Locked in for a month.

At the moment I'm thinking about VULNERABILITY.


I know. Light subject matter.


I'm fresh from a month of placement so that tends to get me thinking. I was on the hospital's only locked ward, Acute Medical (locked because some of the elderly patients have dementia thus  try to escape hospital grounds and get lost). Being exposed to different people with varying responses to the situations they find themselves in is really interesting to be a part of. It can also be exhausting. 


What I've found is that despite so many differences in patient's conditions, families and beliefs one thing can be said for all of them. When they're admitted to hospital, they are vulnerable. No doubt about it. Most of the power that may well usually be the patients' is in the hands of other people. Right down to when you have your dinner.


There tend to be three main responses to this loss of power by either the patients or those supporting them. 


Anger is one of them. People can often become very different versions of their usual selves when they're stuck in hospital, feeling like they've lost all control over what is happening to them. A great deal of the time, taking some time to listen to how the patient or the supporter is feeling takes a significant edge off the anger. It gives some of the power back. Being a student, asking the patient whether you can give them their IV drugs or their injection, and genuinely appreciating the opportunity to do so, can have the same effect. Because it is entirely their choice to let me do something to or for them, or to refuse. 
Relatives and friends can also be angry about the situation on behalf of the patient. Some become demanding, even abusive. Sometimes there isn't enough active listening, cups of coffee or extra linen that can satisfy the onlooker of the patient's comfortability. There are times when you have to do your job then walk away.           


Dependence is another. Some people can become attached to you and seem to perceive you as more of a friend. Some try to search for personal information to identify with. For the people you get along with it can be difficult not to talk to them like you've met on the street rather than when they're lying in a bed waiting for you to give them tablets. I get wary of telling patients and family too much, because at the end of the day I disappear back to my life and back to uni. They can't call me if they need me when they're discharged. Particularly those patients who are elderly and isolated, it feels almost cruel to let them like you too much, because that connection isn't going to be there for long. The relationship I have with them will end the second they exit the hospital.


This can be a challenge for both parties when you experience something very intimate with people. An example was when I was with a patient and her adult children when she died last week. The family were friendly, courteous people, who were a delight to have around the ward and had a very solid rapport with the nurses.  It was very difficult, hours later for the daughter to leave when her mother's body was being taken from the hospital, as there was tensions within the family. We had been her support base for two months. It had been my supervisor nurse and I who had answered her questions when it was clear that things were not looking good. When it was confirmed that her mother had indeed died, I was the one who held her and prevented her from falling to the floor overwhelmed by grief. It's a choice not to take that home with you, because I know however hard it is for me, it's harder for the people whose lives and deaths it is. I didn't go home and cry about it, which confused some people, even myself, because I didn't feel it like it was someone I was personally connected to. I felt some sadness but I didn't go through any grief, because she was my patient. A lovely lady, but my patient.


Optimism is the other. Not optimism to the point of denial, but the patients who are truly hopeful for the best realistic outcome for them, make up for the ugly sides you often see from people. The patients who are happy to have a student poke around with their medications, surgical site or just take their blood pressure. And then tell you how good a job they think you're doing gives you satisfaction makes the feelings of inadequacy from the negative experiences almost disappear. I admire these people, who  often have multiple chronic illnesses or serious diseases, manage to take the terrible things they are going through as a learning experience for them and me. The wife of a patient I met was recently diagnosed with leukaemia and was telling me how lucky she was. I don't know how these people don't become engulfed in the sympathy, sadness and the fear that surrounds them. But I certainly admire them. 


Because really, underneath any of these responses, is fear. Uncertainty and loss of control make fear in bucketloads. It can even give you insight into how you personally deal with being vulnerable. Learning how to help people who are dealing with situations where they have every right to be fearful, without making it personal, takes time. But now after a month of what felt like living at that hospital, I'm at least getting somewhere.        


It's going to be nice not to have to clean up any poo for a while either. Ha ha


K x

Life tastes better with gluten/ Paramedics week 12

My sister has been on a month long clinical placement at our local hospital for her course which finished this Friday. Because of this she has been keeping some somewhat irregular hours and often missing dinner at home. 

Our family is a little bit special when it comes to food. I have anaphylactic allergies. I've known about this since I was about seven after an unfortunate incident involving a cup of sesame seeds being added to a batch of homemade chocolate chip cookies. Whilst my allergies are somewhat severe (I'm meant to take an Epipen with me everywhere), awareness these days is pretty good and I'm used to having avoid the things that will kill me.

