bit of a confidence boost with that. It was really interesting as well to see all the different paperwork that comes with having controlled drugs in a patient’s home. It was strange though, meeting patients who knew that their disease was terminal. I guess I found it a little awkward because I've not really dealt with death before, so seeing these patients who have seemingly accepted the illness was different. 

I am finding it easier to talk to people now though. That start was really hard but honestly over the last few weeks it has gotten a lot easier. I think it’s helped as well that I’ve seen a few of the same patients so have managed to build up a relationship with them, mainly through having conversations about seemingly random things like their dogs, or kids, or the weather ha! 

But so far it’s been enjoyable, even if it did take some getting used to at first. Just got another 3 weeks to go now, it’s going really quickly. It has been difficult though, trying to juggle family life and being at placement 5 days a week. I mean, I appreciate it's a normal working week, but with Cal looking after the baby all the time and working nights as well it's just seemed like we have no other time in the days! But we both know it's only temporary, and we're working quite well around it as well. 

Placement starts soon!

I wish I was funny enough to think of witty blog titles, but I'm just not that good! 

It’s been a good week. I’ve done loads with the baby, and Calum’s finished most of the DIY so we can all get a chance to do something together this weekend. I’m sure that something is going to be watching the football tomorrow, but as long as we’re altogether then I don’t mind! I’ve invited his sister over for a roast on Sunday as she’s a little bit down and lonely (she’s 19 and goes to uni here too). She’s just gone through a bit of a bad break up with her high school boyfriend so I thought it would be nice to get her fed and stuff. Just got to hope the dog behaves, he can get a little bit over zealous protecting the house (since the baby arrived) but he’s usually better with women than men. If not, he can sit in the garden for an hour or so, if it’s not raining it won’t do him any harm! I’ve been eating a lot healthier recently as well. And when I say that I mean I’m not eating a WHOLE pack of custard creams with a cup of tea just because I can. But it’s been good, I’ve lost like ½ a stone even thought I wouldn’t even technically call it a diet. I put no pressure on myself to lose ‘baby weight’ after Alys because, frankly, my mental health was more important, and I’m not really bothered about the whole ‘diet’ culture. I actually think it’s probably counter-productive to being healthy. The next step now is quitting smoking, which I did before whilst I was pregnant, so I know I can do it again. The only problem is that it makes me eat so much more, and that was alright when I was allowed to put on weight, but now it’s not ha! We’re going to give it a go anyway.

I also had a small hair-related breakdown (honestly there was just too much of it and I cried trying to blow dry it) so I got it all cut off. Didn't quite go fully mad with it, but about 12 inches came off!

Placement starts on Monday now. 

I’m quite looking forward to it. I finally managed to get hold of my mentor to organise where to meet and start times, she’s on annual leave for the first week so I’m with a different nurse to begin with, but she said she’d call me next week to update me on things. It’s quite handy actually because where my mentor is based is actually only a 5 minute walk from my house, so I don’t have to worry about traffic or getting the baby ready so Calum can drop me there on time. It’ll be nice to get started as well, I think the first week probably is going to be a bit weird, but it also means I can start thinking about the dignity essay and what interaction to use for the reflection part of it. I’ve started the introduction and whatnot- I’ve got about 500 words done so far, but I can’t really go any further without knowing what I’m going to write about. I've done about 600 words of the patchwork essay as well, but that’s a long progress one and I’m not overly worried about trying to do more of that at the moment. 

Four of us met up this week at one of the girls houses. It was nice to sit and have a social, but we also went through essay plans, referencing, all of that. Which, if I’m honest, is stuff I’m familiar with already from when I did my degree before, but I think I at least managed to help them out by explaining the referencing system a bit more. And it was nice to chat about everything we’ve got coming up. 

So I’ve sorted out my year one competencies folder for Monday as well. it’s quite nice to get it all ready and organised, I feel a bit better about it all now. I've read through them all and I honestly don’t know how I’m going to get some of these things signed off, but I think that knowledge will probably come with time. Maybe it’s not something I should be worrying about right now. 

There’s not much else I can write about really, the interesting stuff starts next week!

