Adjusting

Like a ship maintaining course, we make small adjustments in our lives every day. Sometimes it’s as simple as changing the cereal we have for breakfast, changing our morning routines, or adding in a new diet or exercise plan. For me, this week, I have had a challenging adjustment to make… sleep.

Adjusting Course

Adjusting Course

I would classify myself as a night owl, or some kind of permanently exhausted pigeon. I do not do mornings particularly well, though I can rise early if required, And work now requires it. I now start work at 0530. Which means I am up at 0400. Now, I don’t care who you are, thats early! 5 Years ago I wouldn’t have said that was early, I would have told you I was going to bed a touch late. However, I am adjusting. The hardest part I am finding is not actually getting up early enough, its going to bed early enough. I am in such  habit of going to bed at 2200 to 2300 every night, that trying to go to bed at 2000 or 2100 is almost impossible.

The small adjustments we make to our daily lives are important. They keep us on track for our goals, they help us maintain sleep, they help us with our children, our work, our day to day living. Without small adjustments we wold crash into a reef, or into some other metaphorical trouble. Some people resit change, even small change like the adjustments we are talking about now. These people have become so rigid and immovable in their lives that they can’t seem to even budge on the smallest of changes. I am reminded of an old urban legend involving a US Naval Ship;

Americans: Please divert your course 15 degrees to the North to avoid a collision.
Canadians: Recommend you divert YOUR course 15 degrees to the South to avoid a collision.
Americans: This is the Captain of a US Navy ship. I say again, divert YOUR course.
Canadians: No. I say again, you divert YOUR course.
Americans: This is the aircraft carrier USS Lincoln, the second largest ship in the United States’ Atlantic fleet. We are accompanied by three destroyers, three cruisers and numerous support vessels. I demand that YOU change your course 15 degrees north, that’s one five degrees north, or countermeasures will be undertaken to ensure the safety of this ship.
Canadians: This is a lighthouse. Your call
Carrier vs Lighthouse

Carrier vs Lighthouse

We all laugh at the thought of a US Aircraft Carrier arguing with a lighthouse, but for some people it is their reality. We come across these immovable objects every day. And we find ourselves being the ones to make the small adjustments to avoid them. This can leave us feeling put out, feel like we are worthless, or even like is was our fault that we had to adjust. We need to remind ourselves that it is OK to make small adjustments in course, so that we do not become these immovable Aircraft Carriers.

Adjusting Course

Adjusting Course

I will continue to try and adjust to early mornings, I will continue to make small adjustments in my life to stay on track, like my diet to lose weight, my schedule to have more time with family, and my habits to try and facilitate a more balanced lifestyle. Maybe there is a small adjustment you have made in your life recently, or one you can see on the horizon? Share it in the comments below and show everyone you aren’t afraid to adjust your course.

Maintain the Rage

Luke Sondergeld

 

Weight Loss this Year: 4kgs

Outside the Box

When we think of Nursing, or for those outside the field, Nurses, we tend to think of Hospitals, Doctors Surgeries, and Aged Care Homes. But, as my recent furor with the job  market will attest, there are plenty of unknown opportunities. I was unaware that some Schools still employ Nurses, there is the Prison system which employs on site Nurses, the Meat Works employs Nurses as I will bear witness to, along with some Mine Sites, Cattle Stations, and of course the Military. My advice to you, as the potential Graduate Nurse, or Re-Deploying Nurse are the following three things; Look Wide, Ask Everyone, Talk to People.

Nursing Imagery

Nursing Imagery

Look Wide

As I have hinted towards already there is a large and varied workforce in which to select from when it comes to Nursing. Each one has its own pros and cons, and you as the Nurse will have to weight those up for yourself. For example, I would trade salary for time with family and availability to volunteer. So a Monday to Friday, Dayshift, or at least rotating roster were you can plan more than two weeks ahead, was worth more to me than an extra couple of dollars an hour. To this end, when you have decided what you want out of the job look everywhere, even places you wouldn’t expect. Look outside of Seek, Job Search, or the local Paper, jobs these days are also advertised on LinkedIn, Company Websites, or even FaceBook. Look in places that you would not have normally considered like Schools, Meat Works, the Military. Apply for EVERYTHING as you may not be successful your first few interviews, regardless of experience.

Dreaded Job Hunt

Dreaded Job Hunt

Ask Everyone

Don’t be afraid to ask around, ask those in the field, ask your friends, ask your acquaintances, or do what I did and ask FaceBook. Whatever your tactic for this particular portion is, be ruthless. Don’t be afraid to ask people you haven’t spoken to in a while, don’t be afraid to ask people if there is a job at their workplace, ask if they have heard anything, ask if they know someone who knows someone who might know about a job. The point being ASK EVERYONE!

Social Callout

Social Callout

Talk to People

While I was looking for a Registered Nurses Job one of the things I took it upon myself to do was to email EVERY SINGLE GP Clinic in my Hometown, Rockhampton. I must have sent out 30 emails to all of the Practice Managers with my Resume and a Written Reference. Some wrote back to me fairly quickly with a Dear John email stating they didn’t have any positions at the time. I had two interviews, and a call back for a third after I accepted my job at Teys. I also applied to the Three Hospitals Nursing Pool, and directly to several of the wards. None of these places were advertising for Nurses, none of them were asking for my application, and most of them at least wrote back to me in some form or another. As I mentioned in Ask Everyone, most of the Nursing jobs secured, especially in a small town such as mine, will be by who you know. With a little bit of what you know as well. The job I ended up with wasn’t advertised, was a suggestion by a mate of mine, and started with an unsolicited email to the HR manager of Teys. So Talk to People, it may land you the job you didn’t even know existed.

Never Know Who Will Have the Job

Never Know Who Will Have the Job

These are three quick and helpful hints to assist you with your Job Hunt, whether it’s for a Graduate Position, a Re-Deployment, First Enrolled Nurse Job, or Re-Entering the Workforce after a sabbatical. Don’t be afraid to pick up the phone, drop an email, post on Social Media, or do the classic walk around with your Resume. When it comes to Employment it may not come easy, you may have to work for it, but it will all be worth it once you are working in the best profession in the World.