After becoming very ill a couple of years ago Katie was diagnosed as fructose and lactose intolerant. A food intolerance means that someone cannot digest a certain chemical properly. If the intolerant person continues to eat foods containing that chemical, it will simply sit in their intestines unabsorbed and over time impact their bowel. Once the bowel becomes impacted, the person usually becomes malnourished as the compound they can't absorb forms a cement-like lining that prevents other nutrients from being digested. This is different to Coeliac disease, which is an autoimmune disease whereby exposure to the gluten protein gliadin causes permanent changes, inflammation and damage to the villi of the small intestine.

People intolerant to fructose cannot eat most normal wheat based breads, pastas or cereals. It has nothing to do with the wheat and all to do with the fructose based sweetening agents. Because of this, our household had converted almost entirely to gluten-free rice pasta. At first we tried to convinced ourselves that we couldn't tell the difference, then we told ourselves that it, whilst different, it wasn't that bad. However, after months of weird, powdery rice pasta Mum treated the non-intolerant members of the household to NORMAL WHEAT BASED PASTA when Katie had an evening shift. Mmmmmmm.

On another food related note, I made little self-saucing chocolate puddings from scratch without a recipe and without measuring the ingredients. Sorry to sound very tryhardMasterchefwanker, but I was proud of my effort. They are stupidly easy and I am certainly nothing special in the kitchen, they did taste good.

My uni week started very differently as I spent the day at the Berendale school for my "special needs" placement. The point of the placement is for us health students to practice working with people who have communication difficulties. I spent the day with year 7s and year 8s. It was a fantastic day and the kids are pretty remarkable. Whilst they certainly have challenges (I saw four mild tantrums throughout the day), they are so aware of each others' limitations and have created a really positive and supported atmosphere for themselves.

The school looks and feels largely like a normal high school. Once you are inside the classrooms they do look a little more like primary school classrooms than senior school and the work the year 7s were doing was probably around year 1-4. 

Being helpful to the teacher was challenging. I wanted to be as useful as I could but I soon worked out that assisting every child that asked wasn't the way to go. Lots of the kids have attention deficit type problems and it is really important for them to be able to build up the amount of time that they can go without attention for.

The emphasis at Berendale is on independent learning. Whilst the work the kids did was simple, they are expected to be able to become self-directed learners from a much the same age as kids in mainstream schooling. The year 7s were given a book full of worksheets which they had to have finished by Friday. They had to plan out by themselves using their timetable how many sheets they would do and when they were going to do them.

One activity the kids was doing was making a mobile (the dangley, ornamental type not the type you make phone calls on). The mobile was about the food groups as part of their module on healthy eating and nutrition. 

Making the mobile is considered a complex task for the kids as it involved cutting out shapes, shorting the shapes into the food groups and then putting it all together using bluetac and string. Lots of the kids couldn't tie a knot by themselves and I really enjoyed teaching them. Firstly, I would show them and talk them through the process, broken down into simple steps. Then I got them to do one whilst I talked them through it. Lastly they did one by themselves whilst I was still watching just in case they got stuck. All the kids I helped could tie the knots in the string by themselves by the end of the class. Seeing the pride in their faces when they told their teacher that they'd "done it themselves" was very special. 

It also reminded me of how much I enjoy coaching and tutoring.

The feelings were mixed out at Frankston this week. There were frustrations. A couple of subjects have been taking an age to give us our work back. We did get an essay back, the one I spoke about recently where the whole cohort was told that we didn't do very well. Thankfully I still did ok, but the feedback was sub par to say the least. I was deducted marks for neglecting to reference an introductory sentence which had no facts or ideas in it. It was just the sentence at the start of a paragraph introducing the subject matter to be discussed. I was also criticized on the grounds that my language use was both too simple and too complex. Both comments referred to individual word choices. 

The marking schedule was also intrinsically flawed. If you achieved a "pass" mark in each assessed category, you would not have achieved enough marks to reach a pass grade for the whole essay. 

I'm grateful that I still got a decent mark, given that so many smart, capable students did not. I know that as a result of this mediocre marking a lot of people will be feeling a lot more pressure going into that subject's exam than they probably would have anticipated.

I voiced my displeasure in my feedback survey about the teaching of the unit.

There were some lighter moments at uni this week. At one point all the paramedics students ended up with a 3 hour break which we spent a fair chunk of squishing about 8 of people around a 3 seater couch watching funny cat videos on youtube. At one point I was in tears from laughing so much.

http://funniespet.com/funny-cat-pictures-2.html/funny-cats-pictures

 

Tonight I will be planning my impending swotvac week. I haven't been this nervous about exams ever. I probably should have been in year 12, but I wasn't and that's a story for another day. 

