Posted by: medicblog999 | September 21, 2010

A Mistake to end a career – Moving on

This could well turn out to be a  rambling post because as I am sitting here writing it, I don’t really know where it is going to go. What I do know is that this may well be split into two parts as well so as not to bore the pants off you in one sitting!

As I finished part one, I ended with me walking off the ward and leaving my job as an oncology nurse. This was only two days after I had made the mistake, and my head obviously wasn’t working straight.

All I could think of was running back home to a place where I felt comfortable and safe. Somewhere where I wouldn’t harm anyone and could just get on with life without having to worry about a single thing (as if that was ever going to be possible!)

I arrived back home and tried to piece together what had just happened and what I was going to do now. I should have tried to think rationally, work through what went on; look at a ‘root cause analysis’ and trace back what exactly caused me to make the mistake in the first place. If I did that then I could formulate a plan so that I would never be in that position again.

By reflecting and learning from your mistakes you can become a better provider; you can become a safer professional and you can be assured that you won’t repeat the same mistake again.

That’s what I should have done.

Well, what I really should have done was to stay on the ward, accept the help and support that was being offered to me, work through my own little (or not so little) demons, and get on with consolidating the last three years of training to get me to the point of being the type of health care provider that I knew I could be.

What I actually did was delve into a depression that saw me not work for three months.

I eventually sought some help, I took a short course of anti depressants and Beta Blockers to break the cycle of depression and anxiety and slowly but surely I started to test the waters again.

My wife (at the time) had the difficult job of trying to get me out of bed and into the car for my first day at my new job. I knew that ward nursing was out for me, that was a no brainer! Rightly or wrongly, I could not imagine being able to work on a busy ward again. Even now, writing this, it brings that familiar knot to my stomach.

I needed to work. I needed to earn money.

I took a job in a local nursing home. After all, how hard could that be right?

Day one came and before I knew it I was standing in front of the drugs trolley after being asked from the matron to go and ‘ do the drugs ‘

Shit, shit, shit, shit, shit, shit, shit.

This time, though, I couldn’t run away. I knew that if I walked out of this job I would be finished in nursing. I can bounce back once, but twice???

The only way I got through that first day was to work on the excuse that I didn’t know any of the patients and should have a carer come round with me so that she could double check what I was giving and that they were for the right patient. It worked, but it was a painful experience for me.

I still think that I probably hold the record for the longest ever drugs round at the nursing home!

It should follow that this was then the start of my career and everything was tickety boo, right?

Wrong.

I hated it there. Hated it with a passion.

The residents were fantastic. The staff were great. The manager however, was in it for the money rather than the care of our elderly family, but we made the most of what we could get for them and I truly believe that they were well looked after but more importantly, were actually cared for.

What I hated though was the crippling anxiety every time my alarm went off in the morning. I used to have the blissful 20-30 seconds as I was waking up, and then BANG! I realised I had to go to work and give out the medication again. I couldnt eat breakfast and I drove as slow as I could to put off the inevitable.

This wasn’t going to get better, I knew that then. Or maybe it was that I didn’t want it to get better. Maybe I just didn’t want to be in that situation any more?

Things got bad at home too. My marriage ended after my wife had an affair, but let’s be honest, who can blame her? I must have been a nightmare to be with, plus we were so young. I don’t think of that as a marriage looking back now, we were young and silly and should never have been married in the first place.

All of a sudden, I found myself alone, living in a mates spare room and really not sure what to do with my life.

Waking up one day, I suddenly felt different. I cant explain what happened, I just knew that I had to do something about my situation.

I knew that I had to leave again, but this time it was on my terms. I wasn’t running away, I was choosing to leave. I had made up my mind and I had accepted my own weaknesses but  more importantly my strengths.

I was not capable of looking after 20 patients at one time. I didnt  have the brain capacity to care for so many different people with complex medical histories and on multiple medications at the same time.

What I was though, was a damn good nurse. I knew I could make a patient feel cared for and at ease. I knew I had a great bedside manner. I knew that I had knowledge and a brain like a sponge waiting to devour more and more to help me care for people who needed it.I knew that I wasn’t ready to leave health care.

I applied for a job about 130 miles away from home. I looked at the various options open to me and chose one that wouldn’t have me facing my fears. Where could I work, that wouldn’t have me in the same dreaded environment?

Theatres (O.R)

I was successful at the interview and started work the following month. I moved down by myself, took up residence in the nurse’s accommodation and started to learn a whole new way to be able to deliver healthcare to my patients. Sure, there were still medications to give out, complex infusions to work out and administer, but this was for the patient in front of me. The focus of my attention.

I didn’t have to concern myself with 20-30 other patients at the same time, just this one vulnerable patient, about to go off to sleep in front of me.

I was in my element, and I shone.

I started to enjoy work again. Within weeks, I was bugging the Charge nurse of the Women’s & Children’s wing that I was working in, to let me start to ‘scrub in’ for some of the major cases.

“I don’t know, do you think you are ready?”

“Definitely, let me show you”

What he didn’t know was that I had got hold of the surgeons file the night before and memorised the precise way that he liked to do the radical vulvectomy (A major gynaecological operation to remove the entire vulva and part of the vagina as a result of advanced cancer) that was listed for that morning. I had come in early and opened one of the ‘major gynae’ trays so that I could test myself and ensure I knew all of the names for all of the instruments that we would be using. I had been practicing mounting the sutures at speed, handling the instruments properly and had worked through the operation in my mind a few times already. I knew that at whatever stage the surgeon was at in the operation, I would know what he needed next.

Reluctantly, he agreed and came in to theatre to help out if I needed it.

After 30 mins, he looked at me…

“You’ve got this, I’m going to leave you to it”

After then, I had a plan. I was going to change speciality every year. Within five years I would get a charge nurse position and be able to scrub for ANY case that came through the doors of a multi theatre operating suite.

The next few years saw me work my way through, general surgery, paediatrics, orthopaedics, vascular, gynaecology, neurology, trauma, ophthalmology and my favourite of them all, cardio-thoracics (including transplantation).

4 years and 10 months after starting at the Women’s and Children’s wing at Leeds General Hospital, I got the position of acting charge nurse at a hospital back up in the North East of England.

Three months later, I left to start my Advanced Technician training for the North East Ambulance Service.

So what changed?

How did I turn it around?

That’s for part 3…

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