Put some Concrete in your Breakfast: Tales from Contemporary Nursing

Put some Concrete in your Breakfast: Tales from Contemporary Nursing: Building Resilience, Empathy and Confidence within a Challenging Profession

Description:

This book gives a sincere yet honest representation of modern nursing in all its forms rather than purely focusing only on the ‘good’ ‘the funny’ ‘the sad’ or the ‘ugly’. This book provides a collection of stories that concentrate on nursing, that validates, educates and encourages those undertaking a career in nursing. In addition, this book also celebrates the amazing rewards that the unique career of nursing has to offer, for those who can find a way to persevere through the challenges.

There is a high rate of burnout among nurses in their early days of practice, because of the high demands placed on them by the healthcare system; hospital administrations; the expectations of management, patients, families and carers; and the sheer size of the patient loads with complex needs these days.

The global pandemic erupting has now pushed a health care service that was already under pressure to now be in complete crisis. The world now knows that we need more nurses employed to be able to move forward from this calamity. This book closes that gap in that it encourages the readers to continue to pursue a career in nursing (despite the challenges that the profession holds) while also positively promoting the incredible work that nurses do.

The chapters within this book, explore a cornucopia of different aspects of nursing including: caring for dying patients, dealing with bodily fluids and how patients are not very good at working out how sick they really are. The book also covers how to manage the care of patients with complex mental illnesses and those contemplating suicide.

This book is targeted at nurses who may feel a little overwhelmed with the world that is nursing but who wish to thrive and further their career. Discussion questions at the end of the book further add to the reflection and learning process of the reader.

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Introduction

The good nurse has a weird sense of humour, is an ace multitasker, and is likely to have abused chocolate, wine and/or chips at least one point in their career.
‘We’ll need to put some concrete in your breakfast’. is a phrase which inspired the title of this book. I heard a sweet nurse say this once, with both humour and empathy, to a patient who had been in hospital for a long time because of chronic gastrointestinal and pain issues. Both nurses and patients have to put a bit of concrete in their breakfast to get through the day. This expression does not dismiss the pain or the struggle that people endure. Rather, this phrase is a way of reminding people that they will need to be brave to get through their hardships and that they are capable of resilience throughout turmoil.

This book is a collection of stories that concentrate on nursing. I am a nurse, and in my opinion, nursing is not just a profession, it is a calling. There is a high rate of burnout among nurses in their first years. This is because of the high demands placed on them by the healthcare system; hospital administrations; the expectations of management, patients, families and carers; and the sheer size of the patient loads with complex needs these days.

If I had read a book full of stories about nursing like this one before I decided to study nursing, then I would have likely had second thoughts about entering the field in the first place. Such a book would have either prevented me from wasting my time, or it would have better prepared me for what I was likely to face in the clinical environment. For this reason, this book is targeted at young people considering a career in nursing who would like to get some honest insights into the life of a nurse.
Although nurses have many interesting stories to share, I have met a nurse who has written about her experience extensively in the format of a book. The truth is, while nursing—especially if a person is both studying nursing and working in a nursing field—one’s world is, naturally, largely consumed with all things nursing.

Insightful nurses will debrief with colleagues and, outside of that, will do what they can to look after themselves and find a way to ‘switch off’, so as to achieve some balance in their lives. Finding this balance can be done through healthy avenues: spending time with loved ones, physical exercise, and mindfulness. Other ways of switching off can be more harmful, if used excessively. For example, drinking alcohol and eating chips while spending time inside alone watching a TV series all day. I feel that all these ways of finding peace can be appropriate, at times, in the right quantities.

The point I am making here is that nurses are often exhausted at the end of the day working. When they are not working, nurses are usually trying to find ways to decompress. Generally, this means the last thing that a nurse wants to do at the end of a hectic shift is to write a story about ‘a day in the life of a nurse’.

When I began to think about writing this book, I found myself at an age where a lot of my friends were partnering up, having babies and settling down. At that point, I made a decision to resign from my job and travel for 4 months before seeing where life would take me next. This time of unemployment, travel, excitement and uncertainty also gave me—for the first time I could remember—a meaningful amount of time to calmly reflect and write about nursing.

The tales that I have written in this book, I feel, shed important light on the crazy and beautiful work that nurses do. The reality of a nurse is different to a lot of other people; a concept that I struggled a lot with as a new graduate nurse. In the first year after I completed my nursing degree, I felt very disconnected from life outside of work because of what I was seeing and experiencing in the hospital. I also felt angry that no one else could seem to understand the nitty gritty of the things that I had to deal with during my day as a nurse, and I started to refer to people who worked in other business sectors as ‘not living in reality’.

When I talked to my dad about this disconnection and the frustration I was feeling, he told me something that, somehow, felt reassuring: ‘All people live in their own reality. It does not mean that one type of work is more valuable or less “real” than another, it’s just different. However, the work that you are undertaking as a nurse is a different reality than what most people have the opportunity to see or understand’.

