Surviving COVID-19

I was initially avoiding writing a ‘How I am surviving COVID-19’ post, but thought about it, and had inspiration from my Alma Mater, CQUniversity. So I have compiled a short post about my experiences with COVID-19 and how I am surviving what has developed into a very interesting 2020 and Year of the Nurse.

My experience staying connected with family and friends

Thankfully for me, I have a fairly tech savvy family. We all own Apple products, so FaceTime gets a fair workout, and we were pretty good at staying in contact anyway. I call my parents every couple of days to check in out of habit, and I FaceTime the girls when they are actually sitting still for longer than 30 seconds.

I play Dungeons and Dragons with my friends once a week, on Saturday Nights. We chat during the week on Facebook Messenger and Discord, and generally share our days, what’s going in life, the struggles with our kids, the difficulties of being ‘essential’, and the day to day mundane facts of life.

The difficult people to stay in contact with are my extended family. My grandparents aren’t tech savvy at all. My Grandfather here locally has trouble working a microwave let alone a mobile phone, and I can’t visit him as we have to limit the number of people who drop in. I tend to share things through my Father to him, he shows him photos and tells stories about the girls. That’s what makes this COVID-19 stuff hard, the time that my Grandfather is missing with his Great-Grandchildren.

I am taking time for myself by

I am shamelessly watching Netflix, a lot of Netflix. While my girls are watching ABC Kids, I have my phone out and headphones in watching the shows I want to watch. So far I have binged my way through the entirety of Brooklyn 99, Rick and Morty, Altered Carbon and I am about to continue on my adventures with Gotham. For me, escaping into a TV show and not thinking for a while is very relaxing.

As mentioned earlier, I play Dungeons and Dragons over Discord with my friends. I actually run the Game, as Dungeon Master. I write the story, create the characters that players interact with, I describe the world they are in, and guide them through their adventure. I love it. I love creating the world, the non-player characters, and I love watching (or in this case listening) to my friends realise the error of their ways as the story unfolds.

Something I have found comfort in this time is

I have found comfort in the little things. COVID-19 has been an interesting time to realise what really matters, how much busy-ness we all have in our lives, and for a chance to simplify. For some, slowing down to work, home, and family is a drag. I am trying to make the most of it. I am spending more time with my girls, taking more time for me, trying to make sure I self care a little better, and most of all stay connected to those who matter.

It comforts me to know that we, as a community, have banded together, done the right thing, and are beating this thing. We aren’t getting pig headed and selfish in our quest to go back to normal at whatever the cost. We as a Country have supported those in need, given a hand to those who can’t do it on their own, and strived to be better for it. The real comfort is being part of that, it’s being Australian.

Something I’m not doing (and that’s okay) is

I am not, however, taking it easy…. completely. My role as the only Nurse at a Meat Works has meant some very long days. Some days are 12-14 hours, then we are working 6 days a week, public holidays included. This time at work has meant that I don’t always have the amount of time at home, and the one day off I do have, I try and cram everything in. Which then leads me to be tired and worn out for the week.

So in short, I am not balancing work and life as well as I should be.

Something I want to say to people who may be having similar experiences is

It’s ok to be a little out of sorts. It’s ok to snack a little heavier than normal. It’s ok to feel a little disconnected. It’s ok to be a little scared of what is going on. It’s ok to feel a little blue, and a little worn out.

We are going through a Global Pandemic. Tens of thousands of people are dead, millions are sick. The Country is in lockdown. We have spent more on Social Support now than we have since the War. For the first time since WW2 we are told to stay at home unless absolutely necessary. Our shopping centre shelves are bare. People are out of work. There is less to go around. People are struggling.

It is OK to not feel OK.

We have to remember that this is only temporary. Before long, we will be back to swimming at the beach, catching up with friends for a coffee, eating a Parmy at the Pub, and getting back to the way things were. But we have to acknowledge that not everything will be the same, there will be a ‘new normal’ on the other side of this. And we need to be ready for it.

Maintain the Rage

Luke Sondergeld

All Behind Me

I write this post after disposing of every last one of my Mental Health Medications. I no longer have a secret stockpile just in case, I no longer live in fear of having a relapse, I no longer have the same internal struggle whether I wished to live or die. I firmly believe that this is All Behind Me.

I was sorting through our medication box that was tucked up in our hallway cupboard, looking for something to settle my wife’s stomach. Unfortunately I didn’t find anything that could help my wife, but I did find all of my old medications that I used to take for Depression and Anxiety; Lithium, Olanzapine, Sertraline, Temazepam, and Quetiapine. Boxes of them. Hundreds of tablets designed to keep me safe from myself. I looked at them all. I looked at the cost, the number, the side effects, the regime that I was under. I looked at myself. I looked at where I am now, where I have come from. I looked at the bin. I decided that I would no longer keep the medications as some kind of safety net, a fall mat for just in case. I would dispose of them all and finally say good bye to that part of my life.

Since I gave up the medications at the end of last year I have been feeling elated. I am still struggling with my anger, though I am improving day by day. I am more positive than I have been in years. I laugh, I cry, I joke, and I interact. I don’t shy away from social situations, I feel like I have my mojo back. Like I can take on the world, and Win. My job is great, it challenges me, pushes me, but most of all validates me, respects me for me, understands my background, my knowledge, my experience, and uses it. We as a family have been battling with Illness for the better part of 2-3 months, sinuses, snot, and coughing, but we are better together. We play more, interact more, laugh more, enjoy each others company. We live together more.

I write this post knowing that not everyone is having the best time. I know that I have friends and family struggling with their own Mental Health issues, physical health issues, family issues, work issues. I write this knowing that I may not be able to physically do anything about it, but at least I am now physically here to be leant on, to be a shoulder to cry on, to be a sounding board, to listen, and to share with. And sometimes that all you need. To know that there is someone in your life that no matter what, is there for you. Not to provide answers, or pearls of wisdom, but to listen. To allow you to say your piece, cry your eyes out, open your heart and reveal everything. Right before gathering it all back together again, composing oneself, and rejoining the fight. A little bit less burdened knowing that someone has your back.

That’s the feeling I have. I know that I have a great circle of friends, and an unshakable family that have my back. That listen to me whinge, bicker, yell, scream, cry, and in every other way emote. That don’t necessarily have the answers, but are there to just listen. And it helps. It helps a lot.

But I move forward. Every day I move forward and leave the past couple of years behind me. Like a bad memory, and in some cases no memory at all. I leave the drugs behind, the ECT, the weekly Psychologist appointments, and the constant meetings with my Psychiatrist. I leave it all behind, and hope and pray that I never end up there again.

Maintain the Rage

Luke Sondergeld

 

Weight Loss since Jan 2020: 8.5kg

Dungeons and Dragons

As you are all well aware by now, I am a massive GEEK. I enjoy table top board games, playing with plastic men, and have waaaayyyy too many movies and TV shows that start with Star. But most of my love for all things geekery began when I was 10, and I was introduced to the wonderful world of Dungeons and Dragons (D&D).

Dungeons and Dragons

Dungeons and Dragons

Some good friends of mine, and their older more experienced brother, introduced me to D&D one summer afternoon. I had no idea what was involved, what I had to do, or even why I needed so many dice; having not played a game with dice outside of Yahtzee. But never the less, we persevered. I rolled my Level 1 Human Fighter, like most young boys starting out. I chose my weapons based on nothing but how big they where, and how likely I was to chop someone’s head off. We engaged in the scenario, explored the world we had been thrown into. I nearly drowned after I attempted to swim in Chainmail armour. But we learnt. We came across our adversaries, a Goblin Raiding Party, I summarily chopped them into pieces and the day was won. I was hooked. This one campaign on a hot Summers afternoon would spur a 20+ year love affair with Roleplaying Games.

Dungeons and Dragons

Dungeons and Dragons Parties

As the years would go by I would play as part of several groups, some more successful than others. Some I would only reach levels 3-5 where as others I would become an Epic Level character and top out in the mid 60s. No matter what I played, I loved it. It was a way to explore a strange new world, interact with its inhabitants, and throw just a little bit of me into every character. I loved to play. Then someone showed me how to run a game. How to design a world of my own. How to shape the very fabric of space and time and wield it as my own play thing. I was gob smacked. I didn’t realise how much excitement and enjoyment I would get out of creating a whole new world and sharing it with people. I would run a couple, quite unsuccessfully might I add, campaigns in my early days. But it was all in the spirit of learning. I have since created and run many different campaigns, different worlds, in different time periods, using may different rule sets. But I always come back to D&D.

Dungeons and Dragons

Dungeons and Dragons

When I first started playing D&D it was in its 3rd Edition, I would continue to play 3rd Edition until 2020. I also played Pathfinder, Golden, Fantasy Age, Star Wars Roleplaying, and finally D&D 5th Edition. I can see some of you wondering why it jumped from 3rd to 5th edition of D&D? It’s simple. 3rd Edition was amazing, so amazing that people wanted it to constantly expand and improve. So much so that eventually Wizards of the Coast (WotC) who own D&D decided to re-release 3rd Edition as 3.5 Edition. I was not amused. I was staunch in the fact that 3rd Edition was completely fine as it was. So much so that I refused to play 3.5 Edition. Then they released 4th which was such a complete flop that it was almost immediately withdrawn and noted that a better 5th Edition would be on its way. I had the opportunity to play test for 5th Edition in the early days, and I was intrigued by the play style, the nod towards 3rd Edition, but still being its own thing. When I decided to run a game for my Friends I decided it was time to leave behind my beloved 3rd Edition and get with the times, so I began generating a 5th Edition campaign.

Dungeons and Dragons

Dungeons and Dragons

So I began writing in earnest. I started with a basic idea of the Big Bad Evil Guy (BBEG) how he was going to interact with the world, how this was going to change the landscape, and what the party was going to have to do to stop him. I then started to come up with some low level encounters for the party to get started, and before you knew it the World of Eseron was born. I spent nearly two days perfecting the map alone. I love world building, I love creating people for the party to engage with. I love coming up with social structures, social standings, geography, city names, weather events, BBEG, and everything else associated with creating a new world.

I may have even got so wrapped up in my creating, I forgot to post last week. So don’t be alarmed, I hadn’t forgot about you all, I was just a little bit preoccupied. I will share, periodically, how the party is traveling and how the world of Eseron progresses. Do you play D&D? Perhaps another Roleplaying Game? What are your fond memories of the Game? Share them in the comments below.

Maintain the Rage

Luke Sondergeld

 

Weight Loss Since Jan 2020: 6.5kg

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

Check In

So after a month of being off my medication, looking for a new Job since graduation, and hitting 2020 like an out of shape boxer, I thought it prudent to perform a little check in. This serves both to satisfy my own sanity and to let my readers know I’m not completely falling apart. I will use the DASS score to assess where I am at mentally, along with a set reflection as the DASS has its own limitations. I will also share about some of my struggles since coming off my medication and the strategies I have put in place.

So the measurable things first. DASS. I used the Das 42 to ascertain my levels of Anxiety, Depression, and Stress. Typically I score reasonably high on Anxiety and Depression, and despite not feeling stressed, I usually score some ridiculous number.

DASS Scores

DASS Scores

As you can see, my score being the darker colour and the normal being the lighter colour, the DASS has me sitting pretty well. Being on the higher end of normal for Stress is seriously the best score I have EVER had, I scored nearly 40 in one of the last ones I took. This test thinks I am doing pretty well, and I would have to agree. I haven’t felt true anxiety for quite a while due to medications, and I was worried that they would make a resurgence but even with the added anxiety and uncertainty around Job interviews and applications I have felt pretty good. My depression is mainly due to adjusting to life without medications again. What the DASS doesn’t show is the opposite emotions. I have felt more periods of absolute elation, hysteria (in a good way), happiness, and fancy free than I have in years. I have been openly laughing at movies, TV, people’s jokes, entertaining scenarios, and things that I would normally find amusing. I have also been experiencing the opposite too. I found myself in one afternoon laughing myself silly to Lilo and Stitch, and then nearly balling my eyes out at the end of a Bluey episode. These swings are becoming easier to manage, but I also welcome my full gambit of emotions back into the fold.

Emotions

Emotions

It hasn’t been all smooth sailing and laughter however. I have found myself more irritable than I have been in years. This has meant that, at times, loved ones around me have copped the brunt of it. I have had several… heated discussions… with my wife in the past month over my behaviour and mood, and rightly so. I know I am on a journey with my emotions and there are going to be speed bumps, but that does not give me licence to be a jack hole. Sleep has been a little hit a miss, I have returned to taking anywhere from 45 minutes to several hours to get to sleep, however once I am asleep I tend to stay there for a reasonable amount of time. I have tried putting strategies in place when sleep eludes me like reading a book, praying, leaving the room the get a drink, or something else that just changes the situation enough to give it a go again. So far it is working. Getting up in the morning is still a bit of a struggle, but I have never been a morning person, and whilst I was on the medication it was almost impossible to wake me up and get me moving unless the drugs had worn off enough. These things have been improving over the past weeks but will take more time, so stay posted.

Dreaded Job Hunt

Dreaded Job Hunt

Otherwise, things are travelling pretty well. I am a little disillusioned with the Job hunt thus far, but I remain confident the right job, at the right workplace is out there and I just have to find it or have it thrust upon me really. I am looking in places I would not have considered in the past, either because I thought that schools didn’t have nurses anymore or some workplaces didn’t employ them, I have also tried GP clinics which is something I wouldn’t have considered previously. It is interesting to see how many different facets of Nursing there really is, and I thought I knew most of them already. It is also refreshing, as someone who is constantly trying to improve the community between Nurses both within Rockhampton and outside of, it is good to know these opportunities exist, as it may be the perfect fit for someone else in the future. Again, I will keep everyone posted on the Job front.

