Humility

I hadn't expected to find being a qualified nurse so different from being a student nurse.  But as well as qualifying, I also moved hospital; and so many things are done differently at this hospital to the ones I trained at (often done in a better way, too).  

These past six weeks have been an exercise in humility as I have had to re-learn how to do some of the simplest things that I assumed I'd already mastered as a student:

• a new type of catheter bag that empties with a tap not a valve;
• beds that have completely different controls (and that work reliably, unlike the ones at my last hospital);
• a macerator rather than a bedpan washer (infinitely nicer and more hygienic);
• completely different cardiac montitors that have integrated ECG machines - no more going hunting for a portable ECG machine, wheeling it back to your patient, plugging it in, connecting it all up and then finding that it has run out of paper - here I just press 'print' on the monitor;
• a whole different system of ordering food for my patients;
• completely new prescription charts, fluid charts, nursing notes and observation charts;
• wound dressings that I've never come across before;
• cleaning everything with old-fashioned chlorinated water, rather than anti-bac wipes. 

My new colleagues have been so friendly and supportive.  It didn't take me long to feel a part of the team.  However, I still do a double-take when I catch sight of myself in the mirror and I am wearing the royal blue scrubs of a Staff Nurse, not the grubby white tunic of a student.  Sometimes I feel like a capable, qualified nurse, and sometimes I don't.  Sometimes I know what to do and sometimes I don't.  I work much more slowly than the other nurses, and that is another lesson in humility, because in order to be safe, I have to ask for help more often than others.

I have at least one moment in every shift where something suddenly happens, an alarm goes off, my patient deteriorates, and I mentally shriek to myself "Fuuuuucccckkkk!!!".  But either it is something I can quickly fix myself, or I need to call for help and another nurse is by my side in moments showing me what to do.  I learn more each day than I ever thought possible.

And that's the joy in this new job.  Intensive Care is a stressful place to work, but its also so very interesting and fulfilling.  Patients are at their most vulnerable and at their most sick, and it is deeply satisfying to be able to nurse them one-on-one and give them really good quality care for thirteen hours at a time.  I am using my brain as well as my heart, and I love that.

All change

It's all change for the New Year around here:

• I'm working. 
• The car only gets used once or twice a week, now that we no longer have a school run to do. 
• I'm earning money. 
• After a very late night out and a slow bus ride home, I awoke at 9:30am to find that Cam had unloaded the dishwasher, made a big pot of coffee and was frying bacon for breakfast sandwiches for everyone. 
• I no longer travel to work by tube.
• We are going to go to Switzerland for our summer holiday this year.
• I'm wearing bright blue scrubs at work, and a name badge that says 'Staff Nurse'.
• There is a hipster-run new bistro in our local neighbourhood.

I absolutely love this time of year: the crisp cold, the white skies, the sense of clarity and energy after the velvet-luxury, over-indulgent, laziness of Christmas.  It makes me want to run, to clean, to sing, and to organise.  Starting a new job fits perfectly with this vibe.  In the dark early mornings I warm myself up with one of the (many) hats I knit over Christmas and walk briskly up the hill to work, marvelling at how much I enjoy this new life I've chosen.  On my days off I make plans and lists: where to walk next, what I need to learn next for work, what I'm going to buy with my first month's salary (a new printer, most likely), what my sewing plans are for this year, and which bag I don't need to buy in the Cath Kidston sale.

There's still cake though.  There's always cake.

Lemon and blueberry syrup loaf

Walking in the new year

Two Christmas weeks of whole-family idleness has been blissful.

mocha and knitting - this is what much of my Christmas looked like

And now I'm starting the year with a pair of new walking boots, a whole pile of lists, plans, maps and new pens.  Its good to feel busy and energetic again after so much sleep and rich food.

I have resolved to cram as many walks as I can into 2015.

10 things

• About a month ago I realised that working as a nurse feels completely normal now, rather than strange and new.  This is A Very Good Thing, as it means I no longer feel overwhelmed, but I still retain my excitement and enthusiasm.

• I have just nine shifts left as a student.