Maintain the Rage

Luke Sondergeld

 

Weight Loss Since January 1: 5kg

Pain

As most of my regular readers are aware, I am no stranger to pain. I have suffered through 15 operations in 8 years, have suffered through the recovery for all of them, have numerous permanent conditions that cause all sorts of chronic pain, and all at the tender age of 32. This is not meant to illicit sympathy or cause a feel of shock. This is a cautionary tale that I hope someone who reads this will take heed.

Five of my surgeries were in direct relation to a genetic or since birth conditions. Most of them are Ear, Nose, and Throat related. I have had my Tonsils removed, my Adenoids removed, and my nose holes widened (technically its the Turbinates being widened). The other was a Hiatus Hernia repair. Thankfully these don’t cause constant pain, they are in fact, among the most successful surgeries I have had. The only negative to any of them is my Hiatus Hernia Repair has meant that I need to consume my foo slower, otherwise it gets stuck above the diaphragm which causes a fair amount of pain. Out of these procedures the removal of Tonsils was the most painful and uncomfortable. I cannot even begin to describe the level of pain even drinking water caused. So take note, when your small ones have had their removed and say its painful, THEY AREN’T LYING!

Carpal Tunnel Release

Carpal Tunnel Release

The next cautionary tale is about listening to your body, and acting on its warning signs. At the beginning of 2016 I had some pretty severe lower abdomen pain. I didn’t think much of it as it felt like I had eaten too much junk food, so I ignored it. this pain went on for several days, getting worse the whole time. Then, four days later, I could barely get out of bed because of the pain. My wife put her foot down and bundled me in the car to go to the hospital. I was quickly seen by the ED staff, and after much poking and prodding it was decided I had appendicitis. I was taken in to theatre to have it removed. Now an appendectomy is a 30-45 minute procedure. After my wife didn’t receive a call for four hours, she called the hospital, only to be told I was still in theatre. She finally received a phone call six hours after being taken into theatre to say I was out. Turns out my Colon had a severe case of Diverticulitis, and had ruptured. Filling my abdomen with, well, faeces. After much cleaning up, removing nearly 12 inches of my bowel, and creating a stoma, I was on the ward. This ordeal would last six months, with numerous returns to ED, two more surgeries, half a meter of scar tissue, and one hell of story, Thankfully there is no ongoing pain or issues following this ordeal. However at the time, especially with a long midline incision, there was much pain during the recovery. So listen to what your body is telling you.

Post Stoma Reversal

Post Stoma Reversal

No doubt my biggest issue is all things Orthopedics. I have had a Tibial Tuberosity Transfer (TTT) on both of my knees, a Bankart repair to my Right shoulder, Bicep Tendonesis to my Right Shoulder, excision of my Distal Clavical, and excision of my Sub Acromium. Most recently, 3 days ago to be exact, I had a Carpal Tunnel Release to my Right Hand. To be blunt, ORTHOPAEDIC SURGERIES HURT. Each surgery has meant weeks to months of pain and agony as I recover from the operation. It has also left me with Chronic pain to my Knees and Shoulder. It has meant I have to be careful with some activities and make sure I am using proper lifting techniques, not squatting, and not working above my head. So my warning regarding anything Orthopaedic is be sure that the remedy is not worse than the condition.

ED Trip Number 347

ED Trip Number 347

If someone can take something away from what I have been through, then it will have not been for naught. I know that this story seems like a a bit of a pity party, but that is not the intention. It is a cautionary tale to look after yourself, listen to what you body is telling you, and go into any decision regrading surgery with open eyes.

Maintain the Rage

Luke Sondergeld

Advocacy

Advocacy is one of the most important and under utilised components of a Nurses job. It sits at the very core of our being, the reason behind every action, and heart behind every conversation with a Doctor. Recently, whilst caring for a patient, I didn’t exercise my right to advocate for them, and as such they have continued to be mis-managed. For confidentiality reasons I will not disclose particulars of the patient, but will instead refer to them as Jeff. I have come up with a nemonic of ABCDE to remind me of the components of Advocacy for the future, and I hope they will help you too.

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Always

As some of you are aware I am both an Enrolled Nurse, and a student Registered Nurse. I am also on my last placement before graduating at the end of the year. I felt that because Jeff was a patient of mine, whilst under supervision, as a student I couldn’t or shouldn’t raise my concerns and subsequently Advocate for them. I was wrong. As Nurses we should always feel empowered to Advocate for our patients. It doesn’t matter if you are a LPN, EEN, AIN, GRN, RN, CN, or NUM you should feel comfortable to stop what is happening and Advocate for your patient. I have been beating myself up since the event, and cannot seem to console myself regarding my inaction. Jeff continues to be, in my opinion, mismanaged because I, and others, feel that we cannot raise our voices and say STOP, this isn’t in the best interest for the patient. STOP, we need a different course of action. STOP, we are not caring for and treating this patient, we are treating our own conveniences. I wish I had spoken up, but now I know what a difference it could have made, and how lousy it feels when I don’t, I will never step down from Advocacy again and I will encourage others to do the same.

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Back Up

When Advocating for a patient we should remember we aren’t just individual Nurses, we are part of a team, and we are stronger together. That wasn’t supposed to sound like a chant for a Union, but there you go. If we don’t feel strong enough to confront a Doctor directly, enlist help from other Nurses in the team, bring in the Supervisor, the Shift Coordinator, the Clinical Educator, the Clinical Facilitator, or even the Nurse Unit Manager. Together you can approach the Doctor and Advocate appropriately, it will look less like an idea from a solo Nurse and more like a considered idea, and it is good to know that you are justified in your Advocacy when you have the assistance of another. This won’t come across as “Ganging Up” if done correctly, and could be the component you need to successfully Advocate for your patient.