Checking In

Checking In

Otherwise, everything continues to tick over. My wife goes back to work today, my Son in a week, the Girls have been back at daycare for a week which has given Wife and I plenty of time to get things done around the house, not necessarily achieved them, but time to do so. I truly look forward to what 2020 has to offer, and the brighter outlook I have off my medication.

Maintain the Rage

Luke Sondergeld

Die to Self

For several nights now, actually more like just over a week, I have been having wonderfully vivid dreams. These dreams tend to stick with me when I wake up, and I remember great detail about them. These dreams I share with my wife. She notices that the ‘Evil Villain’ in all of my dreams bears a remarkable likeness to characteristics and traits of myself. Furthermore, she states, that in these dreams whereby I am “Defeating Myself” perhaps I am actually trying to formulate or perpetuate the idea that I should be removing these sometimes negative traits and bettering myself. To Die to Self, in a manner of speaking.

Not Me Sleeping

Not Me Sleeping

A few days ago I was vainly attempting to get to sleep. I had been tossing and turning for nearly 2 hours and I was done. I was becoming frustrated, agitated, and I was getting nowhere and fast. I knew that if I didn’t do something soon, the night’s sleep was a write off. So I stopped. I calmed down. And I prayed. I asked God for peace, quiet, and to finally rest and go to sleep. Well, eventually it worked. I would get to sleep. But not before I was smashed in the face over and over again the verse Romans 8:28

And we know [with great confidence] that God [who is deeply concerned about us] causes all things to work together [as a plan] for good for those who love God, to those who are called according to His plan and purpose.

I read the passage several times to ensure the meaning wasn’t lost, then I turn over and got some much needed sleep. In the morning I shared my experience with my Wife. She reminded me that the verse was the theme from Church, for almost the entire year. I guess I needed to hear it now, and not in 2019. We both found it interesting, however, that this scripture had come up at the same times as the dreams I had been having. For anyone who has been a Christian for a while will attest, when a work is going to begin in your life there are signs along the way… these where those.

Purpose

Purpose

This Sunday just gone our Senior Pastors Son preached. He preached on the need to be focussed on goals and purpose for 2020, as so many people fail to meet theirs every year. But, he also shared on one verse, and one verse only, which made me consider things differently, it comes from 1 Corinthians 10:31

So then, whether you eat or drink or whatever you do, do all to the glory of [our great] God.

It isn’t just about what we do, but who we do it for. In a lot of ways, I could stand to Die to Self. I am naturally pragmatic, my wife would say Destructively Negative, but semantics. I can be forthright, which stems from my natural standpoint of wanting it done right and timely in the first place, which people have called Overbearing. I possess strong leadership qualities, some would say Bossy even when I don’t have the “authority” to be so. I am deeply passionate regarding certain things, my Son would say quick to anger. In these regards I could stand to Die to Self a little and shed some of the potency of these traits. I could “Be less of Me” as I have been told once. But in this regard I would find it difficult to simply change and become someone who is, in my book, the Diet Coke version of Me.

Die to Self

Die to Self

However, if I was to Die to Self for merely my own sake, or even for the comfort of those around me, then my journey is going to fall short even before it begins. But, if I am to die to self because it is the right thing to do by God, and in turn become a better person for those around me, then the journey is already half over, the battles are won, and I can move forward. This does not mean to say that I am from this day forth going to be better, but what it does mean is that I have a path ahead of me, and the best wing man anyone can ask for. So what does all this mean exactly, well as folks in 2020 like lists and goals here it is;

  1. See the light in others, if all I see is the dark then I can’t be very bright myself
  2. Give others a go, others can’t grow or even be given the chance to shine while I keep taking the opportunities away from them
  3. Soften the words I use, the old adage of catching more flies with honey than vinegar springs to mind, also people don’t like being beaten with proverbial bricks
  4. Swear less, this is simple, I don’t want my kids using the language and lets face it, its unbecoming anyway
  5. Fill my cup with something better, I can fill my cup with coffee, the news, the world, but what I need to do is fill it with the Word and let that pour out onto others

It’s a start, and that’s where all journeys begin. It’s not a resolution, but more of a personal Revolution. A chance to change for the better and perhaps move into what God has planned for my life.

Maintain the Rage

Luke Sondergeld

Better or Worse

I trust that everyone reading this blog had a restful Christmas and New Year. I know I enjoyed the time with family and friends as I ramp up into 2020. Thank you to everyone for their patience during the break time here at Maintain the Rage.

During my time off I had a lot of time to reflect on where I was, how I was feeling, life in general, and what I wanted out of 2020. One of the thing that I knew I wanted to change was weight, the other was to regain control over my emotions and the ongoing effects of my medication. I noted that my medication could be contributing to both my weight and the numbness I was experiencing. Most of the medication that I was on, namely Seroquel, Lithium, and Venlafaxine all act to reduce the swings in mood and control depressive episodes, but also have the nasty side effect of weight gain. These two factors led to the choice, without consultation with my medical team, to cease my medications. For better or Worse.

No More Meds

No More Meds

The first step was to research the right ways to cease my medications. Most could be stopped reasonably easily without too many issues. the Seroquel and Lithium however would have potential side effects if ceased. These side effects would be small for a long period if weaned down slowly, or a week of pain if ceased suddenly. For better or worse, I chose the week of pain. I ceased all of medications knowing I would experience mood swings, insomnia, dizziness, nausea, headaches, and a list of other potentials. Most of these side effects would be reasonably minor and manageable. Insomnia was hell for the first two nights, no sleep there, a couple of nights with help from Phenergan, and my sleep returned, if not a little broken. Headaches were managed with hydration and aspirin as needed. The nausea wasn’t too bad. Mood swings were managed as I was on my own most of the time anyway, as my family were visiting family in Western Australia, and I was taking the opportunity to rest up before a big camp that was coming up. The worst and most annoying side effect was definitely the dizziness. The only way to describe it was like being tipsy all the time. I felt that every day started with 6 or seven beers and never let up. Since then the side effects have subsided and I feel that I am now completely off my medications, so now the only thing left is deal with my emotions.

Rollercoaster of Emotion

Rollercoaster of Emotion

Since the drugs are no longer in my system I have been feeling the full gambit of my emotions, in their full, unbridled fashion. This has been great, in some respects, as I don’t feel numb or disconnected from myself or those around me. The down side is I have been swinging from hysterical laughter, to crying, to blood boiling rage. I have not been managing these very well and it has led to arguments with friends, family members, my children, my wife, and myself. It has meant that something I would normally have dealt with appropriately and civilly was instead dealt with; sarcasm, a sharp tongue, or harsh words. Those around me know of the part of the journey I am on and are, thankfully, patient but this won’t be the case forever. I know I will regain control, even if it is a little slower than I would like, however I believe this choice needed to be made, for better or worse.

For Better or Worse

For Better or Worse

I will continue to share my journey through mental health, and all of the lumps and bumps along the way. I will continue to monitor myself, and have safeguards in place to ensure I don’t wind up where I was last year. I am taking a hiatus from my psychiatrist and psychologist while I work out what I want from myself and work through the rollercoaster of emotions. For better or worse.

Maintain the Rage

Luke Sondergeld

 

Teenage Years

I was a little stumped on what to share this week as my week has been pretty benign. I thought I would ask the youngest person I know who reads my blogs to give me inspiration, my son. He asked that I write about Relationship Advice, or the trials and tribulations of my teenage years. I have decided that Teenage Years it is. My Teenage years were a rollercoaster ride of emotions, experiences, and interactions. The years can be divided up into School, Friends, Everything Else. This will give the clearest picture of what my teenage years were like.

Calwell High School

Calwell High School

School

School for my teenage years was, like every child in Canberra, into two location, Calwell High School for grades 7 to 10 and Lake Tuggeranong College for grades 11 and 12. Calwell High was a public school in a mid to low socioeconomic area. There was no uniform, only a colour code that was barely adhered to. The teachers tried their best but were worn down by years of attitude and filth. Most of the schools funding a resources were spent replacing or fixing equipment and facilities that had been destroyed by students. Fights were frequent, and often involved weapons of both the ad hoc and very deliberate type. There were issues with violence, drugs, alcohol, cigarettes, and general poor behaviour. Police visits, both called and random, were commonplace. There would be a fence erected around the school, not to keep people out, but students in. Often relief teachers would be asked to come in and baby sit 2 to 3 classes at a time, which is somewhere near 100 children.

With the scene set this is the High School I attended. Before I go any further I don’t regret going to the school, I don’t resent my parents for sending me there, and I don’t blame anything on anyone outside of the situations described henceforth. My earliest memory of the school was outside the art class room, a class which to this day I have never excelled at. I was standing out the from with my backpack over both shoulders, shirt tucked into my jeans, and sneakers on. It was the 90s leave me alone. I was approached by one of my classmate who said if I didn’t want to get picked on I should untuck my shirt and only carry my bag on one shoulder. I thanked her for the advice, acted upon it, and continued to wait outside. No more that 5 minutes later it would prove that no matter what I did I was going to get picked on. I was not the statuesque man mountain I am now, at the time I was the better part of 5′ 2″ tall and rotund to say the least. This drew the attention of the Jocks, my mildly ethic looks and distinct lack of ethnicity caught the attention of the Lebanese and Greek crowd, and the catty girls followed the jocks so you can guess where that went.

Through my 4 years that I spent at Calwell I was seen as the short, fat, nerdy kid. I was picked on, harassed, bullied both verbally and physically every day of my schooling life. This did grate on me, I did spend days, weeks, and months dreading the very thought of going to school. I did though continue to attend most day short of a physical ailment. And though it was emotionally and physically tough to do so, it did build resilience and toughened my exterior. I learnt how to read people better. I learnt how to take a punch. How to stand up to people at the right moment. I learnt how to survive in a less then pleasant environment. All of this while still trying to study and do well enough to pass and succeed.

Lake Tuggeranong College

Lake Tuggeranong College

My graduation from Calwell High School was an absolute blessing. It meant the end of torture, beating, bullying, and the start of something new. The reason why this was such a God send was years 11 and 12 were not compulsory for Canberra students, and most of the bullies dropped out, and the ones who stayed behind realised that between graduating December one year and coming back to school the next I had grown nearly a foot to a shade over 6 feet. So bullies were no longer an issue. Classes were interesting and engaging. Free lines were amazing. And life just got better. Not to mention the light was at the end of the tunnel. GRADUATION!!

Despite the release that was Graduation, what it really marked was the end of childhood and the beginning of adulthood. It meant responsibility, bills, cars, loans, bills, rent, mortgages, bills, and more responsibilities. And though I took these in my stride, securing a full time job straight out of college, securing my own home by the age of 19, and joining the military at 22. It certainly didn’t mean the transition from school to the real world was without issue. Poor financial choices, poor friend choices, and poor life choices in general meant I hurt my family for my own selfish need or gain, and that is never right. Yet another lesson learnt really.

Friends.jpg

Friends

Friendships are forged out of need, circumstance, opportunity, action, or some mixture of all. My high school friends were a mixture of all of the aforementioned. During year 7 the three ladies above where running a performing arts lunch project in which young teenagers explore their emotions, behaviours, and reactions to different scenarios that were plaguing young people. I participated because i was both interested and it provided a lunchtime safe haven. However, the friendship wouldn’t truly kick in till Tegan, the one in the hat, found me one day crying in the playground. You see I had a rather savage falling out with people who I though were my friends, were in actual fact they were just using me and teasing me about it behind my  back. Tegan invited me to come and hang with her circle of friends, some of whom I knew, like Kate and Sophia (left to right in the photo). This friendship, though I never would have guessed it at the time, has survived trials and tribulations of high school, college, real life, mortgages, relationships, breakups, arguments, and every thing else you can imagine. Though I don’t talk to them as much as I used to, or should for that matter, these three are some of my closest friends. And I truly miss them all.

Everything Else

Teenage years are a mixture of hormones, bad choices, bad skin, bad people, bad circumstances, and bad more bad choices. I am a firm believer in everything happens for a reason, and I wouldn’t change a single part of my teenage years. Not the beating, not the dodgy school, not the dodgy girlfriends, the bad choices, the bad focusses in life, nor the body choice of first house to move to into. Every single choice and experience has made me the person I am today, and you should equally treasure your life choices for the same reason. I have totalled cars, blow up engines (yes plural), hurt people, hurt myself, pushed the wrong people away, held onto the wrong people, prioritised the wrong things, and as always made bad choices. I wouldn’t know what I know about now with cars if not for the little accidents along the way. I wouldn’t know what I know now about people if I didn’t have all of the negative experiences, and a whole lot of positive ones too. Don’t be too quick to move out of a situation, unless its not safe in which case leave that place yesterday, as it may be trying to teach you something. It may not make sense now, but and 10 or 20 years time, it may become relevant.

Teenagers

Teenagers

I may not have enjoyed every day of my teenage years, but it has made me the resilient, well rounded, educated, compassionate, caring, loving person I am today. I don’t regret a day, and neither should you. Enjoy the simpler times that are the teenage years, before everything becomes even more complicated.

Maintain the Rage

Luke Sondergeld

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

Reason to Write

As bloggers we all write for different reasons. Some write to have a message heard, some write to reach the masses, some to simply have their thoughts written down, and some (like me) write to reflect on their life and hope that the struggles they are going through are not selfdom alone. When I started Maintain the Rage in 2017, I never expected anyone to read my blog outside of family and friends. To this day I am still surprised by the fact that several hundred choose to visit my blog on a weekly basis. But I am left wondering, what is my reason to write in the future.

Blogging

Blogging

I do not think that my thoughts, reflections, and musings will stop being my main source of material. What we indeed all go through on a daily basis is the source of much material. I feel that these reflections either need to be more targeted or have a different focus. I have been reading other blogs of late on ‘How to Blog’ and the like, and most say to have a clearly defined voice, and subsequently a clearly defined target market. Sometimes I feel I am writing with a shotgun, so to speak. I write to so many different topics, with different views, and with different audiences that some days I wonder if I will ever find my niche.

