Week 9 of Semester 5 - Pediatrics Begins

I finally started my pediatric rotation!  I was so excited/scared about it that I could hardly sleep the night before.  What if I can't handle the kids?  What if I totally SUCK at working with kids?  I had been reading about all the different play techniques to persuade children to let me do my job.  It had sounded very difficult.  

Lucky for me, my first patient was an eight year old.  This meant that I could talk to child and the child was very cooperative. (Yessssss!)

Halloween, Sponge Bob, and Tape

We had an animated discussion about Halloween costumes and Sponge Bob (Thank goodness I knew just barely enough about Sponge Bob to keep up with the conversation.) Apparently Halloween is a hot topic among kids right now.  I'll have to remember all my holidays so I can use them as distraction topics.

I almost cried when I had to pull tape off to remove some IV's.  The tape was firmly stuck to the child's arm hair.  Poor child... there was so much tape, so much hair, and so much pain  :(  We had to experiment together to see whether is was less painful to rip fast or rip slowly.  The answer seemed to depend on the amount of hair involved and the particular type of tape I happened to be pulling off.  Grr...

My time with my first patient was limited as the child was discharged pretty early in the day.  I wandered around the hallways helping my classmates out and visiting with little kids.  It was really fun.  

Baby Time

My favourite was helping one of my classmates out with a baby.  She had to run off to get some medication ready and I got to hold the baby while she was gone.  The baby was very fussy and upset, but some rocking, singing, and soothing later, the baby was snoozing in my arms.  It was so sweet  :)  Cuddles with babies are the best  :)

NICU

Soon, I was running out of things to do.  My teacher (the best teacher EVER) asked if I would like to spend the rest of my afternoon observing at the Neonatal Intensive Care Unit (NICU).  I could barely contain my excitement.  The NICU is where I would like to work one day!

Up I went to the NICU.  I had to surgical wash my hands (up to my elbows!)  I thought that was super cool, partly because I also enjoyed my experience observing in the operating room in semester 3.

NICU First Impression

My first impression of the NICU was that it was really hot and humid.  It's kind of like a tropical area because of all the moisture and heat that is needed to keep the babies in womb-like conditions.  Then I saw all the specialized incubator boxes that they keep the babies in.  They are all covered with a blanket so that it stays dark inside the incubators.

I got to peek into all the "boxes" and look at the tiny babies, the nurses told me about how the different babies got there and how they were kept alive, and I even got to see a surgery!  A doctor and a medical student inserted an umbilical vein catheter and they positioned me strategically so that I got an awesome view.  Oh, it was my lucky day!

I really enjoyed my time there.  The nurses were super nice.  I loved that they took me around as they fed the babies and cared for them so that I could watch what they were doing.  They would explain to me about what they were doing, why as they did it, and answered all my questions.  I was really impressed.

Lookin' Good

I have to say, compared to Mental Health, this Pediatric rotation seems more natural to me.  I really wanted to help the mental health patients, but I feel really comfortable on the Pediatric ward.  Part of what makes this rotation especially nice for me is that all the really sick children are transferred to Children's Hospital.  So the kids on my ward are usually pretty healthy.  That means that I actually get to see my hard work end in success when the kids feel better and go home.  There's something to be said about feeling good about your job.

I noticed that some of the nurses don't really love Pediatrics though.  Some of them are transferring out to other areas like Public Health.  They tried out Pediatrics and it wasn't really their thing.  That's not to say that they aren't super Pediatric nurses though.  They were kind of fantastic (so it's a shame they are leaving!).  I guess I'll find out eventually what area I love too.  So far, Peds is not so bad at all...

Have a great week!

P.S. - The pictures are from my stroll at the edge of the woods!  The mushrooms just popped up one morning and I had to take some pics to show you.  They are literally about 6 inches or bigger in size each!  Cool, huh?  

Just Like Wonder Woman

A friend of mine posted this on Facebook today and I wanted to share it with you.  It brought tears to my eyes.

I hope people will remember that what they say really does make a difference, whether it be words that encourage and respect someone or words that tear a person's self esteem down and make them cry.

The Internet is still abuzz with good words and bad words about this girl.  While the bad words still make me feel sad (and sometimes lose hope in humanity), I am thankful and warmed by the people that have come together to honour this girl and to remember that she was one of us.

