Soft Anatomy

Oct 8, 2014

Yesterday on the psych floor, a woman told me about her struggles with living in an severely abusive home and was being released that day and had no where else to go, but back into it. I gave her basic info about the Artemis Center, which I even pointed to and read out loud to her because she didn’t know how to read. I thought about her this morning and I hope she used that to better her life. I remember people, their faces stick, their stories make me a better listener, a more perceptive student nurse, a better human being. I know our mental health system fails us in the U.S. It apparently fails in the UK too. Worldwide in fact, it’s just so full of stigma that it’s not given the importance, treatment, and prevention work it deserves. Many people work hard every day to help mental health patients and clientele.

I am writing about stigma. About what I can do as a nurse to change that stigma….I think first it boils down to learning about my own mental health before I can properly assess others. It’s something I work hard on every day as I reflect on what I offer.

I am reminded of a patient from 2 weeks ago whose demeanor was so calm, cooperative, and easily placated that it was hard to believe him as anything other than sad. But sad IS an illness and this man surely had so much of it in him. He was at a loss for self esteem, had no social system to call his friends, and a young daughter that he only saw here and there. His struggle was so real, sober from his addictions for over a month, feeling trapped and “boxed in”, he self admitted himself into the ER, worried he would harm himself. Once on the floor, he was a perfect patient if one could be charted and written up. Med compliant, listened intently, showed intent for change, contracted for safety, kept to himself and made little to no noise. But as my patient, I realized he was still struggling hard with his withdrawal symptoms and not smoking (his very last vice he’s allowed himself). His anxiety was peaking and he had none of his prior substances to help him cope. And NO meds listed. None. Not even a nicotine patch to help cope with the cravings. But….he told me he didn’t want to “rock the boat”, so he just suffered through it. Told me these feelings are what drove him to things like alcohol and sedatives. During his entire stay, the man never had a med assigned to him and was released back into the world, free to make the choices he was going to to survive.
It is this patient which makes me wonder…..do the quiet ones slip through? In the world of mental health, do you receive treatment based on how much attention you can garner for it? The ones who are compliant seem to sit on the sidelines while the acute patients, the more volatile ones, the more “difficult” ones, receive new meds, frequent doctor visitations, assessments that delve a bit deeper….just more focus their way. And it makes me wonder if they know this too and so the survival for many chronically ill psych patients depends on their outbursts from time to time? Not in a manipulative way (though that does occur), but more from a “I am falling through the cracks, not getting well and no one is SEEING me, hearing me, or feeling my presence today”, kind of way.
I imagine if I began to notice that being “good” meant being forgotten, my survival instincts would kick on too. Mental illness isn’t something you can see, like a wound or record like an EKG. Often the nurses and doctors rely on the patients behaviors and conversations to find out what’s going on. And in the case of my patient above, sometimes being quiet in those areas will result in you slipping below the scope of treatment, falling into an area where you’re “safe enough”, “treated enough”, “calm enough” to be sent on your way so someone “worse off” can take your place in the facility with only so many beds and space.

I have seen a lot of good come from these places, but I definitely got my first look at a moment when not enough was done for someone and I couldn’t advocate enough as a student nurse because I had to leave.

Sep 26, 2014

"Certainly the primary imperative of a physician is to be skilled in medical science, but if he or she does not probe a patient’s soul, then the doctor’s care is given without caring, and part of the sacred mission of healing is missing."

(Source: medicalschool)

Sep 4, 2014

So, it’s back to school time again. Another semester of intense clinical and classroom work. Having the summer off was amazingly cruel as it reminded me what it was like to be a low stress, free person able to make plans and do enjoyable things. I had a wonderful time with my family and am thankful for the break though.This semester is med/surg and psych with clinicals in a hospital and both are intense in their own ways. I love it all so far and couldn’t be more pleased with the structure of the classes or with my instructors, I know I will be pushed respectfully and made to learn quite a bit for the next 16 weeks. Here’s to another semester closer to my degree, only 14 months left of classes and clinical to get there and with every week that passes, with every clinical shift I encounter, I realize more and more that this was the career that I meant to have. I may not be the best, I may not know everything, I also may not always have the best words to offer….I am getting there. Competency is coming with every week, every test, every chapter and new section of learning. I still shake in my scrubs from time to time when new things are coming up, but I get through it and then I look back and say “I CAN do that, can’t I?”