Much study awaits.

Paramedics Week 11: survived! & other things that happened this week

Week 11 felt like the calm before the storm. Exams are close, but we can't quite smell them yet. No major pieces of assessment were handed in or given back so the reality of grades was not thrust at us for a few moments. 

I'm trying to get my head around the amount of rote learning I will have to do to prepare for these exams. Rote learning and I have been enemies in the past. I find it boring. I don't like that it doesn't require any analysis and that basically anyone with the most basic level of intellect is capable of it.

At school that meant that I didn't bother to do it. Early on in high school I didn't do it because I didn't need to. I have decent memory and general knowledge and that was enough to do well without doing any work. Once things like languages came into the equation, I dropped them as soon as I could.

The only thing rote learning requires is the willingness and time to do it. I keep trying to remind myself that I will be really pissed off if someone with less raw intellect than me does better in the exam just because they were bothered to put in the work and I wasn't. I don't mean this to demean other people and the less intelligent people I refer to are entirely figurative. What I'm trying to do is use my ego and pride as motivation.

Probably the most enjoyable thing I did this week was watch the end of my brother's footy match. I was coming home from Frankston on Friday and I knew his team was playing against another team from his school at school on Friday afternoon. I also didn't know whether someone was going to pick him up or whether he'd just take the train home. I decided to exit the Monash Freeway one exit later and have a little look.

The boys in my brother's team, Alex in particular, had been talking up the clash all week and it drew quite a respectable crowd. I only saw the last quarter and a half, but Alex played well and his team won. There was a serious amount of 16-18 year old pubescent boy pride on the line, which was hilarious to watch. The victory celebration involved a chant that left Alex hoarse for a day and the boys chairing their coach off the ground.

Seeing my brother in his natural habitat without him knowing I was there was interesting too.  As it turned out Dad was there, so Alex got to chose his chauffeur (he chose me, not that that's important). It has been a little while since I was in an environment full of teenage boys and was reminded of the rowdy, smelly, energetic and vibrant creatures they are.

The other highlight of this week happened at work of all places. On Saturday I served one of the most aesthetically delectable guys I've laid eyes on in a long time. He was tall, tanned with sandy light brown hair and had mysterious dark blue eyes. His arms were very toned (good musculature, but not freakishly ham-like body builder big) and he had a very charming smile. Thankfully I managed to maintain control over my vocabulary throughout the transaction. I ought to be ashamed of my superficiality.

I have my "special needs" placement tomorrow at the Berendale School, a high school for intellectually disabled children. I had my induction a couple of months ago. I'm a little bit nervous but I think it'll be a really valuable experience.

Fines, death and petrol

*Potentially distressing post: the following post talks about the death of infants*

I haven't been writing much lately because I haven't had much to say. Things are very repetitive; eat, sleep, go to uni, go to work, go to the gym, do assignments and repeat.

The universe has been giving me a crash course in motoring responsibility this week. I got my first speeding fine on Monday, going 109km/hr on Eastlink (100km/hr limit). Hardly hooning but a somewhat expensive reminder that when you are driving at the same speed sitting in the same lane for 40 minutes, it is easy to lose track of your speed.

Today was a drainer. I didn't realise I was low on petrol until I was about to merge onto the Monash freeway. Thankfully I realised just in time, but finding a petrol station and getting back to where I started took an additional half an hour so I missed my morning class. 

I arrived at uni in time for my lecture which was about SUDI, SIDS and childhood trauma. SUDI is sudden unexpected death of an Infant, which is the unexpected sudden death of an infant resulting from any cause including asphyxia, homicide, death from a previously undiagnosed health condition or SIDS. SIDS is sudden infant death syndrome, which  where a baby dies and an autopsy cannot determine a cause. In most cases it occurs when a baby falls asleep in an inappropriate environment.

Inappropriate environments include soft mattresses in cots, soft toys or  bumpers in the cot, positioning a baby at the top of their cot instead of the bottom are all dangerous because babies can roll over and become trapped by toys or slip down under blankets and asphyxiate. Co-sleeping in the parental bed and sleeping on the couch with parents are also dangerous because of the potential for accidental asphyxia and crushing. 

Babies between 2-4 months are most at risk of SIDS and SUDI because they are able to roll onto their faces but have insufficient motor skills and head control to roll themselves back onto their backs. Simply rolling over onto a pillow can kill a baby, which is why firm sleeping surfaces free of any pillows or toys are the most safe.