Have a great weekend.

The Last Week of Mental Health

Well, the last clinical day of mental health has come and gone.  It was a relatively quiet day, made more somber because we watched a video clip of Amanda Todd.

Suicide
My teacher wanted to talk with us about how we felt about the video.  He talked with us about how suicide is not so much a choice as an illness.  Sometimes people with seemingly perfect lives will still commit suicide.  Of course in Amanda's case, that was not true, but he wanted us to understand that there was a lot going on when someone takes their life and that it's a tragedy.  We debriefed about the video and how felt like we, as part of the system, had failed her.  Some of my classmates cried.

It was nice to be able to talk as a group about the video because it's all over the Internet.  The video stirs up a lot of strong feelings.  Since we are working in mental health, it gave us some perspective on what could happen to some of our clients when they leave.  It's very sad.

A Heavy Burden to Carry
I went back to the ward feeling a bit low.  When I sat down with one of the patients and he told me he was there because he tried to commit suicide, I felt a bit frustrated.  I wished that I could possibly instill some hope in him so that he wouldn't follow through later on.  I feel like the nurses on a mental health ward have a heavy burden to carry.  I know it's not their fault when a patient commits suicide later on, but you can't help but feel that it's somehow your fault too.  It just hurts inside.

The Pros and Cons of Mental Health
My favourite part of mental health is that there is a lot of time to talk with the patients.  You have time to hear their stories, and you have time to build a bond.  It's a nice change from other wards like Medicine or Surgery where you're bustling around non-stop.

The downside of mental health is that you get close enough to the clients to feel their pain.  If you don't take good care of yourself, you'll start to hurt too.  I think it's something about being a nurse and putting ourselves into their shoes in order to understand them better.  Sometimes you put their shoes on and you walk out of the hospital still wearing them.

Pediatrics Next
Next rotation is pediatrics.  I'm looking forward to working with kids, but boy am I going to ache when the little ones don't do well!  Somehow though, it's seems easier to cope with medical illness than mental illness. There's less stigma, less fear of the patients, and wounds are visible.

Mental Illness is Everywhere
One thing that I'll always have to remember though is that mental health patients are everywhere. Just because someone is on another ward doesn't mean that they are psychologically okay.  I will still encounter depression, schizophrenia, bipolar disorder, suicidal patients, and other mental illnesses.  They get sick too.

I guess the good thing is that I have more understanding and compassion for these patients now.  I'm not as scared of them anymore, and I know that a little talking and caring can go a long way to helping them heal inside and out.

I wonder if I'll ever work in mental health one day?  I guess I wouldn't rule it out.  Despite it all, I still do carry some satisfaction in some of the interactions and conversations I had on the mental health ward.  Who knows what good we can do when we put a little effort and love into it?  The least we can do is try.

Have a fantastic weekend!

P.S. - Those are some new dog paintings that I made when I was taking breaks!  It's my first time painting dogs, but definitely not my last!

Week 3 to 5 of Semester 5

Emotional Burden
This semester so far has been a difficult one.  Studying about mental health is new to me and often very demanding on an emotional level.  The wards are wandered by tortured and lost souls.  Many weep inside because of lost ones, difficult moments, lost opportunities, histories of abuse... many of the patients are suffering.

Unlike other wards, I can't give them a pill to make the pain go away.  Their pain is much more difficult to soothe.  I sit with them, talk with them, and listen to their stories.  My heart is often heavy as I hear how much they hurt inside.  Sometimes they are not suffering from depression; sometimes they have an illness like schizophrenia or bipolar disorder.  Unfortunately, the end result of these illnesses is still often suffering.

Most people don't know what to do when someone has a mental illness.  So people with mental illness tend to get the short end of the stick with jobs, education, relationships, etc.  That's not to say that they don't achieve these things; they often do.  It's just that, when I see them, they have hit a rough spot.

Some days, I go home and I feel sad.  I wish I could do more, say more, sit for longer, care better, etc.  I spend time thinking over how I could have done things differently or what I could do next time to make things better.  When I get back to the ward the next week, however, they are often gone or I am assigned different patients.

Who's Responsibility Is This?
My teacher taught us that nurses often feel responsible for their clients.  When things go wrong, they feel bad and as though they have not done their job properly.  She said that it was okay to feel bad for the clients, but that we should not feel responsible for them.

