the thoughts of a very new nurse

I’m counting it as a blessing that I’m able to see the good in almost every shift combination I work at the hospital.

An early? Oh it’s so lovely to be home by 4.30pm and have a slow, peaceful late afternoon and evening extend before me.  A late?  I love a morning at home – get up with the family, make breakfast, take Abby to school, potter about with my patchwork and chores then meander on into to work for a 1pm start.

A late followed by an early?  Yes, I come home utterly exhausted after that morning shift that followed a late shift with just a few hours in between for sleeping, but it’s almost like getting 2 shifts over in 1 – bargain!

And even when there’s a long stretch of days before me – next week I will work 8 out of 9 days – 4 days on then 1 day off then 4 days on again – I remind myself, with such gratitude, of the lovely days off that will follow.  That’s right … I am such a Pollyanna :-)

jumper

Mind you, my Pollyanna skills have been put to the test this week with the rather dismal breaking down of our car.  Our car will be with the mechanic for the next week and when we pick it up, we will be almost $3,000 poorer.  Ugh!  That means rides to and from the hospital on the back of Julian’s motorbike, and when he isn’t around, looooong,stuffy, motion sick inducing tram rides.

But then, this afternoon, home from an early and sitting in our back garden with my knitting, a cup of tea, a brisk autumn wind and the late afternoon sun, then later inside preparing supper, I was thinking about the patients I cared for today and realised with a jolt that I needed to practice a bit of what I had preached only a few hours earlier.

In turn, this gave me the opportunity to reflect on my last 10 weeks or nursing, of all that I am adjusting to, the practical experience I am gaining as a nurse, and importantly, how I look at and listen to my patients each day, and how this shapes my relationship with them.

cup and wool

Throughout my degree, we were constantly reminded that each patient we care for is unique.  That our nursing and communication with them has to be guided by their individuality and their needs.  Whilst I always believed this as a student, it was not until I was standing in a room with four utterly different people before me that I appreciated this.

And I have to add, that in the first few weeks, the whole experience of nursing as a new grad was so indescribably overwhelming that I was probably more focussed on getting all the obs done, all the medications delivered, and actually making it to the end of the shift without having a nervous breakdown than to really notice who my patients were and how best to support them.

needles

This last couple of weeks – things are getting a bit smoother.  There are still moments of panic and things that I simply don’t get done and have to hand over at the end of my shift to the nurse taking over from me.  But today I was able to tick off each of the tasks on my planner AND find the time to appreciate who each of my patients were and try to meet more than just their physiological needs.

It’s a humbling experience, let me tell you.  So I thought I would share just a few of the things I try to practice each day.

Most of my patients are quite old and have several things going wrong for them.  Each person deals with this in a different way.

Some are cheerful and make funny little jokes which remind me of my grandad.  These patients have an inspiring outlook on life – philosophical about where they are, full of gratitude for what they’ve had, and cooperate with everything you ask them to do.  Without fail, each of these patients I’ve met, come from families that share so much love.  They speak of their partners and children with such love, appreciation and joy.  They want to be at home with them.  They look forward to what time they have left, no matter how short or compromised it may be.  I so look forward to seeing these patients each day.  And with every laugh and little story we share, I am reminded of the incredible power of love.  Of how rich love makes our lives and how much it nourishes us.  And so, when the shift ends and I am at home, I remember to focus on love ’cause that’s what will make everything else happen.

splash of gold

Other patients – especially when they’ve lost a lot of their independence – look up at me with angry, confused or distant eyes.  I totally get this.  Being very ill and coming towards the end of life can be horribly undignified.  And I’ve noticed that this is even more so when English is not that patient’s first language.  I can only imagine how isolating that must feel.

Accidents happen.  Bodies need washing.  And sometimes all these patients can do is lay there staring up at us, at our mercy, as we roll them from side to side so that we may change their pyjamas and sheets for the 3rd time in as many hours, push pillows under different parts of them in an effort to relieve the pressure their poor old bodies are under, and pull them up the bed so that they may breathe easier.   At these moments, I look into their faces and try to imagine who they were before their illness took over.  Who they were when they were younger and fitter.  What these eyes before me have seen and loved.

