End of the line?

After almost 3 years of training, just 2 months from qualifying, I may have finally messed it up.
I've been referred to the Conduct Board meeting due to extended sickness and absence during this final placement.
I've not been off work due to mental health problems, but due to flu followed by a rather nasty chest infection. I've clocked up 3 weeks of absence, and I fear that this coupled with my abysmal attendance during the earlier half of the course due to depression may be the end of the dream for me.

I love my job - in many ways it has changed my life, and the idea of losing it now is hard to stomach. I've stayed on medication (Venlafaxine) for a lot longer than I would have been happy to otherwise, in order to keep my place at Uni. However, I'm not happy to work when I know my health (physical or mental) would make me unable to do my job as well as I'd like to.

I know I can be a good nurse, and I have worked hard to get this far, but I also know that sickness and absence is what has cost me a job in the past, and what will probably cost me this one.

I'm hoping for a minor miracle.

Don't make a mole out of a hole...

... As a nursing collegue quoted earlier.

I'm on placement now, its an team which works within the early intervention in psychosis model. I'm thoroughly enjoying it, or was, until this weekend.

My mental health seems to be taking a bit of a kicking, not helped by the fact that one of my previous consultants works within the team. I'm unsure whether he has recognised me or not, and am unsure whether to speak to him about it.
I was having some issues with racing/intrusive thoughts earlier today, and over the weekend, which lead to an arguement with my other half. We have sorted things out now, it was silly really, but I am extremely sensitive to criticism at the moment due to the critical, even abusive thoughts in my head.
I often wonder, given my borderline-psychotic presentation two years ago, whether my brain is gearing up for me starting to hear voices. I don't hear voices currently, however my intrusive, self-abusing thoughts have increased with each episode and I have little control over them. I am able to combat them with CBT-based techniques, however this can be very consuming, to the point that I can't engage in a conversation as if I break my concentration on them they may win.

This is probably just me bing over-vigilant given my placement area, but it does concern me.

I'm also considering having future counselling/psychotherapy of some sort, as I have something lurking on the borders of my sub-concious which I was loathe to bring up in my previous sessions. Essentially, I think that the bullying I endured during primary school may have culminated in sexual as well as physical abuse. I have a disturbing image of being held down, and then feeling dirty and ashamed. Knowing it was wrong but not knowing what it was. I am not sure if these are false memories, my mind playing tricks or an overactive imagination. However I think it may be something I need to address in future.

Is this a common experience for nursing students?

Do the majority of consultants and junior doctors you meet encourage you to study medicine?

Basically, at least six doctors have now seriously encouraged me to do the Graduate Entry Programme to medicine. At first, I thought nothing of it. Now, I'm starting to question whether, actually, I could be capable of it.

I want to go further than just the BSc Unclassified, most people reading this will know I was bitterly disappointed to not do the Honours degree. But, being a doctor? A Doctor? A Dr.? Little me?

Has anyone else encountered this? Has anyone else done it?

Feeling a bit brighter

Think two days off helped, although I now have VERY painful sunburn on my legs. I decided, as I'd burned the backs, I'd have to burn the fronts of my legs as well. Regretting it, can't believe I chose to get burnt. I don't recommend it. Next time I'll experiment with some fake tan instead... Ha. I'm usually so pale it's unreal, and now I'm pink instead :s


Unsure what to do about the horses... I'm going riding tomorrow after work so I'll see how things go then.

Work was a little better, but the individual who has been giving me some hassle is definately targetting me... Not sure if this is some kind of delusional thinking in the mania or just that I'm easy to intimidate? Maybe in his situation, feeling powerless, the only way to assert some power is over me?

Working on a male ward has been quite challenging - generally, I find male aggression difficult to handle. I'm getting more used to it, but I am the sort of person who flinches. I'm not sure if I've written about this much previously, but my Mum dated a guy after my parents split up who turned out to be an ex-alcoholic. He was lovely, until one night he started drinking. I was about 5 years old, and it was terrifying. I remember the aggression, and being so sure that my Mum would run, and I wouldn't be able to keep up. I wouldn't have blamed her for running.
Him grabbing her by the hair in the street, as she tried to walk away. Me clinging to her coat, being knocked over into the gutter as he swung her around, grazing my knee on the kerb. I think the fact that he had been so nice when sober made it harder, it was a betrayal of trust as well as an incident of aggression.