Writing

Writing

My life, like so many others, is a coming together of all the small parts of our days. For me that generally consists of;

  • Parenting
  • Being a Husband
  • Nursing
  • Being a Friend
  • Scouts
  • Blogging
  • Being a Son
  • Being a Brother
  • Being a Mentor
  • Chairing Committees
  • Weight Loss
  • Depression
  • Anxiety

Thats a lot of different things to focus on. For me I write about what has occupied my week, or is currently occupying space in my Brain. This does mean that for the most part no two blog posts from week to week follow the same topic. Which means I am aiming at different groups, different parts of the internet. I have found this hard. I have found that my ability to share the message is not good enough. However, I am also unsure of how to fix it.

Blog

Blog

I will continue to write about my life. I will continue in the only style that feel natural to me. I will continue to share the message as best I can, and rely on others to fill the gap and share it to theirs. I hope you enjoy reading my posts and I hope you will continue to return, don’t hesitate to bring a friend.

Maintain the Rage

Luke Sondergeld

Happy Memories

This weekend saw another camp with friends and family at Seeonee Park, a local Scout Campground. We sat around and chewed the fat, we played cards, we burned things, we threw the kids in the back of the ute and drove around the grounds, but best of all we simply existed together. These things all created Happy Memories, but there were also the Happy Memories that were triggered by activities. Memories of driving around Nan and Grandads property running errands, memories of bouncing around in the back of the ute mustering, and enjoying the quiet serenity of rural landscape after a hard day’s work.

The weekend just gone was a camping weekend for my eldest son’s 17th Birthday. He had a couple of his friends come out and camp with us and we wiled away the weekend with activities and food. We sent the teenagers on a scavenger hunt that led them all around the campgrounds and discover the hidden gems that Seeonee had to offer. We also threw everyone in the back of the ute and went for a tour around the grounds. This served as a trip down memory lane for most of us and a shared experience for the younger children who have never had the joy of bouncing around in a ute tray. It was these simple happy memories that were created over the weekend that make it all worth while.

Back of the Ute

Back of the Ute

On Friday we had arranged to meet at Seeonee at 0900 to set up before the day got too hot. As usual, I arrived way to early. So I took the opportunity to drop off camping supplies to the different areas around the site, I set up the kitchen, and ensured the campsite was getting water from the town supply. As I was driving around performing these errands, I was reminded of the errands and chores I used to perform around my Nan and Grandad’s farm. More often then not, when I was visiting I would be responsible for the morning and afternoon feeds and waterings. I would either walk around with the food or drive around to the different areas to feed the cattle, chickens, pigs, horses, and whatever other animals happened to be housed at the time. This solo time around the farm was fantastic. I loved the smells, the sounds, the sights, the rewarding feeling you get after you finish working with your hands. Just all of it. It was nice to be reminded of this.

Droughtmaster Cattle

Every time the family and I visited my Nan and Grandad it was Mustering time. Didn’t matter if it was May, December, or August, it was Mustering time. During the muster the days were long and hard. They required a lot of concentration, a lot of hard manual labour, and your fair share of risks. I loved it. I loved moving cattle between paddocks, I loved moving them around in the yards, I loved preparing them in the crush, and loved the tasks that were performed there. By the end of the day though, you were physically and mentally exhausted. My grandparents had this wonderful patio area off their house that overlook the bull’s paddock and the yards. As we finally stopped and the sun was beginning to set the peaceful serenity of farm life became apparent. There would be some distant mooing, the short cluck of the guinea fowl, the whiney of the horses, but mostly the silence; the gentle rustling of trees, the occasional chime of a an outdoor ornament. That memory of the calm after the storm is one of the best memories I have of farming life.

After a Long Day

These memories, both new and old, highlight the need for experiences over things. Nothing was centred around the latest phone, the hippest look, or an expensive restaurant, they are all simple memories of activities or events shared with others. I love the idea of owning land and having a small collection of animals for private consumption. I love the idea of looking across the vast horizon and seeing nothing but nature. I love the silence. I love the peace. I love this barren outback we call home.

Maintain the Rage

Luke Sondergeld

Own Company

I have had the unfortunate issue of being at home away from work. I have an acute case of Carpal Tunnel Syndrome and can barely butter toast. It was therefore agreed that I stay home until it is remedied. So far we have done the conservative, today I am having a Cortisone injection, and we will see how everything unfolds from there. Anyway, as a result of all of this I am at home. While everyone is at work, school, or daycare. I have been completing small tasks as much as my wrist will allow. Unfortunately, most of the tasks I want to achieve require way more physical capacity than I currently have. This has left me with waaaaay to much time for my brain to go into overdrive, schemes and plans come out of said overactive brain some of which are probably best left as ideas, and too many hours to be wracked up on my favourite game Dragon Age: Inquisition.

Overactive Brain

Overactive Brain

Now as most of you who have been reading for a while now know, my Brain and I have a love/hate relationship. Though my brain is my superpower in many ways, when it is left alone with little stimulus or mental drain it tends to run different ideas, what if’s, and half truths. Most people, and probably a fair portion of the readers, who have depression and anxiety are well aware how crippling racing thoughts, what if’s, and half truths can be. It can take a considerable amount concentration and positive thoughts to bring you back around, if that even works. Normally, like me, you find the easiest way to avoid the negative headspace is to keep the brain active, and sometimes that involves getting off your backside and catching up with people. I know I find it hard most days, and if I don’t have things pre-planned then I will often make stories up that ensure I don’t have to leave the home. I suppose we all need to ensure we take positive steps to ensure the best possible headspace.

Anxious Mess

Anxious Mess

The positive that does come out of having an idle mind and therefore tons of free thought time is some other plans, schemes, and ideas that make their way out. Now, some of them, OK most of them, are pretty terrible ideas like opening my own business, moving interstate, having like 7 more children, and the list goes on. However, every now and again a good idea pops up. Currently the best idea that has graced my cerebral white matter is moving to a parcel of land of 50 acres or more, building the house we want, and selling the one we are in. Now there are a lot of pieces to this puzzle, not the least being finances, timeframes, and livestock. Now this idea is not beyond the realms of possibility, and the more I investigate the idea, the more plausible it becomes. This will still be a long term project; though who knows, everything may fall into place quicker than expected.

Property Search

Property Search

The large amount of time that I do have at home, when I have accomplished all that I can, I find myself spending a majority of it playing Drag Age: Inquisition. I fell in love with this game in 2015 when it was released and I am currently playing through it for the third time. The last time I played it through was during ECT, and subsequently I can’t remember any of it. So far, I am up to nearly 100 hours of game play for this run through, and I am no where near finishing. I enjoy the game, mostly, because of the story line and interactions between characters. I also really enjoy making the decisions that sway the game and actually impact of how the world around you looks or reacts. I am also playing through again in anticipation of the 2020 release of Dragon Age: The Dread Wolf, which follows on from Inquisition. I am no way a hardcore gamer, nor am I an elitist or competitive type, I am just a casual gamer, with way too much time on his hands.

Dragon Age: Inquisition

Dragon Age: Inquisition

And that has been my week. I have an interview for a Graduate Nursing position at the public hospital today, and of course that lovely injection I am sooo looking forward to. But both are for a good reason, and both are for my future. I will see how the next week shapes up, hopefully I will find more to keep me stimulated, or I’ll design my house, pick a block of and, sort out the finances and push the plan forward. Either way.

Maintain the Rage

Luke Sondergeld

Dear Reader

Dear Reader,

Whether you are a long term subscriber, or happen to chance your way to this post, you will soon realise this is not a blog with a singular goal. It doesn’t inspire people to reach their goals, it doesn’t give hints on how to succeed, it rarely gives people a laugh, and it is not in any way a large scale influencer. What it is however, is very real, very open, and sometimes very raw look into the life of the author of this letter, Luke Sondergeld. You may not agree with everything he says, you may not like everything he says, but if you have found yourself here there is something for you.

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Now you should know that Luke lives for his readers. He is checking in more times a day to see what his readership is doing, engaging with everyone that comments on social media, and on the blog, and loves hearing feedback from readers about what he has written. Does that mean he is fishing for the 1 million subscribers, No. If only one person reads his post for the week, but that one person is really and truly impacted, then he considers it a job done. He values every single person who comes across this blog. He values every comment and every share. He loves to interact with the readers, it is after all what gives him purpose.

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The topics that are shared are very real at the time of writing. If you are reading a post from May about weight loss, that is because he was trying to loose weight in May, if you read posts from last year surrounding suicide and depression, that was the very real struggle that he was going through. Every week is a snapshot of what is going on in Luke’s head at that very moment. Even this letter. Luke is striving to engage with his audience more and more, so what better way to achieve this then by literally writing a letter to them. Some of the topics and conversations can be very raw, especially the ones surrounding his mental health. Take the time to read these posts, but don’t see them as a pity party, they are there to normalise an otherwise taboo subject.

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Now that you are armed with the heart behind the posts it needs to be considered, what now? Well, for the most part, keep reading. Keep reading the posts as they come out. Take the time to go back and read the ones that you missed. Engage with the post, even if it was from two years ago, every comment gets a reply. If you get something from a post, or think of someone who will, don’t hesitate to share it, that share, may reach the one person who needs to read that post, hear that message, see that plight. In short, continue to Maintain your Rage.

Luke Sondergeld

Final Placement

Anyone who has seen my Facebook feed this week would know that I finished my final placement for my Bachelor of Nursing this week. This means that I no longer have to wear the Teal uniform of choice, I no longer have to practice under someone elses registration, and I no longer need to work for free. But despite all of the finality, and the opportunities that lies ahead, the journey to this point has been both enjoyable and enlightening. Every department had its own secrets to share, every shift had a lesson to be learnt, and patient a mystery to resolve.

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During my time studying to become a Nurse I have had placements in many different facilities and many different wards. My placements where in Aged Care, Community nursing, Acute nursing in a Surgical and Medical ward, Mental Health nursing in an Inpatient facility, another Surgical Placement, another Acute care Ward placement, Emergency Nursing, and Intensive Care Nursing. Each placement, and subsequently each ward, has had a profound impact on both my learning and clinical practice. The first placement in Aged care taught me compassion above all else; to treat every patient as a person and not a condition, to take solace in the small tasks for each person, and never be in a rush to be done with a patient. Community care showed me how easily a simple condition can become something far more sinister, and how people can be so accepting of the worsening of a condition under the guise of convenience. My first Acute nursing placement showed me the importance of time management and good communication. Mental health nursing firstly showed me that despite common misconceptions, it is not an easy option, and showed me the difficulty we face when our own mind fights against us. The Emergency placement showed me the wonders of critical care, the pace, the broad spectrum of ailments, the need to maintain nursing skills to the highest level. Intensive care taught me the importance of taking my time, the little details matter just as much as the large one, and the need to show compassion and tenderness to those who need it most. Every placement had something unique to share, I am blessed to have had these opportunities and I trust these experiences will serve me and my patients well in the future.

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38 weeks over 3 and half years, 190 shifts, 1520 hours, every single moment a new opportunity to learn, grow, and develop my skills and knowledge base. Looking back over my placements its hard to believe that so much time was spent in different wards, for so many shifts, with so much to come out of them. I have always had the mentality that you should endeavour to learn something new every day. It helps fight stagnation and keeps you growing as a person, a nurse, a father, or otherwise. Every shift may not have taught me about a medication, a disease process, a new technique, a new piece of equipment, or even a new practice, some days it was a different way to show compassion, a new way to engage with my patience, or even a new way to deliver bad news. I feel it is important to keep the practice of learning something new every day, and not just from fellow nurses, out doctors, or the patients, but from family members, the wards man, the kitchen staff, or the stores staff, each have invaluable information that could make your life a whole lot easier.

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Every patient is not just a human being who has befallen an illness or ailment, and they are most certainly more than just these. Each patient is a story, a journey, a life. Every patient deals with their ailments differently, they develop comorbidities and often take them in their stride; to see near life ending events as something trivial as they have survived them and moved on. We as nurses can never assume that two patients who have the same conditions will act the same. And for this I am grateful. Every patient also has a life of stories, stumbles, triumphs, and complications. These life events can not only help build a better picture of the patient you are currently treating but also give you insight into how others may develop their illnesses. We need to take the extra time to spend with our patients to collect these little gems as we go about our day.

All in all, the placement process has been enjoyable. I’m not going to lie, I am glad I will no longer be working for free. I am truly thankful for all the staff, patients, others involved in my placements and the learning they imparted onto me. I will do everything I can to ensure the information is used to the betterment of my patients.

Maintain the Rage

Luke Sondergeld

Dear Body

To All Major Organs, Muscle Groups, and Systems,

It’s not all my fault. I am of course referencing the letter in which you wrote to me a little over a fortnight ago. I think it is entirely unfair to lump all of the bad diet choices, demands, and ramifications squarely on my lap. I believe there needs to be some spreading of the blame, namely; the hormone and thought producing Brain, his evil counterpart Eyes, and those perpetually lazy lumps around bones called the Major Muscle Groups.

Firstly, the mastermind behind this whole endeavour, the main cause behind our binges, and most certainly behind the lack of motivation towards exercise. In the letter you wrote to me, I was blamed for the increase in sweet consumption. I am going to start out by saying I am just the end user of a long line actions in the sweet consumption. To start, brain begins with thoughts of either self gratification and the need for a treat, or the need to eat our emotions. Either or, the consumption is triggered by both sides of the same coin, so no matter which side it lands, SWEETS! So as the poor organ that has to digest and make the treasure trove of sweets into some kind of absorbable and useful goop, I simply ask to limit the intake to a more sensible amount.

