The night shift - 10 things

Trying to get to sleep at 10am, the day before my first night shift

Commuting to work from an empty tube platform - unheard of

A nearly empty train - another novelty

Reflections in the window of an empty tube carriage

Break time - 4am in an empty, silent staffroom

Heading home to bed - still in semi nurse mode with my hair up and my glasses on

I have to do a minimum of six night shifts as a student nurse before I qualify.  This week I did my first two.  There was much to learn - I didn't expect them to be quite so different from a day shift, but they were.  At the hospital I am at right now, the night shifts are the same length as the day shifts - twelve and a half hours, from 8pm to 8:30am.

• How any patient ever gets any sleep in a hospital is a miracle to me.  If it's not the sound of the other patients snoring or shouting, then it's the hum and hiss of the pressure-relieving mattresses, the beeps of the drip pumps or feed pumps, the call bells, the clatter of the nurses' medications trolley, the phones ringing, the lights turning on and off.  We try our very hardest to make night time feel like sleep time, but it's not easy in a hospital environment.  No wonder so many patients look tired and have naps during the day.
• I loved my commute to and from work for the night shifts.  A guaranteed seat on an empty train.
• On a day shift we have two or three small breaks of 15 or 30 minutes each.  On a night shift we have one long break of an hour and a half.  Some nurses have a quick nap during their break, others stay awake.  I tried both and much prefer staying awake - my body clock was less confused that way.  I did some knitting and listened to the radio on my break the second night, and arrived back on the ward feeling really quite refreshed.
• It's not the night shift itself that's so exhausting - it's the enforced jet lag you have to put yourself through.
• I liked having the time to talk to an anxious patient, chat with the matron who did rounds of the wards, or make a cup of tea for a family member sitting up with a dying patient.  There's generally more time for everything on a night shift.
• The crash trolley and the controlled drugs register must be checked every single night.
• I still haven't worked out how you eat normally during a run of night shifts.  I slept through mealtimes during the day, and didn't fancy eating a proper meal in the middle of the night; all I could manage was a couple of clementines and some cheese and crackers.  I was permanently hungry but it never felt like the right time to eat.
• One patient vomited all over my shoes thirty minutes before the end of the shift.  I just stared at my feet in surprise and then the patient and I both burst out laughing.
• I realised how many different people are on the wards during the day: visitors, physiotherapists, occupational therapists, porters taking patients to x-ray or theatre, pharmacists, social workers, speech and language therapists, nurse specialists, couriers and ward clerks.  During the night shift it is just the patients, the nurses, the healthcare assistants and the occasional doctor popping in to check on a particularly unwell or unstable patient.
• My children were amazing at keeping quiet when they got in from school.  I slept right through and never even heard them come home.   

Knitting oddments

I am crazy about knitting at the moment - I think because it's an easy bit of creativity to fit in whenever I can: sitting at ballet waiting for Olivia, for half an hour in the late evening before I collapse into bed, for twenty minutes during my break at work.  I love knitting for its pick-up-put-down qualities.  Little by little it grows no matter how busy I am.

At the beginning of this week I finished a slouchy beanie hat made from sock yarn, and almost immediately felt bereft and cast on something new.  Holding the tiny little ball of yarn I had left over from the hat, I was reminded of this shawl which I knit eighteen months ago and wear constantly.  I obviously use more sock yarn than I realised because since I finished the shawl, I have once again built up enough yarn oddments to make something with them.  This time I've decided to make a simple cowl.  I just cast on 160 stitches on 3.25mm dpns, did a few rows of alternating knit and purl to stop the bottom edge from curling, and then switched to stocking stitch.  I'll keep going until I run out of little balls of yarn.  Easy, mindless knitting - with the added excitement of not being quite sure how it will look when it's finished.

10 things about a new placement

I am back on the wards.  I've started a six-week placement in a rehab unit, which marks the end of Part II of my course - after this I will go from two to three stripes on my epaulettes, and have less than a year to go before I qualify.  It is both scary and exciting to write that.

I have only done two shifts, but already I am:

• missing being able to wear nail varnish (this post on A Cup of Jo just makes me swoon with desire);
• remembering how long a twelve or thirteen hour shift is;
• remembering how a long shift just flies by in a flash when you are busy, busy;
• enjoying working with gentle, kind nurses who have decades of experience and still take the time to teach me new skills and enthuse about their career;
• appreciating the colour and vividness of a day off;
• enjoying a nap on the sofa under a quilt, once the children have gone to school on my days off;
• getting back into the swing of constantly washing and packing uniform;
• wondering when I might do any Christmas shopping or planning if I spend all my days off asleep on the sofa?
• wondering when I might also write the essay which is due in on the 23rd December? 
• remembering how I end up eating and drinking at such odd times of the day when I am at work (lunch break at 4:30 pm and supper break at 5:45pm on Monday);

    

I am also missing my nursing friends who are on placements at other hospitals, and hoping they are getting on well.  This course...this profession...it asks so much of us, but it gives more back.  Each time I go on placement I realise I have forgotten how tiring it is.  But I also forget how much I love this job; and it's good to be reminded again. 