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Considerate

As Nurses we pull some pretty long and random hours, with things like Late-Early shift, overtime, Double Shifts, and a myriad of other whacky ways the roster seems to wind up. Our job is physically demanding by being on our feet all day, lifting and rolling patients, performing care, and everything else we do in a shift. Our job is also emotionally and mentally draining with supporting the patients and their families, dosage calculations, evaluating observations, constantly assessing a patient, and somewhere in all of that is Advocacy. Now, we all know what we do is demanding and exhausting, we justify the extra coffee, the second bar of chocolate, or ignoring the phone on breaks because of it. We flay ourselves over jobs missed, or errors in judgement, and we feel terrible when things are late. Now, our Doctors may not be there for the hands on cares, the lifting and rolling, the supporting the patient during mobility, but they are carrying the burden. The Doctors are trying to manage a massive patient load, the medications, the investigations, the outcomes, the families, and the demands we as Nurses put on them. The Doctors are under the pump all the time. They can’t ignore the phone, their breaks are constantly cut short, they are the ones that get to explain to the patient and their family about a poor prognosis. They have a huge burden to carry. When we advocate for our patients we need to be Considerate and keep in mind these burdens. Don’t Advocate by telling them they are wrong and should be doing it a different way, or calling into question their education. Come along side of the Doctors and show them what you are seeing and suggest the alternative course of action.

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Don’t forget the Patient

We shouldn’t forget that the reason we advocate is for the best outcome for the patient, as such we shouldn’t forget to include them in the decision making process. It may be entirely necessary, and entirely justified to discuss your concerns with the patient prior to stepping up in front of the Doctor. Some patients, despite the best intentions you may have won’t want to take differing actions to what the Doctor has ordered. This is why it is important to discuss your concerns with the patient, or if the patient is unable to then a discussion with the next of kin may be appropriate. This seems simple, but can be just as difficult, if not more difficult to achieve. Discussing with a patient that the care that has been prescribed isn’t the best, and a different action would be better, can be seen as conniving, sinister, arrogant, or just plain rude. A polite tongue and respective tone when discussing this matter will need to be adopted, and under no circumstances should the Nurse belittle or bad mouth the Doctor, or professional prescribing the care. We are all a team, we need the Doctors just as much as we need them, nobody wants to be seen as “That Nurse” and as such we shouldn’t behave that way.

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Evidence

Whilst we should advocate for our patients, always, we need to make sure we have the evidence required to back up our claims. This can be something as simple of observations, blood work, an x-ray, comment made by family or friends of the patient, or statements made by the patient themselves. We may also have written evidence from Journals, textbooks, Research Articles, or recently attended workshops or conferences. It may be something as simple as showing the doing guide from MIMS or the product information leaflet enclosed with the medication. We as Nurses need to be prepared when confronting Doctors in relation to our patients, it may not be enough for us to simply say “I am not happy, we need to do something differently”. Being educated, well read, up to date, best practice using badasses we are we need to show the Doctors that we know what we are talking about, and that we need to be listened to.

These five components; Always, Back Up, Considerate, Don’t forget the Patient, and Evidence or ADCDE, will help you remember what needs to be considered when Advocating for your patient. Don’t end up where I did with Jeff. Don’t be afraid to stand up and be heard. Don’t think that you are just a Nurse. You are the patient Advocate, exercise the right, but do it properly.

Maintain the Rage

Luke Sondergeld

12 Hour Shifts

I have started my placement in the Intensive Care Unit (ICU) of one of the hospitals in my region. Like most ICUs they run on 12 hour shifts, specifically for the one I am placed at 0700 till 1930 and 1900 till 0700. On the surface this seems great, over 3 weeks you work 10 days and are still counted and paid as Full Time, you have 11 days off over the same period, there is no such thing as a late-early, and the likelihood of being asked to stay back is greatly diminished. Though all of these things are true, and I will expand on some in a moment, there have been some interesting issues develop along the way.

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The Roster

I have to admit, the idea of 12 hours shifts, 11 days off in 21, and never having to work a God for sake Late-Early again, is awfully appetising. I adore the fact that the days you work, in which you seldom get anything done anyway, are just a little longer. I do enjoy the possibility that you are handing over to the person you received handover from. On the surface it seems like the dream, but there is a catch. So far I have been doing nothing but day shifts, which involves getting ups at 0530 to get ready and leave the hour by 0630 to be at work ready to go by 0700. The day then proceeds thill 1930 when I depart, walk to my car and drive home, arriving somewhere between 1945 and 2000. So far in this day I have not seen my children or wife awake, on arrival only my Eldest and Wife are still awake. No biggie, spend some time with them, wind down then off to bed, to get up at 0530 and do it all again. As you can see, there isn’t a lot of family time going on. There is  a lot of just surviving. Working, eating, sleeping, working. When I first arrived to ICU the Facilitator made a remark about working 12 hours shifts and how you shouldn’t expect to get anything else done on those days as you are just doing what you need to do to get to the next shift. I scoffed when she first said it. Now that I am living through it, she isn’t far from the truth. You wouldn’t be able to engage in any drawn out, meaningful activity. Normally I eat my dinner with my wife, we talk about our respective days, she returns to her school work, I read for a while, then sleeping for the next day. It took me by surprise. So though on the surface the roster seems really good, just keep in mind, you are almost useless for 10 days out of 21.

Plan Your Sleep

Plan Your Sleep

Self Care

The need for self care is incredibly important while undertaking 12 hour shifts. You need to make sure you are adequately fed, a mistake I made on the first day, just catering for lunch and that was it, didn’t make that mistake again. Staying adequately hydrated, which I know as Nurses we are notoriously bad at but we need to make an effort to do it. Getting enough sleep, and I mean good sleep not naps on the couch or two or three small naps, I mean a good solid 8 hours, which when you do the math leaves you with 4 hours for EVERYTHING that isn’t Work and Sleep. Supporting the home front, for those of us that aren’t single and have a partner and maybe children, you need to make sure that they feel adequately loved and supported. It is all too easy for us to say that we are tired, and worked a long day, and were on our feet all day, but your partner has also worked all day, cooked, cleaned, organised the finances, or performed ALL the other homely duties that aren’t getting done because of the 12 hour shifts. You should also engage in a ‘Me Activity’ on your days off. This could be hiking, swimming, boating, painting, or stacking rocks, whatever your chosen ‘Me Activity’ is make sure you take the time to engage in it, it is all too easy to just work to live and live to work.