It was an incredibly sobering lecture. It is hard to imagine something more awful than having your baby die unexpectedly. It was delivered well and way incredibly interesting, for example, I didn't know what SIDS does not involve respiratory or cardiac arrest.

The emergency service response to a 000 call to an incident of an infant death. In the past the paramedics would take the baby's body in the ambulance straight to the morgue with the parents following. Now the paramedics encourage grieving parents to spend time with their child and hold them. They are able to take their child in the ambulance, which takes them to the local hospital where a nurse is assigned to them. The nurse spends time with the parents in a private room and assists in taking photos, hand and foot prints of the baby and to help them say their goodbyes before the child is taken to the coroner's office. 

After that component, we were told about all the different ways in which trauma damages a child's development and how paramedics are about double as likely to develop post traumatic stress disorder. 

I am really glad I have a day off tomorrow.

Paramedics week 10: survived

Poor old blog has been alone and neglected lately.
 

Last week was a weird one. On Friday I found myself sitting in class filling in my worksheet whilst the girl next to me filled out a course continuation form. That was an odd experience. As much as I was a little jealous, I have come this far, I may as well tough it out for another 3 or 4 weeks. There was a lovely little lunch for her including an incredible cake made by a quite gifted member of our cohort. It is quite sad that this girl is dropping out, she is quite a character and brought so much positive energy with her to uni each day. THat being said, I completely admire her decision to pursue her passion.

I had one of the most hilarious clinical concepts prac classes on Friday. In prac we practice actually being a paramedic, using our fellow classmates as patients and bystanders. I enjoy the acting as the patient or a bystander way more than being the paramedic! I pretended to be a patient who's ruptured their appendix as well as being an additional scene distraction panicked overzealous sport parent. Prac classes are often great for a laugh and the MICA paramedic who was leading the class had a great sense of humour. One of my classmates cracked a hilariously terrible joke whilst he was being the paramedic, we were all in stitches.

Rather than just telling you how I've been for the best little while (which I'm sure you're all so fascinated by) I decided to represent my mental state diagrammatically...

I feel this diagram could be developed further but it's a good start. It combines the valuable skills I have learned from my inter-professional education subject, IPE1011, as well as Draw Something. Today I am at stage four.

My first parking fine

I got my first parking fine in the uni car park yesterday, $24. I was annoyed. I came prepared to uni with the $7.70 for the all day ticket only for the parking machine to spit all my coins back at me with the message "too many coins." THE MACHINE ONLY TAKES COINS! I subsequently had to feed the metre throughout the day but eventually ran out of coins because it is much cheaper to buy the full day ticket than pay $1.60 an hour. 

That being said, even with the $24 fine, paying to park on the days I drive in has been more coast effective than paying for a permit. I've also never missed out on a spot in the ticket area, whereas the permit zone fills by about 8.45am and plenty of permit holders either end up buying a ticket or parking 15mins away.

Oh university life, how poor you make us.

The other thing that university is making me at the moment is damn tired. I know I'm not the only one. It has been a long semester, exams are looming and all I feel like doing is sleeping. Most of the teachers at uni have been pretty good at guiding us in our revision and seem to want us to do well. One subject is proving the obvious exception. 

We haven't received our major assignments back but one of the teachers told us yesterday that she only awarded 1 high distinction out of her half of the marking. She said that she marked them harshly and that she didn't think we'd done very well. 

I would argue that for the first assignment for a subject in the first semester of first year, if the cohort has seriously underperformed the teaching staff ought to question whether they gave adequate instruction. The reality of first semester of first year is that we have no idea what we are doing. I think it is reasonably logical to deduce that if all of us have gone down the wrong track, then the map we were following was probably not sufficient.

For this year the subject is a combine first and second year subject. Whilst the second years' had a slightly different task, I wonder whether the marker reading their work in the same sitting as the first years' has been to our detriment. 

It irks me because it is not a particularly conceptually challenging or content heavy subject and I don't understand why the staff don't have a more collaborative attitude to their teaching. They seems to be making it difficult to score well to prove a point, but I can't work out what on earth that point could be.

Hopefully I will have done alright, or at least well enough for it not to impact my overall grade too much.

Exams are now less than a month away and I can't wait for them to be over!

Paramedics week 9: survived!