People outside of nursing often say how they think it would be hard to be a nurse. They ask me what was the most challenging experience as a nurse. I then ask them to choose a subcategory: the goriest? the most upsetting? the most confusing?

I’m not sure what people are expecting to hear when they ask these questions, but when I answer honestly, I think people are taken aback. I’ve learned that most people are not prepared for the answers given to them and my nursing stories can either make great party conversation or can leave everyone looking a little bewildered.

In my career as a nurse to date, I have borne witness to many deaths as well as some intense spiritual experiences. I have been able to help people in the most joyous of ways and I have also seen a lot of trauma, both physical and emotional. I have had to keep a straight face in the most strange and hilarious circumstances, and I have also seen many, many, naked bodies.
I don’t think the general public understands the high amount of responsibility and the complex skill set which nurses need to have in their clinical roles. Some nursing tasks are simple, and can be enjoyable, but these tasks are typically only achieved with a great deal of compassion, patience and people skills. Elderly people, for example, can have a very different concept of time to the nurse that is helping them in a hospital. The elderly person is generally in no rush to get out of bed. The nurses, however, are always looking at their watch, as they are aware of how many things they need to do before the medication round at 8:00 am. The elderly person will be telling a rambling story to the nurse while the nurse will be trying to find a way to get them dressed and showered in record time; breaking a sweat and yet finding a way to not appear harried.

The old-fashioned notion that nurses are just employed to keep patients’ company and do simple tasks is totally inaccurate and outdated. In my first year of nursing, I attended an advanced mechanical ventilation (colloquially known as life support) course to learn how to understand shockable and non-shockable cardiac rhythms and how to run a resuscitation team (see Glossary for words in bold type).

The above examples show the contrast between two important, yet completely different, nursing tasks: assisting an elderly person to shower and dress and knowing how to run a resuscitation team.

The stories of modern nurses are unique. They discuss humanity in its ultimate grit. Yet these stories are rarely documented; perhaps because nurses are just too tired to fathom the idea of using any more brain power to formally document nursing tales in their off time. This, I totally appreciate. As I mentioned earlier, most nurses want or need to find ways to leave these stories at work and tend to immerse themselves in other areas of their life, as a distraction, when the day is finished. This is important, and I fully support these rituals. However, I don’t want my stories, and the stories of other nurses (particularly modern nurses), to be left unheard.

My aim in documenting these stories is to provide a different view of the nursing world. These views are mine, and perhaps, at times, my perspectives will not be shared by other nurses or the public. It is not my intention to throw anyone (patient or colleague) under the bus, but I also need to allow these stories to be honest, which can—at times—also mean ‘raw’. In this current day and age of political correctness, we can often spend a lot of time giving the version of a story that does not offend anyone. No one wants to get their feelings hurt, and for this reason it is appropriate to ‘put a sock in it’ sometimes. However, at other times it is a breath of fresh air to just hear things straight. This book is honest: straight from the nurse’s mouth.

The author wishes to thank the interviewees who provided permission for excerpts of what they said to be reproduced among these stories. Their courage in allowing themselves to be made vulnerable, through sharing their voice and perspectives, is greatly appreciated. These stories are a gift and are an invaluable contribution to this book. The names of the interviewees, as well patients/clients and all other persons discussed within the chapters of this book, have been changed to protect confidentiality.

I have made deliberate efforts to avoid, or at least explain in simple terms, nursing and medical jargon. However, where a simple explanation is not possible, terms in bold have also been explained in a glossary at the end of the book.

These are real stories that I have highlighted during my time working as a nurse for the last years. In this time, I have worked across a wide range of clinical areas, which have given me a plethora of rich experiences. Many of my stories revolve around mental health nursing as this became an area of specialisation for me.

Nursing is a profession that, at times, I have questioned and nearly given up on, but which I continue to be passionate about. In this book, I relate stories containing both the fun and challenging aspects of being a nurse. I’m going to be real here: being a nurse is tough. There are definitely other career paths out there which provide easier ways of getting paid and provide far better working conditions.

You may ask: ‘Why am I still nursing?’ Nursing has forced me to face some of the most challenging and stressful situations that I have ever encountered. Nursing has also given me the opportunity to help people find some healing on the worst day of their life. In the tough times, and the good times, my experiences in the nursing profession have added more meaning to my existence than any other job has done. Becoming a nurse is the most life-changing decision I ever made.