She drew a pie chart and called it the responsibility chart.  She began to divide the chart into wedges.  For example, family played a part in how the client turned out, the people that abused the client played a part, the health care system, society, friends, work, environment, choices made, and the list goes on.  She asked us where we fit in.  We agreed that nurses were part of the health care system and society.  However, we ourselves were just teensy lines in the wedges because other people also played parts in those wedges.

As just teensy parts of the responsibility chart, she pointed out that if we did our portion well, then our job was done.  We did not have to feel responsible for the entire pie chart.  If we did feel that way, then we would get burned out.  She cautioned us against taking on too much responsibility on an emotional level.  It was better to step back once in a while to re-examine the pie chart so that we could be better aware of when we took on too much.

Do Your Job
She also cautioned us against overstepping our boundaries in other ways.  She said that nurses have a lot of power over patients because we see them in some of their most vulnerable moments.  She didn't want us to abuse our power.

For instance, one day we will meet patients that have done terrible things.  As nurses, we have the power to control how much pain medication they get, how we treat the patient, and how much attention we give to them.  We could technically give a bad person less pain medication as a way to punish them.

My teacher says that we need to remember that we are not judges and we are not policemen.  Our job is not to judge or to punish.  Our job is to care.  So when a bad person comes to the hospital, we have to treat them with as much respect and care as a good person.

This is no easy task, so she taught us to avoid as much media information as possible (regarding that patient), to rehearse before meeting the patient, and to always ask ourselves, "If this was any other patient, how would I act? How would I treat them? How much pain medication would I give them?"

Overwhelming
The teachers are trying to help us with developing better ways of coping.  It's good because I often feel overwhelmed by how much hurt is on the mental health ward.  My teacher at clinical said that it was fantastic that I was able to connect so well with my clients, and that I was so open to listening to them and helping them.  However, he cautioned me to be extra careful with taking care of myself.  He said that it would be easy for me to get burned out if I wasn't careful.

I feel a little warm and fuzzy from the praise, but the warning hits home too.

Coping
To help me cope so far, I have taken up some new/old little habits.

1. Petting Poggles - I discovered that I become very calm when I pet Poggles.  He is very sensitive to my emotions because he is such a terrified little fellow.  So I think I have learned to calm myself down when I am around him.  I talk soothingly to him, sing him little songs, and move slowly and gently in touching him.  I enjoy the time interacting with him.  I try to make it a positive experience for him and the focus on making it positive for him means that I have to think of good things that would  make him happy.  
2. Painting pets - a girl on the hedgehog forum asked if someone could paint her hedgehog for her.  I volunteered.  What started as something nice for her turned into something nice for me.  I discovered that I loved painting in digital watercolour.  It's a nice break for me and it makes someone else happy too.  So now I take breaks and paint pets  :)
3. Eating stuff in the garden - I've been lazy with tending the garden this year, but the garden has been growing anyways.  I love going outside and picking tomatoes to eat, picking beans to cook, picking blueberries, raspberries, strawberries... it's fun!  One of my favourite things lately has been finding hidden beans.  I have some densely growing sugar snap pea plants and impatiens have grown up and hidden many beans.  It's fun to peek in the flowers to find them.

Almost Over

My mental health rotation is almost over.  Next week will be my last day there.  Will the last day be able to convince me that I should work in mental health one day?  

Right now, it seems too hard.  There is honestly less of the typical work on a mental health ward to do.  The patients tend to be pretty healthy aside from their mental illness.  That means less medications to give out, no wounds to clean so far, no bathing/toileting, no beds to even make... I'm basically getting rusty in all my usual nursing skills.  

Despite hardly any of the usual bustling around, mental health nursing seems like hard work.  I know that my teachers say that I'm helping by talking to them, spending time with them, and listening, but I just don't feel like I'm doing anything.  There isn't anything really tangible to help me identify success in my work.  On the surgical ward, I can watch a wound heal after days of cleaning it.  Here, the wounds are invisible.

I wish I could say something positive and enthralling, but I just don't seem to be able to wrap my brain around mental health nursing yet.  So many things frustrate and confuse me.  I could go on for days about it.

For now, I guess, I'll just keep plugging along.  

Have a happy Thanksgiving!