So, it’s back to school time again. Another semester of intense clinical and classroom work. Having the summer off was amazingly cruel as it reminded me what it was like to be a low stress, free person able to make plans and do enjoyable things. I had a wonderful time with my family and am thankful for the break though.

This semester is med/surg and psych with clinicals in a hospital and both are intense in their own ways. I love it all so far and couldn’t be more pleased with the structure of the classes or with my instructors, I know I will be pushed respectfully and made to learn quite a bit for the next 16 weeks.

Here’s to another semester closer to my degree, only 14 months left of classes and clinical to get there and with every week that passes, with every clinical shift I encounter, I realize more and more that this was the career that I meant to have. I may not be the best, I may not know everything, I also may not always have the best words to offer….I am getting there. Competency is coming with every week, every test, every chapter and new section of learning. I still shake in my scrubs from time to time when new things are coming up, but I get through it and then I look back and say “I CAN do that, can’t I?”

(Source: ox-how-do-i-tumb1r-xo, via nursingschool101)

Apr 22, 2014

gauzeandeffect:

thedisneyhipster:

Would the Lindsey Bluth fan working at the Walt Disney Studios please stand up

OMG

Awesome. :)

(Source: kristoffbjorgman)

Apr 18, 2014

Nursing is something to be proud of.

Apr 18, 2014

And in that moment, she put one cautious foot in front of her and walked that rope….

Motivation. Motivation + exhaustion. Motivation + exhaustion + doubt.

I know this is hard on more than just myself. I see the effects my choices have on those around me. I realize my absence and my lack of patience. I hear myself say “I can’t right now” more than simply “yes”. I am pushing my old life further and further away from me to make room for this new one that I am inadvertently shoving the wrong things accidentally along the way.

Balance is always key, balance in mind body and spirit. But when you’re thick amongst the chaos and the clatter of the battle you feel you are fighting, balance is only what you can perceive it to be. And sometimes, even when you think you are walking the rope perfectly, wobbling only slightly and you have conquered the fears and are heading towards the other side, someone tells you to look down and you are so confronted by your fear of falling and failing, that you lose your footing and clamor for a better grasp.

Walking that tightrope is what I do. I’m good at what I’m doing, but I am also horribly bad at it too. And it’s not me that is seeing my feet slip and my legs shake and my entire body tensely moving without assured grace…..nope. Everyone else is pointing at it now while I look straight ahead at the end. Everyone else is witness to my brazen and sometimes false bravado as I move towards the other platform of my life.

…..and now, I just looked down. I just looked down to see it all, my fears, my unsteadiness, my own weakness, my own self doubt and I have slipped. Whether or not the faults shown to me were real, whether or not they were manifestations of another person’s own insecurity or truly mine, it’s effected me either way.

Clinging to this rope now and attempting to get back on it is exhausting and part of me wants to let go and feel the sweet release of falling and the safety of the ground. Part of me doesn’t want to pull forth the strength to hoist myself back onto that high, scary rope…..

Except that I can’t stop looking at that platform, it means everything. It justifies every moment of hardwork it took to get here to this day, to this rope, to this decision of motivation + exhaustion + doubt.

Mar 28, 2014

"Nurses are notoriously broken people. And we seek out other broken people because we think that we can fix them. This applies to our personal lives as well as our professional lives. It’s nothing to be ashamed of, but just know that you can’t fix everybody."

—my nursing instructor on our last day of class (via myheart-likeakickdrum)

Wow

(Source: uncharted-territory, via nursingdiary)

Mar 28, 2014

artsciencenursing:

Nursing School


This is me and my nursing buddies. I couldn’t be making it through this without them.

artsciencenursing:

Nursing School

This is me and my nursing buddies. I couldn’t be making it through this without them.

