Secret Diary of a Student Nurse (I)

My student nurse journey was utterly diabolical – and for the most part, I’m reclaiming that adjective and making it a positive.

Some of the situations I got myself into were beyond belief.

One of my earliest misdemeanours: having a rather animated argument with another student across a lecture theatre (mid-lecture); mutinied lecturer and a hundred aghast students all awkwardly counting the ceiling tiles and wishing they were somewhere else. I recall it being a SafeMedicate lecture, so really the performance was more likely to have been an unintended consequence of them wishing the lecture to be a bit more enthralling.

About a year after that I found myself in the course leader’s office having the most childish tantrum – it was the evening before a big exam, I’d come up to the library to revise and found myself stranded on campus when my car wouldn’t start. Anyone who has experienced vehicular breakdown may attest that all it does is pave the way for further breakdowns of another kind. If only I could jump-start my brain and get it working the same way I did my car.

As the three years progressed I seemed to get myself into more and more trouble, each passing incident slightly more ridiculous than the one before. On one occasion the university were so concerned about my dropping off the grid that they considered reporting me as a missing person. I wasn’t missing – well, not from my perspective – I’d just broken my phone and didn’t realise people were trying to contact me.

Would you believe, although the centre of many storms, there were several occasions where I ended up taking the blame for situations which had nothing to do with me – that should be a part of the diagnostic test for Autism, I feel. I had even dedicated to myself what I called ‘the telling-off room’, a little cubby between two adjoining offices (the course leader’s and the deputy’s, obviously. One of them needed to keep their eyes on me).

I liked the telling off room, it started off as literally that, but over time it developed into a space where I could talk and reflect. It was the time that my lecturers gave to me that taught me some of the most profound lessons. It doesn’t matter who you are, or largely what you’ve done, we are all going to make mistakes in this life (some more than others, admittedly). It’s not the mistakes that you make, or the scrapes that you get yourself into, it’s how you learn from them and move on. I can’t sit here in reflection and swear an oath that I’ll never make the same mistake again; what I can say however is that each time I will handle it better than what I have done the time before.

A key to my growth and development of accountability is the time and patience I have been afforded by others.

Let he who is without sin cast the first eye-roll..

It was in no small part due to Autism that I really struggled to understand the expectations of me during my training, and sometimes it had nothing to do with Autism – just the incivility of others. So here’s a few anecdotes as to how I misunderstood others, how they misunderstood me, and how I’ve learned lessons in social life (and hospital politics).

 Placement #1

My first placement was on a care of the elderly ward, for reasons that I cannot yet fathom, I was not allowed to use the word ‘geriatric’. I enjoyed this placement, it was my opportunity to really throw myself into hospital life; a world away from what I was used to. I ran around the ward, answering buzzers, spending time with patients, and doing everything I was supposed to be doing.

Or so I thought.

As a student I had gained for myself a reputation amongst the staff as being someone who doesn’t play well in a team, and who isn’t very good at following instruction. Uh-oh.. I spent practically no time following around my mentor. I hadn’t yet learned that a student’s job is to stick to their mentor like a limpet on a damp rock and follow them throughout the day to get a feel of what being a nurse is; no-one had told me, and to be fair I’d not asked. So, by the time that placement had finished, I hadn’t spent very much time learning from my mentor at all.. it actually wasn't until the end of my penultimate placement that one of my mentors pointed out I didn't do a huge amount of shadowing. Too little, too late.

What was it Cher said? If I could turn back time.. [I’d likely have done exactly as I had done, no regrets eh, Dappy?]

As a mentor I’m fairly laid back with my first year, first placement students. For a lot of them it’s their first experience of hospital and if they are happy and feel that they’ll learn more just by throwing themselves in wherever they’re needed I would absolutely encourage that. You’ve got three years to follow around your mentor, just take your time getting to know hospital routine for the moment, the rest will come with time.

Sorry Cher, we don’t need to turn it back at all.