• I am making time to run, although I am starting to realise that I can't always go running exactly when I want.  Such is life though - anyone working or looking after children, or both, has the same problem.
• Yesterday, when the coach at my running club said that our session for the evening was "Chats", I assumed that this meant running and chatting.  So I set off, cheerfully chatting to the person next to me.  It turns out that "Chats" is actually a loop of over 8km, which includes the long Chatsworth Road in Hackney.  And it also turns out that the lady I had started chatting to is very experienced, races competitively most weekends, and runs at a much speedier pace than me.  My good manners and sense of pride meant that I couldn't bear to either stop chatting or drop away from her, so I ended up running over 8k at my 5k pace, whilst discussing analytics methodology in the publishing industry.  An amazing achievement.
• I bought some new lunchboxes from Lakeland.  This yogurt-and-granola pot is my favourite, and means I can quickly re-fuel with much needed carbs during my 15 breakfast break at work.  Plus, how cute is the tiny honey pot?

• Cam is in Year 10, and has test after test at school at the moment.  Some of them are progress tests and some of them are official GCSE assessments.  He's characteristically laid-back about it all, but it strikes me as being pretty relentless.  I made him a chocolate cake yesterday, and when he came home from school and ate a big slice with a big grin on his face, I was so pleased.

• I read Gone Girl last week and didn't like it one bit.
• I've had some good walks lately - just locally around Epping Forest, Hackney and Walthamstow Marshes and the Olympic Park on my days off.  The damp, misty, golden autumn colours and smells just take my breath away.

• One of the first things I am going to buy when my salary comes through in January (the first money I've earned since 2009 - oh my), is a new pair of walking boots.  Mine are ten years old and the sole is coming away from the boot on the right foot; they are not really very waterproof anymore.

• There is obviously a very long list of Things I want To Buy when I am earning again.  

Seen in A&E

We do three or four twelve hour shifts a week, and we see EVERYTHING.

• A nurse covered in white splashes of plaster of paris.
• A patient being kept nil-by-mouth before going to theatre for emergency surgery, trying to sneak a swig of beer from a can in his bag.
• A bike helmet, crushed like an eggshell.
• A floor awash with urine.
• Doctors and paramedics in bright orange helicopter jumpsuits.
• Relatives crying and hugging each other.
• A passport drenched in blood.
• Porters pushing trolleys around with incredible skill.  How do they never hit anything?
• Nurses and doctors crowded around the radiographer, who is looking at a patient's brain scan.
• Nervous looking medical students.
• People practising walking down the corridors with crutches.
• A linen skip full of discarded red ambulance blankets.
• A nurse talking to a patient about cupcake recipes as she puts a needle in his vein to take blood.
• A man handcuffed to a trolley, escorted everywhere by two tall policemen with crackling radios. 
• Many, many people whose problems will be solved by going home, taking a paracetamol, and seeing their GP next week.

The new, blue, hospital behind the old one

The new normal

I am back at work; charging so very fast towards mid-December when I will qualify.

It is good to be working again, and to feel useful and skilled, but I'd forgotten how busy and chaotic everything can seem when I am working.  I am trying to remember to use my commute as a way of easing in and out of the working day. 

These past three weeks, I've been working in Hackney - very close to home.  I commute by bus, which is far more frustrating and unreliable than taking the tube, but has more interesting views.

 

I'm tired, energised, busy, constantly carrying around a heavy bag of books and clothes, losing track of which day it is, spritzing hairspray on my up do, texting the children to remind them to do their chores, feeling full of purpose...and also starting to feel a little bit as though this is the new normal.  And this is A Good Thing.  

Back to it

These days I don't feel as bereft as I used to when the children go back to school in September.  The silence in the house is still deafening, and I miss their wild enthusiasms and crazy logic spinning through my day, but these days they really need to get stuck back into school by the time September comes around - and more importantly they want to get back to it too.  

Olivia has left primary school and is now at high school with Cam, which they are both very pleased about.  I am delighted too because the days of the school run have finally come to an end.  To celebrate, I have waved them off to school each morning this week still in my pyjamas - standing on the doorstep, with a cup of coffee in my hand, as I watch them walk up the road together.  Utter luxury.