(via nursingdiary)

Mar 28, 2014

lilredrunner:

detainable:

me: wow that exam was easy *gets a 53*

Every. Single. Nursing. Exam. Ever.

Which is why I no longer say any of them were “easy”. It’s like a kiss of death.

Yes. This exactly. No 53’s, but a 78.

(Source: subtotalled, via nursingdiary)

Mar 28, 2014

Just for fun, I once added up all the hours of actual classes, outside schoolwork and online lectures IN ADDITION to in class lecture, and recommended study hours per hour of class. Once I figured in about 4 hours of sleep….my week was full. I didn’t even factor in eating or showers (which often in real life, I kinda do forget about)

Being in this nursing program doesn’t allow for sick, full time work (it states that they really want us to NOT work full time through this in order to make it), or a social life.
And it’s been really hard to give up that last one…not having a social life has made me a Facebook and online junkie because I live through other people now, it’s my connection so that hermit life doesn’t become my norm. So I adjust and have been really proud to become addicted to school, to place my entire focus on it, knowing it’s what will get me my goals in life….for me and my kids.

Kids…remember those?? I try to. I do have 3 amazingly understanding kids but the time away from them is nearly impossible some days. Not feeling connected and on top of everything like I once was…it’s unspeakably weird. The entire weekends where we used to hang out on the couch and watch movies and go out ans do things have been replaced by me sitting in my “office/schoolroom” and them making visitations to me. My dedication and connection to my children had always been top priority and there’s a lot of guilt in taking them down from that highest shelf and placing them on the one right underneath and putting myself and all this craziness that is becoming a nurse on that top shelf instead.

I know some people really try and understand how life consuming my school is, but there are also plenty of people who toss ideas and suggestions and advice out there without fully grasping my schedule….just how much time I spend doing all this. While well intentioned, it’s also sometimes really infuriating when I hear stuff like “oh yeah my 50 hour work weeks are killer so I know how you feel.”…..sorry but you dont. Not to be cocky here but you don’t get it. For me it’s like putting in that 50 hour work week PLUS then coming home, eating something weird like oatmeal for dinner because it’s fast, and heading right up to my laptop, opening up my books and sitting there putting in MORE time after a full day of classes. While your work week sounds exhausting for you, you get to stop once you walk away from your work day. I would LOVE to only go to school, do my 12 hour class day and come home to do…. whatever I wanted. I don’t have that option if I want a good GPA, if I want to pass….If I want to be a nurse.

And I don’t fault anyone for their comments, I dont. I think we all try and relate
And here’s the thing….I’m not even doing ENOUGH right now. I am a B student….I used to pull all A’s, but realized that A’s would send me to the hospital for delirium and complete devestation of my health and family life. So I accept B, it’s not what I prefer but it’s what I should be proud of because being a B student beings I can still be a B parent, a B friend, a B partner to my most amazing supportive fiance.

Speaking of MY health….I think so often of other people’s health that mine falls dead last. I know it cant, it’s a juggle I haven’t learned yet but being sick is just not allowed. I have the utmost respect for the nurse going to her shift while not feeling good. Right now, a simple sinus issue has laid me flat as it has progressed into something more vicious because I can’t stop. I CANNOT take a day off and just sleep like I want to or I will fail. Every week there’s a test, or an exam or some kind of HESI case study or graded in class activity. Right now feeling like I am sick and pushing on feels horrible and I caved and got myself some amoxycillin.

I am still learning how to do this dance….still learning how to make sure.i can be everything to the people who need me…..family, friends, and patients. In four short weeks I will have completed nearly half of my program. And it has been amazing don’t get me wrong. My human dissection class was one of the best experiences I have had at school and passing meds and starting to function as a nurse on a floor is very humbling and awe inspiring.
I have so many things I know and can apply now, it is what keeps me going in all this craziness.