Live

 

My friends husband died suddenly at the weekend. I found out on the day we celebrated another friends 21 st. My friends husband died in his sleep, on his 21 st Joe jumped out of a plane and survived. 

This seems incongruous to me. One high risk activity led to a new vitality and the other everyday , normal activity ended up in death. It is a bit difficult to process really. 

My mum was a healthy young woman, in the prime of her life. Lots of friends , a job she loved and us- her daughters and husband. At 38 she was diagnosed with M.S and over the next 20 years she died a slow and painful death. Literally. 

The point of this morbid post ( sorry) is that this past week it's really hit home how short life is and how privileged we are to live it. Live life to the fullest. Of course we have to work ,grocery shop ,clean the house and do all the other mundane things that keep us going practically. But find joy in the small things. Hug your loved ones more often. Smile. Be kind. Choose your attitude

The day I got my epipen

Ok. So it was actually only this week. Ironic really when I work in an Allergy Clinic. 

I've always had allergies. I'm the poster girl for ' the atopic march '. Eczema at 6 weeks of age, allergic rhinitis at 6 and then asthma at 11. As a baby nurse I developed hives using latex gloves and so I avoided them. 

This week , after having hundreds of exposures to my sons latex basketball , my immune system finally had enough and sent me into anaphylaxis. Not fun. Of course , being a nurse , I didn't go to the hospital. I didn't have an epipen. I took Zyrtec and salbutamol and rode it out. It was stupid of me and I won't do it again. I now have two epipens. I am taking double dose antihistamines and a preventer for my asthma. I have great doctors and nurses looking after me. 

It got me thinking. How many times ,as nurses, do we advise our patients to do one thing and then don't do it ourselves ? I'd never ,ever advise my patients to 'ride out' an anaphylaxis. I'd tell them to dial 000 as soon as symptoms start. Why did I not think my health was equally as important? In truth I didn't really think it was that serious. It was only after the event I got a little bit nervous. But I also didn't want to go to ED. I've worked in ED's and didn't really want to spend hours there when I thought I'd be ok. Lots of nurses avoid hospitals. When we do go we don't tell anyone what we do. Is it because we get treat differently ? Is it because we feel like we're wasting our colleagues time ? Is it because we don't want to intimidate those caring for us ?

I don't know the answers but I do know that as nurses our health is just as important as our patients. We do ourselves , and our families, a disservice by not looking after our health and seeking help. I hope I've learned my lesson. My family and myself deserve for me to be as well as I can. 

  

A new venture

So I've published my first few articles on the Ausmed international site. Have a look below and let me know what you think. They are short and to the point and  are supposed to be read in 5 minutes over a quick cuppa. 

Thanks

Abbie 

https://www.ausmed.com/articles/supporting-children-clinical-procedures-important/#more-1310

https://www.ausmed.com/articles/supporting-children-clinical-procedures-techniques-can-use/#more-1318

https://www.ausmed.com/articles/paediatric-eczema-care/#more-1172

Emotional Resilience- how I survive

So I've been thinking alot about 'Emotional Resilience ' recently. How can some nurses survive the emotional roller coaster and others not ? What does it mean to be emotionally resilient ?

I just want to really reflect on how its been for me. What I've learnt and how I've learnt to cope. It would be great if readers could also share ideas and experiences. I think  sharing helps us to understand and learn new skills and support each other.

One of the hardest experiences I've ever had to deal with was fairly recently. A 4 week old baby came in to ED with traumatic ,inflicted injuries.My role was as a resus nurse alongside a junior nurse from Paeds ED and two adult resus nurses. I was so lucky to have two of my most trusted and experienced Paeds ED Consultants there too. The baby was so sick and the potential for serious, life long damage was very real and unknown at that time. The family were present and  at that point  we had no idea who had inflicted the injuries-we just knew this baby had injuires that were non-accidental. It was a tough situation for all of us. At one point, while I was standing by his infant warmer, the Consultant came over and put his arm around me. There were no words.

The baby was stabilised and transferred to PICU(He actually did really well and was discharged into the care of a Foster Carer a few weeks later)

We had a team debrief that same day and all team members involved(there were a couple of nursing students there too) were present. We were able to ask questions of the Consultant and also reflect on how we felt and how we would deal with these feelings over the next few days. I drove home that night absolutely drained. I was exhausted. We had a birthday dinner for a member of our family planned at our house and ,although I definitely didn't feel like entertaining,I put on my best smile and carried on. It wasn't until 11 pm that I finally was able to talk to my hubby about what had happened and let him know how hard the resus had been.