Exams Exams Exams

 Exams, and all the things that come with it. 

That’s pretty much what the last few weeks has been about. Placement is creeping closer and closer, and this week we finished our last exam until afterwards. It’s been a while because honestly the last few weeks has been a bit mental, personally and academically. Calum’s been super stressed and tired, he’s been working so many hours trying to make us a bit of money, whilst looking after Alys, as well as trying to do all the leftover DIY jobs in the house and get the garden sorted for summer so it’s safe for her to play in. I’ve been trying to help as much as I can, which is hard when I’m in uni on weekdays, I don’t get home til after 4, I give the baby her tea as he goes to work at 5, entertain her for a few hours, do bedtime, and by the time I get to eat my tea and get on with stuff it’s gone 9pm. There’s just not enough time in the day, and I worry that he’s unhappy with it all. She’s been teething like a monster as well which has made things (bedtime!) a lot more difficult. Thank god for calpol!

Aside from that, my best friend just had a baby she didn't even know she was pregnant with until 4 days before she went into labour, so it's all been a bit chaotic. Luckily the baby is okay- she was born at what they think was 35 weeks- she's a bit small but she's doing good. It's mad though because she's the same size Alys was when she was born, and she was full term! The mum's doing okay, it's obviously a bit of a shock and I said to her that I think the stress of finding out she was 8 months pregnant (no bump or anything!!) probably sent her into early labour. It's a good thing I kept all those baby clothes!

 AND

 Alys's godparents also had their baby as well, although she was actually planned, and they had to spend 3 days in NICU as baby got stuck on her way out and had some trouble breathing. They both look like they're getting on well with it though, although I have been sharing more PND mental health things on my facebook- it's really hard to be a new mum especially as there's so much pressure and people telling you to 'enjoy it'. Honestly if anyone says that to me if I have another one, I'll probably snap. There's not much enjoyable about raging hormones, sore nipples, sleep deprivation and stitches in your vagina!! 

So many babies around at the moment. Sometimes it makes me feel guilty about not really enjoying having Alys at first. I really struggled with my feelings and everything, and I know Calum did as well, and that whole first 4 months of hers is just a blur of trying to get through it. I was lucky that I managed to speak to people about it, and I think my love for her came gradually instead of in a 'rush'. Couldn't be without her now. 

So, anyway, we had the handwashing exam (which I passed!) as well as the MCQ, the recognising the sick patient practical, and the safe medicate exam. 

The MCQ wasn’t actually as bad as I thought, although some of the girls were really anxious about it and kind of overanalysed it afterwards. I guess that’s just human nature, but to be honest I said to them before we went in that you only actually have to get 14/30 right to pass. I think they probably think I don’t care about some things, or don’t get nervous, but the reality of it is that stressing about it isn’t going to make you do any better. I’ve reached a stage in my life now where I just try and take things as they come- if you can’t do anything to change the situation then there’s no point worrying about it. But maybe that’s just me. I care about what I’m doing without a doubt, but I know there’s no point letting it effect my mental health, that’s not good for anyone. I think the one I found the worst was RSP, but that was mainly because I hate the idea of roleplaying- I can talk for England in real life but ask me to pretend and it’s so far out of my comfort zone ha! 

The exams went well to be honest: I got 93% in the MCQ, passed handwashing and RSP practical, and got 100% in the SafeMedicate one. I probably should be more proud of myself really. I think a lot of people put stuff on Facebook and things, but I’ve never really been one for bragging about grades and all that. I think sometimes it can feel like a bit of a competition- who did better than who- but I hate that and I’m just happy to pass. Let’s face it, in 10 years’ time nobody is going to be asking what marks we got on an MCQ exam in the 1^styear, are they?!

But I will admit it does make me feel a bit more like I’m doing the right thing. The mum-guilt is real. 

