Nursing my mental health

Today is World Mental Health Day so I thought probably a day to write one of my occasional blogs. This is quite hard for me to write. I’ve tried to keep it succinct but it’s a bit long.

I started my Registered Nurse preparation in 1973 and I retired in 2017 – that’s 44 years of full-time work. I worked clinically and in nurse leadership for 28 of them and then in academic leadership for another 16. I was (am) successful in both areas, became a Director of Nursing in an Acute Trust and then led a Faculty of Health and Life Sciences, became Dean and Pro Vice Chancellor and was awarded Professor title. I spoke, wrote and published for many of these 44 years. Was pretty well-known. Have a couple of textbooks under my belt, old now, but good sellers in their time, lots of articles. This is not trumpet-blowing, it’s simply a reflection of the facts. Good for me. But underneath that success was a different, untold story.

I had my first bout of severe anxiety in my late twenties. (I may have had one before, but I’m not sure). I was a Night Sister at the time. I loved the job – the autonomy, the busyness, the requirement to know something about a lot of different things. I was really ‘feeling’ my professional confidence. One morning on my nights off I started to feel ill. I was dizzy, nauseated, hot and sweaty, my hands tingled, I thought I was going to faint. I couldn’t breathe, my chest hurt, my heart was beating irregularly. I went to A and E, where they did all the expected things. Bloods were fine, nothing on my ECG. Because I was staff they kept me overnight for observation, but sent me home next day. It scared me. It kept happening. I thought I was going to die. I was constantly preoccupied waiting for the irregular heartbeat, surreptitiously feeling my pulse. My GP was kind and referred me to a physician who told me there was nothing wrong. He didn’t say I had anxiety or suggest anything other than rebreathing into a paper bag. I didn’t want to go out in case I was ill. I kept working – I felt safe at work. I became very depressed, had a psychiatric referral resulting in out patient treatment for depression. I still didn’t really believe it was anxiety and depression. How could it be? I was a competent professional, dealing with emergencies and significant clinical issues all the time. I spoke out. I supported others. How could I be anxious?

The bouts of severe anxiety continued to happen regularly. They would last for a couple of months, then subside, sometimes accompanied by depression, sometimes not. In my thirties I began to have episodes of supra-ventricular tachycardia. It was exhausting and frightening and reinforced my feelings of imminent death. I saw a cardiologist who told me to have a baby (yes, really), I obviously didn’t have enough to occupy me. I was a senior nurse by this time, working in practice development, travelling around the country and overseas giving talks, speaking at conferences. I was holding things together, but it was hard. I was on hefty doses of beta-blockers, then even heftier doses of verapamil.

By the mid nineteen-nineties the anxiety and subsequent depression had become chronic. I became really quite ill and didn’t work for almost a year. Prolonged episodes of SVT were a real problem. A Nurse Director friend put me in touch with a cardiologist who specialised in conduction issues. Within a couple of months I was diagnosed with a re-entry syndrome, had a partial AV node ablation (of sorts, it was pretty early days for interventional cardiology) and, hey presto, the SVT stopped. The multiple ectopics stopped. I came off all the medication. I was cured. There had been something physical wrong with me after all.

And then? The bouts of anxiety and depression kept coming back, without the cardiac symptoms. With help, I began a long period of accepting that this was and had always been, a mental health problem. Years of counselling, of regular anti-depressants (which by the noughties were much more successful), I found an SSRI which suited me well. I learned what the things were that pressed my anxiety buttons. I learned to recognise the symptoms at a very early stage and to seek help straight away. I recognised and accepted that this was me. That this had always been me. That anxiety and depression were my thing and that it didn’t make me a bad person, or an inadequate nurse, or something I had to hide. It was just a thing I had to learn to live with. And so I did. I had almost twenty five years of fighting with it, but when I stopped fighting it and started working with it, goodness me, how different it was. Not for my career – that continued on its successful, upward trajectory – but for me. Recognition and acceptance of my occasional mental ill-health – hard won, but so liberating.