For the next couple of days that baby weighed heavily on my mind. It was good to able to chat to colleagues about what had happened and gain support from them.I reflected on my role in that resus. Whilst I was there to nurse the baby,I felt a big part of my role ,as the most senior nurse,was to support the staff. I was working alongside a junior RN,who was excellent,but still only very young and not long out of college. I was also working with some very experienced ED nurses but who had not had much experience with paediatric trauma and most definitely not with child protection. I allowed the junior RN to lead the care and I supported her. We debriefed together and shared our experiences with each other.

I was able to continue on after a few days with no problems. I continued to be compassionate,good nurse. I was able to relax at home and laugh and live(and love) my life.

In previous blog posts I have alluded to different times in my career where I maybe haven't been able to cope as well. I had experiences in paediatric oncology that have been difficult and actually had a profound affect on my home life and nursing career.At one point I was so drained I left nursing nursing for a while. How is it that I can cope with some terrible situations much better now?

I think experience does play a big part. I think you learn alot about yourself when you are a  nurse. I am older and can compartmentalise things much better. I can literally mentally 'put things in boxes' to store away for reflection another time if I need to. That doesn't mean I don't deal with issues ,its just sometimes,when you're in 'the moment' like a resus or just half way through your shift, you need to be able to continue on and not stop to think .

On reflection, when I look back at some of the most tricky resus's or situations, I can remember having senior nurses there to support and guide me. In my early career I remember two particularly difficult situations with very sick children(one died,one survived) and on each occasion, the ward sister(NUM) was present. They let me run the resus but supported me all the way and helped me reflect afterwards. I think as senior nurses this is absolutely one of our most important roles- support not take over. Guide not instruct.

I have been lucky throughout my career to be surrounded by great 'teams'. That is work colleagues,friends and family. Having a good team around is so helpful in maintaining sanity. We all know clinicians can laugh(have black humour) even in the most tricky situations. Nurses provide a great sounding board. I cannot talk to friends and family about some of the things we see and do like I can talk to my colleagues or nursing friends. No-one understands like a nurse.


I also think having something else in your life helps too. I now have two kids and a busy life outside work. When I was a new grad I was consumed by work. That doesn't mean that you have to have kids or family to  be emotionally resilient but its so helpful to have 'something' else. It can be friends,pets,volunteering or a hobby-anything just so that work is not all you are. I honestly think this makes you a better nurse.

Learning to leave work behind is really important. One of my very first ward Sisters used to tell us to leave work behind as we walked over the hospital crest painted on the floor in the hospital foyer. Its a good tip. I now like to have the journey home (in the car or by train)to reflect on my day. Of course some days its easier that others. Sometimes it just takes a little more time.I've also learned that's OK too.

Having fun at work is important . There is nothing wrong with enjoying a lovely morning tea with staff or laughing with patients. I once had a mum of a child with cancer say to me " How can you nurses be so happy all the time when you work here? Why aren't you crying?" My answer ? "Because how is crying all the time going to help our patients? How do you think we could come to work and care for your little boy if we were crying all the time ?" Of course there are times when I'm so overwhelmed at work I do cry. Not weeping and hysterical but maybe teary. When you see a baby being put in a body bag as you stand alongside their parents, how can you not tear up ?

I once asked my husband to tell me if it ever seemed that to me a child dying was normal. That would be the day I resigned. I have worked with nurses that are so 'hardened'. I never ever want to be like that. I want to retain my humanity.I count my blessings every day. I'm so grateful for all that I have. Nursing has done that for me. Nursing puts life into perspective.


Let me know what you think. Its good to talk..........

I have a Sari .....

I have a Sari. It was given to me by the matriarch of the refugee family I work with. I love it. Its red with a green trim and is beautiful. I love it not because of the colours or how I look when I wear it,I love it because of everything it symbolises.

To me that Sari symbolises the unique and privileged relationship I have with an amazing refugee family from Bhutan. It symbolises the difference in cultures that I am witnessing. It symbolises generosity beyond measure. It symbolises hope against terrible odds.