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The Shift

Talking about working 12 hour shifts could not be done without actually talking about, the shift. I can only talk on the Day shift presently but as I engage in Nights I will be sure to add my thoughts. But, the shift, putting aside the obvious thing which is it is 4 hours longer then a normal shift, is divided rather nicely into roughly 3 hour blocks. Each shift you have a single 20 minute break and two 30 minute breaks. They are usually taken around 1000 for the 20 minute, 1300 and 1700 for the 30 minutes. This gives you Morning Tea, Lunch, and if you wish an Early dinner, I tend to simply enjoy a coffee and the extended break time for my 1700 break. This break pattern helps divide up the day and ensure you aren’t too intently involved on the floor for too long without stepping aside and breathing for a moment. It allows for a little bit of the aforementioned Self Care with regard to diet and hydration, it also allows for a brief period of contact with loved ones to make sure they are adequately supported, and gives you a moment to switch off from the intensity that is ICU.

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As you can see there is a lot to consider with regard to the 12 hour shift, and Nurses have made entire careers around it. I would love to hear some of the stories from those out there that do live the 12 hours shift day by day and what secrets they would like to share with regard to surviving the shift, self care, and days off.

Maintain the Rage

Luke Sondergeld

Being Me

I have written a lot about different portions of my journey, whether; weight loss, depression, parenting, nursing, or other facets of my life. In almost all of these posts I am either striving to reach a particular point, or I am trying to stretch myself. The commonality between them, however, is the continued dissatisfaction with who I am, where I am at, or even how I am perceived. Now, I am not saying that we shouldn’t push ourselves to grow, or to improve, stagnation is the enemy. However, I am reaching a point in my life whereby I need to accept me for me, and not always looking at myself in a negative light.

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Every day I endeavour to learn something new, or expand on something I thought I knew enough about. This extend from my family life, to nursing, to my hobbies, and everything in between. I enjoy being a perpetual learner. I enjoy putting into practice new ideas, and new thoughts. The toxic portion of this is the internal voice that says “You are not good enough”. When I apply this to my work, for example, I am constantly displeased with the level of knowledge that I have. I am always angry at myself for not knowing an answer, a treatment, a medication, or a diagnosis. Setting the bar as high as I have has made it unachievable. I will continue to learn over my career, which I hope is long and fruitful, but still have the idea that I am not good enough. I need to step back, acknowledge what I don’t know, and be thankful that I know what I know, be OK with Me being Me.

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In my family life I take every disobedience, back chat, scream, yell, disapproving look, and other child like behaviour as a personal attack on my parenting. I think that I should have guided them better, taught them how to vocalise better, how to express their emotions. I feel that when I snap and loose my cool, or begin the dreaded count, that I have lost, and I am letting down my children. I know I need to not judge the behaviour of my children as a reflection of myself, at least not entirely, and I need to acknowledge that they are spirited free willed individuals who will do as they want, regardless of direction and correction. I need to remember that I am doing pretty well as a Dad, my kids aren’t dead, my eldest isn’t into drugs or drinking, and they all have some leaning towards God, I need to remember that I’m doing OK, and therefore I can just let Me be Me.

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Outside of striving and self correction I still have a particular image I try to portray. This is the image I endeavour to project onto people as I meet them, work with them, chance encounter, or otherwise. This image of myself is confident, capable, knowledgable, funny, interesting, and a slew of other positive traits that I won’t bore you with. This image though is hard to maintain. There are days, and they feel more frequent these days, whereby the only thing I want to project is that I was able to put on pants this morning. Instead I have all of these rules in place to ensure that I continue to portray the aforementioned version of myself, like, no thongs, no stains, belts in belt loops, no tracksuits outside the house, some clothes are designated “home clothes” and therefore are never seen out of the home. These rules are great to ensure that I am presentable and well-groomed, but not necessary all the time. I need to be able to accept that I don’t need to force an image of myself, others need to accept me, just as I need to let Me be Me.

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So whats the end result of this. I am sitting here acknowledging that I need to give myself a break and not have such ridiculous standards for myself, but at the same time I need to maintain these standards as they make me what and who I am. There needs, I feel, to be a measure of both. I need to able to relax and let go once in a while, but still maintain the highest standard in the things that matter the most.

Maintain the Rage

Luke Sondergeld

Just Do It

I was recently interviewed by the Australian Teachers Magazine for one of their upcoming Student Guides. I was humbled and privileged to be a part of something that could potentially impact on the next generation. Part of the process was an interview in which a variety of questions were asked regarding my educational journey, my journey to becoming a nurse, and it culminated with the final question which was If you could give just one piece of advice to a student considering further study, what would you say to them, without hesitation I answered with Just do it!

This experience led me to reflect on the journey through Nursing to this point, the people along the way, the learning opportunities, the teaching opportunities, and the people impacted along the way. Before I even began studying my Diploma I had friends and family who were either currently studying the Bachelor or have been in the industry for a number of years offering advice on how I should go about my study, areas of Nursing to pursue, or even anecdotes of encounters with different patients. Even during this early stage I began to notice that nursing was more of a harmonious collective then a series of individuals. As I progressed further with my study this notion didn’t falter, of course there are the odd few that are the exception to the rule, but for the most part Nurses here in Australia are a fairly accomodating and encouraging bunch.
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During the Diploma itself, I was with some 40 odd other students who came from a variety of backgrounds, and had a diverse range of skills. We had everything from the School Leaver to the Re-skilling Mum to the 30 something Career shifter. All of these different people made for a unique learning experience. We were at the University for three days a week, every week during the semester. This gave us all a lot of time to spend with one another. Friendships were formed, clicks began to emerge, but on the whole we worked as a class to get through the learning, practice the skills, and become better nurses accordingly.