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Eyes, you have the wonderful power to trigger saliva, trigger the release of hormones, and even get me excited for the delicious feed in front of us. I do, however, have to ask that you remember my size and portion appropriately. Now I understand when we are all hungry and when it comes time to suss out the fridge it is your job to ascertain what we have and if it is sufficient for us. But in that period of rummaging please remember that I cannot, in fact, eat three wraps, a large serve of pasta, left over taco meat, 750ml of Iced Coffee, and a chocolate, without feeling like an over inflated balloon on the verge of either expelling all of my contents or simply exploding. If isn’t comfortable for me, and could be uncomfortable for many other systems too.

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Now I am going to pick on the Major Muscle Groups, not because of their role in the overconsumption but because of the role they play in the burning of energy and the constant excuse generating pain you seem dead set on producing. Now, the burning of energy we realise isn’t entirely your prevue, Brain plays a large role in encouraging and spurring you on. However, when it comes to aches, pains, and other inconveniences you are nearly 100% to blame. I cannot sit at a chair without my feet being flat on the floor, otherwise sharp pain running up my shins, standing still for longer then 5 minutes causes back pain, and merely sleeping tends to either cause agony in my shoulder, numbness in my hand, or neck spasms. It would seem that I cannot perform even the simplest of tasks without pain. In order for us to burn energy we need to be able to work harder and get rid of some of these extra layers of fat.

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I propose then that we stop blaming one another and start working together. We need to stop smashing sweets, need to stop filling me up so much, and we need to get off Arse and work out at some point in our lives. I’m not suggesting anything radical, just a couple of changes to extend the life expectancy of us all. Well that’s just my two cents anyway.

Maintain the Rage

The Stomach of Luke Sondergeld

Dear Stomach

Dear Stomach,

It has come to our attention that your desires, drive, and consumption are no longer taking into account the best interest of Body, and by virtue Brain. We have therefore decided to write to you today to cover a few concerns we have and how we may rectify these moving forward. We need to talk about your seemingly unending desire to consume everything that has a sugar content about 5%, your complete disregard for portion sizes, and the concerning nature of the food you choose to consume.

Back to the Start

Back to the Start

The unending desire for you to consume, chocolate, lollies, cake, custard, ice cream, and other sweet treats is nothing shy of unnerving. Prior to this year the consumption of sweet things was a rarity. In fact in recent history you even gave up all sweets for a whole year, drinks, food and all. Then, over the past 18 months you have decided that you will try your level best to force Body into a state of either sugar high, or crushing low. Brain feels that you are forcing Body to behave like a 5 year old without parental supervision. He admits it was fun at the beginning, but that was 30kg ago. Pancreas is in a constant state of shock, and I won’t even mention what Intestines said. We feels, as the collective organs, both vital and not, that the consumption of sugary treats should be exactly that, a treat, and not in fact, a daily occurrence.

We also need to talk about portion sizes. We have recently undertaken diets and meal plans that showed what proper portioning is, and how it is sustainable with a little effort. Even with this knowledge on board, you seem interested in only showing the rest of the world that you can consume not just your portion, but that of everyone else at the table. A large serve of root vegetables, a large sourdough roll, and 14 gyoza dumplings IS NOT ONE SERVE, that’s a meal for at least two, maybe even three. Also, half a bag of chocolate bullets, a litre of ice cream, and one and half litres of chocolate milk is also not a single serve dessert. Thats enough for four people. Even you felt sick after that one, and the pain seemed almost unbearable. Changing portion sizes back to one average adult will stop us from being one and half average adults stuck together. We all therefore request that you stop eating with Eyes and consider what we actually need. The other Organs and Muscles will notify you of the caloric requirements.

My View

My View

Let’s talk about food choices. Brain is aware of what good food choices are, and he has shared that information with you in the interest of stimulating you to make good food choices. However, you seemed set on choosing anything that is full of carbohydrates, fat, or sugar, sometimes even all three, see Bush Doughnuts. All things in moderation should be adopted as the governing idea behind your desire for food. For example, sweets are fine, choose a yoghurt, or a Bulla split, or even a piece of fruit (if you can remember what they are). You can have a small serve of carbohydrates, Muscles appreciates the carbs in moderation, the rest Body doesn’t appreciate it when you decide to eat 3 bowls of pasta then go looking for sweets. Leafy vegetables have been a request from Intestines for a while to help with their work, Skin and Brain are after good fats vs the trans fat you keep requesting, and Heart would appreciate the reduction in cholesterol. You can make good choices, you can have treats from time to time. Currently we have been running on treats all the time and behave and eat sensibly once a week, and it needs to stop.

Nourishment

Nourishment

While we have the opportunity we need to talk about the revenge pain you seem set on delivering. As you know you spent the better part of 10 years trying to escape through Diaphragm and occupy the same space as Oesophagus (Google Hiatus Hernia). To rectify this, Brain decided to engage a surgeon. We know that surgeon blocked your escape route, and tied a knot around your neck (Google Hiatus Hernia Repair and Nissen Fundoplication). This, however, does not give you the right to cause an unbelievable amount of pain in the upper chest, merely to remind everyone that you went through something traumatic. You don’t see Intestine causing pain every time he performs his duties in protest of loosing 12 inches of himself (Google Hemicolectomy, Stoma Creation). We understand that consuming any liquid in large enough volumes seems to satiate you, however we would appreciate this act of defiance to cease entirely.

We understand that this is a lot to take in, and we are requesting a lot from you. We also understand that even while writing this you are sending the signal to eat half a tub of ice cream with chocolate topping with a side of Berry Bliss lollies. We thank you in advance for taking action in regard to the aforementioned. If it is any consolation you are not being lumped with the entire blame for weight gain, Motivation and Effort are in the firing line too, and there needs to be a serious talk with Knees and Shoulders. Until then, we would appreciate the head start that only you can provide.

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

Emergency Department

This week, and subsequently the week prior, saw me completing my two week placement in our local Emergency Department. Originally, I was merely excited to just get a glimpse of the chaos and mayhem of ED. Having now spent the two weeks in ED…. I WANT MORE!!!

Emergency Department

Emergency Department

A while ago I wrote a piece call Medical Nursing, whereby I reflected on the exposure to different sections of Nursing and how they impacted me. In the conclusion I stated I felt that I was more a Medical Nurse than a Surgical, namely due to the chaos and distant style of Nursing that it tends to be. I then surmised that a Medical Nurse is responsible for the growth and healing of a Patient and not just bandaging them up to get out of the bed. This is the same thought I had towards ED, prior to my placement. However, upon arrival I noticed a few things;

  • The chaos of ED is a finely balanced ballet of Nurses and Doctors
  • The pace is clearly defined by those Nurses and Doctors
  • ED isn’t all gunshot wounds, mass trauma, and gallons of blood
  • Bed blocked is a very real and serious danger
  • There is more care given to one patient in four hours then some receive in a week
  • Nurses and Doctors work together as equals, not superiors and subordinates
  • Everyone is learning, Nurses and Doctors alike
  • A litre of blood can pour out of someone’s nose
  • A baby being born is truly magical
  • Drugs, illegal drugs, are bad
  • Mental health is not an isolated issue, its part of the patient
  • Not everything is running around
  • No-ones opinion is invalid

Theses are just some of the things I noticed while working in ED, and all of these things showed me that its not an adrenaline junkie’s hot spot, and only suited to those mad few, it is a high intensity, knowledge pushing, crucible that produces some of the most well rounded and knowledgable Nurses and Doctors that anyone would have the pleasure to work with or have work on them.

Emergency Nursing

Emergency Nursing

With all of this being said, like some five year old in a candy store, I still have a six week placement in the Intensive Care Unit of the same hospital. I could fall madly and deeply in love with the 12 hours shifts, organised structure, and relative peace of ICU. Or I could simply be left longing for the high speed rush of ED.

Where will all of this take me, I don’t know. I will float like a leaf on the wind, and land were I will serve best. I have the capacity to be a great Nurse wherever I am, and I can take great joy in every section, if I do so chose. Only time will really tell. My career, based on my current retirement age, has the potential to be 38 years long. Making 40 years of Nursing in total. I have the time to be able to move around if I am not comfortable in a section. Or simply fall in love with one, study my Masters in that area, and strive and thrive in the environment.

Only time will tell.

Maintain the Rage

Luke Sondergeld

Recharging

Last week I wrote about where my headspace was at, the immediate actions that were taken, and the decisions that still had to be made. This week I have been reaping the benefits of the changed medications, Thiamine, and the ever recharging event of Camping. All of these have been attributing to a greatly improved mood, improved motivation, and reduction of both negative self talk and suicidal thoughts.

Medications

Medications

As discussed last week, my Psychiatrist has upped my Venlafaxine to 375mg, added 1mg of Risperidone, and added 100mg of Thiamine three times a day. I will admit it took nearly four days for a noticeable change to take effect, however, once it did it was hard and fast. Like a switch had been flicked over, the negative self talk stopped, the suicidal ideations stopped, I was more engaged, more motivated, and generally more like me again. My wife is almost completely convinced that it’s the Thiamine, mainly because she hates Risperidone, but I am also beginning to see merit in her theory.

Out Camping

Out Camping

One of the best ways I recharge and recenter is camping. I find nothing more relaxing then sitting around a fire with a bunch of mates, enjoying the serenity, chewing the fat, and forgetting about all of life’s stressors. This weekend was no different. My friends and I decided to go camping this weekend for my birthday. We picked a suitable location, in this case it was Cockscomb Veterans Retreat, booked it all in, and set off. My brother and I were the forward party that arrived early and set almost everything up. Over the course of Friday afternoon we were joined by everyone else. We ate tons of great camp food, some of which was a little more charred then desired but that’s camping in the end of it all. We played trivia games, thanks to Jess, which showed our intellectual prowess, and shortcomings all at once. We walked through the peaceful forests and admired the majesty of Constitution Hill, which we can sadly not attempt to climb. The kids had an absolute blast getting dirty, exploring, and generally causing mischief. It was an amazing weekend that we are attempting to replicate every month or two, as we all need to camp more, and we all need to rest and recharge.

Constitution Hill

Constitution Hill

Other then that I have very little to report, which is actually a good thing in the long run. I would like to thank everyone for their love and support through the continued roller coaster that is my mental health. I thank you all for continuing to read, share, and support Maintain the Rage, and I hope that I can continue to share stories and experiences that spur conversation and action.

Maintain the Rage

Luke Sondergeld

Collapsing

This week I have been feeling the weight pushing down on me harder and harder. Every day seems like I have found a new way to disappoint myself and those around me. Little Luke seems to be becoming more and more negative, and that voice is getting louder and louder. The scary thing is I think I am starting to believe what he says. I think I am seeing myself as he sees me. I feel myself collapsing under the weight of it all.

The phrase “I am sick and tired of being sick and tired” seems to be my life’s motto;

  • I am sick of being in pain
  • I am sick of these headaches
  • I am sick of my sinuses
  • I am sick of my Brain
  • I am sick of being fat
  • I am sick of seeing the ugly person in the mirror
  • I am sick of walking around corners to hushed conversations
  • I am sick of this anchor I am dragging around
  • I am sick of the anxious feeling I get when I talk to somebody about it
  • I am sick of the perceived judgement that follows
  • I am sick of the way people treat me because of my depression
  • I am sick of the expectation I have of myself
  • I am sick of not meeting it
  • I am sick of being the only person people seem to rely on
  • I am sick of feeling like it would be easier if I was gone
  • I am sick of feeling like it would better if I was gone
  • I am sick of feeling like I should be gone

The daily struggle consumes more energy than I would like to and it is getting the better of me. Even as I write this entry I am holding back tears, feel defeated, feel like I just was to crawl into a hole and never come out. I feel like I just want to let everything collapse around me, and let it just end.

Maintain the Rage

Luke Sondergeld

Rough Patch

For those who have been following my journey through Depression and Anxiety, you will know that the trip has had many twists and turns, ups and downs. Well unfortunately I appear to be at one of the downs. The past couple of weeks has seen my motivation decline, mood slip, and overall my headspace to take a sharp turn towards the negative. So much so that my Psychologist left our routine session and made a time with my Psychiatrist for the end of our session. Made me feel awesome, huh?

I'm Fine

I’m Fine

I don’t know if it’s the end of University Semester, or the recent placement I had, or my brain just changing things up for a bit of excitement, but I hit a wall. A rather large wall. I had little to no energy to drag myself out of bed, I felt like last year were I was dragging a boat anchor around. I would go to bed early, rise late, and still feel as though I hadn’t slept a wink. I felt drained, I felt demotivated, I felt lousy. Something that was out of character for me, I was actively avoiding social situations. I was avoiding my friends, church, life group, family, everyone or anything that would drag me out of the house, or invade the hovel at home. I knew this wasn’t a good place to be but at the same time I couldn’t seem to shake it, or see the reason to actually do anything about it. I even ran into my Psychiatrist on placement when the decline started, but didn’t want to cause a fuss so just said “I’m Fine”. This was in no way going to help my situation, but it sure as heck made it worse. I slid further and further into the depressive phase, until I had my meeting with my Psychologist…. then things changed.

I'm OK

I’m OK

My headspace was in no way helping the situation. Other then feeling like I was swimming through molasses or dragging an anchor around, I had a little niggling voice at the back of my head. The voice started small and quiet, occasionally making a remark about what I was doing or calling me stupid or fat. This voice steadily got louder. Soon it would be commenting on my driving, what I was eating, things I said to patients, my weight, my clothes, my cooking, what I was watching, when I was doing things…. EVERYTHING! The voice was so loud and so constant it became impossible to ignore. Soon I started to listen. Maybe I am going to be fat forever, maybe I’m not good enough to be a Registered Nurse, maybe I am a lousy Husband, a Terrible Father, a horrible friend, an awful cook, a slovenly mess…… you get the picture. This just fed the aforementioned anchor problem.