I think that is probably why I flinch.

A Review of Me, Myself and Blogging

Do you think the people at My Therapy are going to be celebrating their success this weekend? "Look at all the people who have signed up - our online diagnostic tool is BRILLLIIIAAAANNNNNNTTTTTTT!"

Such a shame.

I think tools like this are good for two things -
a. A bit of a laugh
b. Double-checking that yes, you are still a MENTAL.

So... I took their survey, and according to my, possibly unrealiable answers, have been diagnosed with;

- Bipolar II (Depressive)
I was diagnosed during my one-before-last episode as having "severe recurrent depression on the Bipolar spectrum", so this sort-of-fits.

- Schizophreniform Disorder
This was based on my rather unusual ideas during episodes of high and low mood, and around food. I'm also a bit paranoid in social situations, but I think that is more to do with low self-esteem. I have been monitored for "emerging psychotic symptoms", but think I can safely say this isn't a correct diagnosis.

- Agoraphobia without History of Panic Disorder
I think this because I don't go out when I am depressed. Which I think is a pretty common experience. So, incorrect, again.

Overall, not too inaccurate, considering it is a computer. It might be on par with one Consultant I had the misfortune to be allocated too!


In other news, I'm questioning whether to continue blogging. It served a purpose during my last-but-one severe episode of depression, but I spend much more time readng blogs than I do writing mine. I'm not sure yet, but I am considering a hiatus.

I've also got a new hobby, or rather, revived an old one.
I've started part-loaning a pony, a couple of days a week. He is lovely, safe and has already started increasing my confidence greatly. It is also another reason to say "NO" to the eating disordered thoughts, as well as any suicidal ones.

I'm going to try and blog more often over the next few weeks, and then decide whether it is helpful or useful for me now. I can't promise anything, as I'm tied up with two essays which are progressing extremely slowly. I keep trying to write something, anything, but being unable to string together a sentence.

A Sharp Reminder

I write this with tears in my eyes.
I have just watched the second half of the very moving "Can Gerry Robinson Save Dementia Care Homes?" [BBC iPlayer]. I feel so much for the residents of these homes, having spent most of last year seaching for somewhere suitable for my Nan before she died*.

I have also seen care of this sort, as it is often "the norm". People don't realise the capabilites of those with dementia. I had a placement on a ward, which I felt was generally good, but which certainly failed its usual standards in the early morning. Once staff had come on shift, following the handover, there was around 45 minutes for 6 staff to assist the clients to shower, dry and dress. Some where able to do this with little assistance, but normally there were around 18 people to assist. Most needed two or even three staff members to assist, mainly due to mobility issues, or because they could become aggressive**.
Older people have fragile skin, and often need much more care. A quick rub down is not sufficient to dry them, and they will often need to be assisted to apply cream etc. You need to check for pressure sores, bruising, soreness or damaged skin. You need to respect them as a person, assist them to change into their clothing, assist them to chose colours and textures whenever possible. I could easily spend a hour with someone, longer even, enabling them to wash themselves and choose their outfit, do their hair. 18 people, 45 minutes, staff working in pairs. Thats 7.5 minutes per person. It seems quicker to many staff to just do it for their clients to get the task done, because you simply don't have the time to take.
When I worked on a adult ward, I worked with a lovely lady who was very confused. I spent over an hour assisting her with showering, even washing and applying cream my own face to show her what to do, as she found it easier to copy than to follow verbal directions. Just spending time choosing her shower gel, enjoying the smell of it, or the feeling of having her hair done.

We need more staff, particually more regular staff. Bank staff simply do not know the clients and the clients do not know them. Staff need more training, and we need to have the time to spend with clients and families to find out the important things. What is your mother's routine? Does she shower or bath, morning or evening? What products do they use, lots of bubbles or just unscented soap and a soft flannel? Do they like to read books, or the morning paper? Do they take sugar in their tea?

