Dear interwebs, you decide…

So, there’s reasonable evidence to suggest things haven’t been going too well as late. I actually don’t want to go in to too much detail on this post as it has another purpose but in summary: self harm bad, eating and sleeping erratic, pressure on friends insane and unfair and now there’s a crisis referral in. Basically, placement has proved too much. I was back in lectures last week which was fine, not fun, but fine and since then, nothing. I just can’t see how I can go back there. I was meant to be on shift today but after visiting both tutor and GP, I’ve gained a couple of days to make up my mind. I’m seeing my tutor again tomorrow when she’s expecting a definitive answer on what I want to do. So, since I don’t have a clue, I thought I’d let you lot decide for me…

Some details of the options for you:

1) Go back to placement – return on Friday and wait to see what happens

Pros:

• “easiest” option – minimal hassle to arrange
• Nobody needs to know anything, I’m still within a safe amount of absence so we can call it a blip and move on
• The next placement might be better and all I have to do is get there
• Gets me qualified in minimal time, I may yet make a good nurse

Cons:

• If the stress is anything like before I WILL meltdown and it won’t be pretty
• I’m not sure I’m in a state where I can guarantee to provide good care to my patients
• If it’s not just this placement and is more about nursing not being for me, then I’m just wasting mine and everyone elses time
• Any more absence for any cause will be a problem

2) Go back to placement +drugs – go and see my GP, get a bunch of sedatives/tranquilizers etc and drug myself through the next fortnight

Pros:

• Makes the placement pass without meltdown, just float through it
• The next placement might be better and all I have to do is get there
• Gets me qualified in minimal time, I may yet make a good nurse

Cons:

• Is it really ethical? It’s certainly not a sign that I can cope
• I don’t like having to rely on medication just to get me through the day
• Remember what happened last time I had access to a bottle of tranquilizers?
• Can’t drive on them so will have to keep cycling/only take them when I get there
• If it’s not just this placement and is more about nursing not being for me, then I’m just wasting mine and everyone elses time

3) Degrade – pull out for now and restart in March or October

Pros:

• Removes masses of current stress
• Will probably have a different placement next time round which may well be better
• Gives me time to get more stable, try and access therapy etc. and to work out if this is really what I want

Cons:

• Will have to come up with something to do in the meantime, money doesn’t grow on trees
• Why should things be better next time round?
• Lose all the work I’ve done so far
• Seems like a failure in my eyes

4) Quit – leave and don’t go back

Pros:

• Removes current placement stress
• Gives me a chance to come up with new options

Cons:

• Closes the door for good, no turning back
• Still have to work out what to do with my life
• Feels like failure

5) Bury head in sand – deny for as long as possible until I can’t avoid it any more

Pros:

• “Easy”
• Denial can be a comforting state

Cons:

• Doesn’t solve anything, still have to make a decision at some point
• Cowards option

6) … – the one I’m not allowed to talk about. Probably shouldn’t go there.

So, what should I do? I hope you lot know, because I’m damned if I do!

I’d appreciate comments as well as just a mouse click. I can’t guarantee I’ll listen but I could do with as much advice as possible at this point. This post may well be edited if I come up with more options or more pros and cons. Thanks all

This made me angry.

To be completely honest, lots of things make me angry – I’m a volatile moody person at the best of times but this is an extreme example. Yesterday I received a letter from Clinical Psychology in York, you know the ones who’ve been promising me CBT and who I’ve been on a waiting list with for over a year now.
The edited highlights:

Dear Anickdaler,

As you know, you are on the waiting list to see a Clinical Psychologist following referral by your GP. As you have been waiting some time, we would be very grateful if you could confirm on the slip enclosed if you would still like to be seen.

…

Once we have received your reply slip, we will send you an appointment when one becomes available. If we do not hear from you within the next three weeks, we will assume that you no longer wish to be seen and will discharge you.

Thank you very much for your help.

Yours sincerely,

Waiting List Administrator

Psychology Services

My translation:

Dear nutter,

As you know we’ve fucked up and have kept you waiting for over a year with zero communication. Can you please let us know if you have

a) recovered or

b) topped yourself

in the intervening time so that we can remove you from our waiting list and make our statistics look somewhat better. It’s not like we have an appointment available anyway but you know how it is with statistics, got to look good.