Either of these should be the soundtrack for this week's post:

 

This week was tough. I don't seem to be having too many straight forward weeks at the moment! As I've already said, Katie was very unwell at the start of the week and I wasn't well. I had an assessment on Friday that I had been dreading for weeks and was worried that I wasn't going to be well enough to go to uni to do it. Usually I'm happy enough to use a medical certificate to move an assessment if I am sick but with a practical assessment at the pointy end of the semester it was going to be far more convenient just to do it.

I think it is fair to say that this assessment had everyone on edge. One of the major differences I've noticed between Arts and Paramedics is the slight air of competition between some folk in the course. It's not everyone, but there certainly are a few people who are adamant at all times that they are on top of absolutely all their work and not the least bit concerned about any looming assessment. Call me cynical, but from the start I haven't entirely believed them.

The assessment on Friday changed the cohort dynamics. I didn't come across a single person who has at least slightly nervous. Most, like me, where completely jittery. I barely slept the night before and was so nervous I got to uni half an hour early because I couldn't stand sitting around at home any longer and was terrified that I would get stuck in traffic.

The assessment was for the clinical concepts subject which involved operating 2 pieces of equipment, the oxysaver (metropolitan ambulance edition oxygen and suction unit) and the MRx monitor (3 lead ECG and defibrillator). We were also questioned on facts about each of the pieces of equipment. Learning the facts was simple rote learning but we hadn't had access the the equipment to practice with it since we first learned the skills in week 2.  I found this lack of practice really frustrating.

In previous years, paramedics students have had access to the equipment to practice whenever the building is open. Due to too many breakages and thefts, the Faculty has decided that the solution to this problem is to cease access all together. This kind of pendulum swing response disappoints me. In a course centred around practical skills, the opportunity to practice clinical skills should be paramount. An equipment room booking system seems the obvious answer to me and I know that other unis do this successfully for similar facilities.

Anyway, my assessment went really well, which was a relief. It was nice to see everyone being so supportive of one another and genuinely pleased for each others' success. Hopefully the sentiment will continue through as we lead up to exams!

My Mum came back from a longer business trip yesterday and she brought the family some fantastic gifts. I missed her, especially when I was sick and am really glad to have her home.

I'm going to have to rename one of the cats Julia Gillard

My family has a lot of pets including an above average number of cats. With the "top cat" of the household approaching 12 years old, the younger cats have clearly decided that she's "passed it" and it must be time to establish a new leader. Currently the small female ginger cat is making her intentions known. Her first campaign move has been to constantly intimidate all opposing parties and the second has been to starting building an alliance with the dogs. If she doesn't calm down we'll start calling her Julia, as in Gillard.

This week has been a rather eventful one already. My sister spent Monday night in the local emergency department with a very painful infection. She was very unwell and it was a very distressing incident for all involved. Thankfully she has made a full recovery.

Yesterday I was lucky enough to contract a nasty stomach virus. It has been quite a while since I felt that unwell. I managed to drag myself off the couch and to the doctor where they whisked me onto the bed in the nurses room and gave me IM maxalon and some buscopan. The doctor and the nurse flirted with the idea of sending me to hospital to put in an IV to rehydrate me but thankfully once the drugs started to kick in I was able to keep some fluids down.

Just about every time Mum goes interstate one of us kids has some sort of weird and wonderful medical emergency. Given that Katie was in hospital on Monday night and Mum flew out on Tuesday morning, I was especially keen to do whatever I could to avoid a hospital admission. 

I have an assessment tomorrow that I have been panicking about for a few weeks now. It will be my first practical assessment for paramedic clinical concepts. We are being assessed on our knowledge and ability to operate two pieces of equipment; the oxysaver and the MRx monitor. The assessment looks quite straightforward, however, we were taught the skills in week 2 and until Tuesday had not had a chance to access the equipment again to practice. For a course based around practical skills, I found this to be quite inadequate.

In previous years, students were about to access the equipment to practice for assessments any time the paramedic building was open. Due to too many breakages and thefts, the uni has decided to discontinue unsupervised student practice opportunities all together. This seems an absurd response to me. I don't see why the uni couldn't set up an equipment borrowing/ equipment room booking system through the library. I know that other universities have this kind of system for courses like mine. It gives their students a chance to practice as well and the university can track down the culprit in the even of an unreported breakage or theft.

I have a medical certificate which has me covered for work and uni, Friday inclusive, but I think I will try and drag myself in for the assessment. Sometimes the only thing worse than having to do a test is to have to wait even longer for it to be over.

I saw something today which I found particularly compelling which was this collection of photographs. Craig F. Walker won the Pulitzer Prize for feature photography for this collection and I think he was a very worthy winner.