[I also managed to offend a senior nurse by singing loudly at the nurse’s station when he was trying to hold a board round; and irritate the ward manager by repeatedly asking her why none of her staff liked each other.. but I suppose they're other stories which are best left in the Filofax in my head.]

Placement #2

Looking back, I don’t know how I survived this placement. It was my most miserable, my make or break.. and oh did I break. There was a healthcare assistant on this ward who made it very apparent from the beginning that she didn’t like me being around (who knows why, I’m angelic). Whenever I was on the same shift as her, I would invariably find myself crying in the toilets over the way that she’d behave. At the time, I believed I was the worst student nurse there had ever been. Belief can lie.

On one occasion, a patient had been discharged and she had told me I had to turn over the bed space, on my own. I cleaned and disinfected the bed, the chair, the drawers; replenished the oxygen equipment, plumbed in the suction, then re-made the bed with the most perfect hospital corners that had ever been achieved, I say hospital corners, they were fitted sheets; but I made sure I fitted them well. I took my time, knowing that I had to do this properly so that no flaws could be found in my work. As I was walking back towards the nurse’s station, I hear her voice behind me: “Do you really think that is suitable for the next patient?”

I vividly remember looking back at the bed space and studying it the best I could to find the thing that I’d missed. She marched me back to the bedside, “you would be happy to put the next patient in that would you?!” Yeah, I would. If it were are a cartoon she’d have turned red from the chin up and steam would have billowed from her ears.

 The discharged patient’s name was still written on the board above the bed – that’s what the great sin was. The NA stripped the freshly made bed, threw the sheets on the floor, and made me do it all again, because in amongst all the angst of doing an A* job I'd neglected to wipe a whiteboard. I believed all her huffing and puffing, I believed for those six weeks that I was the problem, that I was simply incapable of doing anything right.

Now I’m qualified, and what a load of rubbish.

I used to think that substantive staff were in a league close to angels, that they'd made it (whatever "it" was), that everything they said was gospel. Thing is, now I am one of those substantives and I have my own perspective. We're all just people, flawed people trying to do the best with what the day throws at us.

I am frequently heard reciting: “we do our best with what we’ve got, and what we’ve got is not a lot.”

My role as a student was to learn from every staff member I came across, I was learning from them how to behave when I reach the lofty heights of a qualified. Realistically though, there are lessons to be learned from those who are less than civil - primarily how not to behave. I learned valuable lessons around respect, attitude, and communication; I like to think that if a student had a similar experience as to what I had then they know they could speak to me, but it's situations like that which keep you humble.

May mercy be upon anyone who dares to speak to a student like that in front of me, I can get pretty spicey.

Placement #5

I was in my final year of training when Covid became what it was, and this placement was my re-deployment. In response to pressures that Covid had put upon the health board, I was employed as a band 4 for three months on a specialist ward. By the very nature of its specialism, many patients were immunocompromised. This was before the hope that was the vaccine was developed, and many people died.

I felt like I shone on this placement, it was rough, I probably saw more death in those three months that what I did the preceding two-and-a-half years, but there was a time of national crisis and the notion of enjoying yourself was a distant dream.. unless you’re a politician.

Come the end of the three months, I sat down with my mentor for the final eval. This is where my mentor said the words:

"You're very confident." She did not mean it as a compliment.

She recalled a time when I boldly walked up to a consultant and asked him if he was a doctor, before launching into whatever problem I had or prescription I needed. I don't remember the occasion, but apparently I left the consultant very affronted.

So, what's the lesson I can learn from this? I suppose it's remembering to be gentle in speech, it's difficult as a student to know who's who, which doctor's which, and how to tell a doctor from a visitor – or a patient.

I must remember sometimes to be a bit more tactful, approach the situation with more grace.. a tip I have learned actually, is when approaching someone unfamiliar, introduce yourself first. More often than not the other person will reciprocate, and if they don't - well you've just got close enough to have a subtle nose at their ID badge!