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

Medical Nursing

I have been Nursing for about a year now, which isn’t a lot in the grand scheme of things but never the less, and I have had the pleasure of experiencing Mental Health Nursing in two different facilities, Medical Nursing in two seperate facilities, Aged Care Nursing, Community Nursing, and Surgical Nursing. Though this only scratches the surface of what nursing is available with; Oncology, Cardiac, Emergency, Intensive Care, Renal, Respiratory, Rural and Remote, and Midwifery just to name a few. I have recently been reviewing my career and what each section has taught me, showed me, and revealed to me about my nursing.

When I first started my career I was almost exclusively employed in the surgical ward of my Hospital. I thoroughly enjoyed the work. It was fast paced, I had a tonne to learn, the staff were great, and I was able to meet new patients almost every shift. This was amazing, for the most part, but I felt that something was missing. Occasionally I would float to Medical and Mental Health, and though this was great exposure I didn’t really get a chance to experience the whole ward and what it meant to Nurse in these sections. My time in surgical felt very much like a revolving door, every day saw the discharge of one patient just to be replaced by another, that patient would stay overnight then would be gone again. It was something that I never got used to, it was something that I never felt comfortable with, it wasn’t the way I liked to Nurse.

medic treating patient

My exposure to Mental Health Nursing is varied. On one hand I was floated to Mental Health at random times which was great for a small taste of Mental Health but I never really had the opportunity to perform all of the duties a permanent Mental Health Nurse would, and for very good reason. My placement for Mental Health showed me a whole new side of Mental Health Nursing involved with involuntary mental health orders, and forensic mental health orders. This changed the behaviour of the client drastically compared to that of a voluntary client. Following everything that happened mid last year I no longer float to the mental health ward, to which I am thankful.

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When I returned from leave I found myself permanently assigned to the medical ward, at first I was a little miffed, I had always considered myself a surgical nurse, but never the less I gave the new role my all. What I did not expect was the learning, the experience, the joy, and the mental exercise that I would get on a day to day basis. I began to see what one of my nurse-mates said which is surgical is like the sports jocks, and medical is more like science geeks. Surgical pushes you as a nurse to be constantly one step ahead, be organised, and know what the next step is. But when it comes to medical its noticing the little things, the comments made by the patients, the changes in behaviour, the myriad of medications, and the effect of medications, bowel status, and fluid intake has on the human body and behaviour.

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This last week I found myself back in surgical again, and I began to realise something…. I am not a surgical nurse. I am a medical nurse. I love taking care of people, I love watching as someone improves, I love encouraging patients to do their best and stretch themselves. I never thought that I would find myself saying those words, I thought I would be the speed freak chasing the quickest nursing with the quickest turn around and the least amount of physical time with individual patients. I was so sorely wrong. So what does this mean for me in the future? Currently I will continue to enjoy my time on the Medical ward of my workplace. In the future, I still don’t know. It could be a full career on Medical Wards, Intensive care, maybe even palliative. Only time will tell.

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.

People-As-Numbers

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

Placed Upon

Through out our lives we get called a lot of different things, whether by virtue of our job, by our loved-ones, our friends and those around us. These names, these titles, carry with them a certain level of expectation from the person giving them to us; it places us in a position that we may not fully understand ourselves.

Placed Upon

For myself, I’ve been called, and still am called many different things;

Each of these comes with their own level of expectation and assumed level of knowledge and understanding. It is a huge responsibility to accept some names, and for some people it can be what breaks them.

HMAS Perth

When I was in the Navy, simply being referred to as Sir meant that I not only had an understanding of the situation being discussed but would have the answer to any questions and strategic oversight to know what to do next. In the same breath, when I was referred to as Mr. Sondergeld by a superior, that expectation shifted to a subservient role, I was expected be able to follow, blindly if needed, any direction that I was given to follow. Between my counterparts, my ship mates and those I served a while with, I was Sonny. The young officer who bent the rules when dealing with enlisted rates, took a relaxed outlook on most situations, believed that the best answers often came from those below, not above him, and someone who could get the job done, or at least know the guy who could. I was still just one man, one young officer, but all of these differing expectations and levels of understanding were valid.

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In our daily walk we often have differing levels of expectation put upon us, as a Father that is extremely obvious when a young boy starts the conversation with “Dad I want to ask you something” or when your little girl is standing at your feet, tears in her eyes, quietly sobbing and mumbling ‘Daddy’ with her arms extended. These are the everyday expectations that can break people, and we as a community need to support them and let them know its ok to not have all the answers, and know they are not alone.

There is also a change in our behaviour when these names are used, when we are called out by a particular appellation we respond in a particular way, like a child being referred to by First, Middle and Last name by a parent.

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My Son and I both participate in Scouts, myself as the Leader of the Scout section and my Son, who until recently was a Scout, is in the Venturer Section. I had a rule that the second we put the uniform on, I was no longer Dad, I am Bass. This did two things, it meant that he knew that he was on the same standing as any other Scout, and secondly every other Scout knew he was going to be treated the same. It was also a bonus for myself as I didn’t have to worry about trying to seperate my brain between Dad and Bass. The changes in behaviour between a Scout Leader and a Father are surprisingly subtle, both require finesse, discipline, honesty, integrity, leadership, quick wit, behavioural management and patience. The main difference is I personally have one Son and 20 Scouts. So the scale, and subsequent odds, are a little off.

Wife and I

In the relationship between my Wife and I, we refer to each other as Wife and Husband. To some this may seem odd, demeaning or detached. But we see it for what it is, a voluntary commitment to each other to the exclusion of all others till death do us part. I have referred to my wife as Wife in conversation with people who have not known the reasons behind our family tradition, and have been met with hostility, shock, and at times amusement. To me there is no greater pet name, than Wife, and nothing makes my heart sing more than hearing my beloved call me Husband. For us this works, for others, maybe not. But even this endeared name that we have embraced carries with it a level of expectation, that we will be supportive of one another, be a united front, openly communicate, place the other before ourselves, make time for each other, share, love and laugh together, but most of all Love each other. And that’s an expectation I don’t mind living up to.

Do you have a name that has been placed upon you? Something where the expectation is sometimes too high? Do you know someone who has a name bestowed upon them that they can’t live up to? Is there a name you don’t think fits? Write it down in the comments section below and share your story.

Maintain The Rage

Luke Sondergeld