I recently read a piece in The New York Times by a man praising the care his wife received in her final hours. The staff of the unit went to extremes to ensure their parting moments were as memorable and perfect as possible. So frequently, the news is plagued by negative stories about hospital care, debt, and standards of practice. This piece was both refreshing and moving-serving as a gentle reminder of exactly how rewarding working in healthcare can be. It is easy to forget how simple gestures can change the lives of those who we care for and how they may remember these details for the rest of their lives. The article can be read here.
This week I completed my revalidation with the Nursing and Midwifery Council. When this process was first introduced, I felt irritated at having to justify my right to a pin. Is 120 pounds every September and working full-time not enough? The paperwork was extensive so I placed it in the corner of my room and allowed it to collect dust until the last minute.
When I finally accepted that the portfolio was not going to complete itself, my frustration was rapidly replaced by a sense of accomplishment as I scrolled through the pages. In reviewing training and reflections from the past three years, I came to the realisation that I have grown a considerable amount since I first entered the register. While feeling preoccupied and deflated recently, I had neglected to acknowledge this.
In my first year of qualifying, I was trained to manage tracheostomies, neuro patients, intravenous medications, patient controlled analgesia, extra ventricular and lumbar drains, and nasogastric tubes. During the second year, I became trained in intermediate life support, cannulation and venepuncture, and trauma management. Not to forget any skills I learned on the job. Recently, I became an accredited sonographer in early pregnancy and passed my contraception competencies.
Although these three years of training cannot be amalgamated into progression towards a specific role, reflecting upon them has given me the strongest sense of achievement in my career. A recollection of our past, although in a seemingly unnecessary medium, allows us to take ownership for accomplishments and milestones. It provides incentive to make the next three years equally, if not more fruitful than the past. Most of all, it serves as a reminder that, even if we are in undesired jobs, our experiences have not been a waste of time.
I recently had a piece published in The Guardian. The thrill of seeing my writing published (and shared) was rather overwhelming. I’d like to thank anyone who shared this-I think it’s central to survival for healthcare professionals to be in touch with their emotions. Although death (after time) seems routine in nursing, it is important to not become desensitised. One comment in particular resonated with me-
it is when you stop feeling it it’s time for another job
You can read my piece here.
For as long as I can remember, I have had a fascination of the unknown. This interest has often led me to pursue opportunities removed from any area of my expertise. It is this that has kept me motivated throughout my career. Perhaps it has prevented me from reaching satiety but it is the satisfaction of conquering unexplored territory that has fostered this drive.
Pursuing a career in nursing presented a significant challenge. The night before I commenced placement, I phoned my mother in hysterics. With minimal knowledge of healthcare and a vague idea of the role of a nurse, I could not foresee what the future held. What if I wasn’t equipped for this role? Where would that leave me? I reflected upon my reasons for following this pathway-with an affinity for spending time with people and a fascination with pathophysiology, how could this route not belong to me? As first year progressed into second, memories of previous doubts faded into the back of my mind.
Post qualifying, an awareness of complacency has left me intrigued by the unknown. After a year and a half of ward nursing, my interest was piqued by a position in the emergency department of one of the busiest hospital in the UK. When I was offered the job, a spark of excitement was ignited within. This was promptly followed by fear. In the first few months, I was propelled to the furthest corner of my comfort zone and shrouded with demoralisation. As I progressed, those sentiments were replaced with fluency. Although I left that role by no means an expert, overcoming my fears enabled me to build the confidence necessary for autonomy.
In a dramatic sequence of recent events, an unintentional obstacle has been placed in front of me. Although I am unable to discuss details in depth at present, I already find myself mulling over the could-be’s of the future. Despite not knowing where this could lead me, I can’t help but feel this could be my greatest challenge yet. With the summer months passing by at the speed of light, I am consoled by the realisation that the next encounter with the unknown lies within reach.
In selecting a nursing school, I was fortunate to have the option to attend in either the US or England. If I were to have remained in the US, I knew a vast amount of money would be spent on my training. The prospect of free tuition and a bursary provided a large incentive to consider other avenues. For this very reason, I declined a place in the US and accepted a position here.
The entitlement to a bursary did not come without sacrifices. While on placements, we worked the same 12 hour shifts as our mentors-days, nights, and weekends. When social events arose, fulfilling clinical hours was always our priority. In practice, we functioned as units of the team, filling in gaps created by staff shortages. In my first hospital placement, I fought to be treated as a student nurse. Excuses were usually made-‘we’re short of staff’. I left that placement with basic medical knowledge but an expert in toileting. But with each monthly bursary payment, consolation came. I was paid for this role-even if it was only 250 pounds a month.