These ladies and gentlemen and I would hone our nursing skills by using each other as patients, this gave us the unique opportunity to see what the care we were providing was like from the patient’s perspective. We practiced everything from bed making to hoisting to basic observations to administering medications via a mixture of routes. Some students came forward as natural leaders and teachers and subsequently lended themselves to assist the class when they were having difficulty. I formed a close friendship with two of the ladies in the class, Sarah and Michelle; we studied together, learnt together, and unwound together. I am thoroughly thankful for every single person in the class, without them I would not have strived to be the nurse I am today, I would not have the skills or the knowledge I have now. Ladies and Gentlemen I thank you.

As I entered the workforce I found that the same camaraderie that I found during my study continued into the profession. The nurses I work with every day have no issue taking the time out of their busy day to help out, and conversely know that if they need assistance for whatever reason I will be all to willing to provide it. I am currently on one of my placements for the Bachelor, it is in a facility I have never worked in before, and the staff have been great. They have taken the time to show me around, answer all my silly questions that arise in a new facility, and help me to stop thinking like an Enrolled Nurse and start thinking like a Registered Nurse. What I didn’t expect was the opportunity I had to share my knowledge. I was on shift when one of the patients required their Negative Pressure Wound Therapy, or Vac dressing, changed. None of the RNs on shift that day had changed one before, or it had been so long that they had all but forgotten. Given I work in an area that sees frequent vac dressings, as well as having  spent a large amount of time with one personally, I was able provide the information required.

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So why share this story? Sure its a nice feel good, heart warming piece, but what’s the point? The point behind this post is to encourage those who are considering taking up a career in Nursing to jump in and Just Do It. For those who are thinking of taking up an apprenticeship or traineeship, Just Do It. For those who are wondering whether or not they should study at TAFE or University and are concerned they might be too old, Just Do It. For those who considered study but thought to yourself I am not smart enough or I am no good at school, put the doubt aside, and Just Do It. No simpler message could I possibly impart.

Maintain The Rage

Luke Sondergeld

Schools Out

This week saw the last exam for the semester, and the last contact day for University in 2018. Though I have enjoyed the learning and content covered this year, I am also looking forward to having some down time and enjoying time with the family, friends, hobbies, and other neglected facets of my life. The journey through 2018 has been an interesting one, with a new child, new mental health issues, and the challenges of continuing to juggle everything else.

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In March of this year, consequently the start of term, my wife gave birth to our third child, and second daughter. The normal strains that come with adding a new screaming bundle of joy into the house were of course prevalent and made work, study, and parenting interesting. I am supremely glad that my wife is the trooper and super Mum that she is. Without her ability to manage the house and children, normally at great personal sacrifice, I would not have been able to get thought the first semester of University, working 10 shifts a fortnight, and contributing were I could. Our daughter is  just over 6 months old and is an adorable happy ball of cuteness. Unfortunately, I cannot post any pictures of her as my wife and I agreed on no pictures of the children online. But take my word for it, she’s adorable.

As I have written about in many posts, my mental health took a sharp decline not long after my second daughter was born. I had thoughts of suicide, I was depressed, I was anxious, and I could barely function on any reasonable level. I sought professional help, I became medicated, and I began seeing a psychologist to talk through my emotions and diagnosis. Everything continued for a while, but alas did not improve. The decision was made between the psychiatrist and myself that ECT was the best way forward. So we began a course of 12 sessions, three times a week, until completed. I saw the course through and things had improved. Now, some weeks on, I have had struggles, but we get through it. Now, I am still medicated, still see the psychiatrist on a weekly to fortnightly basis, and see the psychologist when our schedules align.

Whilst the treatment happened, whilst my second daughter continued to grow and be awesome, I was studying. I managed to get through my first semester with reasonably good marks, one subject was a High Distinction, and I felt pretty chuffed. Unfortunately, one of the side effects of ECT is memory loss, and I have a rather large blank spot in my memory. It extends roughly from June through to the end of August. It is interesting to say the least, people will tell me stories of things that happened, that I was involved in, like rebuilding my mate’s back stairs, or cutting down and moving a ton of firewood. This had lead to the second semester being less fruitful when it has come to my grades, leading me to the expression Ps get Degrees. Its not pretty, its not how I like it, but its what I have to do to survive considering the circumstances.

27862164-school-s-out-for-summer-on-blackboardI will just be glad that over the University break, which runs from now till March 2019, I will be able to spend more time relaxing and doing the things I love doing. I am also glad that I will be able to have a recharge and hit the ground of 2019 running. I still have one more placement to go in just over a weeks time, stay tuned for the reflection, but otherwise, its work, family, and rest.

Maintain the Rage

Luke Sondergeld

Five Acute Care Reflections

Over the past Five Weeks I have completed my Acute Care Placement for my Diploma of Nursing, to catch up on the day by day click here. Over that time I learnt may very valuable lessons, what many different drains can be used for, the effect of different wound care products, the differing cocktails of anaesthetics, and how diverse the multidisciplinary team really is. But given that most of that can be learnt from a book or educator I will leave those particular lessons to them. Instead, I will focus on the lessons that are picked up along the way, shared by other nurses and learnt from the patients themselves.