Ta muchly,

Pointless NHS administrator #13,465

One wonders if they’d still have sent the letter if I had topped myself and if so, how that would have looked…

 

Placement

So, yes, this whole nursing home thing. Actually, it hadn’t been as bad as I was anticipating. Then and again, if your expectations are that low, it’s actually relatively easy to exceed them. It’s a case of limited members of staff doing their best with a lack of resources and funding. For example, the optimistically labeled ‘Sensory Room’ is in fact a store cupboard. Saying that, it’s one of the better of the limited number of nursing homes I’ve come into contact with. The patients are also all advanced dementia which makes it hard to say the least although there are rays of entertainment with some of the things they come up with. As one of my colleagues pointed out, “How come they still have a full vocabulary of swear words and yet can’t even remember their own names?”.

Tuesday though was an impossible day. We had a new admission which meant lots of management interference to make the place appear respectable. The sheer hypocrisy of it really got to me, pretending this is how it always is for the sake of the new relatives just isn’t right. Plus, I’m not there to be managements slave. Then there were aspects of the admission that really upset me. The wife has advanced dementia – doesn’t know who she or anyone else is and was the one being admitted. The husband also suffers from alzheimers although currently at a much earlier stage. Still pretty much entirely with it but becoming more forgetful, not passing on messages, that sort of thing. I felt so sorry for him, watching his wife and knowing that, but for some medical miracle, that will be him in a few years. *sigh*  Then we were short staffed in the afternoon which meant my supernumerary status really didn’t apply. And to top things off, I got a shit load of highly personal abuse off of one of the patients who really doesn’t have dementia, it’s just nowhere else will take him. Oh, and we had about 6 fire alarms which gave me the headache from hell.

On top of all this, I’ve been desperately trying to return my car to roadworthy (which it now is, yay!, although mostly due to amazing friends rather than me) and becoming highly sleep deprived for varying complex reasons. This meant that yesterday, my alleged day off, when I had a to do list as long as my arm, was spent asleep bar vague periods of consciousness to deliver the car to various appts. In the past 36 hours, I would estimate I’ve spent more than 24 of them fast asleep. This morning I was meant to go into work, hell I had the car back, didn’t even have to cycle and I just couldn’t do it. Phoned in sick and spent another 4 hours asleep. Now I don’t know, this has been a lot of sleep even for me and I haven’t been feeling 100% so maybe I’ve got some short term virus in which case being off is justifiable. But I suspect, as afraid as I am to admit it to myself, any physical symptoms are just a manifestation of what’s going on in my head. I just couldn’t do it after Tuesday so my body has attempted to create an excuse that my mind will tolerate. This isn’t justifiable. So now I have to deal with the guilt on top of everything else

And it all goes back to shit.

If anyone wants the password for the previous post then ask but I warn you that it’s 1500 words of pointless whinging and was written to allow me to sleep.

I don’t know what to do   I’ve started self-harming again which is a real bugger to put it mildly. I’d stopped for 6 months and now it feels so safe to get back into it, the wondering how much damage I can cause without generating too many awkward questions. The temporary distraction then the guilt but at least guilt is an “easy” emotion to deal with.

My first placement allegedly starts tomorrow. I say allegedly because I’m not entirely sure I can do it. I needed something inspirational for it, something to convince me that I’m doing the right thing with my life, that this all isn’t just a big waste of time. Instead I’m in a crap nursing home for people with dementia. The place smells, the staff don’t speak any English and I just don’t think I can face it.

Plus my car failed its MOT this morning. My car was my independence and I’m rather fond of it. I build up deep attachments to anything that is vaguely nice to me, ever if that something is a big lump of orange-painted metal. I now feel like I’ve failed it which I rationally know is insane because what could I have done different? I need my car. Twenty minute drive to placement vs an hour on the bus. Freedom to travel, to escape the Cambridge bubble, to seek space and clear my head all gone.

So it’s back to googling for exit strategies. How did my life come back to this so fast?

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Why is it always so hard?