Negative Self Talk

Negative Self Talk

Through all of this I am going to say I didn’t have suicide ideation like I had last year, and for that I am eternally grateful. I did however have thoughts of self harm, and toiled with the idea of different ways in which my life could be taken. Like whilst cutting vegetables with my exceptionally sharp knife, acknowledging the fact that the brachial artery was an easy target, or after refilling my script for Seroquel how peaceful it was be to just consume a whole box. I know to most these would seem like the start of a plan, or even intention, and if I hadn’t gone through last year I would have agreed with you. However, the power in which the thoughts carried, the lack of conviction, and the lack of desire to see them undertaken did not lend, to me, the idea that they were “proper” suicidal ideations.

Depression

Depression

However, after my Psychologist appointment, I did go and see my Psychiatrist. He was less than amused by what he heard. He was also less then amused that I didn’t say anything when we ran into each other. He was concerned that we were heading down the very slippery slope to where we were last year. So some changes to my medications where made. My Venlafaxine is now 300mg a day instead of 225mg, and my Quetiapine is now 600mg per day, instead of 450mg. I’m not overly excited about the prospect of the increase, but given the alternative, and where it could lead, I’ll take it.

I am going to call on the Maintain the Rage community, please keep me in your thoughts, prayers, and best wishes. I am doing OK, but not great. Because I am slowed, my wife shoulders the burden, which is not sustainable. Keep being awesome, and normalising the conversation. I’ll keep writing, as long as everyone else keeps reading, sharing, and motivating.

Maintain the Rage

Luke Sondergeld

2nd Year

Well I thought the First Year went by quickly, it seems as if I blinked and the second has disappeared. I thank everyone for coming on this journey through depression, weight loss, nursing, parenting, and life as a whole. It has meant so much to me that you have decided to come along for the ride.

Second Birthday

 

Firstly, the numbers. In the past twelve months I have written 67 posts, starting with Quoth the Raven and ending with this one. I have written about my success, my stumbles along the road, and the treatments I went through to save me from myself.  I began to share about my struggle with weight, and the steps taken to change the image that was in the mirror before me.  I explored more of my own struggle, ideas behind death and the nursing implications, what it is to father someone who is not your biological child, and a pictorial view of the town I love so much. From these posts, and many more, we can sum up the year with some key numbers;

  • 64,659 Words Total
  • 696 Words per Post (average)
  • 139 Comments
  • 348 Likes
  • 6,288 Views, of which the top five countries were
    1. Australia
    2. United States
    3. Canada
    4. United Kingdom
    5. New Zealand / India

These are just the figures from the Maintain The Rage website and do not account for comments, likes and shares from Facebook, Twitter, LinkedIn, Tumblr, or Reddit.

When I started Maintain the Rage I had the intention of sharing what I had learnt, my tips and tricks, and general advice. I quickly realised that I would immediately be thrown into the Do these five things if you want to be rich, successful, and sexy category. I shifted to sharing about my life, not in an attempt to illicit pity or praise, but to show that you can do all the things you want to do, to juggle the different activities, work, school, family, and life, to show that even if your are struggling, thats ok. I hope that this has been a well received shift and that I have made the right choice. But judging by the reads and conversations with people in comments, direct messaging, and face to face contact, I am going to say it was the right move.

For the future of Maintain the Rage I am going to stay the course, I will continue to share my journey as a Parent of both a 1 year old, a 3 year old, and a 16 year old, my life as a Nurse, my journey through life with my Wife, my Scouting life, and my struggles and successes with depression and anxiety, and the victories and struggles through weight loss.

I thank everyone of you who have come on this journey with my and hope you have enjoyed and taken away something from the posts. I encourage all of you to ask me what you want to hear about, and what part of my life you are curious about. I also encourage you to share this blog with family and friends, not for mere likes or views, but so we can expand the community that Maintain the Rage has and continue to share together.

Thank you again,

Maintain the Rage

Luke Sondergeld

Duplicity

The word Duplicity conjures up imagery of being deceitful, untrustworthy, or as the literal translation actually goes, two faced. However, there is another meaning to Duplicity which is the state of being whereby you feel two normally conflicting emotions at the same time, both are equally as rational as the other, and both are valid emotions at the time. The later form of Duplicity is where I am at. I feel torn inside myself, like there is two me’s occupying the same space. I cannot help but think of the movies Split and Glass, both of which have a character who suffers from Disassociate Identity Disorder and has 24 known and identifiable identities occupying the same body. I am not saying that I am developing DID, but it helps draw the parallel.

Duplicity

Duplicity

This week has seemed like a struggle. I have been on placement for my Bachelor of Nursing, which was interesting but a difficulty in itself as I felt like I was simply doing my job but for free. I have been endeavouring to finish my last written assignment for the semester, in a subject I find quite interesting, but the final assessment left me feeling drained and beaten. These two things probably dragged me down enough without the continued badgering from within. My internal voice, Little Luke as previously written, has been unrelenting in the negative self talk, between my weight, my memory, my seeming inadequacies, thoughts about my children, my shortfalls as a father, shortcomings as a husband, and my absenteeism as a friend. This thrown in with constant thoughts and feelings of inadequacy and failure when it comes to my study, my work, and well every other facet of my life, has left me feeling a touch defeated.

Defeated

Defeated

This object negativity has been periodically broken by moments of spirited energy, positivity, and sometimes glee. I have been driven to finish my essay; research and plan ideas for a camp kitchen setup, and engage with my children with more frequency. On Sunday, for example, I spent the morning with my wife out at OfficeWorks, Bunnings, BCF, Anaconda, and of course Gus’ Coffee. I was more engaged than I had been in recent days. I enjoyed the time with my wife, and I felt genuinely happy about the prospect of a new project that would benefit the family. However, by the time we returned home the mood shifted from enthusiasm to a near blunted absenteeism. I would performs tasks, complete jobs, and look after the kids but feel disconnected, and had to fight the desire to simply run into my room, shut the door, and sob in the corner.

Depression

Depression

I feel that there may be a link between the Duplicity of the past week or so and the discussion regarding Masks several months ago. Masks are the voluntary changes in our state, whether to serve other better, protect ourselves, or something in between. I don’t feel that it is truly honest of me to be one thing in one moment and something completely different in another. It makes it hard on my wife, my children, and myself. It dosen’t serve any purpose, but to create division and hostility. The bible asks us to ensure that “Our yes’s be yes, and our no’s be no’s” that we are transparent and display who we are, and what we are honestly. I am struggling with what I am feeling, when I am feeling it, and the similarities to the thoughts of 2018. I don’t want to go down that road again. I have come too far in my journey to simply turn around and walk back.

Pre-Walked Path

On the surface I may be accomplishing everything. I may seem to have it all together. But underneath, not even that deep underneath, I am struggling, I am burning out, and I am failing. I need patience, love, prayer, and grace in this particular period. I thank everyone who already provides all of these things and more. I don’t know why I am feeling so Duplicitous in this very moment, I just hope I land on the uphill side of it.

Maintain the Rage

Luke Sondergeld

Little Luke

Through our day to day lives we reflect, review, argue, weigh up, decide, and posit over a myriad of different things. Sometimes this internalisation can be heard inside your head as an echo of your own voice. Some see this as the classic Devil vs Angel on the shoulder, or others as a respected figure they hold dear. Myself, I hear me echoed around in my head, this is sometimes drowned out by the noise around me, other thoughts, or otherwise. When I am reading it is the voice that reads the word, and even when I am writing, like right now, he is the one dictating what is to be written. This is Little Luke.

Devil and Angel on Shoulder

Devil and Angel on Shoulder

It should be stated that this discussion is not dealing with the psychosis of hearing voices, hearing instructions to do certain things, or the dehumanised detached ego of self. This is more the reflection on the voice that is you on the inside. I enjoy the fact that Little Luke reads my stories, it makes it feel more like I am a kid having a bedtime story read to me, even if it is complications surrounding acute kidney disease, or leadership principles and their applications. I am thankful that I hear the words that are being written onto the page before they are written. It gives you an odd pre-completion sanity check for the sentences, and the knowledge that what you are writing is heading somewhere. Sometimes Little Luke freezes up and forgets a word, mispronounces something and therefore spells it wrong, or get distracted by a thought, an idea, or a problem, and therefore has to be encouraged to come back on topic.

Official Conscience

Official Conscience

For some, the little voice we carry around is like Jiminey Cricket, our Official Conscience. They are our voice of reason, the sound person in your corner, the person who often tells you what would be the best course of action but you summarily ignore. Little Luke plays this role. He plays it as either the sounding board, or simply voicing what would be a sound idea, even if I end up ignoring it. Thankfully, these discussions don’t tend to become heated, Little Luke is not easily offended, and even if I have completely disregarded my Conscience, he will still be there to read me a story.

However, Little Luke is overly hash and judgemental. Small mistakes taken during the day will be dragged up for weeks. The negative self talk that comes from Little Luke does at times, have a huge impact on my mood and mental health for the day. He can berate me for days about my weight, my attitude, my choices at work, my habits, the way I spend my time, and even the fact that I listen to him. These words and the venom that comes with them is hard to escape. No amount of background noise, distractions, or changes in activity can silence Little Luke when he is on a tirade.

Is it worth keeping Little Luke around? Even if I had a way to purge my internal voice would I really want to? Would the benefits of less negativity outweigh the complete and utter silence that would follow? For all his faults, and subsequently mine, Little Luke does provide an invaluable service. I just need to kerb his behaviour a little more.

Maintain the Rage

Luke Sondergeld

My Rockhampton

Welcome to Rockhampton

Welcome to Rockhampton

In my life I have lived in a number of cities, across most of the states of Australia. I have seldom called any of them home. I have felt that for the most part I was either a visitor, or an outsider. Even Canberra, where I spent most of my formative years, where I purchased my first house, and where my two best friends reside, I still struggled to feel a sense of community. Rockhampton, however, has surpassed that. I moved to Rockhampton in 2014 with my wife, and son. We bought a home, and started to grow roots.

Rockhampton Home

Rockhampton Home

The beginning of any community is those closest to you. I am exceptionally lucky that I have my parents and brother here, as well as my Grandfather, most of my uncles, and last but not least my Sister-in-Law. We found ourselves in one of the local churches and felt immediately at home within the church family. We quickly began to make friends with some of the congregation, and are still friends with them today. We both got jobs and began to settle in. But Rockhampton is more than family and friends.

Rockhampton Floods

Rockhampton Floods

Rockhampton is more than Beef and Floods, though both of those happen. It is a wonderful city that has all of the benefits of a large city, and none of the draw backs. Traffic in Rockhampton will delay your journey by no more then 5 minutes, and even if you are unlucky enough to be stopped by the train twice, there won’t be a massive addition to the amount of time you will need to travel.

Old Rockhampton Home

Old Rockhampton Home

Central Queensland has seen its times of hardship and struggle, and Rockhampton is no different. Whether is has been Cyclones, Flood, Downturns, or mass laying off of staff the people of Rockhampton have struggled. Images like the home above aren’t as commonplace as they once were. New mining contracts, employment opportunities in the regions, stable weather patterns, and general economical improvement has seen these houses fall in a reduction of numbers, instead of increase.

Rockhampton Architecture

Rockhampton Architecture

Rockhampton is steeped in history and grandeur, the architecture of the CBD is an excellent reflection of this. The large sandstone blocks, the grand balconies and casements, it is like looking directly into the past as you walk down the street with your latte on the way to work.

Rockhampton Cemetery

Rockhampton Cemetery

A quick stroll through the Rockhampton Cemetery will show you that there have been families here in Rockhampton since the town was first planted. You can see the introduction of vaccines and reduction of childhood deaths. You can see the different faiths and belief reflected in burial practices, tombstones, and words on memorial plates. As a snapshot of the lives of people in Rockhampton, the cemetery shows this.

Rockhampton Masonic Temple

Rockhampton Masonic Temple

Every historical building has seen use after use, nothing is left to rot and collapse. The Rockhampton Masonic Temple has seen numerous uses over the years, the obvious original purpose, an office space, and most recently a dance studio. This constant renewal of life ensures these amazing structures are still in place for our children and theirs.

Gospel Hall

Gospel Hall

But, not all things that are old need a new purpose. The old Gospel Hall is still to this day being used for exactly what it was designed for. The well maintained building still strikes imagery of old Churches nestled on hill tops, or centred in an old country town. This one is tucked away, unassumingly on the outer edge of our CBD.

Rockhampton Trains

Rockhampton Trains

When we first moved to Rockhampton my wife couldn’t get over the fact that there were trains rolling down the middle of the road, through the middle of the CBD, in the middle of the day. 5 years on, nothing has changed. The railway which bought much of the life and business to Rockhampton in the early years, still acts as an artery providing much commerce in the way of goods and cattle. I see the train as our own mid street carriage way like Melbourne has her trams.

Rockhampton Graffiti

Rockhampton Graffiti

Similarly the lanes and alley ways are decorated like much of Sydney or Melbourne. They aren’t hate speech, or graven images, just simple artwork from our young and young at heart. The tasteful art is ever changing, walking down this alley in a months time will spring forth new imagery and life, with its time waining just as quickly.

Rockhampton Laneway Life

Rockhampton Laneway Life

The laneways are not simply an avenue for street art, they are the practical driveway of many a home and business. As such, the laneways see springs of life through hedges, flowers, and ferneries. This life brings forth colour and greenery to an otherwise cold and grey landscape. It also serves to show the individuality of the person who lives in the  home, or operates their business from the laneway.

Rockhampton Laneway

Rockhampton Laneway

With almost more laneways than Sydney, seemingly, there is no end to what can be found as soon as you round the corner. It is safe to say though that each laneway is full of  unheard stories, unmet people, and connections that are yet to made. One of the best things about living in Rockhampton is the sense that if you hang around long enough, you may just get the chance to hear all the stories tucked away in these laneways.

Gus' Coffee Rockhampton

Gus’ Coffee Rockhampton

Every city has their special little coffee hole, somewhere where you can unwind, enjoy a lovely cup of coffee, and just recharge. For me and my kin, that place is Gus’. A local chap who started the business with the singleminded goal of making a great coffee, a real “Shot above the rest”. Though everyone around Rockhampton has their own idea of the best coffee; The Two Professors, Stellarosa, Zaraffas, or Coffee Club jut to name a few.