Time Management

We all get taught at some point during Nursing School the importance of Time Management. I have always been a fairly organised person by nature, so thought I would be ok by the time I hit the floor. Oh how I underestimated how much needs to be done, and how many interruptions to your time there will be. I would suggest that, especially as a junior nurse, come up with a time table to break up your time that suits you. I found that by the end of my placement one hour blocks were too broad, I needed 30 minute blocks to sort my time. So I would draw up the patients I was assigned with hourly columns and a diagonal line. The Left triangle would be the first 30 mins of the hour, and the right the last 30 mins of the hour. You will also need some sort of key that works for you. I used for medications, IV for anything intravenous, Dx for dressing changes or checks, Obs for any observations, BGL for any blood sugar checks, and would create others as I required them. This creates a quick reference of your night, makes handover a cinch, and means that if you get pulled away by the NUM, you can ask someone to cover the things you now about.

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Self Care

I know I have written about Self Care in my Aged Care Reflection and I feel it even more important to talk about it again after my Acute Care placement and the impacts of family, life, and the dreaded Late to Early swing. The temptation, and Lord knows I pulled this stunt too often, to simply try and live a normal life when you are on PM shift, getting off at 2300, getting home, writing for an hour, bathing and getting to bed at 0130, then getting back up at 0600 to be with the family, then proceed to stay up all day living life before heading to work by 1530. It sounds ok, till four days of only five hours sleep begins to take its toll. Sleep is key. Please ensure that you get the requisite amount of sleep. You may get away with little sleep in the short term, but Nursing is a life long career not a flash in the pan job.

Eat well, eat regularly and keep up the water. I know in the first week of placement, I wasn’t the best at keeping my fluid, and was terrible at skipping meals before or after shift. So I had to actively change the habit. I ensured that I had access to a bottle of water somewhere on the floor, as you will rarely have the opportunity to leave and get a drink, and made myself eat before and after shift. this will ensure your body will be able to deal with the coming shift, and recover from it after the fact.

Take time to yourself. I wrote two weeks ago on my Post Fall on Sword about how I was terrible at taking a moment to have time off for myself, my family or my friends. TAKE TIME AWAY FROM WORK AND SPEND TIME WITH YOUR FAMILY. I was going to be more subtle but decided that it wasn’t necessary, and would get the point across as well. The people around you will be the only ones to help you after a rubbish shift, they will be the ones that are there when you loose a child on the ward, they are the ones who will be your sounding board when the NUM rosters you for 16 days in a row then calls you on your first Sunday off in a month. Spend quality time with them, switch off from distractions and try to leave work at the door.

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Take your Time

As previously mentioned, there are a myriad of things that can drain your time during the shift. However, an extra five minutes during an admission, asking a couple of probing questions when taking observations, or simply making small talk when checking up on your patient could give you key information that would otherwise be missed. During my placement, and subsequent time in Surgical, there was a patient who was in having a hip replacement. During the admission it was discovered that they had recently completed a long haul flight six day prior. Now those two things on their own are concerning enough, however, 24 hours after the procedure the patient had a seizure, their O2 saturation were below 80% on 15L of O2, and things were looking grim. It would  later be discovered that during their time overseas they had consumed some bad seafood, had a diarrhetic episode and subsequently took six Imodium to stop it. This subsequently kept the bug inside the body and it festered away, which eventually caused the Septic Shock that the patient had suffered. Now, the nurse who admitted the patient did ask probing questions about the trip, the travel  and all other matters of questions. What was missed was when the patient stated they felt unwell on their day of travel home, the only question asked was How do you feel now? Which is only an issue in hindsight, however, for me it will stick forever the importance of asking probing questions of anything that is out of the ordinary.

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Be Personable

I spent the first 5 years of my working life, like most young Australians, in Hospitality. For most of that I was heavily involved in Wedding planning, coordinating and serving. This generally meant that for six months of the year I would plan, run and serve for over 400 weddings. As you can imagine it gets a little mundane, as each wedding, no matter how unique, is formulaic; people arrive, couple gets married, a whole bunch of photos are taken, everyone eats, there are some speeches, some people cry, some people get drunk, the couple leave, everyone stays way longer, then just before the wedding day becomes a wedding weekend everyone leaves. So after doing this 400 times you could say you would get over it. However, my boss at the time had been doing it for over 15 years. So just a few weddings. He told me that despite the fact that it may be my 400th wedding, for the couple it was their first, and hopefully only, and that stuck with me. Now, as a young practitioner, I take that lesson with me. For me it may be my 5th day on the ward, my 100th day, or heaven forbid my 1,000,000th day on the ward but for the patient it may be their first, and even if it is not the first time on the ward it may be the first time for this condition, treatment or procedure. Be a real person, talk to them about their lives, laugh where appropriate and don’t treat them like a number or another body in a bed. It is a simple lesson to listen to, but proves to be difficult to put into place when under the pump.

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No Dumb Questions

No matter how many times I hear it, no matter how many times I have tried to impart this little gem it still seems to be something that is missed. I know during my placements, my lab days at Nursing School, my study sessions with my friends, or simply asking old Dr Google, I asked a ton of questions. Some of them seemed a bit simple or dumb at the time but I soon realised that either I wasn’t the only one thinking it or it wasn’t such a stupid question at the end of it all. I recall after ECT, during my Mental Health shifts, I noticed that the consumers right eye was almost alway more blood shot then the left. I knew it was the side that the treatment runs through and assumed it was a side effect of the treatment, but asked the question anyway. It was a seemingly dumb question but raised an interesting problem, no-one know why, and more interestingly, most people hadn’t even noticed it previously. So this seemingly dumb question now moves into the realm are curiosity for many. I am still yet to actually find a reasonable answer other than because of the electricity, but I live in hope. The lesson is, NO DUMB QUESTIONS, with the sole exception of Who’s ID is this…

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Well there you have it, my Five lessons that I couldn’t learn in a classroom or book for my Acute Care placement. This brings me to the end of my journey as a Diploma Student, in a number of short weeks my registration will come in and I will be an Enrolled Nurse. Come March I will begin a new journey as a Bachelor Student as I study to become a Registered Nurse. I thank you all for coming on this journey with me far and I hope to see you all as the journey continues.