Damn it all, I’m having a bad day. I know everyone has them and I’m not expecting sympathy more just after a place to rant. I nearly threw my phone full pelt at the wall before it thankfully clicked in that my phone may not appreciate making high speed contact with something quite as strong and unmoving as the wall. I need to get out and do something but I don’t know what, just release all this stress somewhere.

So, despite having occy health clearance, they’ve sent me a letter inviting me to attend an appointment with no explanation of why. This is stressful. I know I have the clearance but I want to have as little to do with them as possible. The more they know, the more damage they can cause. I know I could phone them and see what’s going on but I HATE making phone calls. Besides, if I speak to them they might tell me they’re taking my clearance away…

I’m also coming to a rather unfortunate conclusion about my meds. I like them, they make me happy and as long as I remember to take them we’ve been getting on together just fine. The only thing is that I’ve been noticing recently that I bruise rather more easily than I should and cuts and grazes take an unnaturally long time to heal. Taking up rock climbing should not leave me looking like a victim of a particularly severe case of domestic violence. Now I initially assumed I was just clumsy but my legs are quite literally black and blue all over. My housemate (who has infinitely more common sense than me) asked if it could be a side effect and it turns out that a rare side effect of venlafaxine is poor blood clotting.

Warning: pseudo science mumbo-jumbo follows!

Now, being the unbearable geek that I am, the explanations google was given me weren’t enough so I used and abused my student nurse journal access to read the scientific papers behind the hype. It turns out platelets use serotonin to help with blood clotting but can’t make their own so they need to take it up from the blood stream. Now, one of the effects of venlafaxine is it prevents the uptake of serotonin in the brain. While it initially seems this would be a good thing for the platelets, in a few cases it seems the serotonin receptors on the platelets are sufficiently similar to the ones in the brain that the platelets can’t take up enough serotonin either and blood clotting becomes poor. Now, the papers do emphasise that this alone wouldn’t explain all the symptoms they studied but it is concerning.

Basically, I may have fucked up my blood clotting and the only way to sort it out would probably be to come off my meds. This is all conjecture at the moment, I could just be really accident prone! The thing is I don’t currently have a GP in Cambridge and it will take me a while for me to build up a level of trust with a new one. Plus, I don’t want to come across as an over-paranoid nutter seeing problems where there aren’t any. So, at the moment I’m not taking any action on that one either and hoping that I don’t get stabbed any time soon.

But to be honest, it’s neither of the above that have set me off today (although they may have contributed to me being less forgiving than I usually aim for). Despite studying adult nursing at uni, all branches do the same course in first year which means that the first module is the one on mental health. Fun, fun, fun for all the family… Although, I may have an unfair advantage for our first assignment, 3000 words on “What is Mental Health?”. Do you think I can use myself as the case study

Anywho today we were looking at a scenario that was a tad close to home and the biased, ignorant views of the others in my group really offended me. The way they leapt to assumptions and made judgements based on a few words was painful. Put it this way, if they were running occy health, I’d never have been given clearance and would probably have been locked up or possibly shot for good measure. I tried to argue with them but as I obviously wasn’t too keen on the whole self-disclosure thing given their views, I think I just came across as contrary and deliberately awkward. And yet, these people are in the majority, this is what I’m putting myself into. Is this really what I want? Is it possible to be a good nurse without getting on with a lot of others? Can I rise above all this?

Oh, and my car is due its MOT and I don’t want to act on it because then I’ll have to phone a garage and they’ll almost certainly laugh at me and then try and rip me off as I know less than nothing about cars. And it might fail and then I’d be car-less which would suck.

I don’t want to have borderline personality disorder today. I’d be quite happy being an ignorant fuckwit like most the rest of them. Then none of this would matter.

At long, long last!

I apologise for my extended silences of late both on here and in terms of comments etc. I promise I am still reading what everyone writes. I’ve actually rediscovered having a life (of sorts) and it’s very good! It would be a lie to say everything’s perfect (upsetting someone and then spending half an hour contemplating a railway bridge wasn’t smart) but it’s getting more there than it’s been for a long time.

And as of half an hour ago I actually have my occupational health clearance! This means I’m officially in (we’ll ignore the fact I’ve been going to the course for the last fortnight anyway). And now I’m there, it’ll be a darn sight more difficult to get me out again no matter what happens. The theory bits of the course are great and seem more than doable. I’m more than a little bit nervous about starting placements in a fortnight but I feel in a state to take on whatever it throws at me.