This week the world has been rocked by terrible images of a dead little boy. A child fleeing terror in his homeland and his mother,despite not being able to swim,seeing NO other alternative but to get onto a small boat to seek safety in another land. There has been uproar and petitions and tears. Rightly so. What has happened to this little boy is despicable. It is inhumane.

What I find so frustrating it that is has taken this one terrible image to galvanise people into action. This baby died like millions before him. For many years people have fled terror. For many years the world has shut its eyes and turned its back. This little boy may not have died if there had been a safer way for him to reach a peaceful place. He may not have died if the media hadn't dehumanised asylum seekers. He may not have died if people had not bought into the mass hysteria of 'illegals' taking all of our jobs. He may not have died if we had mobilised and stood up to our government and made them take notice.

In Australia just last week the Victorian government tried to implement 'random visa checks'. Essentially stopping any one and checking visas. Who do you think they would target ? White Caucasian people like me? I have a visa. I most certainly do not carry it.  It is likely they would have targeted non Caucasians. Social media went wild. Within one hour hundreds of people mobilised to protest in the CBD. The government backed down. There will be no random visa checks.

In Australia our government proudly proclaims - 'we stopped the boats' . Nope-they just pushed terrified starving people back into international waters. They 'process' asylum seekers offshore in 'camps' no better than concentration camps.They tell them they will NEVER be re-settled in Australia and have attempted to send them to countries with questionable human rights records.

 Children are abused and women raped in Naru and on Christmas Island. Men die of preventable illnesses or are beaten to death. Human Rights lawyers fight tirelessly to offer the government an alternative. A cheaper sustainable way to take in refugees has been offered. Over 90 % of those desperate enough to arrive by boat are found to be in genuine need of asylum. They are not 'illegals'. It is not illegal to seek asylum. They are desperate ,afraid people.

There has been little social outcry. There has been little media coverage.

We have failed this little boy with our silence. We have failed him because we turned our back and refused to take action.

Two years ago I got tired of 'liking' Facebook pages and signing petitions about refugees. I felt a fraud. So I made it my business to do something about it. There are lots of options out there for those willing to look.

Get up and do something .People power changes lives.

My Sari symbolizes the day I decided to stop just 'saying' and actually began 'doing'.

I do my best thinking at the beach....

I do my best thinking at the beach. I've always been lucky enough to live, the most part of my life, in close proximity to some amazing beaches.I think they are good for the soul.

I walked the dogs today at one of our local beaches and after a busy couple of weeks full of illness in the family,I had space to think. I got to contemplating the blog and why I felt the need to write one. I think it stemmed from a love of being a nurse.

I know lots of nurses(obviously) and I know lots of nurses that hate being a nurse. I know lots of nurses that cant wait to do something else. I know nursing is not for everyone. Its challenging and hard work. The hours are sometimes terrible and to be totally honest,sometimes its just down right messy.

The thing is, I know all of this and I still love it. I have worked in really hard positions,with some very challenging patients and families.I have worked night duty and late/earlies. I've missed lunch breaks and I've been too busy to pee for a whole 12 hour shift(my poor bladder !). I've also been so tired I've had to pull over the car to get a coffee so I could actually make it home without falling asleep at the wheel. I know all of my nursing colleagues absolutely have been through the same thing.

The reason I love it, I think,is the utterly privileged position we get to have with people at often the most hardest time of their lives. A patient asked me yesterday how anyone could bear to work with kids with cancer. How could you remain happy and sane? The answer is, we can make a terrible experience better. We can be excellent nurses to our patients.We can be compassionate and patient,we can be considerate and respectful. We can make patients feel valued and that we have time.

I once knew a nurse that seemed to take great pleasure in turning on all the lights in the bays at 6 am on the kids cancer ward. Regardless of the families sleeping or not. Regardless of the type of night the kids had had. All because she needed to 'read the drips'. I have seen nurses bathe elderly, frail ladies in their bed with absolutely no regard to dignity. Talking over them, leaving them exposed. I have seen nurses barely acknowledge their patients,never making eye contact. Eye rolling if asked for anything.

We've all seen these nurses. These are not great nurses. These nurses give nursing a terrible name. We can make bad situations better.

I don't work shifts now. I looked for a '9-5' job with weekends free and evenings spent with my kids. I no longer work in such a high pressured environment like the Emergency Department or Paediatric Oncology. I work with children with eczema. These children are no less important. We don't always have to  work in the high profile departments to make a difference.My families have often tried everything they know to make their kids better. What I do is not hard-I just point them in the right direction. I take the time to listen .I allow them to tell me of all their frustrations and I acknowledge them.