Illness does not define a person.  Nor do tired and broken bodies.  Inside what we see on the bed before us, is a person who has lived – had passions and ambitions, created a family, worked to support them, enjoyed holidays with their partners and children, laughed over family dinners, been enchanted by the arrival of grandchildren.  Keeping this at the front of my mind as I care for these patients, really helps me find every bit of compassion and love I have, no matter how awkward or unpleasant the task at hand may be.  I hope they feel this.

leaves

Other patients are much younger and yet are confronted by very serious illnesses and a future that is full of medical intervention and uncertainty.  These are the patients I truly have to listen to closely because it is their experience, not mine, and I need to make sure I am very sensitive to this.

Some of these patients have experienced a life so completely different to my own and can be a bit difficult to care for on a psychosocial level.  They might not take responsibility for their own wellbeing and no matter how hard we try, make very little progress.  I can’t imagine what it would be like to walk in their shoes.  So I listen.  And listen.  And then listen some more.  I imagine them as they were when they were little and wonder what forces shaped them, what they struggled with.  Some might think this is naive – or even patronising – as adults make their own choices in life.  Yes, that’s true.  But as Abby would describe it, there’s always a back story somewhere.  Working to catch a glimpse of that backstory gives me patience and empathy.  That goes a long way towards creating a rapport and caring relationship with someone I have so little in common with.

potatoes

 

Other patients are terribly anxious and afraid of what might come next.  Again, it’s really important to gauge their approach to life and what’s important to them.   For some, they’ve rationalised all of what’s before them according to their belief system and simply need to be listened to with compassion and respect.  No point sharing Pema Chodron with someone for whom control and structure is essential.

But yesterday I cared for a patient who was so very anxious and it became obvious a bit of Pema could be comforting.  So we talked about understanding that some things are just beyond our control and thus, letting go of them can actually help us feel a little less uptight.  We talked about how we can choose how we respond to situations – we can be overwhelmed by them or look at them as another step on the journey.  We laughed at how this choice might feel a bit contrived at first but how with practice, it can become easier and feel more genuine.

And I shared a strategy that I find really does work for me … that the experience at hand – be it life changing surgery or a broken down car – might feel horrible and overwhelming.  It might make us feel anxious, our stomach tied up in knots, our breathing faster, and make it difficult to think of anything else.  But we don’t need to turn these feelings off.  They are what they are and are a perfectly reasonable response to the situation at hand.  Instead, I try to acknowledge these feelings – just sit with them – and then remind myself that they won’t hurt me and sooner or later, the experience at hand will be resolved and the feelings will go.

My patient really liked this idea and shared later that it had helped make their day a bit more bearable.  Given all that is standing before this patient, and all that they’ve been through, it was very humbling that something I shared had made a difference.

chicken

So you know, a broken down car is just what is happening at this moment.  It too will pass and life in Bootville will return to normal.  Shifts will be late and early, stressful and rewarding.  Weeks will be long.  But there will be lots of love.  There will lots of time with my family.  Dreams and plans will continue to grow.  Suppers will get cooked.  Jumpers will be knitted.

And just think of all the moments I have before me to grow in experience and knowledge.  All the fascinating and lovely people I will meet and care for.  All the opportunities I will have to give.  All the times I will stumble, fail and learn.

This nursing life is a rich one indeed.

pointy little Christmas hats

Well hello there!  Goodness – the last two weeks have just zipped by.  In a flurry of making.  Mostly Christmas making.  A little bit of birthday making.  Busy fingers indeed, with many hot creamy coffees to kickstart early morning stitching (one morning I made a bag between 5 am and school drop off!), and steamy cups of tea to keep the fingers moving into the wee hours.  So much to show!

looking down

But first … the dreaded GRAD YEAR!  I realised the other day – well, actually I was reminded by a lovely reader’s concerned email- that whilst I had blabbed all over instagram about the grad year applications, I hadn’t written about it here.  So, here it is! On the 14th October – an hour later than I thought was the designated time – I received an offer.  My first preference – The Alfred.  And last week I finally received my contract – I will be working a 4 day week (phew!) in the Renal, Endocrinology and Rheumatology Ward.  Also a first preference.  All that fretting ….