Warm hands

Earlier this week, I ran for the first time in my winter running top.  I love the thumb hole so much and came back home wondering why manufacturers and knitters don't make thumb holes in every single garment.  It makes the top so much more cosy to wear.

And then yesterday I remembered my armwarmers, which also have thumb holes.  There's now no need to hack at my clothes, or spend the winter in running gear.  Problem solved.

 

Essays and OSCEs

Walking to University early in the morning

Unwinding with the student nurses in the pub, after the first week of simulated practice

Essay editing, made more fun with a pink pen

Leyton Techical pub - glorious on the outside

Leyton Technical pub - and glorious on the inside too

Walking past St Paul's during a coffee break

Lunchtime in Postman's Park

Messy desk

Tidy desk

Revising on the sofa - my view

Revising for the OSCE

A surprise OSCE good luck card from Olivia

Celebrating the end of the OSCE in style

Sunset over the Olympic Park, on my way home

I have had a very full few weeks of essay writing, exam revising and some excellent trips to the pub.  The exam I've just done was an OSCE (pronounced oss-key), which stands for Objective Structured Clinical Exam.  An OSCE is a practical exam, used in medical and nursing degrees, where we have to perform a clinical skill in front of the examiner whilst giving a running commentary about what we are doing and why.  It's a pretty terrifying ordeal, and endless books are published to help medical and nursing students pass them.

For this OSCE we were given a list of nearly 60 clinical skills which could be examined, and we didn't know until we walked into the exam room which one we'd have to do.  The whole process made me simultaneously realise how much I've learnt since this time last year (give an intramuscular injection? yep - fine) and how much I still have to learn (insert a naso-gastric feeding tube? yikes).  In the end, the skill I had was a fairly basic one, so they were expecting me to know it very well indeed.  I have no idea how I've done, but I'll find out in four weeks' time.

To prepare for our OSCE, and for our next hospital placements which start next week, we've just finished two weeks of simulated practice.  This is where we spend all day in the University's mock wards and clinical rooms, in full uniform, learning new clinical skills, and practising the ones we know already, on mannequins (if they're invasive), or on each other (if they're not).  Simulated practice is always a very intense fortnight, where we are overwhelmed with information and new skills, and have to discuss and act out many different scenarios.  

We were let loose on the advanced mannequins for the first time - these ones had pulses and blood pressure, and could be programmed to suddenly vomit or go into cardiac arrest.  The mannequins are cool, but scare me slightly - they have very glazed eyes.  On the very last afternoon I had to catheterise my mannequin, and made a complete botched job of it.  This is why simulated practice is both reassuring (it's just a mannequin, not a real patient) and necessary (I'm going to have to catheterise real patients very soon without getting it wrong).  It's probably also why the mannequins have scary eyes - the result of many hundreds of student nurses practising their catheterisation and resuscitation skills on them over the years.  They could probably do with a pint of cider after two weeks of simulated practice, too.

Knitting punctuation

My photostream is punctuated with knitting at the moment.
  

There are so many good, big, things going on at the moment: birthdays, visits from small cousins, exams and essays (not just for me), high school open evenings and open mornings, meet-ups with grandparents and plans for my next placement.  And in between all these important things, I knit a row here and there, cast on, rummage through patterns and consider yarn choices.  I can lose myself in knitting more and more as I get better at it; and the ability to switch off, take some time for myself and be creative is so important for my mental health and general outlook on life.



Before I started my nursing degree, I rarely considered my emotional wellbeing - but now I am mindful of the very great stresses of the profession I am going into, as well as the more obvious stresses right now of a full-time degree, two children, four chickens and a husband trying to valiantly pick up all the pieces.  I also come across so many issues to do with people's every day mental health and wellbeing during my training.
  

I now consciously try to incorporate activities into my life which make me stop, think, slow down and enjoy things.  Running is great, walking as much as I can is very good too.  Photography (just snaps on my phone) is a great tool for observing the smaller, prettier, more interesting things about my day.

And knitting.  The soft squidge of the wool is so therapeutic.  The sense of accomplishment is enormous.  The colours and textures of what comes off the needles is both interesting and pleasing.

I'm not talking here about resolving serious mental health conditions by knitting and taking photos - mental health issues need trained nurses, doctors and other healthcare professionals to treat them properly.  But rather, it is about everyday mental wellbeing.  So much is spoken about a healthy lifestyle in terms of stopping smoking, eating well, keeping your heart healthy, or your joints in good condition - but keeping your mind healthy is not discussed or promoted as much.

The NHS Choices website has a good basic article about 5 steps to mental wellbeing, and The Mental Health Foundation has some popular, free wellbeing podcasts as well as a good article on 10 ways everybody can look after their mental health.  They don't mention the healing power of squidging lots of balls of wool, but they still have some pretty good advice and tips.