Samo's Fish Bar

Samo’s Fish Bar

One thing that is probably universally agreed upon is the best fish and chips in town goes to Samo’s Fish Bar. A Friday night can see you waiting for up to an hour for your order, Samo’s is that popular. Their chips are always crisp and hot, the fish looks thick and juicy (I’m allergic so I will say Looks), and the prices are hard to beat. Samo’s is known by almost every person who lives in Rockhampton, and if they haven’t eaten there themselves they know someone who has.

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Keppel Island

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Fish

If, however, you would prefer to catch your own fish and prepare them to your personal taste, then Rockhampton is conveniently situated about 30 minutes from Yeppoon and Emu Park, both are great launching platforms for your boating adventure to the Keppels. The diversity of the seafood that is available to the cunning anglers is impressive, an even if you spend the day on the water without so much as a bite, you are surrounded by some of the clearest waters and best views around.

War Memorial

War Memorial

I’ve been around the country a number of times, I have served in the military for five year, and subsequently seen my fair share of War Memorials. Outside of the capital cities I can say, hands down, the memorial at Emu Park is stunning. It captures the moments of the war that some people don’t realise, it honours the memory of those who have gone before us, and has one of the most beautiful memorial pieces I have ever seen. At the right angle, the above photographed sits in just a way that the ships and men appear as though they are storming the beach of Emu Park.

My Backyard

My Backyard

The great things about Rockhampton, Rockhampton being a regional centre, a small town feel with the big town attractions, a town of classical values, a town that believes in bettering itself, a town that hangs onto traditions, its a town everyone can call home. From my back yard to yours, I encourage you to stop in and share a steak, at the Beef Capital of Australia, Rockhampton.

Maintain the Rage

Luke Sondergeld

Dear Wife

Dear Wife,

I know you hate these public displays of emotion, especially affection. They cause you to feel anxious, shy, and force you to become a little more recluse. I know that what we feel is between Us and God. I know that everything I am going to say here is of no surprise. And it shouldn’t be. This should be nothing more than an overly public confirmation of everything you already know. But I am going to share it anyway.

While I am writing this you are baking treats for our children and trying to pry out of me what I am writing. I am doing my level best, and failing, at trying to hide it from you. You tell me that somedays I am a brick wall, and this is true. But even still you manage to leave your mark, and it doesn’t go un-noticed. I know some days it seems like I am not present, I’m sucked into my phone, or zoned out on TV, or even simply staring off into space. You try to engage with me, I give simple one and two word answers and seemingly get annouyed when I have to answer anything more. All in all, a wall. However, every conversation, every comment, every question, is graffiti on that wall. It is something that I will see, and feel, and show forever. Every conversation is cherished. Every moment together is precious.

Graffiti on the Wall

Graffiti on the Wall

You could very well be the most loving, kind, good hearted person I know. You not only see the silver lining in almost every situation, you see the good in every person, and every action. There are days were I feel like I am the worst human being, not worth anything, and generally useless. You always take the time to life me up, encourage me, show me what I am, what I am capable of, and the worth that you and God sees. I love your selflessness, your drive, and your inability to do something half arsed. You kill yourself over a computer, planning, researching, replanning, organising, building, and scripting every class you teach. Every classes script is uniquely written for each student. You endeavour to make sure that every single person in that classroom has the very best shot at learning, and growing. It is that that level of dedication and self sacrifice I strive to even get even half way towards, so that I can be the best nurse, the best father, the best husband that I can be.

Self Sacrifice

Self Sacrifice

My love for you grows every day. Every day I get the opportunity to wake up next to you, fall asleep listening to your faint gremlin like snore, every time I come home to your embrace, even hear your voice on your voicemail. I am so incredibly lucky to have you in my life, let alone have you as my wife, the mother of our 3 beautiful children, my confidant, my sounding board, my common sense, my anchor in the storm, my shield, my shoulder to cry on, and my warm body to curl up with. Every day I think I couldn’t love you more, and every day I am exceedingly delighted to be proven wrong.

If not for you I would not have come to know Christ in the very real and intimate way we should. I would probably have wound up miserable in the middle of the ocean somewhere pining for my next drink in one moment, while struggling with my direction and sense of self in the next. You showed me what was possible, the love that He can provide. You showed me how much closer we could be with Him in our lives. You nurtured me through my stupid questions, and encouraged me to lean in. You are the physical embodiment of what Jesus Christ has asked of us. You are kind, love others, you share the word at every possibility, and you live your life like it is the only bible someone might read. You are amazing.

I Love You - I Know

I Love You – I Know

If by now you can still stomach me being open for just a few word longer I will conclude. Alinta, you are the kindest, sweetest, nicest, most loving person I have ever had the pleasure of crossing paths with. You take me at my faults and use them to help me grow. You soften my often hasty, and rash decisions, but you still allow me to lead or decide as necessary. You are the love of my life, and I just wanted you to know that.

Love you Always

Luke Sondergeld

Good Death

Over the past couple of weeks I have been reflecting on palliative care and what it is to experience a Good Death. I have had the honour of being a nurse to several patients in their final days and moments, and to my glee they have all experienced what I would call a Good Death. This also triggered thoughts surrounding my family losses in recent years, and the ones that are to come. More broadly this raised the discussion around assisted suicide and the moral, legal, and ethical issues surrounding the idea.

Some people will find it unusual or even confronting to read the fact that I had glee in my heart when dealing with someones death. Please realise that it warms my heart to see friends and family surrounding someone, who is comfortable, in no pain, well presented and cared for, all in their final moments on the planet. For me I define a good death by several factors. Firstly, comfort; the patient should be as comfortable as physically, emotionally, and spiritually possible. If this means Morphine infusions so be it, if it’s aromatherapy so be it, 12 pillows, a heater, their favourite blanket, if it can be arranged and not be a danger to them that’s what I will do. Secondly is pain; unfortunately most of us won’t meet the end of life without pain. My job as a nurse is to liaise with Doctors and ensure that the pain is either eliminated all together, or kept to an absolute minimum. Thirdly, well presented and cared for; the patient should have their hygiene needs met, new clothes as appropriate, hair attended, mouth cares attended, clean pad if appropriate, and generally look like someone has actually cared for them. Finally, family, and this can be a tricky one. Nobody can force family to be in attendance. Nobody can force family to be civil. We can facilitate an environment whereby the family don’t feel the need to clash, bicker, or argue with one another. The family of the patient should be able to say their goodbyes in a fashion that suits both them and the patient. Nothing will fill a person with regret quicker than not seeing a family member in their final moments, and having to apologise at the funeral.

Nan

Nan

A couple of years ago I lost my Nan and my Aunty within the same week. My Grandfather lost a Wife and his Only daughter. It was a rough week, and an emotional roller coaster. My Aunty suffered a massive brain haemorrhage and spent over a week in ICU before being declared brain dead. Within 24 hours of her passing she saved 6 lives as an organ donor. Please register to donate your organs here. My Nan was moved to palliate care after 4 days on a medical ward deteriorating. She spent 3 days on the ward before being called back to God. In those three days she was surrounded by family, memories, stories, and a whole gambit of emotion. She was prayed for, prayed over, and had the last rights read to her by the local chaplain. She was kept comfortable by some of the most attentive nurses I have ever met – one of the driving forces behind my choice to become a nurse. She was part of a going away party the night before she passed whereby her husband, sons and their family at pizza, drank beer, and reminisced over stories old, and not so old. There was laughter, there was tears, there was acceptance. We left Nan that evening and returned in the morning. That morning the Cheyne Stokes pattern kicked into high gear, we all knew it was close. We gathered around, and there was an absolute silence, and she slipped away. I led a prayer for her as she was taken back to be with God, and then the inevitable emotional release hit all of us like a ton of bricks. There was tears, and hugs, and silent nods of acceptance. My Nan passed without pain, well presented and cared for, surrounded by her family. She experienced a Good Death.

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In the effort to ensure that everyone has the opportunity for their Good Death, the conversation around Assisted Suicide or Euthanasia was bound to come to the front. My viewpoint is simple, everyone has the right to choose the way they want to die, how it looks, who is there, and what is involved. I am happy to facilitate all of that, just don’t ask me to push you over the edge. I can appreciate the fact that some people are in immense amounts of pain, and that their final days could be potentially agonising, though I am not convinced that a medical and pharmaceutical care plan could not deal with the pain. I also appreciate that some people won’t have a quality of life that they are accustomed to in their final days. I am not convinced that a well structured and considered Nursing care plan could make their final moments as dignified and for-filling as possible. I know that this subject is both currently controversial and emotionally charged, however it is something that needs to be discussed. It is also something that is unlikely to simply go away.

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With all of this said, the best way to ensure that the patient, a family member, or even yourself experiences a Good Death is to talk to your friends and family. If you want to be an organ donor, register and tell people so they know. Have an Advance Health Directive drafted so your wishes, should the terrible befall you, can be executed. Talk with your friends and family about your wishes and how you would like to be treated. Be informed of what is available in your region for palliation. Can you be palliated in your own home? Do you need to go to hospital? Would you need to travel to be palliated? These seemingly macabre things are considered as irrelevant or too distant to warrant discussion, but accidents can happen to anyone, or a sudden and fatal medical episode could befall you. Set yourself up properly for a Good Death.

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

Placement Rage

As regular readers will know I am coming to the end of my Diploma of Nursing studies, which culminates with a five week Acute Care placement, totally some 200 hours. As I did with my Aged Care placement and my Community Care placement, I will be documenting my thoughts, interactions and reflections on my experience. Unlike my last two placements, I will not be summarising after the fact, but in fact giving a daily summary of experiences, emotions and lessons learnt.

Placement Rage 1

Current Thoughts

I am looking forward to putting my accumulated knowledge to use, I am looking forward to the challenge that lies ahead. But, I would be lying if I didn’t say I was slightly apprehensive. I hope I never get to the day where I feel like I know enough, if you don’t think you know enough you will keep asking questions. I am not concerned with my clinical skills, and I am looking forward to learning and applying new ones.

I want to excel, which brings with it a certain level of apprehension as D-Day approaches, doubt creeps in and you begin to wonder if you are going to be good enough. If any of my class mates are reading this, they will be getting ready to echo back the same thing i have been saying to them for months, You will be fine, you know what you are doing, just breath, relax and dive in. And I have been reminding myself of these words, and the sense of irony certainly isn’t lost on me either.

The first day will set the tempo for the whole placement, Orientation Day. We are meeting up at a facility outside of the hospital to be inducted, trained and tested to ensure we are up to scratch before we hit the floor. With previous orientation sessions, the information was simple enough with the focus being on manual handling and general safety. This time however we will be conducting more complicated procedures, delivering medications and monitoring patients who are in a far less stable condition. But as my old Chief Bosun used to tell me, or rather yell at me, Pressure Makes Diamonds.

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Blogging Timetable

So the nitty gritty. I will be writing my daily reflection almost as soon as I get home. Therefore if I was to publish as soon as I wrote them, the posts would come out at all varying times, and no one would be able to keep up. So instead I will be releasing the posts the morning after my shift. That will mean the blog posts for the week will be published as;

  • Monday’s at 0600 (AEST) will be normal Maintain the Rage posts
  • Tuesday’s through Saturday’s at 0600 (AEST) will be Acute Care Reflections from the day previous
  • Sunday’s will remain the Sabbath and there will be no new posts

Placement Rage 3I thank everyone for their support of Maintain the Rage thus far, and I thank everyone for their words of encouragement going forward not only with my placement, but my Nursing Career in general.

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

Walking With

I have been reflecting this week on my personal journey, my failures and triumphs, the good leaders and the bad, the men and women who invested their time in me, and those who left a lasting impression. I reflected on leadership and the importance of Mentoring those who we lead and not just giving blind directions. I reflected on the importance of walking a journey with someone beside them, not in front leading blindly, or from behind barking arbitrarily.

This lead me to write about, what I believe, is the most important facet of Leadership, and that is Mentoring. The understanding between two individuals at different points on their journey to walk together and learn from each others experiences. This may sound like a different model of mentoring than what is commonly taught, namely where an experienced person takes an inexperienced person and attempts to impart knowledge and experience on them. I kindly draw your attention back to the person leading from the front. Or where a person will share their experiences with staff or individuals via a mass email while never actually allowing time for the people to engage with them personally, I draw you attention to the person barking from the rear.

I therefore want to share the three points I feel are integral in Mentoring, along with some experiences I have had with good and bad mentors, and pitfalls and windfalls of mentoring that I have discovered along the way. The three points I will cover are; Neither Equality nor Equity, Be the Example, and Never Stop Learning.

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Neither Equality nor Equity

Simply put Equality is everyone receiving the same thing, and Equity is everyone receiving what they need to meet a socially perceived goal. I never liked either of these labels as they are both narrow in their view. In leadership Equality presumes that everyone should benefit from 10 minutes of mentoring from their Mentor, regardless of actual need. And Equity presumes that everyone should receive what they need to be at a certain knowledge base, productivity level, or personal understanding of  leadership. Both of these ideas are flawed.

Not every person can be mentored in the same manner, with the same material, with the same time allocation, Equality. Just as a fish cannot be competently judged on its level of success by its ability to climb a tree, Equity.

I therefore believe that everyone, we as leaders take on, should receive what it necessary for them to succeed in the goal they have set. This may seem like a watered down version  of Equity, but hear me out. Understanding that an individuals have differing ideas on what success is, what achieving that success is, and what the mentoring relationship is, has already fundamentally changed the idea of Equity. Remembering that Equity has a pre-established level or goal. Therefore the amount of mentoring, support, instruction guidance, leadership and opportunity for that individual is dependant on both the goal and the ability of the Mentor. Neither of which are fully supported in the idea of Equity.