I really like more complex nursing where the patients have conditions that affect them systemically – where you’re constantly assessing and caring for the whole person not just one thing (I’m not at all cut out for the likes of orthopaedics – too production line).

I also like patients that hang around for a bit (not so good for them of course) because I really like building relationships with people and their families.  And Renal and Endocrinology – well that’s a growth industry in our western societies at the moment so the skills and experience I gain will stand me in good stead.

I hummed and haahed over these preferences.  I really really really would have loved to work at the Children’s and initially made them number 1.  But then … they are on the other side of town – so dreadful travelling – horrible public transport – no train, only tram with a change in town that requires running helter skelter down two blocks and up 1.  Car is no better – shocking traffic coming home from earlies (can take up to 2 hours to travel less than 10km) and often bad starting lates as well – and difficult, expensive parking.

Secondly – when I spoke with people in the know in Bega they said that if I applied to the new Bega hospital having done my grad year at the Children’s they’d be all “oh how nice.”  But if I applied having done my grad year at The Alfred, they’d be all “Woo-hoo!  Sign her up quick!”  Even my pharmacist yesterday was excited by the Alfred – it’s such a big hospital – and the state centre for so much, that I will see HEAPS.  And I loved working there in the ICU.  It’s a great place – especially for a learner like me.

So – as of the 12 January, 2015, I will be Lily Boot, Registered Nurse (Grade 2) at The Alfred.  Extraordinary really.  Really.  I arrived in Melbourne 5 years ago, with a basic BA, years of tutoring and boarding school work behind me, a smattering of retail experience and my horizons extending only as far as the dear little bookshop I worked at up in Elsternwick.  And I loved it.

But once that began to wind up – and Abby was settled into high school – and Julian busy with his work – and dreams of moving to the country/beach and building our own straw bale home began to take shape – I needed something else.  Something to fill up those long empty hours.  Something to challenge my mind.  Something to give me skills that would allow me to both contribute meaningfully to my community and give me a decent living so that our country/beach/strawbale dream could become a reality.  And nursing just ticked all the boxes.  I still can’t believe I did it!

I think back to that first year – travelling into town 4 days a week, sitting in classes, grasping exactly how they wanted me to write an essay (scientists are so different to humanists!), picking my way through the throngs of noisy teenagers I shared my classes with.  It was so weird.  I was really scared about losing my sense of being – of stopping being me – stay at home mum to Abby, wife to Julian, stitcher, knitter, home potterer.  Still am a bit.  And the end goal of BEING a nurse seemed ridiculously far away.  Oy!

But the take home message dear reader – do it!  Doesn’t matter how old you are (I was by far the eldest in every class and on almost every ward).  Doesn’t matter what you’ve done in the past.  Just do it!  Pick that thing you’ve always thought might be good and jump in feet first.  It will be scary and overwhelming and make you think you’ve utterly lost the plot sometimes, but if you just keep plodding away, it can happen.  I failed Biology in high school – which was 25 years ago – and yet I topped my University Physiology and Anatomy class.

Honestly, I think as adults – especially creative adults like us, who enjoy a challenge, learning something new, keeping busy – we are so well suited to starting something new.  We’ve sorted almost everything else.  We’re know we can’t afford to stuff around – time, money, family, responsibilities and all.  And we know how time flies.

We’re so much more efficient and capable than those lovely, ditzy teenagers (said with complete affection – I made many lovely friends amongst my young classmates! – and they’re only just like I was when I was their age) and we’ve just had so much more experience at LIFE, that so many things make so much more sense to us than them.

So – if you want to make a change, come over here so I can wholeheartedly throw my arms around you, give you a big hug, and say “Of course you can!!!!!!!”

Okay …  onto pointy little Christmas hats …

pink one

So Mum’s gone to Canada for the holidays – we have family in Vancouver – and at the last minute – of course it was last minute – I thought it would be nice to knit each of the little cousins – there’s 5 of them now – a pointy elfy hat for Christmas.

I could just picture them all at Aunty Mary’s, the snow falling outside, the lights twinkling inside, and all five of them lined up – in height order – with their pointy knitted hats.  What a cute photo, huh!  So a couple of days before Mum arrived (her flight left from Melbourne), I began knitting and at first I was able to use wool from the stash.  Awesome way to finish up leftover bulky yarn and I didn’t even have to leave the house.  That’s my kind of crafting.