It hasn’t gone away. I still take medication a lot of the time. But I’m not scared of it or ashamed of it. I know it. Anxiety and depression didn’t and doesn’t diminish my achievements or undermine my success. If anything, it makes those achievements and successes more extra-ordinary.

If you recognise anything here – I hear you, I feel for you. Get help. Work with it. Good luck.

Troubled times (revisited)…

I stopped writing on this blog in March this year. Here we are, less than 6 months later and I’m moved to write again. Sadly, it’s about a problem with the Royal College of Nursing.

Presidential elections all set up and ready to start voting, and over the weekend a Tweet is sent out from the College saying that the elections are suspended. A little later and a message on the website states that two candidates have been disqualified and the electoral rules have been (allegedly) breached. No further information. Over the next hour or so tweets appear on my Twitter timeline from various people wondering what is happening. What rules were broken? Who decided they were broken? Who decided it warranted disqualification? Who decided to ‘pause’ the election? None of this was forthcoming. These are serious allegations with serious consequences, serious decisions made, also with serious consequences. The issue of the governance of the College raised its head for the second time in two years. Last time resulted in an EGM and the resignation of senior people – the RCN promised it had learned lessons and things would be different. I blogged about it here and I’ve recently reposted it.

I’m no longer a member of the College, but it’s the biggest organisation for nurses in the UK, it is both trades union and professional organisation (see that blog again for my views on that issue), it’s the go-to for the media on all things nursing. And as such it needs to be trusted not only by its membership but by employers, and it needs to be transparent with its membership and with all of its stakeholders. Integrity, trust and transparency should be its hallmarks. They MUST be its hallmarks.

I understand that there have been many welcome changes since 2018, many changes of personnel and a real effort to strategise in a way that includes and celebrates membership. New committees are working hard on communication, on professional strategy, on being seriously member-led, and I applaud and support these efforts. I also recognise the difficulty of doing this. Bringing about significant change in a big (and traditional) organisation like the College is not a 1,2,or even 3 year plan. It will take time, commitment and heartache. There will be setbacks and anger and undermining. Anyone who knows about culture change in organisations knows that it is hard won and the road towards it is full of potholes and rocks. So while I understand and share the outrage and disappointment about this latest issue, I hope there won’t be knee-jerk reactions as a result of righteous anger.

When things like this happen in the middle of a major change process, it’s a sign that there is more to do. That the promises around governance and transparency have held out until a crisis happened – and then old ways of working kicked in. It’s not an unusual thing to happen. Governance of large organisation has to be clear, transparent and the details lived by everyone – when this doesn’t happen, there must be a means to address it and make sure the sticky bits are sorted out – good governance rescues and straightens up. The College, it seems to me, is on a good governance journey and this is an opportunity to strengthen that by being open about what happened here, and fearless about the remedies – no matter who is impacted by them.

So, with no right at all, I appeal to members, activists, and others – be patient. Insist on a full and independent investigation into what happened and why, and then take the necessary action. It won’t be quick, but it will be more thoughtful and probably more likely to get the long term results the College needs without causing collateral damage. Especially at a time when nursing needs thoughtful, credible national representation more than ever before.

One for the road

So much harm, hurt, distress, grief. So much death, so much dying.  It’s hard to know what to write or whether to write at all.  I’ve been thinking about things, and wondering, and sometimes it helps me to get these thoughts out of my head and on paper (screen).  I said I’d put this blog to bed just a few short weeks ago. But sometimes, I have to write.

Over the weekend a few things have been running around in my head and they make me sorrowful but they also provide me with an opportunity to reflect and try to understand.

The old trope of  nurse and doctor as superhero/heroine and angelic special being is alive and well.  It is the overriding narrative of politicians and in all media, together with war metaphors and notions of fighting, of winning and losing.  I’ve been wondering about the pressure this puts on health care workers.  Being constantly heralded as superheroic and/or angelic with all the connotations of extraordinary capability that this carries is a substantial conscious, and subconscious, burden to bear.