I have recently being tutoring a collection of Nursing Students in Mathematics, the collection of individuals is vast and experiences doubly so. They all have their own strengths and weaknesses, goals and aspirations, and expectations for the tutorial. Understanding this as a leader and mentor, endeavoured to ensure that the goals of each individual were met, while giving each of the students the amount of instruction or guidance they required. For some this was just being a part of the group discussion, for others a more guided approach. In each instance a positive result was recorded. I encouraged each of them, and for those reading this I continue to encourage you, to share what they learn, be the next generation of mentors, take the time investing into someone else and showing them that they matter. I feel the best word to describe this is Patronage. Patronage is a older term that was used when someone, a Patron, would support someone else in their endeavours. This could have been financially, morally, with experience or in whatever fashion the person needed to achieve their goals.

Carey Lohrenz, The Corps Group, female fighter pilot

Be the Example

I had the pleasure of sitting in a service at Lighthouse Baptist Church in Rockhampton one Sunday morning listening to a sermon by the Senior Pastor Dr Robert Bakss and he made the point “Sometimes we are the only Bible a person may see, live like it”. This really struck a chord with me in my Christian walk, but it resonates with other aspects of my life also, especially Leadership.

As leaders we have the need to set and implement culture, strategy, rules, and regulations, we are expected to uphold them all but most of all portray them. We cannot expect anyone else to follow our lead if we do anything less.  As a young Naval Officer we where expected to be able to lead a group of 25 – 35 people of varying experiences, age groups, and backgrounds. It was expected that our influence and our example was strong enough that those we lead would follow that example. We we charged with their safety, they personal development, their mental wellbeing, and their career development. We were praised when our Sailors did well, and were reprimanded when they did not.

Lord Baden Powell once said “Show me poorly dressed Troop and I’ll show you a poorly dressed Leader”. Most people will follow someones example before they arbitrarily follow a written rule, regulation or culture slogan. As a leader be the example of an employee, team member or peer that you would want to lead.

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Never Stop Learning

As leaders it is important to never stop learning, and there is ample opportunity to do so. I had the amazing privilege of serving under the then LCDR Brett Westcott, on Patrol boats early in my career. He was a even handed, professional leader who knew what someone was capable of before they did and could draw it out of them. He never expected perfection but did expect excellence. And his crew gave it to him. One of his parting words before I posted off was “The day you stop learning is the day you become dangerous”. And its true, the day you believe you know everything about your role, your job, your career or even your family is the day you begin to decline into mediocrity and potentially make dangerous mistakes.

I have taken those words and made it my goal to learn something every day, from someone, in every situation, good or bad. I believe that everyone has something to teach you.  A leader who is task orientated, narcissistic, or a slave driver who has no concern for people, families or anything out side their own world, anyone who claims mentor status but doesn’t allow the time for those they mentor, all have some of the best lessons to take away. Most of these lessons are going to be what not to do in your own leadership, or with your own team, but they are all valuable lessons none the less.

If you have been following my blog for a while now you will know that I am the Scout Leader for the Warripari Scout Group, I have about 20 Scouts every Wednesday and more when we involve the region on camps. These Scouts have taught me more about my leadership, patience, modesty, honesty, impact, and time management then I think I would have ever received from a book. Every week I have the pleasure of watching them grow and develop into the young leaders of tomorrow, learning lesson after lesson, and I am glad I get to be a part of that journey.

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Thats my take on Leadership, it is in no way intended to be all encompassing, nor is it designed to be definitive, just where I am in my journey thus far, and some thoughts for others to reflect on. Do you have something you would like to add? A lesson that you have learnt from your Journey? Share it with us in the comments below, and lets get the conversation going.

Maintain The Rage

Luke Sondergeld

 

Baby Lessons

There are numerous baby websites, books, journals, and magazines that will gladly tell you that there is a million things you should get for your new bundle of joy. Couple that with friends, family, mothers, in laws, outlaws and everyone in between, there is a lot of information to sift through.

With the announcement of My wife and I having our second child together, third in total, this week I felt it prudent to share some lessons learnt from the first one, Darby. I will cover the things that I Would do again and the things that I most certainly Wouldn’t.

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Would

  1. Invest in a decent bedroom fit out – Darby’s bedroom suite, graciously paid for by my Parents, was of a good enough quality, that we are actually able to pass it down to the next child.
  2. Buy Nappies, or diapers for our American brethren, in bulk – Quite frankly the 96 pack of Huggies that we were purchasing, sometimes felt inadequate
  3. Buy wipes in bulk – In the midst of a poo-nami you can never have too many wipes, they can be found in packs of nearly 400, and sometimes this doesn’t seem enough
  4. One Piece outfits – I WOULD BUY ALL OF THEM!
  5. Invest in a good quality Baby Car Seat – the one we bought Darby, well actually my parents bought this one also, is so good that we could use it for the new bub and buy a bigger one for Darby
  6. Teething toys/rings/jewellery – If the child can chew it they will, might as well make it safe for them
  7. Take regular photos – In the first 12 months of Darby’s existence I took something like 9000 photos, on my phone. I still feel like I don’t have enough
  8. Spend more time reading – I don’t feel like I have spent enough time reading with Darby, it is something I am currently rectifying but feel that I should have done more earlier
  9. Buy Nappy Poop Bags – These things are basically dog poop bags, for babies, and I tend to buy whichever is cheaper. When you child opens the back door to hell in their nappy, these things make it bearable enough to make it to the outside bin
  10. Feed my child Formula – We endeavoured so hard to make sure Darby was breast fed as long as possible, but you can’t squeeze blood out of rock, so my wife and I have decided this time we will go for as long as we can, and if thats 3 days before formula, then so be it
  11. Continue to Vaccinate my children – I will never not vaccinate my children, EVER!
  12. Let my wife spend more time at home – We were in a financial pickle with Darby, and as such my wife very graciously returned to work after 3 months. This time, however, we are going to try and have her home till the children are at least in school
  13. Let them eat dirt – Seriously there isn’t much in dirt that can hurt them long term, let them eat it
  14. Continue to encourage social activity – Spend time with other mums and dads, especially ones with children the same or similar ages, the children love the play and interaction
  15. Use a Bumbo earlier – These little foam chairs are amazing, supportive and encourage great posture. Sometimes I wish they made them for adults
  16. Heed this advice – There is plenty of advice out there, these are some simple things I have found with experience and common sense
  17. Johnsons Night time Baby Bath – Seriously, I don’t know if there is Nightquil in this or not, but it actually does what it says it does

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Wouldn’t

  1. Buy/use a baby monitor – Other than the fact that you can hear Darby from down the street, the monitor gave a false sense of security that was actually unnerving after a while
  2. Buy a huge complicated baby bag – They are heavy, expensive and complicated. Really a couple of nappies, a change of clothes and some food, you can fit that in any bag
  3. Buy a baby bath – Use the kitchen sink, child too big? Move into the laundry, use a Bumbo in the bath, they’re waterproof
  4. Buy any two piece outfits – Seriously the child is either going to be squirming, crawling or vomiting on the thing anyway, a one piece and a singlet is more than sufficient
  5. Try and dress for a fashion show – basically for the same reason as above, people may find it cute and adorable, but try changing a baby in a jump suit, that has no buttons, zip or other poop access
  6. Buy anything you can’t undo – if I have to remove something, or many things, to change the child, it’s too hard and needs to be thrown out
  7. Pack the kitchen sink – You can go to the shops for a five minute trip without anything, just the child and a rag
  8. Listen to all the advice – There is so much advice out there, if you try and do everything you will give yourself a hernia. However see point 16 of Would!
  9. Buy anything before the baby shower – Other than the fact you will no doubt inherit a lifetime supply of nappies and burping cloths, there could be something that you may not have thought of, or something that is expensive if not handed down
  10. Stress about people confusing your babies gender – My darling little girl has as much hair as George Costanza, and we refuse to dress her in pink. So naturally she gets called a boy fairly frequently, it used to bug me, but now I just laugh
  11. Try and see the child in the car – I set up an overly elaborate mirror setup in the car so I could see Darby when I drove, guaranteed she would roll over and knock it over, vomit on the mirror or otherwise ruin my plan
  12. Stress about whether or not she is going to wake up in the morning – SIDS is a real thing, and I know people who have been struck by it, so don’t mistake my words, but if you spend all night checking on your child every 15 minutes, you will be the one in hospital before long
  13. Fly with a baby – Unless I absolutely had to, I wouldn’t do it again

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So there is 30 Woulds and Would nots with the upcoming child. Do you have any hints, tips, tricks or Would and Would nots? Is there something you would move from one list to the other? Then add them to the comment section below. Or head over to our connect page and drop me a line.

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Maintain The Rage

Luke Sondergeld

Our Rage

I have decided to talk about my favourite subject, my Wife and our life together. But before I loose the male portion of my readership this isn’t going to be a love story with walks on the beach, champagne breakfast and how I was the perfect embodiment of Casanova. Instead this is going to be how my Wife and I stay together, keep it together and Maintain Our Rage. The three main concepts I wish to convey with regard to Our Rage are; Communication, Priorities, and Making Time.

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Communication

All good relationships, whether marriages, friendships or working relationships are based around solid, effective, two-way communication. Our marriage is no different. From the onset Alinta and I set out to communicate every idea, thought, question and issue. Other then the normal getting to know you questions, one of the first discussions we ever had was around the intent of our dating. A hard discussion, but one that ultimately set the tone for our relationship. Alinta shared that dating should be with the intent to determine suitability for marriage, and not some summer fling, thankfully I tend to agree with the notion and the matter was sorted. But the matter was still raised and we discussed it, something not too many people would have given similar situations.

Communicating, discussing, relating, talking, sharing, and listening are all part of the exchange of information in a relationship, and it extends beyond simply sharing of thoughts and ideas. My Wife and I made the decision very early in our relationship that we would never go to sleep angry, we would instead remain awake and discuss what is on our mind and come to an agreement, or at least understanding, before saying I Love You and going to sleep. This isn’t to say that there haven’t been many  sleepless night because of this rule, but it has meant the irritations, habits or disagreements cannot take strongholds within our relationship and rot it out from the inside.

Our marriage began with a six month separation due to work commitments whilst I was still serving in the Navy. This meant our normal sitting arm in arm on the couch conversations weren’t happening.  We missed the personal connection that comes with being in the same location, myself especially, but it didn’t stop us from communicating. We would spend hours on the phone at night taking about our days, reflecting on how different things made us feel, and delving deeper into our relationship through our words.

The most sage advice I ever received in regards to a relationship is Never stop talking. This isn’t to say that you should continue to talk AT your partner until they submit, or fill the air with so much talk and noise that your partner cannot think, but to never stop talking to each other, never stop sharing, never stop reflecting, never stop saying I Love You.

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Priorities

In my 30 Lessons Learnt by 30 I mentioned priorities and how they govern everything I do, how I organise my time, and ultimately what gets my energy first. The lit of priorities, in order are;

  1. God
  2. My Wife
  3. My Family
  4. My Employment and Education
  5. Myself

Now, some of you are going to be asking Why is God first? And it’s a valid question. God forms the focal point of our family, He determines what blessings we should or shouldn’t have, where we go in life, how large our family should be, everything. Our entire life is conducted through the lens of Is this what God has planned for us? To that end, my wife is  next on the list. I ensure that she is the first one to receive my attention when I get home, when I wake up in the morning, she is the last one to get my attention before going to sleep, she is the first (most of the time) to know when plans have changed and she is the first person I consult on anything to do with the rest of the list, including how I spend my me time. I would encourage everybody to organise their lives into a priority list, but don’t do it haphazardly. My priority list has been carefully considered and prayed over for a long time. It took a while for me to realise that I am at number 5 not number 3. And I am OK with that. You need to be ok with it too. This priority list also helps when it comes to decisions about time. Our lives all get busy from time to time, some a lot busier than others. By having my wife as the second on the list, when I get asked by my mates to come to the pub, or come hang out, I will either ask to bring my wife, or decline in favour of staying at home. Same goes with unwarranted overtime, excessive extracurricular activities and the like. I will either decline upfront, or at least consult with my wife to make sure she is going to be OK with the level of commitment I will need to put into something else. See back to Communication to understand why.

So my advice, set a list, put it aside, come back to in a week, think about the decisions you have made in the week. Did they fit into that priority list? What needs to Change? Make the necessary changes and do it again, and again and again until you have a list that works for you.

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Making Time

The need to take time extends to most facets of our lives, and taking time for those we love is no exception. Alinta and I, endeavour, to spend time as a couple, just the two of us, no kids, no distractions, no anything. That doesn’t always come to fruition but we try. Sometimes the us time is merely sitting next to each other at our desks and mutually ignoring one another while we work, study, blog or otherwise. Sometimes it is as simple as watching a movie together on the couch. Whatever the activity is we endeavour to make deliberate time for it.

As I mentioned previously, I personally endeavour to make sure that the first person I spend time with when I get home, is my wife. Without her our family unit doesn’t not have its united leadership. When we are out and about we endeavour to be sitting next to one another, walk with one another, hold each others hands, and all the other cliche things, that normally make people sick due to there sweetness, but we do endeavour to do these things. It is what helps us remain united and strong together.

So make time to spend with your loved ones, take a vacation together, get off early from work and surprise your loved one, small tokens of love and appreciation will always go further than singular large gifts. Time is our rarest commodity and the most cherished, share it once in a while.

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So to conclude we may only be on the early steps of the journey but we have enjoyed every minute of it. I look forward to the memories we will make together in the future and the times we will share. I look forward to the trial and tribulations, the good times and the bad, the sickness and the health, until death do us part.