Biggest first – for my dear little 8 year old nephew Oscar.  Thank goodness I did the biggest first.  I would have hated knitting the biggest at 1:30am the morning Mum left.

one hat

Then I knitted the littlest – for my cute little 3 month old cousin James.  That was a blitz.  One episode of Zen, on iView, at my desk, and it was done.

2 hats

Then there were three middles starting with my busy little 3 year old cousin Caleb.

3 hats

But then there were no new colours for the next two – only rehashes of the previous three – bit ho-hum.  I just had to go down to Wondoflex and for some reason, there never seemed to be a good time – until 2 days before Mum left.

Which meant I knitted one for my sweet little 18 month old cousin Frankie before I cooked Abby’s birthday supper the day before Mum left.

funny little points

And finally knitted the last one for my funny little nephew Sam on the Thursday night AFTER Abby’s birthday supper. I think I cheered when I reached the decreasing rounds.  And danced about as I cast off.  Well staggered’s probably more accurate.  It was very late.

However, I can now tell you, dear reader, that if you need to knit a heap of presents in a very short space of time – the Fuzzy Little Shapka Hat is the real deal.  Awesomely easy, quick, lovely, doesn’t even use a whole ball of bulky … ticks all the boxes it does. Ravelled here.

5 hats

And when the fam send me that photo – of all 5 little heads lined up in their stripey pointy elfy Christmas hats – I’ll be sure to show you :-)

 

all over the place

 

I’m very unsettled at the moment.  You may have noticed.

Each day, I bounce from room to room, from project to project.  I hit upon something that takes my fancy for several hours – throw myself into it – it’s delightful – I’m delighted – I’m going to do marvellous things with it.  Then, the next morning, I’m back to bouncing.

Feverishly filling in a giant crossword book I found.  Spending waaaaaaay to long playing mahjong on the computer.

The one upside to this state, is that slowly, bit by bit, each room is getting a good shaking out and organising.  This only seems to happen by creating an unholy mess first.  And sometimes, the crosswords overtake me and the mess lurks about for a few days.

little boy teatowles

The reason for this chaos.  I am at a completely loose end.  You see, it’s a funny thing this nursing business.  You know how there’s this perception that there are never enough nurses.  Well that’s only sort of true.  The degree we undertake these days, to gain our registration, is so very very university based – with so little clinical practice – that no one wants to employ a newly graduated nurse.  She needs way to much training to be safe and useful.  No one except nursing homes.

They’re usually desperate and will cheerfully snatch up a new graduate and put her in charge of 40 – 80 residents.  She will be the only registered nurse on duty and will be expected to provide medication to frail and vulnerable people she’s never laid eyes on before and accept complete responsibility for their wellbeing.  It’s a recipe for disaster – the examples of which hit the coroner’s court.  Mention working in a nursing home and newly graduated nurses shudder with fear.

And so we have the graduate year.  I think almost all of the hospitals have them.  The big public hospitals have big intakes, the little private hospitals have little intakes.  And they all have hundreds and hundreds of new graduates applying.  And guess what – there are nowhere near enough graduate places for those who are graduating – at least a third of graduates will miss out.  Makes you wonder where they wind up.

Do they just grit their teeth and head to the nursing homes, fingers crossed that they don’t kill a poor old soul?  Do they go rural (another whole can of worms)?  Do they do agency work – as terrifying as nursing home work – imagine a ward in a hospital where you know nobody, don’t know how they do things, have never walked those corridors, navigated that drug room, met those patients, and you have almost no clinical experience – nice! Do they go bank (casual work for a particular hospital – not quite as bad as agency – at least you stick with the one hospital)?  Or do they wind up in all sorts of random places where they will never develop the skills they’ve studied for – like doctors’ surgeries and schools and occupational health and safety things.  All of these alternatives to the real thing send chills down my spine.

crocheted flowers fabric on piano

Where does this all leave me?  Well – I achieved a good GPA.  I have great clinical reports and glowing references from really good placements.  I put in my four applications for a grad year – you are only allowed four – and you can only apply one year (theoretically you can apply every year, but you will always be considered last after your first go – so given there’s a shortage of places … )  I received three interviews at 3 big public hospitals – all of which I had been to as a student and had great references from.