How can we provide personalised, patient centred care, when we don't really know our clients?

I'm tired. I'll continue something along this line another evening, because the guinea pigs need their hutch cleaned out.


*On this note, I read each of the homes' reports in depth, for the past few years. I had whittled a long list down to just four which I planned to pay several visits to with my mum, in order to find somewhere that I was happy with. I forwarded this list to my uncle, to keep him informed, and he replied with the ones he had looked at. It was a list of every home in the area, including the ones I had sent him, with no attention paid to ratings or inspections.

**And why shouldn't they be aggressive? They've awoken in what may seem to them a strange place with people they do not know. They have been assisted half-asleep into a wheelchair, taken to one of several bathrooms, and these strangers are removong their clothing and putting them in water?

Leucotomy, Tribunals and Placements

I have just started a new placement.
It's an older adult ward, which I was extremely worried about - for my own health.
I don't really feel ready after losing my Nan. This will probably be my hardest placement yet.

On another note, I have to wear a uniform... euurrrrggghhhhhhhh.
The two hour commute (each way) isn't fun either.

One of my new service users underwent a leucotomy forty years ago. I am intrigued, and this person really brightened up the afternoon.

I have my DLA Tribunal tomorrow - I'm shitting myself. Literally, it might help my chances? Kidding... Has anyone seen the preperation that N putd herself through in Poppy Shakespeare (or indeed read the book)? Something like that maybe?

I <3 Journalists

This concerns me.

I am worried that an action which could have been purely appalling practice, is being linked without question to mental illness.
I'm sure anyone in nursing has met or heard of people who have mistreated those in their care without having a mental illness. A quick look through the NMC's enquiries would tell you that.

It has been reported that this lady was diagnosed with Bipolar Affective Disorder at the age of 19, and later with "paranoia". The lady is now 52, and has been nursing for 20 years. How does this article help the public to understand that a family member or collegue who has a mental illness is not going to do something like this?

This sort of reporting disgusts me as it instantly assumes that the behaviour must have been because of the diagnosis - have you never heard of someone who is "sane" doing something which is against human morals?

This concerns me due to my own mental illness. I disclosed my history when I applied, and had to get a letter for occupational health from my psychiatrist to state that I was mentally fit to work. My illness has not affected me professionally, except for times when I have been less-than-ok and missed some time. I, luckily, am able to see warning signs that I am becoming unwell. I can recognise when my mental state would affect my practice, and that is when I don't work.

Some people, due to their illness, are unable to identify warning signs, or become unwell very rapidly. Since being diagnoses as probable Bipolar II, I have been increasingly concerned about such things as "Fitness to Practice". I'm quite confident that I am able to manage myself and my illness - I would rather take some time off than endanger my service users because of my poor mental state.

However, it does concern me in terms of my future, my career.


EDIT:
This p*sses me off.
Mental illness often makes people prone to committing crimes.

Some Nursing Stuff, and A Bit of a Moan

I didn't OD and I didn't self-harm. I did feel rather sorry for myself, which I'm now quite embarrassed about.
I've been having some issues with a female friend recently who I think I am realising doesn't really make me feel that great. I'm really questioning why I'm friends with her, and I've realised a lot about how she makes me feel. I don't really want to carry on being friends with someone who refers to me as "poor" and herself as "posh totty", because she has Andrex-on-the-go and a DKNY purse. What do I have? Value bog roll. I do have a DKNY purse - it was a present. I plan on selling it.

Ah. I think I've just answered my own question of whether I want to be friends with her...


Uni stuff. Oh, Cellar_Door, you are soooooo going to agree with me on this....

My university has a pass mark of 40%.
You need to achieve two units at over 60% during the second year to qualify for the BSc Hons - we have received the marks for 2 out of the 4 units which qualify for this.
I had a butchers at my course-mates marks - it anonymous, but I wanted to see if there will be enough of us to run the BSc Hons - if there isn't, I'll have to defer for 6 months and join the next cohort.

So, here goes...