In one more week I go back to work too.  I'm really looking forward to it.  I have just fourteen more weeks of placement, and then I will be qualified - so exciting.  Yesterday, my parents-in-law sent me these tiny little nurse figurines to mark the final stage of my training.  They are sitting by my desk, reminding me of everything that is still to come.

         

10 things

• Graham and I celebrated our third wedding anniversary.  We went camping again - and Olivia insisted on doing a photo shoot of us snuggling up on a bench together.  She took close to 400 photos, just by holding the button down on my phone camera and telling us to smile.  There was just one I liked.  We took an anniversary selfie instead, which I am much happier with.  Sorry, Olivia!

 

• The children and I went to Brick Lane, ate pakoras in the sunshine as we wandered around, and came home with a huge bag of bagels for the weekend.

 

• Cam likes his bagels with kippers for breakfast.  I like mine with avocado.

 

• I did my first parkrun in my new running club t-shirt this morning.  Rumours that I chose this club because I find the shade of blue on their shirt particularly pleasing, are entirely false.

• We have a new dishwasher.  It is so quiet, it purrs.
• Olivia sewed herself a top.  This is the first time she has done any dressmaking, and I was so impressed with the results.  She did everything herself, and all I did was explain some unfamiliar terms on the pattern.  The pattern is the Oliver + S Ice Cream Dress/Top, in the age 12 size.  It comes out quite short on her - she is a couple of months shy of turning 12, but is very tall.  She is keen to make another, and add a few centimetres onto the length.

 

• I did some dressmaking too, and made myself a new dress - another Lisette Portfolio dress.  It has a seagull ribbon trim on the hem, which I bought in Whitby, and contrast fabric inside the pockets.  It may be my most favourite dress I've ever made for myself - or it may just be that whatever I've made most recently is my favourite.

 

• I am keen to make more clothes while I am still on my long summer holiday.  Perhaps the Lisette Diplomat Dress, which I have the pattern for, but have not yet made.  Or maybe this Everyday Skirt?
• My sister and her two small girls came for a visit.  The littlest cousin was completely unfazed by the two big teenagers thrusting their cameras at her every time she smiled, did something cute, or moved.

 

• I made 22 raspberry madeleines yesterday afternoon.  There are only five left this afternoon.

    

Run report - a running club

Finishing an early morning run - red face clashing nicely with my orange t-shirt

Joining a running club is something I've been mulling over for about six months.  The running magazine I read (Women's Running - do you read it? I am a big fan) frequently tells me that joining a running club would be: 

• good for my running, 
• good for my social life, and 
• not at all intimidating.  

To be honest, I've been a little sceptical about those last two points.  The mere phrase 'running club' is pretty intimidating.  But Graham is also a member of a local running club, as are many of my friends at Hackney Marshes parkrun, and they tell me the same thing.

One of the major factors that put me off club running, was the commitment: I work full time, I work antisocial shift patterns, and I have plenty of other things I need to fit into my life.  Was joining a running club trying to fit too much in?  Would they expect me to be on committees and doing races every other weekend?  Again, Graham and other running friends assured me not.

The running club closest to where we live is Eton Manor Athletics Club - a 101 year old club, with a permanent clubhouse in a large, picturesque park, just a ten minute walk away from our house.  It has the added benefit of not being the same club that Graham belongs to - he is so much faster and fitter than me, and I didn't want to join somewhere where I might always be known as 'Graham's slower wife'!  When I looked at Eton Manor AC's training schedule, I saw that they train on three evenings during the week, as well as organise weekend group runs - so even with my unpredictable shifts, I should surely be able to manage to go along once a week? 

And still I dithered.  I've been running for just over a year now, and yet I still feel like a bit of an imposter most of the time.  Am I a real runner?  Well, a real runner is just someone who runs regularly, so of course I am.  I also worried that a running club would be be made up of super-fast young people, full of disdain for my 28 minute 5k time.  This of course, was ridiculous.  I know from going to parkrun every weekend, that running is actually an incredibly inclusive sport - where elite runners cheer on the beginners, beginners can run alongside people who've been running for decades, and everyone, aged from 7 to 87, is impressed with everyone else's time and effort.  