The fourth application – a private hospital where I’d also had a great placement and really clicked with the senior nursing staff – I missed out on an interview – they emailed me one hour after applications closed to advise me.  I was HORRIFIED to have been dismissed so quickly so queried their decision.  Turns out they didn’t like my clinical reports – I used my last two reports which were from the Royal Children’s Hospital and The Alfred ICU – two of the most sought after placements – this private hospital wanted general medical or surgical.  Really?  Bugger them.

owls crochet

I had my interviews.  The first two were up quick.  The third was a few weeks back.  I think they went well.  Hard to know.  And now – I have no clue as to what 2015 will hold for me because we don’t find out until October 14th!!!!!!!  Can you believe we have to wait that long.  My first interview – at The Alfred – was on August 5th.  That’s 2 1/2 months wait.  Aaaaaaaaargh!!!!!  And get this – the final joyful bit of the whole torturous process – we only get one offer.  That’s right.  Even if all the hospitals who interviewed you want to offer you a grad year, you will only hear from the one you listed first, so you better make sure you ordered that list just right.  AAAAAAAAAAAARRRRRRRGHHHH!

For this marvellous process, we say thank you to the State Government of Victoria and their canny little program ComputerMatch.

So, until October 14th, I am bouncing around, fretting hourly about whether I will get an offer.  Rehashing those interviews and thinking up 20 ways I could have answered each question better.  Filling out yet another crossword.  Wasting more time on mahjong.  Not finishing my quilts.  Not writing up my crochet pattern.  Not working on my needlepoints and cross stitches.  Not finishing off that yoke on Abby’s sweater or Mum’s stripey sweater or Julian’s Argyle.  Not upholstering the footstool.  Not painting the front porch chairs.  Jeeez I’m slack.

Instead, I’m hating that here I am – with months of blissful home time – and I am not using it wisely.  I am flitting about chaotically – perpetually lonely and seemingly unable to finish even one thing.  Wanting the day to pass quickly so that Abby and Julian are home.  Incredulous that another week has disappeared.  Sad that the weekend vanished in the blink of an eye.  Longing for the year to just jolly well slow down.  Wishing I could hack into ComputerMatch and get an offer now so that I can stop THINKING about it all of the time and just settle down to being lucky Lily at home.

Man, I am all over the place.

crumpled quilt

dates and needlepoint and interviews

wool

This morning was another cold, dreary, grey, flattening sort of morning.  Melbourne specialises in these.  I have to exert a lot of energy to rise above it.  But the last few weeks, as I’ve been waiting for application acceptances and grad year interviews, I’ve been a little bit wobbly on the rise.  Checking emails every 5 minutes.  Fretting over imagined, terrible outcomes.  Wondering how I’ll ever make it to October 14th without having wasted 2 months ripping off all my cuticles.

Oy!  So, instead of working on the Spring House which continues to cover the kitchen table, I tipped my needlepoint wool onto the library table and curled up under the lamp to work on my Norwegian Queen.  Did you know the Norwegian word for Queen is “Dronning”.  I must say, to my English speaking mind, this doesn’t conjure up the most regal notions – instead, it makes me think of a right bore of a queen, “dronning” on and on and on in a pompous and repetitive manner to her ladies in waiting about all the things the King (Konge) does that annoy her.

Yesterday, when I was thinking of all the things I could do with this wee needlepoint, I looked up lots and lots of ways to say Queen.  The similarities were mostly expected – except for the enchanting Hindi word.   You want to know some?  Course you do – in French they say “Reine”, in Spanish it’s “Reina” and in Italian it’s “Regina”.  Yup – just as expected.  But in Hindu it’s “Rani”!  How cool is that!!  That Sanskrit and European languages share the same root is so fabulous!  Just tonight I heard that lovely Canadian astronaut, Chris Hadfield, say that the thing he really began to feel when he was floating above our improbable jewel like world was the collectiveness of it all.  Such a beautiful thought – and precisely why they say Rani in India and Reine in France.