In other emergency circumstances, in times of short-term exceptional response – the act of terrorism, the unusually large road traffic accident, the major incident of whatever type – the heroic/angelic descriptor sits more lightly.  A few hours, a few days, most people are treated, set on a pathway to recovery, and the sudden pressures are lifted and life goes back to normal.  Angel or hero for a few days may even feel appropriate and rewarding.

But now? When it ceases to be an ‘incident’ and becomes a new way of living, of working, of being at work?  The only predictability is that more will come.  Hard to see an end in sight. No intervention followed by prompt improvement. No ‘heavy’ days and ‘light’ days, just the relentless file of patient after patient, many who cannot be helped, the isolation, the deaths, the gentle handling of distraught and remote relatives.  The overwhelming numbers and the overwhelming shock.  No-one who ever entered medical or nurse training ever conceived that they would be required to handle this.  Coping mechanisms become fragile, incomprehensible levels of stress become internalised and nailed down in order to carry on. To be the hero/heroine, the angel of expectations.  The pressure must be unbearable.

On top of these come the avoidable things – confusing information, rapid preparation with little time to think through, false promises, inadequate protection for many, inconsistent leadership, frustration with what is meant to be the support system.  And as the days go by, increasing fear.  Fear for themselves, their families and loved ones, their colleagues.  Frustration with a lagging support system becomes anger.  Fear and anger – it’s a losing combination in terms of mental health and wellbeing.

So, it’s small wonder that we see people occasionally kick out.  Under these circumstances being heroic and angelic is time-limited, it’s impossible to sustain every moment of every day.  So, sometimes what might be seen as a ‘safe’ target for that fear and anger might be attacked.  Politicians are a pretty safe target, and often deserving of the opprobrium and scathing comments.  Sometimes those who don’t deserve it feel the heat of people’s anger.  Maybe a boss, or a leader of some sort hits a bad moment and the response is unforgiving.  On the basis of a perceived slight, a real or imagined sense of unfairness, bad timing, whatever it is  – the responses are fast and fierce.

There is small comfort for anyone involved in this crisis.  Everyday on my social media feed I see the ravaged faces, I hear the frustration, I see the anger.  But I also see the compassion, the endless patience, the strength of commitment to doing the best job possible whatever the odds.  No heroes.  No angels.  No heroines.  No Superhuman beings.  Ordinary people in extraordinary circumstances doing extraordinary things.  Whatever their role, whatever their level.  And sometimes being fallible and sometimes being less than kind in their comments.  In other words – being human after all.

Time’s up!

Dear all,

I’ve made a decision to stop posting on the Blogs on Nursing site.  I wrote a little while agothat I was struggling to write about nursing and I think it’s a good time to stop. I haven’t wrapped up my identity with the profession for more than 30 years and so I don’t  do this with any sense of loss or sadness.  I no longer have the motivation or the interest to produce a regular commentary and I surely don’t need any more chores!

Thank you to everyone who has read and engaged.  If you want to continue to engage with me on a more personal level then do try my other blog ‘The Optimistic Gardener’ where I write about all things garden and growing, wildlife and, of course, the knitting.

I shall delete the blog at the weekend.  I may leave the content available, I’ll make that decision later.

Hope to see some of you via‘The Optimistic Gardener’.  With every good wish,

June

Being socially distant 4

Hi everyone,

Yesterday evening I broke a tooth and so this morning I was at the dentist for an emergency repair.  I was so impressed by the staff there that I had to make them the stars of my blog post today.

When I went in, they directed me to a washroom and told me to wash my hands for 20 seconds and dry them thoroughly before sitting in the waiting room, away from other people.  The dentist came to call me, she opened and closed all doors, not letting me touch any handles or rails. I kept my arms crossed whilst on the dental chair.  During the emergency repair she reminded me about staying at home, hand washing, keeping 2 metres distant from other people. When I was finished she opened the door for me to go back downstairs.  Back in reception I was asked to pay by card and told to wash my hands before I left – so that I could be sure of being ‘clean’ .  Impressive.

