Half way through my first placement

This is the second guest post from Kate Hopley (first post here) who recently commenced a course here at BCU. Kate has also started a BCU mental health nurse student area on Facebook

I am now more than half way through my first placement, and I have had many new experiences since writing my last entry. I have been involved in all of the day to day nursing duties: meds round; ward round; helping residents to wash and dress; assisting residents with eating meals; completing all the relevant paperwork and, most enjoyably, getting to know each of the residents by spending time with them. 

A difficult time

I had a difficult couple of days a week or so ago, in the midst of several deaths. Over the week following the deaths I noticed how stories of those who had died were told over and over again in the staff room, alongside stories of other deaths which had been experienced. I reflected that the communal processing of grief was important for nurses, because fitting our experiences together and telling and re-telling them led to an acceptance of death and to moving on. We knew that we had done our very best to care for our patients during their stay at the unit, and in the end I felt honoured to have cared for them at the end of their lives, and no longer sad. 

Advocacy

Another subject which struck me forcefully over the past weeks is the need for nurses to act as advocates for people suffering with dementia, and especially for those who are in the stages of the disease where they may have lost the ability to communicate verbally. Most of the residents at my placement are not able to choose from a menu prepared to their liking – they rely upon the nursing staff to make informed choices on their behalf to ensure that they eat a varied and balanced diet. Many of the residents cannot walk about unaided, and so cannot choose whether to sit in a sunny window or right next to the television or who to sit by. Nursing staff must consider what they know of the person’s history alongside non-verbal clues as to what mood or preferences are being expressed on that day, and then make an informed choice. 

A good environment?

I have also spent some time reflecting on the physical and sensory state of the healthcare environment for those who are inpatients with dementia. If the rooms are moved around every day this may be confusing for the person with dementia; if different and unfamiliar staff help residents to wash each morning this may be confusing and frightening; if someone starts to offer food on a spoon without first explaining what they are going to do this could be frightening. If music is played or interesting sensory objects are available and nursing staff spend time talking to or sitting with the residents, then this creates a space for the residents to engage with the world around them and to express themselves. I have spent a lot of time getting to know the residents better, and over time I have learned to understand what they are saying to me better, and finding that it is indeed possible to have a conversation, one side of which consists solely of an array of meaningful facial expressions and gestures. 

I am absolutely loving my placement and I will be really sad to leave. Every day something happens that puts smile on my face, and every interactive response from a resident, be it a belly laugh or simply the raising of an eyebrow, makes placement feel nothing like a job at all, and everything like a satisfying vocation.

Kate

2 thoughts on “Half way through my first placement

  1. I enjoyed reading your reflection about your placemement.It actually served as a reminder to me about some of the little things that we can do to empower people with dementia and improve their quality of life.

    Best regards

    Todd

  2. Hi Kate, your posting really heartened me. I lost my grandfather to dementia and it is so important for the dignity of such people that we as family or carers do not lose sight of the fact that we are looking after human beings, many of whom have had a rich past but have been robbed of their dotage by this cruel disease.

    I remember a placement at a day centre for people suffering from dementia, where we were sitting doing some art activity when a gentleman who did not communicate with staff very much picked up a pencil and drew a detailed map of where he used to deliver milk to as a milkmans assistant many years ago. This really made an impact on me – this gentleman couldn’t remember where he had put his coat and hat a few hours ago, but could remember the route his milkvan followed some 60 years earlier.

    I think whatever sphere of nursing we work in, once the human connection is lost, we may as well join the dole queue. In discussion with a nursing student(from the general branch)some time ago, I was surprised but happy to put her right on her assertion that mental health nursing was about ‘giving out medication.’ Your posting shows that mental health nursing is so much more than that, your insight and awareness is to be applauded and encouraged, well done Kate. That is what makes this job so special.

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