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Maintain the Rage

Luke Sondergeld

Five Community Care Reflections

To follow on from the Reflections of Aged Care and in the interest of continued Reflection so I can Maintain the Rage the following are lessons that I have learnt while on my Community Placement for my Diploma of Nursing. The lessons and revelations that I came to during my placement were; Community Care is not a lesser form of care, Discharge from Hospital doesn’t mean Healthy, Funding is a speed bump not a road block, D is for Danger, a little care goes a long way.

Community Care is not a lesser form of Care

After spending a week in the community setting I very quickly realised, it’s not a lesser form of care, less equiped or less skilled, if anything I found the opposite. The organisation I placed with had two Nurse Practitioners on staff, a myriad of Clinical Nurses and Registered nurses, and an Assistant in Nursing who ran the stores and supply chain. This was a well oiled machine of Healthcare. They were all completely professional, top of their game and the most caring people I think I have met on my journey so far. They work diligently to provide the best level of care they can, and if they can’t, they find someone who can. They didn’t know the meaning of the phrase ‘Too Hard’.  It completely changed my perception of what community care was, which I will admit, wasn’t a very positive one. I alway pictured nurses with a bag of observation equipment, some simple dressings and a box of drugs going from clients home to clients home dealing with  the Elderly and Disabled because they couldn’t make it to the General Practitioners. I could not have been more wrong. This particular organisation ran a clinic in the CBD, an after hours service, visits to the aged care facilities, at home palliation, home delivered clinical services and intra venous antibiotic therapy in the home. Nothing short of a real Hospital in the Home.

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Discharge from Hospital doesn’t mean Healthy

I also learnt that just because someone is released from Hospital that doesn’t mean they are on the mend, they are simply stable and well enough to be at home. This is the sad state of affairs in most countries, where the need for hospital beds is pushing quicker and quicker turn around times. Hospital beds are also becoming cost prohibitive, with the average night stay in Australia costing over $1,800. This has spurred the community health sector into overdrive, the need for advanced clinical skills in the home and community environment is at an all time high. With more people being discharged early, or avoiding hospital and seeking alternative arrangements. That’s were services like the one I conducted my placement with really come to the forefront. We as citizens of our respective countries need to be aware of this, as fathers, mothers, brother, sisters, and children of someone who may be discharged from hospital one day, we need to be aware of what services are available, and what help can be sought. We also need to be aware that the instructions that are given to you on discharge are there to, hopefully, keep you out of hospital. So do yourselves a big favour, especially those who are heading into healthcare, and learn what community services are available and what they can do for your patients on discharge.

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Funding is a Speed Bump not a Road Block

John Kander wrote a song for for his 1966 production Cabaret  which said “Money makes the World go Round”, and unfortunately it does. Healthcare is driven by two things, firstly patients needs, secondly how much those needs cost. Community care in Australia is funded either by the Government or Private Enterprise, and the private enterprises are usually not for profit organisations who receive funding from the Government. These agencies receive a certain amount of money per patient depending on complexity, time needed and a swag of other criteria. These criteria then govern how much the organisation receives to run that service, and what boundaries the organisation has to stay in, so as not to step outside of their appointed jurisdiction. This however does not stop the services from providing the care to the patient. What tends to occur is the service will refer to another community care organisation that has the jurisdiction to cover what is required. As far as the patient is concerned they still receive the right treatment, and the healthcare system get a smiley face sticker for doing the right thing, its a win win.

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D is for Danger

As anyone who has completed their first aid certificate in the past can tell you there is the the pneumonic of  DRS ABCD, where the first D is for Danger, to both the casualty and yourself, community care is a lot like that. Before entering someones home for the first time a risk assessment is conducted, this covers everything from number of people in the house, to pets, to access to the inside, to lighting, everything. The community nurse also has the right to arrive at a patients home and not enter and simply drive away if they believe there is a real threat to their safety, like the 75 kg hungry Rottweiler thats sitting in the front yard. This is paramount for the community nurse, because if they enter the property and the Rottweiler decides they’re lunch, you now have two patients at the residence not one. This lesson can be carried into the acute setting as well, if you have a belligerent patient who won’t settle and is throwing bed pans, grab a mate and tackle the room (not the patient) together.

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A little care goes a Long way

The short amount of time you get with each patient in their home doesn’t leave much room for error, but by providing a little care to the patients in the time you do see them can lift their spirits and help with recovery. Human contact, social activity and conversation are all great ways of battling depression, anxiety and promote good health. The simple act of being kind and caring during your visit could be enough for a patient to see the light at the end of the tunnel and really focus on their recovery, not their condition. Even in community palliation, the difference between openly and compassionately communicating with the client, and always walking on egg shells, can be the difference between what is considered a good death and a bad one. So in all walks of your health care life, care a little, share a little and take the time to be with the patient, not the task.

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My community care placement has taught me a lot, I made a swag of new professional contacts, saw first hand what the services can do for patients, learnt a lot of clinical skills and developed the ones I already had. Do you have a lesson learnt from one of your placements? Do you, or have you had a friend or family member receive care from a community health organisation? If so comment below, if you would like to share your story head to our Connect page so we can share it with everyone. Don’t forget to subscribe to receive email updates of new articles.

Five Aged Care Reflections

With my Community Care Placement beginning tomorrow I have been considering the lessons I leant from my Aged Care Placement I completed at the end of 2016. The placement was nothing like I had anticipated, I pictured the stereotypical residence scenario where most of the residents where mobile, ate in a large dining hall, played canasta for a large portion of the morning and slept away the afternoon, before retuning to the dining hall for an early evening meal. But this was not the case.

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Some ideas are formulated early

1.  Its their home you are just a visitor

The trap some young, inexperienced not necessarily just age young, Nurses and caring staff fall into is that you are at work, a building in which you arrive to every day, clock on, complete a series of tasks, clock off and go home. What you should remember is you are entering someones home, this is where they spend all their time, it’s not a dining hall it’s their dining room, it’s not a common room it’s their lounge room, and it’s not just the room their bed is in, that’s their bedroom, their sanctuary. To that end, you are not an employee who has the right to barge in and do what needs to be done, you are a guest in their home and need to act as such. Tasks should only be completed when they are fully explained, permission is given and in a manner that the resident/client/patient is comfortable with.

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Home Sweet Home

2.  Residents are People and not Tasks

This may seem like something obvious but when you get under the pump and time is short, the task that needs to be completed can seem to be the priority.  As previously mentioned, you are entering the residents home. Picture for a moment a stranger walking into your home; briefly introducing themselves, making your bed, demanding you get up and have a shower, dressing you hurriedly, giving you a small cup full of unknown colourful pills and demanding that you take them.  This is, unfortunately, how some residents are treated. Thankfully the placement I had, I didn’t see anything remotely like this behaviour, but there were times when some tasks where pushed with less than complete consideration given to the resident. So remember you are there to care for the resident/client/patient not complete a series of tasks, take the time to care.

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Task Task Task

3.  Refusal isn’t personal

As Nurses we are taught that residents/clients/patients have the right to refuse treatment, medication or procedures, this also extends to cares, showers, getting dressed and even getting out of bed. How many times have you woken up and just thought “I am not getting out of my pyjamas today, I am sitting on the couch, eating ice cream and watching “Sliding Doors”. This situation is no different for those in your care, they have the right to refuse anything, even having their cares completed by someone who isn’t you.  As a Male I had to be prepared for most of my female residents to refuse to have their cares completed by me. Thankfully this didn’t happen too often, but I did have one resident who absolutely refused to even have me in the room at all, it took nearly two weeks for her to get used to the fact that I was there to assist and allow me into the room, she did however always continue to refuse for me to shower her, dress her or in any way see her in a a state of undress, which is completely understandable. Refusal isn’t personal and as such shouldn’t be taken to heart, just discuss alternatives with your supervisor and move on.

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It’s not personal

4.  You can’t disconnect completely

We are all human, and as such we all develop some degree of human attachment. We are taught to be caring, and supportive, but not to be overly involved. Working in an Aged Care facility I had prepared myself for the inevitable reality of the environment. I am normally quite astute at separating myself from emotional attachments unless it’s necessary, like relationships, friendships and the like. I thought I was doing a great job of it too, I was still caring and supportive of the residents, I was compassionate to their needs, but wasn’t attached in a way that left me vulnerable. Until I met ‘Dave’ (not real name), Dave was a palliative patient who had served many years in a volunteer capacity, his children where only able to visit briefly every week, and he constantly questioned why he was still alive. I endeavoured to make him as comfortable as humanly possible, make sure that his every need was met, but inevitably he passed away a couple of weeks later.  It hit me harder that I expected. Though I was glad that he now had the release he was so desperate for, I still felt saddened by his passing, I knew this world had lost someone who truly cared about others, and placed them above himself. It is perfectly normal to feel saddened, but don’t let it consume you, often there is still plenty of work to be done, and many other residents/clients/patients who need your care as well.

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Don’t let is consume you

5.  Don’t forget to Care for yourself

Anyone who has flown before has been told to “Ensure you have secure your oxygen before helping others”, this extends to the care environment as well, you need to care for yourself before you care for others. If you have cheap, unsupportive shoes, you will get sore feet after standing on them for 8 hours. If you don’t eat properly during the day, you will get tired, lethargic and unwell. Here are a few things to consider to help you help yourself;

  1. Buy good supportive shoes, they may cost over $150 but will save your calves by lunchtime,
  2. Remember to actually stop and eat, we tend to be consumed by tasks and time runs away from us, plan to have a small break twice a day and a longer break for lunch. All this assumes your workplace allows this,
  3. Eat fruit, nuts, lean proteins and complex carbohydrates. Try and avoid the tendency to grab a quick slice of cake, handful of chocolates or other quick snack,
  4. Rehydrate, Rehydrate, Rehydrate! Remember to drink plenty of water during the day. It is not unusual to walk over 20,000 steps in a shift, couple that with the dry air conditioning of most facilities and you will quickly realise that your intake will have to be higher than normal, and
  5. Actually go to the bathroom, it only takes a minute. With all that water, and normal body processes you will need to go to the bathroom. Actually go, there are many health problems that can develop from urine retention over time, take the time to relieve yourself.
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Help yourself so you can help others

This is in no way all of the lessons learnt during my placements, and certainly not an exhaustive list of cares for yourself, but they are some of the most important. I am thoroughly looking forward to the next opportunity to serve the community and those in need. I anticipate there are going to be an inexhaustible list of new lessons learnt from this next placement, but as one of my Commanding Officers once told me “The day you stop learning is the day you become dangerous”, it was true then and remains true today.

Do you have lessons learnt from your nursing experiences? Do you have secret cares that you can’t go a day without? Write them in the comment section below, after all community is key to success.

#3Rs – Reflect, Relax and Recharge

This week in the Twitter-sphere I have been focussing on my Three R’s for Rest; Reflection, Relaxation and Recharging. I believe that these three things are necessary for longevity and sustainability in any endeavour. Maintaining Your Rage, if you will. I know I am guilty of burning the candles from ends myself, but thankfully I have an amazing wife Alinta who reminds me to stop when I forget. In my daily life I am a Nursing Student at CQUniversity, a member of the Student Representative Council (SRC), a member of the Student Participation and Retention Committee (SPARC), a Scout Leader with the Warripari Scout Group, a Blogger, a Father to two beautiful children, and last but definitely not least a Husband.

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My life from time to time

Reflect

I feel that reflection on your activities is a fantastic way of learning more out of a situation then you may have normally, a way to work through a difficult decision made by you or one that effects you, and a great way to evaluate anything you have been a part of, whether a meeting, an activity a camp or otherwise. To that end I find this Blog has been a great way to reflect on my life, studies, practices and events. However, you may find journalling, talking to a loved one, Vlogging or even Tweeting your thoughts (constructively) can all be great ways to reflect. By reflecting we look at ourselves from the outside in, see how other people perceive us, our actions and our intentions. We can continue to grow and develop, and when it comes to reflecting for the benefit of Rest, it becomes a brilliant way to resolve issues, thoughts and concerns in a healthy and productive manner that allows you to Relax.

Relax

We all relax in different ways, some read, some write, some binge watch Pretty Little Liars, some camp and some people run. Whatever your way to relax is you need to make time for it, actually schedule time to stop and take part in the activity you  relax best with. In reality that might mean putting a pause on your assessment paper, or latest blog post, and taking the 30 minutes to go for that run. It may initially seem like a waste of time, stopping your activity to do something that relaxes you, but studies have shown that when we take time to relax we become more efficient and effective at tasks. I tend to spend my time relaxing with friends and family either playing board games or watching movies, but a nice long camp with a fire relaxes my soul, and recharges me.

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Relaxing is important, however you do it

Recharge

At the end of a long day we all tend to place our phones on charge so that at the start of the day our phones are fully charged and ready to go, however, when it comes to ourselves we tend to be content with running down to 1% and then seeing how long we will last for before ‘powering down’. We need to treat ourselves with the same care as some of us do with our phones and ensure we remain at 100% more often. If you have Reflected on you day, your week or even the meeting you just finished, you should then be trying to Relax, whether hammering the Gym or Reading a book, you then need to Recharge. This can be done in a number of ways, some people like to meditate, some pray and spend time in God’s presence, some get Recharged by doing other activities. I get my Recharge from Camping and spending time with God. It may seem odd, but sleeping on a thin foam mat, in the cold, eating rehydrated foods and not showering for a couple of days is the best way to recharge my battery. But if I have had an intensely emotionally draining week, spending time with my local Church family with God and just being in His presence is the best recharge for the mind.

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Sitting around a fire is my Recharge Station

Whatever you find comfortable make sure you take the time to Reflect, Relax and Recharge, it may make the difference between succeeding in the latest project you are working on, loosening the fingers to let you finish that book you have been stuck on, or refresh the mind so you can pass the exam you’ve been stressing over.

Do you have a favourite way to follow the #3Rs? Write it in the comment section below. Know someone who could benefit from this, or any other of the posts you’ve seen? Don’t forget to share them on your preferred Social Media using the buttons below. You can also follow this blog via email so you can be notified when I write again.