Maintain the Rage

Luke Sondergeld

Legacy

Last week I discussed Mentorship in my article Walking With where the idea of providing what someone requires to achieve the goal they have set is a kind of Patronage. This week I want to discuss Legacy. If we consider Mentorship as answering the question of How, Legacy is answering the question Why?

Legacy is what and who we leave behind to carry on when we are gone, in both the physical and mortal sense. As a Scout Leader I am imparting my collected knowledge and wisdom onto the Scouts in the hope that they take it with them into their lives and make their worlds a little bit better. As a member of CQUniversity’s SRC I try and leave the University a little better than I found it through culture change, policy changes and initiatives that better the Student Experience for all. As a Father I endeavour to teach, show and guide my children through life in the hope they won’t make the same mistakes I did, that they go further, do more and achieve their goals, just as my parents did for me.

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The creation of Legacy is less about planning and more about being responsive to the environment you are in. As a parent, the needs of my children change constantly. I can’t plan what they need to make their lives better. I can plan strategically by ensuring that I remain employed, feed them, ensure they receive a good education, and stay safe. But I cannot plan their career, their partners, their lives and where they are going to live. As a SRC member I must be reactive to the needs of the students, I can also be proactive and identify issues before they become problems for the students and the University. The Peer Assisted Study Scheme that I helped develop and implement was birthed from an inherent need the students didn’t know they had. I saw a void in the support structure of the TAFE students and endevoured to fill that void. This, I hope, will leave a lasting legacy on the University and the student body. When a student graduates feeling supported and feels empowered to go further with their study, I can stand tall knowing the legacy I left contributed.

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This whole blog, not just this post, is about Legacy. I share my stories, my life, my journey and my reflections in the hope that others will read them and make positive changes. I know people who have contacted me directly and shared how different posts have pulled them out of a tight spot, or steered their lives into a new direction for the better. That’s why I write, to inspire, to reflect and make real impact on people’s lives.

I encourage everyone to think about their Legacy and what they are leaving behind. If we don’t think of Legacy we are destined to leave either nothing, or worse a negative Legacy that is actually a detriment to the next generation. As a challenge, take a moment this week to reflect on what you are leaving behind and make a concerted effort to change it. Start living life selflessly for the next generation, start the small turns of the ship now before we run aground, make the world of tomorrow better today.

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What did you reflect on? What are you going to change about your legacy? Make a declaration today in the comments section below, who knows maybe your change will help someone else change their Legacy.

Maintain The Rage

Luke Sondergeld

Speed Bump not a Road Block

I write this post as I stare down the barrel of yet another shoulder operation, number four on the same side, in a long list of nine other medical procedures, totalling 13, that left me staring into the stunningly bright theatre lights. I then begin to think about how easy it would have been to just give up; to think that this is my lot in life, to think that my life is meant to be full of pain and misery.  But thankfully I did not. My faith in God, my friends, my family, and my own perseverance has me sitting comfortably today knowing that this is just another Speed Bump in the Highway of Life, and not in fact a Road Block.

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You are not Alone

A useless adage to those who have been in similar situations, where you find yourself completely useless, helpless, and physically alone for large portions of the day. You seem to receive an abhorrent number of messages and phone calls letting you know that you are not alone, and that people are there for you. But for a fair majority of the time, you are. Everyone is at work, school, daycare, running errands and generally going about their day to day lives, while you may be laid up, on couch, with you leg locked dead straight and not being able to move to go to the bathroom without assistance, let alone make a meal or achieve any housework.  This was my life for nearly 18 months, in one form or another, as I was recovering from a Bilateral Tibial Tubercle Transfer, Dr Google will sort you out. In the early portions of my recovery I was almost completely couch bound, struggling to hobble to the bathroom when required. After a period of about 8 weeks I was granted 15 degrees of bend on my knee, which felt much more after such a period of being locked straight. And so my recovery continued. Once I was ‘fully recovered’ the Doctor then moved from Left knee to my Right, and started the whole process again.  During this time my wife was working full time, my son was at school, my friends were all at sea, and I was left in our West Australian home alone for approximately 10 hours a day. An eternity when cooped up with only a dog for company or conversation. I did however have a lot of time to realise something. Despite all of this seemingly empty time whereby, to the outside observer, I was left with nothing but my own thoughts I was, in fact, never truly alone. Thanks to it being the 21st Century and not 1348AD, I was able to call or FaceTime my parents in Queensland and update them on my recovery and have a chat, I could email my friends at sea and catch up on all the Royal Australian Navy news, I had the entire collection of human knowledge in the palm of my hands, and a personal library that would keep me going for years. So I came to realise, no matter how physically empty the house was, I was never really alone, not if I didn’t want to be.

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Reflect

I have mentioned, once or twice, about reflection and its importance on our mental health, this goes double when you are in the midst of an adverse situation. It is all too easy to be in the middle of a scenario and not be able to see the other side of it, or to see the lesson that could be learnt, or to see how this could one day be of use to you. I know I have, numerous times. Most recently I had the unfortunate pleasure of having my bowel rupture, and if you think that sounds uncomfortable and unpleasant let me assure you, it is. Perforated Diverticulitis for those who’s Google fingers are itching. I was admitted to surgery and spent a further six days in hospital, wound up with a colostomy bag, and a gnarly scar for my efforts. I thought to myself, at some un-godly hour in the morning, How can this be? What am I going to do? What if this is permanent? How am I going to live with these changes? and they were and still are all good questions, some of which were only answered 12 – 18 months later. I took the time I had to consider everything, the what, the how, the why, the when, and really consider how I can make the most of this awful situation. I decided that I would take this as a learning experience, something that I can take with me and add to my book of life and share later on. So I changed my attitude, I asked every question of the staff I could, I watched every procedure I was awake for, I asked about worse case scenarios and best case. I became the worlds best and worst patient all at the same time. As I went through the next six months I would go under the knife twice more and spend another five nights in hospital, and have close to eight ER visits. I ended up with 55cm of scar tissue on my abdomen, muscles that are still rebuilding 12 months later and a cool story to share with all of you. But it has also given me a really powerful insight into abdominal surgery, stomas, recovery and the real day to day, life changing effects that surgery like this can have on a person. And as a nurse, this is going to be amazingly helpful. Did I think that immediately at time, NO, but has it come in handy already? You know it has.