Wish me luck!

Dear cyclists of Cambridge,

As the majority of you seem to be amongst the most incompetent road users I’ve ever had the misfortune to come across, I thought I’d explain some basic road rules to you:

1. Red lights mean stop. For those of you that are red-green colourblind or just looking for an excuse, the red one is the light at the top. When it’s lit up, do NOT go through it. It’s really not that difficult.
2. The pavement is for pedestrians. Those are people without wheels. This means you cannot use it to shortcut round the above mentioned red lights. Unless the pavement has a bike lane, in which case go crazy.
3. Lights. These have a purpose, they’re so you can be seen. Ok, I admit the next bit is fairly advanced science… At night it is dark. In the dark it is hard to see things unless they are lit up. No lights = no visibility = squashed cyclist

Thank you for your understanding in these matters.

Yours in eternal hope of not killing or being killed by one of you,

Ana

Recovery

The depths of depression are akin to drowning in a deep, dark and powerful river. You’re swept away with it, no idea which way is up, blackness everywhere. You attempt to struggle but it’s futile, you don’t know what you’re struggling for. There is nothing else. It’s easier to just be swept away, to surrender to the darkness forever.

But eventually through luck or fate or divine intervention, call it what you will, your head breaks the surface, just for a second. And you see that the blackness isn’t all, that maybe there’s an infinitesimal chance of something more. If you have the strength, the struggle really begins but now it has a sense of direction, some of the futility is gone. But the river is strong, and it’s hold on you is absolute and you’ve been drowning for so long that the energy to fight it is failing.

But let’s imagine you escape that river. You find a reserve of power that you didn’t know you had and you pull yourself from those depths, dripping, exhausted but triumphant. It would be great to pretend that was it. That you’ve won once and for all. The river though is treacherous, it licks around your ankles, calling you back to its embrace.

And besides, when you look around you realise that where you’ve emerged is not really much better than where you’ve been. You’re at the bottom of a deep valley, with steep and deadly sides that seem to reach up forever. The one difference is that if you squint hard at just the right moment, you can see a glimmer of light at the summit of one of those cliffs and it’s incredible, it spells hope. But then it fades again and you wonder if it was just a dream.

So you start to climb those valley sides and you realise that no matter how hard they looked from the base, the reality is a hundred times worse. The rock underfoot is slippery, the hand holds give way at the slightest touch and all the time you can hear the river calling your name, tempting you back to it.

Sometimes on the way up you slip and you find yourself falling again but not always all the way. You find your way barred, things fall on you from the heights and you begin to doubt your reasoning. But occasionally, you catch a glimpse of that light and so slowly you begin again. There are ledges of vague stability where the temptation is to curl up and stay forever but those ledges eventually start to crumble and the climb must go on. Worst of all you find yourself at places where the only way to continue to rise is to fall back to a lower ledge and to start again up a new route. Sometimes the light seems deceptively close and you think you’ve made it but it turns out to be a false horizon, beyond is more cliff stretching upwards perhaps forever.

I’m somewhere on those cliffs. Sometimes the light is near, often it’s so far away as to seem unreachable but I do hope to get there. One day.

Nearly there

I had my meeting of doom with occy health this morning. It was such hard work, I’m drained now. Trying to work out how much to tell them, what details to include and what to omit. No lies, just an edited truth. The good news is I’m not out   However, nor am I entirely in. They want a letter from my GP to confirm I’m stable and that he thinks I’m capable of doing the course. I’ve spoken to my GP already and he’s happy to provide said letter as soon as he gets confirmation from them of exactly what they need.

I’m so, so near.

Other than that I’ve had a bit of a rocky couple of days. The euphoric happiness is giving way to the nagging doubts, the poisonous other side of me that is determined to see me at the very least fail. I’m really hoping this is a result of occy health related stress rather than anything more sinister. The problem is that even though it went as well as I could reasonably expect I’m still sitting here with my mind going down a very bad track.

I’m not ok and I don’t think I ever really will be but I just hope I’m doing what’s going to be the best for me.