What about you?  Is knitting the key to your mental wellbeing?  Do you consider your mental health alongside your physical health?  How do you switch off and look after yourself?

Whatever the weather

Last weekend's early morning walk through Epping Forest: sunshine, blue skies, Cam and Olivia for company.

This weekend's early morning walk through Epping Forest: rain, grey skies, Graham for company.

 

Both very different, but both very good.

10 things

•        Olivia lost her Oyster card, which she needs to travel home from school by herself on the tube.  It is the third time she's lost it since the beginning of term.

•        I lost my patience.  "Just. Stop. Losing. Stuff!" I yelled.

•         How do you teach a child to be less scatty and forgetful?  I'm not sure you can.

•         When her replacement card came through I really just wanted to staple it onto her in some way so she won't ever lose it again.  What I actually did was make a long ribbon lanyard to attach it to her school bag instead.  While not completely Olivia-proof, I am hoping it will make it harder to lose again.  Her house keys are already attached to a long ribbon lanyard in her bag.  If she carries on losing things, then eventually everything that is important will be attached to her with ribbons.

•         We are friends again now.  She raided my button jar the other night and made this delicious bracelet.  Her mind is more often on aesthetic pleasures such as ballet, drawing, making and reading, rather than on practical things like Not. Losing. Stuff.

•         I bought a Nike running skirt, after months of the wanties.  I ran for the first time in it yesterday, and loved it.  I hate getting hot when I run, and the knee length running tights I was wearing before were far too hot.  The skirt looks cute, and I feel much faster and more free when I'm wearing it.

•         I made a white chocolate and orange loaf cake from a recipe I found on this blog by Ruby, one of the contestants in this year's Great British Bake Off.  It is utterly divine.

 

•      I am essay writing again.  Paper everywhere, and my head full of statistics and policies and care plans. I am distracting myself by thinking up cakes to bake.

•         When I am not reading NICE Clinical Guidelines, I am reading Bring Up The Bodies by Hilary Mantel, which is amazing but harrowing.  She gave a fascinating interview on Radio 4's Book Club this week.

•         I went to Sweatshop, they measured my feet, analysed my gait and I chose my free pair of running shoes.  They are bright blue.  I love them.

Surprises

There is so much about my running that is surprising; but still the biggest surprise for me is how much I love it.  

I've been running since May, so only five months, but it's now difficult to imagine my life without it.  I can now confidently and consistently run 5k in under 30 minutes and the longest runs I do now are about 7k.  Back in May the 60 seconds of running followed by 90 seconds of walking, which the Couch to 5k podcast begins with, were more than enough for me.  I guess a part of me is still surprised that I can run at all.

The nicest and most exciting surprise lately has been winning the September parkrunner of the month prize from my local parkrun in Hackney.  This means that I win a free pair of running shoes from Sweatshop - one of the sponsors of parkrun - which is incredible.  I have gotten so much from parkrun over the past five months that I feel like I should be the one giving a prize to them, not the other way round.  

Parkruns are free, timed, 5k runs that take place in parks all around the UK, and abroad, at 9am every Saturday.  They are entirely run by volunteers and welcome people of absolutely any age and running ability - the Hackney one which I go to each week has the fastest runners finishing in around 16 minutes, and the slowest between 35 and 40 minutes.  Everyone is welcomed over the finish line with applause and smiles from the volunteers and other runners.  Plenty of new runners run-walk the course, as Olivia and I did at first.  I try to run as fast as I can at parkrun now, because I love running fast, and I like the challenge of trying to get a new PB, but not everyone is a speed freak.

The exhilaration I get from running as fast as I can is another surprise to me.  I don't have any desire to run long distances like half marathons or marathons - I just want to be able to run a 5k as fast as I possibly can - eventually in 25 minutes I hope (at the moment my PB is 28:09, so 25 minutes is still quite some way off).  Mo Farah runs 5k in 12:53....

I am trying to do interval training once a week, where I alternate a few minutes of very fast running with a couple of minutes slow jogging.  It should make me faster, generally, and is also so much fun.  Thanks to the Couch to 5k Plus podcasts (designed for people who have finished the original Couch to 5k podcasts and who want to carry on improving) I have become much better at running to a beat.  I found that incredibly difficult at first, but it gets easier each time I do it.  I can now waste hours at a time compiling and fine-tuning interval training playlists that alternate songs of about 155bpm and 175bpm.  There are programmes you can download that will analyse the bpm on your entire iTunes library, but I just use a free metronome app on my phone and check the bpm of my favourite songs when they come up on shuffle.

I think what it all comes back to though, is not the music, or the speed, or even the friendships I've made at parkrun.  It's that I live so close to Epping Forest, which is a fantastic place to run.  Even though I enjoy it so much, running usually feels hard for me - yet what never fails to lift my spirits are the glorious expanses of skies and trees in this part of East London.