4 people, including myself, have achieved 2 out of 2 units at 60% or more, and will be offered the BSc. Whether they accept it will be a financial decision, as you do not get the full bursary, and more people may achieve the required marks in the next 2 units.

6 people have failed to achieve 4o% in either of the 2 units for which we have received marks. These were not "near misses" either. None of their marks were above 30.

It concerns me. A lot. Not that don't worry about failing, about having a bad day and ballsing it all up. But I already worry that 40% is still a low pass rate. And yet people still consistently fail. Why are people allowed on the course if they are unable to make the required grade? The university is allowing, or even encouraging them to waste 3 years of their lives.

The 40% pass rate worries me because I think that the syllabus which we are taught and tested on contains only the bare essentials. So people are becoming qualified nurses, with only 40% of what they need to know. Now that scares me.

Tribunals, and a return to writing.

I'm writing in here again because right now I need it. I don't need anyone to read it or to say anything, but I need to take control again and this is one of a combination of things which helped pull me through when things got bad again.
No promises that I'll be a consistent blogger, or a good blogger, or an interesting blogger.
I feel better just for getting this out.
I've been on my work placement, in an adolescent inpatient unit, and I love it. I love my work anyway, but this is even better. Despite struggling to fit in initially, and having no clue what to write my essay on, I am really enjoying it and really learning from it.
However, I'm slipping quite badly.
It started initially with being nervous, and having no appetite. Then, I didn't really want to eat in front of people, and I'm still quite constricted in certain areas with what I eat. Eating a meal every day which has been prepared by someone else and which I have limited control of is actually very hard.
I've lost 3 pounds in the past 3 and a half weeks, and I feel good, happier about my body, my smaller stomach.
This is me slipping into a danger zone, and I'm aware of that.
I've also been skipping meals, not taking anything except maybe a piece of fruit to eat during a shift, and weighing myself.

My mood has dipped, and I'm having migraines. I've had two pretty bad ones, and so I've missed two days of work, which I'll have to make up over the next few weeks. My self care and the housework have both slipped, and I'm neglecting to spend time with the guinea pigs and with my friends.

I'm constantly exhausted, and unfortunately still bleeding. I've had about 4 or 5 days this month when I havn't been bleeding. The medical verdict is to change my contraception, but I'm getting no guidance about what to change it too, or what may help. It's pretty much try it and see.

I'm managing, and I know that once I am qualified I am only going to work 3 or 4 days per week. 5 days is too much for me, and I can easily manage on part-time wages. However in the mean time, I need to make my 37.5 hours a week. I'm really struggling to do this, let alone manage university work on top.

I've also got my tribunal date for DLA coming up, on November 25th. I've written to them requesting them to get a supporting letter from my consultant, and a copy of my medical records. I tried to do this myself, but my consultant wants them to write to him, and the surgery want £18.30 for photocopying and administration fees. I'm so tired.

I have no idea what I'm going to say at the tribunal, I mainly want to contend the letter from my previous consultant that says I have no history or risk of self harm or self neglect. I also want to point out that I do require ongoing support with bills and correspondence from my Connexions work, and with ongoing low self esteem and the paranoia it cause from my Counsellor. If I got the lower rate of care then I could afford to go swimming regularly, which I have used in the past to improve my mood. It would also help with travel expenses to see my Connexions worker and Counsellor, and with the increased phone bill as I often need additional support from them, or my mum and boyfriend. When I'm travelling alone, such as to or from work, it helps if I can call someone for support as I often feel very unsafe.

I don't see myself as severely ill, but I do think I have a long term problem which means I require a little more support from those around me than most people. I still work, although it can be a struggle, and I'm planning carefully to ensure that I can continue to work in the future. I'm proud of being independent, but sometimes I need to ask for a little bit of help so that I don't become unwell, and therefore become dependant on others for everything from finances to getting dressed.

It's Been A While...

Hi, and hope you are all well, or as well as can be.

I am on Placement at the moment, which is always a trying time, but Boyfriend has recently moved in and is doing his best to help out. Even if he hasn't got a clue how to work the washing machine, he still manages to make me smile. The flat is full of black ink pen drawings of various smiling cats, and he leaves me little notes if I have a shit day. He loves me.