While I as waiting to go in to see the dentist I could hear the receptionist and dental nurses on the phone.  They were cancelling non-urgent appointments.  For every call, they checked how old the person was, and proceeded to give advice on staying safe. They were matter of fact but firm. Here’s an example of what I heard:  ‘ How old are you, Mrs X? 74? You really need to be staying at home because you’re at high risk.  Yes. It’s very important that you don’t go out, and you need to not let people in the house either. Can you get food? Have you got help? If you’re really stuck, you can always call us and we will try to help.’  Something like that to every single person.  One person was obviously not taking things too seriously, the member of staff said, ‘Look. What you have to remember is that if you get ill, then your age group gets very ill. And there may not be any treatment. Do try to stay at home to protect yourself’.  They were kind, but firm and sensible and calm.

Afterwards I complimented them on their behaviour.  They said that so many people just weren’t getting it. Thought it was just the ‘flu. Carrying on as normal. And many of their elderly clients just didn’t know what to do and they were the first people to have formally given them any ‘in person’ advice.  I was even more impressed.  I went home and tweeted the British Dental Association about the great job these guys were doing.

We can all do what we can to remind people of the actions that need to be taken.  This morning in the Post Office my husband asked someone to to move away from him in the queue.  It caused a ripple of distancing.  Don’t keep quiet – be polite but remind people of their responsibilities.

Stay safe!

June

Remember, we may have to be socially distant but we don’t have to be socially disconnected!

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Being socially distant 3

After yesterday’s little blow-up, I shall try not to rant on this blog anymore.  If you want the rants, then follow me on Twitter!

As social distancing tightens up then I am resurrecting lots of hobbies/crafts/pastimes I’ve always wanted to try.  You know, those things you’d love to have a go at but there’s never time to really get into it.  I do a lot of knitting, and that will still go on – but knitting for hours at a time isn’t quite what I had in mind.  Variety of occupation is important for motivation and reduce boredom.  But sticking to my knitting for now, I currently have two projects on the go:  a pair of socks  – I always have a pair of socks on the needles – and a relatively simple Fair Isle cardigan which I have just started.

If you can knit, i.e. if you can cast on, knit, purl, and cast off, then you can knit socks. In fact we could knit socks together.  I use a pattern that’s a free download fromRavelry from someone called My Knitted Heart.  You need to create an account to get the pattern but it’s all very simple.   Fancy having a go? Let me know below, and I’ll  try to work out how we might have a knit-along.  Maybe via Zoom or something. 

Here are mine, one finished and one on the needles.  Go on, you know you’d love to!! Imagine how satisfying it would be to knit a pair of cheery socks like this yourself?

IMG_1355

Remember, we may have to be socially distant but we don’t have to be socially disconnected!

Click the ‘Follow’ button on the sidebar and the blogs will drop into your email as soon as they’re posted.

Feel free to share this if you want to.   And please, remember to leave a comment by clicking on “Add a comment’ from the side bar above. The comment box will appear below..

Stay safe!

June

June

 

Being socially distant – 2

Don’t touch your face!!  This is one of the things I’m finding hardest.  I don’t bite my nails any more, but I do put my nails in my mouth, especially if I’m reading or watching TV.  So, one of the items that isn’t being stockpiled by amazingly selfish and stupid people is… that bitter stuff that stops you biting them (the nails, not the stupid and selfish people, although God knows I’m tempted).  Ha! I’m going to put THAT on my shopping list and be sure of buying something.  Although it’s a poor look out for my OH when I try to serve it up on toast for tea.