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All things come to an End

The saying usually goes All good things must come to an end but I have found it just as true of the opposite, so now I go with All things come to an End. Just as a broken arm will knit, the movie Titanic will roll credits and the visit to the In-Laws will soon be over, all things come to an end. Recently I was undergoing a Nerve Conduction test to determine the cause of some random arm pains. The test is, to say the least, unpleasant. It went for nearly 30 minutes and basically the technician sends varying strength electrical signals through the nerves in your arms and causes the muscles to involuntarily contract. It is both awkward and painful. But it eventually came to an end, my recent broken arm knitted, my knees healed, my abdomen has mostly healed, the visit to my in-laws ended (I love you guys, you know I do), the Titanic eventually sank and Leonardo Di Caprio let go and sank into the abyss. Everything comes to an end; hang in there, it will pass, you will become stronger for it, and hopefully have a story or two to share.

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These three lessons I learnt are great for transitional issues, injuries, seasons of life, heartbreak, pain, and suffering. Some things won’t pass, and thats ok too. Just remember even though this speed bump may be a long one, if there is no downward side, then its not a speed bump anymore, but a new road for you to travel down.

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Scouts – The Journey so far

I have been reflecting a lot on my Nursing Journey to this point and how it has been shaping me and my ideals both professionally and personally. Last weekend I completed the last of my formal training weekends for Scouts which triggered my mind to reflect on the Journey with Scouts thus far. The Journey has been short, but like a hurricane, it has seen much activity and many lessons learnt.

5th October 2016

It was my first night at Scouts as a newly volunteered Leader for Scouts Australia. My local group, Warripari, put out the call to parents for all who had the time and persuasion to volunteer as a leader to come forward… I was it. It started as a chance to assist the two other leaders, spend some extra time with my son who was, and still is, Scout aged, and to share some of my knowledge gained from past lives with the next generation. Little did I know how quickly the Journey would pick up pace.

15 October 2016

My first camp as a leader, I had the grand total of two weeks experience at Scouts and a standing history of Naval officer training; I could tie a series of Navy knots, some of which the Scouts used, but not as many as I liked; navigation was different to what I knew as there where suddenly hills and tracks to be concerned with and not a vast open ocean; the people under my charge where suddenly very young, very curious and not as willing to blindly follow orders as I had experienced… this was going to be a steeper learning curve then expected. I did however, persevere. The camp was a great success, I learnt very quickly that Scouts will have fun regardless of what they are doing and sometimes you have to let them push the boundaries a little in order for that to occur. Its not about completing the task the way it was designed, its about the journey and what was learnt along the way.

4 November 2016

Basic Scout Training for Leaders camp. After many hours slaving away in front of my laptop completing my eLearning modules, and preparing the myriad of attachments required for the course, I was finally ready to attend the camp. I didn’t quite know what to expect upon arrival, but I quickly learnt to be ready for almost everything. One of the first tasks we had to complete was the construction of a Queenslander Tent, which is pictured below.  Now, I had never erected one of these tents previously, I didn’t know what parts were the tent and which weren’t, I had never even seen one of these prior to the camp, this was my first hurdle. Thankfully the training staff where very accommodating and instructed myself and the other course members on how we should construct the tent. First evening of the weekend done, now we can sleep. The next day was filled with construction (now referred to as pioneering), cooking, paperwork, fires, paperwork, safety, paperwork, and discussions on how we can teach our Scouts without making it boring and tedious. Day two squared away. The final day was similar to the second with paperwork and discussions surrounding the Group, how to grow said Group, manage conflict resolution and the like. We dismantled our tent city, packed everything away and following a quick debrief we made our way home. Basic Leadership course, DONE.

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Term 1 2017

The leadership of the Scout Section shrinks from three to two as one of the Leaders moves onto the Venturer unit within the Group. Things get serious. Myself and the other leader have a robust plan of training, teachings and activities that will see the Section develop their skills and become better Scouts for it. For the most part, it worked. We had many a wet night during the term which saw a lot of our activities and plans be changed from awesome outdoor activities to small scale inside activities but we persevered. The Scouts continued to learn, some moved onto Venturers, others moved on completely, we gained some Cubs coming into the Scout section as they became old enough and the section continued. I was learning more and more as a new Scout leader and completing more of the eLearning towards both my Outdoor Skills and Advanced Course. The term went well, no major activities or camps, just lots of lessons to be learnt, for both the Scouts and myself.

Term 2 2017

Its only me… The other leader has taken a Regional position… Three to One… how did this happen…? I was confident in my ability to lead by this point but I am not going to lie, there were times when I look out at the Scouts and think, nobody do anything silly, nobody get themselves hurt, please pay attention and just do what your told. I should have had as much confidence in the Scouts as I did in my self, but I didn’t. Thankfully, they surprised me. The Scouts are resilient, patient, awesome and attentive, sure they’re still kids and have their moments of silliness and inattentiveness but on the whole, awesome. I would complete the Basic Outdoor Skills course on the 28th of May, which highlighted two things, navigation on land is not too different to navigation at sea, and I hate hills. I would also complete my Advanced training, which begins my four months of probation before receiving my Wood Badge and becoming a fully qualified Scout Leader. The Scouts would see two camps and more lessons on their Journey to Pioneer and Adventurer level cords.

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The Journey to this point has been amazing, I have learnt more about myself then I thought I would. I have learnt how resilient the Scouts can be, how much they can learn and grow, how much they really look up to us as Adults (even if we don’t think they do) and how much the Scouts can achieve when they put their minds to it. I originally came into this with the thought of imparting my experiences onto the Scouts, building the leaders of tomorrow and shaping our world. Little did I realise that’s what would happen to me.