So now all that’s over and done with we’re back to full on lectures until the end of this week, when we have a reading week before placement. I’m still anxious about that to be honest, it’s like the first day of a new job all over again, except this time I probably have more to worry about than just spilling a pint of carling! A few of the lectures in this module have been really interesting though, although I did find one or two of the mental health lectures really hard to sit through. It sounds ridiculous because I really would love to raise awareness about mental health post-baby (for men and women) but one of the people we had in to talk to us took me back to when I was a lot younger and really not very well at all. I guess it was a bit triggering in a way, hearing her talk about attempted suicide and everything to do with it, I spent a lot of my younger years in a really dark place and on a lot of medication, speaking to a lot of people and generally thinking I wasn’t good enough for anything. I mean, I’ve been better for years now aside from the too-common post-natal blip, but I wouldn’t really count that as I was aware of how I was feeling and went to see my GP straight away once the intrusive thoughts started. But there was something about sitting and listening to the talk that really reminded me of how I was, and it took me back to my very poorly 19-year-old self. 

We’ve also done a few smaller group work seminar-type things which have been helpful. I think it’s because I enjoy more of a discussion about things instead of being talked at all the time- which most of the first module was. I know it was because we had to take in a lot of info starting the course, but I feel like I get more out of smaller groups and being able to talk about it, and I know most of the other girls feel the same. 

I did start feeling bad this week though because I think I talk too much, or ask too many questions, but I think I probably just have to remind myself that we’re here to learn, and honestly these sessions would be really awkward if we all just sat there in silence! 

We found out our placements and I’m with one of the Community Nurses.

I’m really happy about this to be honest. I mean, I’m a little worried about being in a car all day with the same person, it’s such an intimate space and it’ll kill me if I don’t have someone who can hold a conversation. I appreciate we’re there to do other things and not just socialise, but it makes the whole situation a little bit easier really if the person you’re spending most of the day with has a sense of humour! I think I’m just a little worried as well because I’ve never done anything like this before. A lot of the other people in my cohort have care experience or already work in the hospital in some manner, whereas I’m just used to pulling pints and telling off drunk people! It sure is going to be a massive change, but I think that’s why I’m glad I haven’t been thrown straight into being on a ward, it’s not as much of a baptism of fire. It’s good as well because I’ll get to meet a lot of different people, but also see how nursing works in a setting other than the hospital, and what the NHS does for people who have care in their own homes. I think it’s probably a completely different experience to being on a ward. 

It’s been a good few weeks though, as well as a busy one. I’ve just got to wait for my placement mentor to ring me back to arrange the first shift- hopefully Monday- so then I know what time I’m starting as well. I think it’ll all seem a bit more real as it gets closer. 

My life after uni this week has been this: 

Easter Time and Exam Revision

Easter Holidays and the rest...

It’s currently the Easter holidays- we’ve got 2 weeks off before exams start in May, which is quite nice as it means I can fit in some much-needed family time before things start to get crazy before placement. I have to admit it’s really hard to try and juggle the whole family/university thing. I feel extraordinarily guilty that Calum takes care of the baby all day, he’s super stressed trying to do the work for his master’s degree and works nights as well. He doesn’t complain or mention anything to me, but I know he’s really feeling it. We’ve made a lot of sacrifices for me to be able to do this, I just hope it all works out. It’s been nice to spend time with Cal and Alys though, his dad came to visit for a weekend as well, so we went to Folly Farm with him and his sister- who’s actually studying at UWTSD as well. The baby really enjoyed it, and the weather held out for the day- so it was sunny at least!

So, exams are getting closer, me and the girls had a study day this week where we all practiced for our RSP exam. It was nice actually to see them outside of uni, we probably did more chatting than actual practicing in the end. We’ve got the handwashing exam and the MCQ all within two weeks when we get back as well. The handwashing should be okay, it’s probably the shortest exam I’ll ever do, I’ve just got to remember to avoid touching the basin or taps so I don’t have to start the whole thing again or fail. We had a bit of a revision session on the MCQ whilst we did the study day as well, it’s only a few subjects we need to know really, so I’m just going to try and go through it the best I can over the next few weeks. 

It’ll be nice to get back to lectures to be honest, after Easter there’s about 2 weeks of limbo around the exams, and I much prefer having structure to my weeks so I can plan when I’m doing things. It doesn’t help that we’re absolutely skint as well, but hopefully getting the bursary at the end of the month will help with that aspect of it all. 

Anyway, not much to report as it’s not term time!