As summer arrived, we watched the campus empty of students. Friends from other courses celebrated the end of exams and submission of assignments. It would be another two and a half months until our summer. As we trudged through our 37.5 hour weeks, we counted down the days while wishing time would slow before our clinical exams. Summers were not entirely devoid of work. We were plagued with reflective accounts and organising our portfolios. During this time, our bursaries would be re-assessed. And each time we hoped for just a bit more.
In second year, I was placed back in the hospital and hurled into shift work again. My mentor had been qualified for years, and despite being amiable, regretted her decision to become a nurse. When she was signed off on long-term sick leave, I was re-assigned to another person who was critical and partial to a cutting remark. My confidence was shattered and I became engulfed in doubt. During this time, debriefing with my friends kept me afloat. The bursary facilitated the opportunity to seek solace and feel liberated again.
When I qualified, I entered the professional world without debt. Managing on a band 5 salary in Oxford presented enough of a challenge without the additional stress of student loans. It is the bursary (and parents) that allowed me to enter the professional world with this clean slate. Other than shielding me from debt, it represented payment from the NHS for three of the most difficult years of my life. As someone who relied on the bursary throughout my training, it is disheartening to think that future student nurses will not be provided with the same reward. The bursary symbolizes recognition of student input in the NHS and a token of appreciation. With student morale at stake, I can’t help but fear for the future.
I recently left the NHS to pursue a career in sexual and reproductive health. When I arrived at my decision, it seemed easy and logical. I had little doubt in my mind that the change would be positive. I was leaving for regular hours, an abundance of training, and a new, dynamic field. The monotonous routine of hospital work felt like imprisonment and it was time to break free.
A few months into my new job, I found myself reflecting on my time in the NHS. Sentiments of nostalgia surfaced as I recalled games of top trumps in comparing shifts with nurse friends (simultaneously making light of horrendous work days and debriefing on systemic faults). Surviving a work week felt like a triumph and days off were spent rewarding ourselves richly. Together, we represented units in a nationwide network. The sense of team and belonging stirred feelings of patriotism-unlike anything before. Contributing to a service exclusive to Britain felt like a privilege—I wanted to wear my pride on my sleeve. The opportunity to share these sentiments often arose when at home in the States. Upon being questioned about my occupation, I consistently identified myself as a ‘NHS nurse’.
What I could not anticipate was a devastating loss. For the moment, agency shifts have enabled me to maintain that small NHS fix. However, over the past month I have become increasingly aware of feelings of inadequacy. The yearning to belong hasn’t yet faded and my pride remains. Despite the murky future of the NHS, I can’t help but feel the desire to reclaim my identity.
In the nursing world, it is common to be told not to take our work home. When confronted with emotive situations, it becomes a struggle to disconnect and worries can be transported outside the workplace. Days off provide little to no relief when thoughts are occupied by work, leaving the body and mind requiring more time to recuperate. In some circumstances, the mental strain of a shift can be much more taxing than the physical. Over the years, my unresolved work issues have manifested in dreams causing much unease.
In my second year of university, I was placed with the district nurses. Part of their role included palliative care. In one of the houses we visited lived a woman with end stage ovarian cancer. She had a close-knit family consisting of two children and her partner. Visiting her often caused me to reflect on my own relations. Over the span of a few weeks I watched her deteriorate. She began to require increased doses of sedatives and pain relief. Upon arriving at the practice one day, I was informed that she had passed away over the weekend, not long after renewing her vows. The reality left me reeling. For nights afterwards, I experienced nightmares in which my mother had become the patient.
During my first year post qualifying, I worked on a hospital ward. As I was adjusting to a new role, my stress levels were at an all-time high. Suddenly, I was in charge of caring for my own set of patients without assistance or direction. Upon leaving the hospital, I often found it difficult to unwind, resulting in nights of broken sleep. Once, after working a set of nights, I woke in the middle of the night convinced I was still at work. In my delirium, I believed I had neglected to dispense a time critical medication, putting a patient at risk of deterioration. The panic left my heart racing as I orientated myself again. During that year, I repeatedly suffered from this recurring nightmare. When discussing my experience with a close friend, she recounted a similar incident in which she had found herself attempting to administer intravenous fluids while asleep.
In more recent years, I continue to dwell on aspects of my job that have evoked strong sentiments. Guilt, feelings of helplessness, and stress often force me to consider coping mechanisms. Through experience, I have learned that it is my own responsibility to find a way to make sense of emotive situations to minimise internal conflict. The identification of a healthy balance between work and extracurriculars has been central to self-preservation. Although I am aware that disengaging is one of my downfalls, I find solace in knowing it is usually only a matter of time until I find my equilibrium again.