The fridge has become centre point of the house, with me struggling to stay friends with food. I've lost 7 pounds, accidentally, though neglecting to eat when I'm working, and this has fuelled my underlying desire to look like a stick insect. My eating has been very irregular, often only one meal a day when I do my best to eat 3 regular balanced ones. This has impacted on my mood, which started to dip, and on my physical health.

I am finally getting blood tests done - through all of this depression, no one has ever checked if there is an underlying health problem. My run down state has prompted my new Doctor to request for full bloods, so YIPPEE. Peace of mind over how much damage alcohol and diuretics actually did to my organs, eh?

Physically, I am quite concerned - I have extremely irregular periods, which often stop completely for months at a time, I seem to be getting constipation a lot, and I'm always exhausted. I just want to make sure I'm OK, and try to find out why I can't keep up with everyone else.

Placement has been going really well, although I constantly exhausted, and haven't found time to revise for my exam. I just spent two hours making preparations for my essay, and seem to have got nowhere. However I spoke to a friend from my cohort, and she hadn't started her essay either, so at least it's not just me. I'm not lagging behind completely.

Oh. My toilet is still leaking. It has been leaking since I moved in, and the plumber has replaced the pipe twice. Argh.

On a lighter note, when you turn on the kitchen light, the electric shower in the bathroom comes on as well???

Poltergeists, me thinks.....

Thanks For The Open Network

... Lovely neighbours!
Yes, I'm being rather naughty, but some social contact and blog venting is needed.
This will be a quick one, and I hope everyone I haven't had time to catch up with is doing OK.
The flat is fine, but my mood is a little unstable. I was close to tears in Tesco earlier - I want to adopt a rat who needs a new home, but I can't afford a cage, and that inability to help him and continue experiencing the little spark of happiness as he licked my fingers was a little too much in my emotional state. I don't really know why I'm feeling like this, but the looming placement could have something to do with it, coupled with the little mantra of "I must not get ill -I Must Not Get Ill - IMUSTNOTGETILL".

The upheaval of moving, even if it was undeniably for the better, has probably just caught up with me, and Boyfriend has just gone back to Leeds after spending most of the Easter break curled up on the beanbags with me.

I am very very very poor - after paying for the flat and the electric, I have £135 per calender month to pay for my food, travel, mobile phone and everything else. Hence the lack of Internet. I'm quite concerned about managing this over placement - my travel expenses will be around £200 for the eight week period, and I can't claim anything back until afterwards, so I think I will be living on beans on toast until July. God knows how I'll cope when I have to pay for heating in the winter, but hopefully Boyfriend will have a job by then.

I have applied for the Access to Learning Fund at my university, and I'm awaiting a decision on my Disability Living Allowance application as well, so things have the potential to get better soon.

My wishes/hopes/dreams at the moment;
- For someone on Freecycle to reply for my [begging] advert for a rat cage
- To complete eight weeks in the acute setting without getting admitted to the ward
- To hold a £50 note at some point within the next year

DWP and Apologies

I'm swatting up on D.L.A. know-how... I've already completed and sent the form, but now I'm worrying over it. It's funny, I never used to do that, not even with exams, yet now I do.
My Connexions worker assisted me with the form, because I concentrate for long enough to figure out what they are asking, and the form is exhaustingly long.
It's hard to fill out because my condition varies a lot over a week. I have days of ok-ish, able to microwave food, keep myself reasonably clean and presentable, get to uni, keep [almost] on top of my work. Then of being either better or worse, staying home and isolating, or sorting through unpaid bills and making a meal. Oh, and of crashing. Doom, gloom and staying under the duvet. Neglecting to eat, wash or talk.

My tutor at university spoke to me on Monday regarding my unacceptable attendance last year. I'm unsure if anyone else has told her what my "issues", as she put it, were. I wanted to say "I don't have issues, I have an illness", but it seemed more appropriate to grovel my apologies and get out of there.