A date-ordered list of the areas of nursing in which I have worked along with the qualifications I have obtained along the way are listed below in chronological order.
2004: School work experience in a paediatric ward in a rural hospital (Griffith).
2005: School work experience in a nursing home. Employment commenced as a personal carer in this nursing home following the work experience placement. Graduated from Grade 12.
2006: Commenced Bachelor of Nursing at university. Continued employment as a personal carer in a nursing home.
2007: Commenced employment as personal carer in the community for an agency. (In people’s homes and various nursing homes.)
2008: Continued employment as personal carer in the community for an agency. (In people’s homes and various nursing homes.)
2009: Exchange semester in Bachelor of Nursing studies in Canada. Employment commenced as a medical room assistant and phlebotomist at a medical centre. Certificate III in Aged Care achieved.
2010: Self-organised volunteer work as a nursing aid in the ASSADE medical clinic in Guatemala. Employment continued as a medical room assistant and phlebotomist at a medical centre. Bachelor of Nursing achieved.
2011: New Graduate Registered Nurse Program: intensive care unit, medical and surgical nursing, palliative care. Level: registered nurse.
2012: Volunteer work to provide medical clinic advice (as well as helping to run activities for orphaned children) in Vietnam for the Friends of Vietnam Orphanages (my father being the founder of this organisation). Relief nursing: medical and surgical nursing inclusive of the following specialities: endocrinology, respiratory, maternity, cardiology, pre-operative care, cardiothoracic surgical unit, neurovascular, urology, orthopaedics, infectious diseases and stroke and neurology unit. Charge nursing at a nursing home. Level: registered nurse.
2013: Casual and agency nursing in a variety of clinical settings as listed for 2012. Rural placement in a major trauma hospital with a large Indigenous population. Experience inclusive of surgical and medical ward nursing including neurology, oncology and rehabilitation. Four-week contract at a community mental health team for adults with moderate to severe mental illness, which led to 2 years of contracts (working with that same team). Certificate IV in Training and Assessment achieved. Graduate Certificate in Palliative Care achieved. Level: registered nurse and clinical nurse specialist.
2014: Continued employment in a community mental health team for adults with moderate to severe mental illness. Graduate Diploma in Mental Health achieved (with Distinction). Level: clinical nurse specialist.
2015: Continued employment in a community mental health team for adults with moderate to severe mental illness. Commenced employment as the clinical nurse consultant in a youth recovery residential program. Level: clinical nurse specialist and clinical nurse consultant.
2016: Continued employment as the clinical nurse consultant in a youth recovery residential program. A Master’s of Mental Health Nursing achieved. Level: clinical nurse consultant.
2017: Continued employment as the clinical nurse consultant in a youth recovery residential program. Quarter-life crisis halfway through the year—resigned from my job and took 4 months to travel and volunteer. Self-organised volunteer work to help run activities in a mental health day program at ‘El Cribo’ in Lanzarote, Canary Islands. Upon returning from overseas, commenced casual work as an emergency department consultation nurse and as a senior nurse with a mental health crisis response team. Level: clinical nurse consultant.
2018: Contracted as a senior nurse with a mental health crisis team. An additional role within this team included working with police to provide assistance with assessments and care plans for clients who came into police contact and who presented with a mental health concern. Level 3 registered nurse position achieved. Commenced employment with a community mental health team for complex individuals with mental illness who are treatment resistant and difficult to engage. Level: clinical nurse consultant.
2019: Continued employment with a community mental health team for complex individuals with mental illness who are treatment resistant and difficult to engage. Commenced employment as a clinical nurse consultant helping clients to improve their metabolic health as part of a large research study. A Master’s of Nurse Practitioner achieved (with Distinction). Endorsed as a nurse practitioner. Level: clinical nurse consultant.
2020–2022: Continued employment as a clinical nurse consultant helping clients with their metabolic health as part of a large research study. Commenced employment as a mental health nurse practitioner in a rural, coastal town in Australia. Level: Endorsed Nurse Practitioner. Accredited Dialectical Behavioural Therapist.
2022–present: Commencement of independent clinical practice as a Nurse Practitioner specialising in mental health.
There are not enough books out there which promote the amazing work that nurses do to help society. The global pandemic erupting has now pushed a healthcare service that was already under pressure now to be in complete crisis. The world now knows that we need more nurses employed to be able to move forward from this calamity. I hope that this book being read may help close that gap, in that it encourages people to consider a career in nursing while also positively promoting the incredible work that nurses do.

Thank you for taking the time to read this book. I secretly hope that some aspiring nurses, or people feeling a bit lost as to where to go in their careers, might read this and consider a career in nursing. This book also brings about a great opportunity to break some nursing stereotypes that we have in our culture and allow people to appreciate what the modern nurse contributes to the world. And then, of course, this is a nice chance to properly talk about all those gnarly nursing stories that I’ve had to downplay at parties and family dinners.

I’d like to finish my introduction with a poem by writer Suzanne Gordon. Suzanne is an award-winning journalist and author with special expertise in healthcare systems, teamwork, patient safety and nursing. My lecturers gave this poem to me and my fellow students when we were undergraduate nurses. At the time, I glued it into the front of my nursing portfolio, and I’ve kept it in that same place ever since. I use Suzanne’s poem as a reference point and read it when I need to be reinspired when clinical scenarios are tough and I am consumed with self-doubt. Every nurse needs a reminder—in times of chaos or tragedy or hopelessness—as to why they chose their profession, so that they won’t forget the important contribution that they do, in fact, make.