Of course I don't love it every day. Sometimes I have a headache. Sometimes I feel like being at home with my family. Sometimes patients are just awkward and unlikeable,to be truthful.But each day is a new one. Each patient is different. And I get to start anew everyday.Most days are great.

I believe nursing to be a privilege . It's not for everyone. To those of us that get to be nurses,we should be great ones!

Its how you make them feel

This is my most favourite 'Maya Angelou' quote of all time. I love it. I'm pretty sure its not aimed specifically at nurses  but it absolutely plays an integral part of being a great nurse.

As a nurse you have the ability to make your patient feel like the most important person.It takes a skilled clinician to be crazy busy,with a million things to do before handover,to take time out to focus solely on your patient.

A while ago I read the 'FISH' philosophy book( http://www.fishphilosophy.com ). One thing they talk about is 'being there'. Its about being present, in the moment. Its about making that person feel important no matter how busy you are. Its about taking the time to take their issues seriously.I think we can take this and apply it to our every day nursing lives( and every day lives too for that matter).

To a parent,their child is the most important thing ever. There have been many occasions when I've had a busy shift in ED. Had really sick kids to care for and often distraught parents too. Quite often once I've finished with the sicker kids,my next patient would be a child who could have quite easily ( and safely) been seen by a GP or even just managed at home. It can be frustrating and exacerbating. It's time consuming. But, to those parents, their child is important. To me,that child needs to be important too.I need to put aside my frustration and treat the family and child with respect and empathy. Because that's what they will remember when their child is actually sick and does need to be in a hospital. I never want a parent to feel like they can't come back if they need to.

That's not to say I don't get irritated or frustrated. Of course I do but I really try to take a step back and breath before I walk into that room.

When my boy was two he had Coxsackie disease (Hand,foot and mouth disease). He had a fever and a mouth full of ulcers. He refused to drink. I took him to the GP(a locum as mine was away). The GP tried to look in his mouth. My boy jumped off my knee and hid in the corner. The GP looked at me disgusted- she said if he wasn't so naughty she'd be able to look in his mouth. Actually ,no. If he wasn't so scared and sore,she may have been able to look in his mouth. If she had an ounce of understanding on how to deal with kids,she may have been able to look in his mouth.
She made me feel terrible. Like I was wasting her time cos she didn't have the skill to look after my child. I never want to make my patients feel like that woman made me feel.

A few months ago I ended up taking my hubby to ED at 3 am. He had a massive tooth abscess and was having fevers and rigours. He had a vasovagal attack and I couldn't get him off the floor at one point. He had seen a dentist and was commenced on antibiotics. He obviously needed more than a simple dose of oral antibiotics. I worked in ED,I know what people said about going to the ED with a 'toothache'. I knew we'd not be a priority.The nurse we saw was amazing. He showed empathy and gave great explanations to my non medical husband. He put him at ease. Took his blood and gave him pain relief and fluids. He was busy. It was 3 am. He never once made us feel like we were wasting his time. We were extremely grateful.


I recently had a mum of a young baby in my clinic. Her girl had eczema. To me it was fairly mild. She was crying and said she couldn't cope with her baby being so sick. I have eczema ,I know its a nightmare, but to me, there are worse things to have. To that mum,at that time,that was the worst thing to happen to her baby. Who am I to tell her different? Of course I tried to normalise her experiences of eczema but it is my job to help her cope. Two weeks later,she was in a different place-able to cope ,with a good treatment plan. If I'd have made her feel uncomfortable,I'd have never helped her to get to that place. I'd not have been able to have that follow up clinic with her as she'd have never come back.

I read a fantastic blog by a student nurse recently-
http://www.nurseuncut.com.au/nurses-are-amazing-souls-a-young-patients-perspective.

In it a young student and cancer survivor talks about the impact nurses have had on him. He talks about the nurses who put in his IV,hung his chemo,held his hand. It made me so proud to be a nurse. His post really gets to the crux of why we are nurses. To be there with the patient. To be present.


Its sometimes tough being a nurse. We give an awful lot of ourselves yet we still are expected to remain professional and able to function. We need to learn resilience. Maybe that will be the subject of my next blog post......