The Butterfly Effect

What comes up must come down.
Cause and effect.
Universal balance.
Insert another theory here, then remember that they are only that.
Theories.

Boyfriend is unhappy. He is unhappy with uni, unsure about whether to continue, unconvinced that the next five months will be enough to gain a degree which will reflect the work he has done. I don't know what to say, except that I love him just as he is. Whatever he wants to do, I fully support him in that, and will sacrifice whatever we have to so that he can be happy. Making him happy is one of the few things that makes me happy, and if something makes him sad then I want to fight it, tooth and claw, for daring to hurt him.

Sometimes I wonder why I can't love myself as much as I love him. Why can't I apply the same way of thinking to me? My counsellor says this to me - it's a bit "inner child" centered for my liking but she has a point. If I met a 10 year old girl who had been beaten up by her classmates, I would want to protect her, help her, give her a big hug and let her cry on my shoulder. Yet, I spend most of my time hurling abuse at myself as a 10 year old for not standing up and fighting. For being weak, pathetic, a loser. For lying down and taking it.

I'm trying to be a bit nicer to my "inner child". I don't like that word. I don't know how else to describe her right now, but as much as I hate to admit it, that stage of my life is still a big part of how I am now. I can't just wallpaper over the cracks and pretend it never happened. I'm also concerned that me being so low may have put extra stress onto Boyfriend, as well as his workload.

Boyfriend's concern over his degree is making me think about mine. I love my work placements, although I do find the social situation of university and also in working as part of a nursing team quite stressful. I find it hard to let anyone get too close. The more they know, the more they have to use against you.

I just spoke to my Dad. There's a nice big puddle forming on my keyboard, and I'm so angry. I hate this. I had to tell him my Nan is ill, and that I might be leaving uni for a while to go and look after her. He says I shouldn't have to deal with it, but if I don't then who else will? I can't trust anyone to look after her properly, and she can't care for herself now. I can't afford to pay for a decent residential care home, and the current property market has made it almost impossible to sell her house.

I want to bury my head in the sand, but there's a distinct lack of beaches in Dagenham, and the idea of a small child finding my corpse in their sandpit makes me cringe and giggle simultaneously. F*cking morbid, eh?

Multiple Choice Exams and The Depressed Mind

Quite simply, it is not a good idea.

The written questions weren't too bad, I just wrote down whatever I could vaguely relate to the topic, and attempted to stay on the topic. Multiple choice is really not a good idea for me right now. I can spend hours in Sainsburys debating over whether I should buy chickpeas or lentils. I can't pick between two flavours of soup, and don't even get me started on buying things like shampoo. They all promise so much!

The exam was a bit disasterous - I was desperate for a cigarette, and being given 4 slight variations of essentially the same answer was confusing and frustrating. I kept getting stuck on words, going round and round until I couldn't tell you which one I originally thought was most probable.

The worst part was that itchy feeling, the one I get when I desperately need to make a list. Pre-exam, list making isn't really an option. I ended up being escorted to the bathrooms, where I proceeded to scrawl some meaningless crap about plucking my eyebrows on my inner calf.

I'm supposed to be going to my Mum's to do some Christmas shopping. It's cold and horrible outside, and I want to get back into bed. I also need to eat the cottage pie I defrosted, but I know that she'll force me to eat again tonight.

On the plus side, my curtain rail decided to fall down on me at 3am. How fun!

Exam...

I don't think it went to well.
How many actual quotations could I remember & reference? Zero*. Zilch. Big Bad Nothing.
However, I think I babbled as much as possible, plus I didn't fall asleep. Actually, some of my stuff on attitudes might drag me over the 40% pass mark. It sounded academic-ish.

On the plus side, I got 90-something% on the Mathematical Calculations test, and I just found out that my pathetic attempt at the Critical Incident Exam got me a fantastical 50%. The pass mark was 40%, and I only wrote 1300 words out of the required 2000, so I'm pretty chuffed.

Pat on the back, GG.


*Same size as the jeans I'm wearing. Pfffft. I'm useless at the willpower thing. £5 in Asda? I don't need a litre of Ben&Jerrys, I'll have the jeans instead!