Archive | August, 2018

1500hrs… 3pm… Three in the afternoon…

2 Aug

It is 1500hrs… 3pm… and I’m sitting on the couch. My eyes feel gritty, like someone has thrown a handful of sand directly into them. The nausea is intense. The next two hours will be my worst. If I can hang in there until 5pm I know I’ll feel better. How do I know? It’s the voice of experience. You see, I feel this rotten at least once a week, but often more frequently than that depending on my shift pattern. It’s the post night shift hangover. Often I can find the self-discipline to do something with these hours. Sometimes it will be a swim or a ride (and occasionally even a run – though this is not my preference). If I can occupy my time in these hours I can sometimes make it through without feeling TOO horrendous. But today is not one of those days. Today I feel that the couch has claimed me as its own, and to separate would be a mistake. So instead, I’m watching the clock and praying those hands will move quicker than normal past 5pm where I generally find a second wind.

As I sit here, I’m thinking about why I put myself through this feeling week in, week out.  Honestly, it’s not just post night shift either. I know everyone has busy days in their jobs.  I had another one just this week – where I was so exhausted when I finished work that I almost couldn’t drive home. As I drove home tears made rivers down my face as I tried desperately to find some extra energy. I was physically and emotionally spent.  The focus it took to serve the dinner that Dave had cooked almost resulted in a fresh round of tears. That day I had spent hours out of the unit with a critically ill, unstable patient. Hours out of my nice safe environment, where I knew where everything I needed was, where equipment is reliable and there is plenty of help on hand. Instead I was in a small room, packed full of many staff, working quickly and decisively as a member of a team working to keep this patient alive. I think the whole state would have heard my sigh of relief when we arrived safely back in the unit.

Thankfully, days like that aren’t really the norm. The norm is more a controlled environment, where while patients are very sick, we are able to see and respond to deterioration in a proactive way. Generally. Time at work though is time where I feel on edge, waiting for the next call. Constantly considering alternatives, and having a plan A, B, C and even D. Being able to calmly respond on the outside, whilst frantically responding to changing scenarios on the inside.  That’s another thing that is a bit tiring. 12hrs of being in a hyper alert state is tiring.

But of course it’s also incredibly rewarding, this job I do. I have had a rare mention in a thank you card from a patient. Though this week marked a first for me – a thank you email from a Doctor, where she took the time to acknowledge the efforts from earlier this week. I was really touched by that. So, as I sit here feeling crummy, I’m reflecting on some of the things I consider to be the reason I do my job. These are just some of them:

  • I have learned that an anxious patient can have their systolic blood pressure lowered some 30mmHg if you sit with them and listen to them talk about their grandchildren, and let them sing one of the songs they sing to them. Should you be interested Thumbelina is a pretty cool song… Patients aren’t stupid, they will comment that they know you are distracting them from the concerns that had them so distressed. But rather I consider it refocusing one’s attention.
  • A patient whose whole life has been educating students, raising a family and loving their grandchildren can experience fear and terror on waking from anaesthetic after having major facial surgery. You find later that fear is as a result of feeling like they will now look “scary” to kids with the scars on their face. You know time will fade the scars, but how you responded in those initial moments was more crucial than you realised. Being the calm, reassuring, kind voice they hear when they wake will help them on the road to recovery.
  • The environment I work in, is to many a highly stressful environment. To family it is foreign and can be quite overwhelming. After all, you don’t come into the Intensive Care Unit when you are healthy. I’ve found an explanation of the immediate surrounds and equipment helps put family at ease. I let them know that the equipment all serves a purpose and my job is to watch them and my patient and respond as necessary. Their job is to spend time with their family/friend, and not worry about anything else. If they see me look worried then they have permission to worry (and then I pray desperately that I never look worried, and school my features to be calm and friendly).
  • I have been incredibly blessed to work with some amazing people. I find a hospital like a little city or community. There are so many different roles and responsibilities. Sure, some of us have the coal face job, but we would be unable to do that job without the support of a massive team – cleaners, administrators, doctors, allied health, hospitality, technicians, scientists… we all play a part in ensuring that our patients leave in a better state than when they arrived (hopefully!).

Your colleagues and your patients take more cues from you than you even realise. Roll with the punches, laugh with each other, and help each other out. At the end of the day we can smile knowing that we all made it out the other side.

That’s what I’m doing now… because you see, sitting here thinking about my job and the things love… reflecting on so many patients stories that obviously I can’t put here, seeing the faces of the families I’ve met and cared for… all these things have got me through the worst part… the 3-5pm post night shift hangover.