Supermarkets know so much about us and our buying habits through the use of loyalty cards, they must be able to identify the stockpiling culprits.  And those who are booking home delivery slots weeks in advance.  Come on, supermarkets, use that information for some good.  For example, when someone gets to the till with their 6 packs of toilet roll and their data shows they bought six packs two weeks ago – ring a loud siren, flash the till light red, and message through the tannoy: ‘Selfish, stupid person at till 6!’ and then prevent their purchase.  Simples.  Or at least, stop the ‘pay as you go’ system, ration purchases at the till, and try be fair to everyone.  I am available to major supermarkets for advice on such things, pro bono.

Latest Government advice here

Something cheery: have some bluebells.

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I know I said that I would post weekly about this stuff, but already I have a million post ideas buzzing around in my head.  Horror! I’m stockpiling blog ideas!  So I shall be posting more often and limiting you to one picture per post of something that’s cheered me up.  Click the ‘Follow’ button on the sidebar and the blog will drop into your email as soon as they’re posted.

Feel free to share this if you want to.  Why not join in by writing your own ‘socially distant’ blog?  Add a comment to this post together with a link to yours.  This means that everyone can easily find all our ‘socially distancing’ posts.  Easiest way is to just view your blog post on the web like a visitor would, and copy the link from the address bar into your comment below.  Remember to also mention how to join in at the end of your own blog.  That way we can be in touch with each other, and share the ups and downs of keeping ourselves as safe as we can!  Remember, we may have to be socially distant but we don’t have to be socially disconnected!

June

Being socially distant – 1 (8/3/20)

Here’s the blog that covers our first week of deliberately socially distancing ourselves – i.e. last week.

We spent a little time thinking about what it would mean, and making sure that we were being socially distant at this stage, not socially isolating ourselves.  Being socially distant means we can still go out, bearing in mind the avoiding techniques I pointed out in the intro blog yesterday.   We distance ourselves, we do not isolate ourselves.  Social isolation  – when we are confined to the house for a set period of time – will come soon enough, I’m sure.

I cleared out the freezer.  Throwing out all that stuff that lurks in there, uneaten.  Gooseberries from 2017 (which actually moved house with us. Why?).  2 very old and decidedly unappetising loose (?loose – eeeew) sausages.  6 loaves of sliced bread (no idea why, unless there’s a plan for us to live on bread and butter pudding when the time comes).  We are not-quite-vegetarian and it’s access to fresh vegetables that I think we shall miss if we can’t go out to get them.  There is space now for useful stuff like mince, chicken thighs, a sensible amount of bread, plenty of frozen veg, and fish fingers.   And it’s all neat and tidy and easy to see what’s where.  For the first time ever.  We won’t dig into this stuff, unless we have to.

We have also told all of our friends, family and local acquaintances that from 8th March we are socially distancing ourselves.  That way, no-one can claim they didn’t know, and hopefully they will think twice about calling unannounced, or inviting us to things that we shall have to turn down.

I promised three pictures of things that has cheered us during the week.  Here they are:

No 1. We are keen gardeners and now that the weather is picking up we are getting into the garden.  I ordered some new roses from David Austin and they arrived on Friday, cheering us up no end.  I think these will reappear in the next blog, planted out!IMG_1343

No 2.  We have been looking at this picture in our local gallery for a little while.  We both love it.  It’s so relaxed and jolly and reminds us of holidays past.  So we went in and bought it.  It’s now hanging above our sofa and makes us smile every day.IMG_1341

No 3. is this vase of camellias.  They were so lovely in the garden, I thought, ‘let’s bring some of that loveliness inside.’  And here they are.  I don’t know what variety they are but they are uplifting.  You can see me reflected on the right there because they are in front of the mirror in our living room.IMG_1344

And that’s it.  As promised, I’ve shared what we’re doing, posted 3 pictures of things that have cheered us up during the week and hope that it might be useful to others.  Feel free to share this if you want to.  Why not join in by writing your own ‘socially distant’ blog?  Add a comment to this weekly post together with a link to yours.  This means that everyone can easily find all our ‘socially distancing’ posts.  Easiest way is to just view your blog post on the web like a visitor would, and copy the link from the address bar into you comment.  Remember to also mention how to join in at the end of your own blog.  That way we can be in touch with each other, and share the ups and downs of keeping ourselves as safe as we can!  Remember, we may have to be socially distant but we don’t have to be socially disconnected!