Last night I decided to put aside my uncharacteristic nervousness and give club running a go.  I went along to Eton Manor AC, for their weekly interval training session.  Right from the minute I turned up, everybody was so very welcoming and friendly.  They asked me about my running experiences, were impressed that I go to parkrun every Saturday, reassured me that the club was full of runners of many different abilities and speeds, and generally put me at my ease.

We ran in a big pack through the local parks to Walthamstow Marshes, chatting as we ran.  This was a very new experience for me as I generally do all my running by myself, listening to music on headphones.  Surprisingly I found I could chat and run at the same time though.  Once at the marshes, we found a straight, paved path and started interval training: two minutes running hard (the guide for 'hard' was at your fastest 10k pace, but as I don't run 10ks I tried to run at my hardest parkrun, 5k pace) followed by one minute walking or slow jogging (I walked - as did most people).  The first two minutes felt like the longest two minutes I'd ever run - it seemed to go on forever!  But after that I got used to it, and managed absolutely fine.  The nice thing about interval training is that everybody gets to run at the pace which is 'hard' for them, and yet as we were running back and forth along the same straight piece of track, you always had somebody in your sights and felt very much a part of the club.  We did this for 30 minutes, before jogging back together to the clubhouse for tea and biscuits and more chat.  

Someone told me at the end that we'd run 8k altogether - which is by far the furthest I have ever managed.  I've only run further than 5k once or twice before.  I couldn't believe what I had achieved - a longer distance than I had ever run before, and at a harder pace than I would ever do by myself.  I was so pleased!  This, ultimately, is why I will definitely be joining Eton Manor AC and incorporating a club run into my life once a week.  I was on such a high when I finished.  Running with a club will improve my running like nothing else, and push me to do more.  But in a friendly, sociable and surprisingly uncompetetive environment.

What about you?  Would you join a sports club?  Do you have similar hang-ups to the ones I had, and wonder if they are only for super-fit, semi-professional athletes?  

I'm really looking forward to the new developments in my running that I know being a club runner will bring.  I'll let you know how I get on, once my achey legs have recovered and I've managed to get out of the bath.

I really earned this muscle therapy bubble bath last night!

Oncology experiences

The longest placement of our course is for twelve weeks, towards the end of our third year.  We can ask to be placed in a particular specialism, and the university and the hospitals it partners with try to accommodate our requests.  I asked for oncology, and was given it.

It was a tough placement.  So much is expected of us by this stage in our course.  Our mentors are assessing whether or not they are happy for us to join the register of nurses, and we are acutely aware that in a few weeks or months (if our mentors are satisfied with our abilities) we will be newly qualified and practising independently.  We are trying to learn as much as possible while we still can, but also prove that we already know how to be safe and work as a graduate nurse.  We have seen so much by this stage of our course (after a Saturday night shift in A&E I truly thought I'd seen everything) - but of course we haven't seen or experienced a fraction of what there is to see.  People's bodies and minds still shock and surprise me.  This placement was when I properly understood that I will never stop learning.

And then there is oncology itself.  Cancer is a very complex disease that evolves and changes over time.  It can be cured and managed better than ever before - but not always.  It affects everybody differently, and touches a person's family, friends and lifestyle too.  

In my first week on the ward, one of the Macmillan Nurse Specialists said that I must make sure to spend a morning with her in one of the outpatient clinics before the end of the placement.  "You will get a very one-sided view of cancer by working on a ward," she told me.  It wasn't until the penultimate week of my placement that I got a chance to take her up on her invitation and join her in the outpatient clinic.  On the ward I cared for people who were very sick - either because their disease had progressed and they were close to end of life, or because the treatment they were receiving was making them extremely unwell, even though it may have been killing the cancer.  However, in the clinic I met a much greater number of patients who were either living a completely full life with cancer and whose symptoms were completely under control, or whose cancer had been cured or removed - by the often harrowing treatment we gave on the ward - and who had been in remission for many years.  Many of these people were the beneficiaries of the enormous amount of reasearch and experimentation that goes into oncology in this country.  It was helpful to be reminded that the very unwell people I was nursing on the ward, were just a small proportion of the number of people affected by the disease.