You want to know some more – all right!  In Russian they say “Koroleva”, in Czech they say “Kralovna”, and in Turkish they say “Kralice.  Must be a connection there.  In Malaysian they say “Ratu” and in Arabic they say “Malikah”.  In Japanese I think they say “Joo” and in Vietnamese they say “Nu Hoang”.  The one that made me laugh was the Maori – “Kuini”!  Isn’t that gorgeous!  I wish my Norwegian queen was a “Kuini” but I suppose I’d best make peace with the fact she’s a “Dronning”.

Anyways – etymological diversions aside – the needlepoint.  I was at a bit of an impasse.  I had – improbably – chosen gingernut brown for the background and spent last eve furiously filling and filling and filling.  Then realised this morning that I couldn’t possibly fill in around all those little red flowers – they would VANISH into the gingernut.  As I sat there, calculating how many hours it would take to pull out all that gingernut, I looked up and realised what was clearly inspiring me when I first settled on warm brown – this here print on the library wall!

background

I’m afraid I cannot remember the name or artist, but it is from the early American colonial period – one of my favourite periods of art.  I just love the wonky perspective and proportions – grapes hanging from huge trees ready to torpedo the small farm houses and the garden that looks ripe for sliding down the steep hill – of gingernut brown!  I’ve always looked at this painting and thought how the artist must have painted and painted the brown hill and then got to that beautiful weeping willow and thought “bugger, I can’t possibly paint in between all those delicate leaves, I know, I’ll paint around it.” And at the moment I was GLAD I’d chosen gingernut brown and knew just how to deal with those red flowers :-)

Then, I practised that ancient sport of “well, before I start a new piece of brown, I’ll just check the emails again.”  Do you know that game?  It goes like this – “before I wash the dishes, I’ll just check the emails again”, “I’ll hang out the washing and then I can check the emails again”,  “I won’t check the emails again until I’ve added three more rows of bricks”,  “goodness, I’ve been out of the house for 45 minutes, it’s time to quickly check the emails again.” Course you do.  But this time – oh thank my lucky stars – there was the email I’ve been waiting for.  A grad interview at the Royal Children’s Hospital for next Friday.  Yes! Phew!  Now I can get on with life.

favourite cookbook

Folks, I waltzed into the kitchen.  I cleaned up with a spring in my step.  I laughed with delight at the thought of baking for lunch :-)  And so I pulled out a real favourite – Hugh’s soda bread from his lovely “Family Cookbook”.  It’s such a good, solid recipe that allows for all manner of interpretations – today it was dates and oats. I just followed the basic recipe – eliminated the sugar (I always do that) and substituted 50g of oats for 50g of flour.  Yum!

dates prebake

Popped it into the oven and did some more washing up.  I must admit – I do like washing up in winter.  I love filling the sink with straight hot water – no cold – and then plunging my hands in.  This year I’ve either developed asbestos hands or the plumber turned the water heater temperature down when he last visited.  Either way, it’s bliss.  Fogs up my spectacles.  The steam rises around me and floats away from the dishes as I stack them on the drainer.  Oh yes, washing up, one of winter’s pleasures.

washing up

Then, whilst the soda bread baked, I got to playing with the beet tops from last night’s supper.  Chopped off the leaves for the rabbits.  And then, was so entranced by the ruby red liquid that dripped from the stems, that I chopped them up too and boiled them up in a bit of water.  I have plans.  Next time you pop into blockaday I shall either be showing you something marvellous.  Or you’ll be laughing until you cry over what happened to those beet stems.  We’ll just have to wait and see which it will be.

beetroot stems

In 25 minutes, out came the soda bread – all bursting with scrumptious, piping hot dates.  I hacked off some thick slabs, carefully layered them with thin slices of cold salty butter and gobbled them up at the kitchen bench. Yum!

post bake wrapped

Washed the butter from my hands, wrapped the leftovers for tomorrow morning’s breakfast – Hugh’s soda bread is marvellous toasted – and returned to my Kuini-Dronning.  Spirits lifted.  Belly full.  New ideas for birds and borders and purposes in my mind.

on the table little grains of rice

Take that you dreary, winter Melbourne morning!