Stay well.

June

 

Being socially distant – intro

As coronavirus takes hold in communities we (the husband and I) have made the decision to practise social distancing. In fact, we made the decision last week and have been getting used to it since 8th March. We are both over 60 and have underlying health conditions that put us at increased risk.  So, we need to protect ourselves.

At the moment, we are taking the following steps:

  • we are neither extending nor accepting invitations to anyone other than close friends and family, and even then for no more than 2 people in addition to ourselves
  • we are practising strict hand hygiene, reminding each other not to touch our faces, and wiping down surfaces when we bring anything into the house
  • we are avoiding crowded places – supermarkets and other big stores, town centres, public transport, restaurants, busy cafes where we can’t sit outside
  • when we have to deal with other people – in shops etc., callers, neighbours, we make sure that we stand 2 metres away from them and we make a joke of it but use it as an opportunity to remind people.

There are other things we are trying to do too:

  • so far we haven’t bought any food or supplies over and above that which we would normally buy weekly.  I’ve always kept a food cupboard and reckon we could eat for  at least a fortnight without buying anything extra if necessary.
  • since the 8th March we listen to the BBC 6pm News only.  We don’t listen to any other broadcast news and we haven’t had a newspaper for years.  Any more is just too much of a thing.  We want information not speculation, scare-mongering and inane chat between presenters/journalists
  • we keep all our electronic devices charged. We are using social media more for communicating with friends and relatives.

I’m going to post on this blog every week on a Monday, starting tomorrow 16th March.  I’m going to share what we’re doing, post 3 pictures of things that have cheered us up during the week and hope that it might be useful to others.  Feel free to share this if you want to.  Why not join in by writing your own ‘socially distant’ blog?  Add a comment to my weekly post that contains a link to yours, this means that everyone can easily find all our ‘socially distancing’ posts.  Easiest way is to just view your blog post on the web like a visitor would, and copy the link from the address bar into you comment.  Remember to also mention how to join in at the end of your own blog.  That way we can be in touch with each other, and share the ups and downs of keeping ourselves as safe as we can!  Remember, we may have to be socially distant but we don’t have to be socially disconnected!

Stay well.

June

 

One year later…

Writing on my other blog recently, I toggled through to this one and noticed that I haven’t posted on here for just over a year.  This surprised me, as I seem to be always muttering or chatting about nursing somewhere in my social media life.  I’ve been wondering why I haven’t blogged here.  Some of it is because I moved house last year and have been pretty busy doing all the things you have to do when you move house.  But that’s not all of it.  I haven’t been able to motivate myself to write about nursing.  More accurately, I haven’t been motivated to think enough about nursing to write anything.  I couldn’t raise the interest or the enthusiasm.

Reflecting on this ambivalence, I think it’s because nursing feels kind of ‘alien’ to me at the moment.  The rise of the ‘nursing family’ – a term I dislike and disagree with vehemently; the continuing overvaluing and subsequent hierarchical ordering of tasks – something I have never understood; the persistence of old systems and patterns of organisation – the same ways of working that I remember from 40 years ago, just renamed or shaped a little and hailed as innovation; a lack of voice – by which I mean wide-ranging and meaningful debate that is energising and challenging, new and unsettling, iconoclastic even.

I know some will say it’s all alive and well, but I can’t see it.  If it’s alive and well, it’s alive and well internally – facing in on itself, talking to itself, congratulating itself.  It feels diminished somehow, static, suspended.  Maybe it’s me that’s moving – moving on and no longer able to engage with what’s happening.  Perhaps.  Does anyone else recognise this?