I had so much to think about and a great deal to say while I was on placement on this ward, but was unable to express it - partly due to confidentiality, but also because there was just so much to process in my mind.  I took even more photos than usual on my commutes, and tried to spend the time on the train really focusing on my nursing skills, and reflecting on my new life as a nurse.  I didn't get enough sleep because the shift pattern on this ward was unusually relentless, and I didn't run for the same reason.  To be able to give of yourself - as you need to do when you are a nurse, and in many other professions - you need to be able to look after yourself too.  I ended the placement with a new determination to make more time for running, sleeping, reading magazines and baking cakes - all those good things which recharge my batteries and keep me content. 

Although I'm not going to be working in oncology when I qualify, I wonder if it might be something I return to at some point in my career.  As well as being the toughest placement I've done, it was also one of the most satisfying.  I had days where I came out of work on such a high because I knew I'd left patients feeling better at the end of the shift because of something I'd done.  And quite simply, that's what it's all about.

   

Messy desk - a snapshot

On my messy desk this morning:

• the milk bill
• a letter from Olivia's school about a summer picnic
• a free cup of coffee from Waitrose - thank you Waitrose
• three unopened magazines
• this week's Nursing Standard
• a leaflet about pelvic radiotherapy in men
• unexpected Amazon parcels, which I think may contain birthday presents
• a new cookbook
• a textbook on acute and critical care nursing
• my Kindle - I need to load it up with more things to read later; I've just finished this book, which was a good recommendation from my father
• keys and glasses
• fabric for another dress
• a freshly baked croissant in a paper bag (my breakfast, along with the coffee)

It is my day off today.  After I've tidied my desk I plan to sit in the garden and read the backlog of magazines and my new cookbook. 

A new identity

A few weeks ago I was offered my first nursing job - and last week, after much dithering, I accepted it.  At the end of this year I will become a registered nurse, and then I will be working on the ITU at my local hospital.  ITU stands for Intensive Therapy Unit and is what used to be known as Intensive Care - it is where the very sickest patients are cared for, and each patient gets one-to-one nursing care, 24 hours a day.  I have so many emotions whirling around my head about this new job:

• pride - I've got a great job, in a specialism I desperately wanted to work in
• fear - I'm going to be a qualified nurse, responsible for the care of very poorly patients
• excitement - I'm going to be a qualified nurse, responsible for the care of very poorly patients
• motivation - I need to revise all my knowledge of acute nursing care, and learn so much more
• eagerness - I want to start now
• sartorial disappointment - I will be wearing scrubs rather than a traditional nursing uniform
• nervousness - can we put the brakes on, please? I've loved being back at University.

But mainly, with the knowledge that I have a good job waiting for me at the end of the year, I have relaxed and started to enjoy myself more.  I have always enjoyed nursing and been certain that this was what I wanted to do, but there has also been an underlying tension - could I really do this?  could I be good at this?  what effect was my change in career having on the family?  I was surprised to find that this tension disappeared when I finally sent the email to accept the job.

"Yes, I have a job in ITU," I tell people.  I'm getting used to saying it.  I have a new identity.  In my head I say to myself "I am an ITU nurse" - trying it out for size - and it feels right.

 

Mothering Sunday

Early morning in the Olympic Park

In the morning we all went for a swim in the London Aquatics Centre in the Olympic Park, which opened to the public earlier this month.  It is one of my favourite buildings from the Olympics, and looks much better now than it did then, because the wings of extra seating have been removed.  It is beautiful inside and out, and I filled my camera with photos.  Cam shrieked when I asked him to take some photos of Graham and me, and we had a little smooch for the camera.

The children bought me presents (Cam this book, and Olivia a scarf with flamingos on it, inspired by my abiding love of all things flamingo) and made me cards, and Graham bought me daffodils and croissants.  I didn't have to lift a finger all day

In the evening Graham and I popped down to the local pub to listen to some live music and enjoy a pint of beer.

What more could anyone need? Perfect.