Category: Nursing

Posted in All The Bits In Between, Family, Health, Nursing

Why go to an Emergency Department

Posted on by nursenoosha

Hello beautiful people 😮

Sorry about the delay in this post, work has been incredibly busy these last few days and the most I could do at the end of each shift was shower and fall into bed!! The photo above should be called the terrifying and highly unusual time you have empty beds in the emergency department, so rare an occurrence several months ago that we took photos!!

This topic will be about what type of presentations we see in a busy Emergency Department (ED), who, why and when you should attend an ED. Of course this is just my observation and opinion not endorsed by any Local Health District, State or Federal Government Health Policy. MY OPINION AND OBSERVATION.

Yes I know we should not subscribe to Wikipedia however this is a fairly good description of what constitutes a medical emergency;

‘A medical emergency is an injury or illness that is acute and poses an immediate risk to a person’s life or long term health. These emergencies may require assistance from another person, who should ideally be suitably qualified to do so, although some of these emergencies can be dealt with by the victim themselves, by attending to Basic Life Support. Dependent on the severity of the emergency, and the quality of any treatment given, it may require the involvement of multiple levels of care, from a first aider to an emergency physician through to specialist surgeons.’ http://en.wikipedia.org/wiki/Medical_emergency

If you think you or someone else is experiencing a medical emergency then please call 000 (in Australia)

http://www.triplezero.gov.au/Pages/default.aspx

Upon presentation to an ED the patient will initially be quickly assessed by a triage nurse and assigned a triage category according to their presentation.


The triage category is based upon the clinical assessment of the patient by a highly experienced registered nurse in keeping with current guidelines in place that determine what clinical signs and symptoms fit which category. The wait times recommended are followed by percentage suggestions that indicate the importance of adhering to these suggested wait times. For example someone presenting with clinical signs and symptoms that are allocated a triage category 1 will require immediate medical attention and this should be adhered to in 100% of cases where a triage category 1 has been given. This category indicates that the patient requires immediate life saving attention. I am trying to example all this in the  simplest manner so that those from a non-healthcare background will find it easy to follow.

For those that are interested in reading up further on what and how the guidelines are for allocating a triage category below is a link with a brief overview from the Australian Governments Department of Health and Ageing, Emergency Quick Reference Guide.

http://www.health.gov.au

So you feel unwell or have an injury and present to ED you are given a triage category score by the triage nurse, so what next? Your wait time will then be determined by your scale. If you are a category 1 or 2 you will be attended to very promptly by medical and nursing staff, the process usually follows the patient being taken from the triage room to the resuscitation bay or acute area depending on how stable the patient is and where beds in the department are available. If your triage category is lower than 1 and 2 and you are stable then you will more than likely remain in the waiting room until your name is called by a doctor that will be assessing you. During your time in the waiting room a nurse may do a brief assessment and attend to things such as your vital signs, blood pressure, temperature etc and may provide you with some basic treatment such as analgesia or anti-emetics. The idea of being attended to by a nurse in the waiting room is to ensure you remain stable and comfortable while you wait to see the doctor and possibly fast track your treatment by taking and sending off bloods so that the results may be available when the doctor is ready to see you.

People in the waiting room can at any point also deteriorate and if you feel this is happening to you or the person you are with you need to notify the nurse immediately. People in the waiting room can also get frustrated at the notion that people arriving after them are ‘jumping the cue’ by being seen to by a doctor first or by-passing the waiting room altogether, keep in mind that these people are obviously so unwell that they have received a higher triage scale and require more urgent medical attention than someone that is stable enough to wait in the waiting room.

Some people that are given a triage scale of 3, 4, or 5 may even be well enough to have attended a general practitioner (GP) or local medical officer. People often present to an emergency department with a presentation that could easily be attended to by a GP. For example feeling ‘a little under the weather’ with flu like symptoms, does not really constitute a medical emergency. Actually without being judgemental I would like to list a few presentations that could easily be seen to by a GP.

Not Emergencies:

  • Splinter in the finger (not active bleeding, nil signs of infection, no attempt at getting it out, circ obs intact)
  • Mild back pain ongoing for years (previous investigations NAD, nil analgesia taken, pt walking fine, wants a referral to a physiotherapist)
  • Woke up at two a.m. with a sore big toe (no discolouration, nil swelling, circ obs intact, nil analgesia taken)
  • Need a repeat of a prescription
  • Need a pregnancy test
  • Need an STI check
  • Need a mole checked
  • Need someone to talk to (sad but true, yes we will take time to talk to you, however if someone else requires emergency medical attention, we are running, no more time for chatting!)
  • Seen here days ago and need someone to re-do dressing on leg wound….. (hhmm we can do it however the wait time will be a good few hours, not sure why pt wasn’t educated on how to change dressing or use GP or community nurse?)

The list goes on in regards to what is not necessarily an emergency and you will find yourself sitting in the waiting room for hours. Although the triage scale provides a guide on how long your wait should be, realistically if it is a busy shift in the ED and ambulances are lining up outside with patients to drop off and the waiting room is full it is fair to say that your wait will be much longer than what is estimated in the triage chart. Please also remember people as well that just because you came in an ambulance does not mean that if you are more stable than someone that walked in who is really unwell you will be seen before them!! If you are stable enough to climb off the stretcher and sit in the waiting room then that its were you will wait, calling an ambulance does not and will not fast track you into seeing a doctor if it is not urgently required!

Examples of Emergencies:

  • Chest pain
  • Loss of Consciousness (LOC)
  • Shortness of Breath (SOB)
  • Seizure
  • Anaphylaxis
  • Trauma ( Motor vehicle / motorbike/cyclist accident, fall, penetrating injury, blunt injury)
  • Haemorrhage (bleeding)
  • Haematemesis (vomiting blood)
  • Appendicitis
  • Ectopic Pregnancy

This list of course is no where near exhaustive, however I just wanted to give a small overview of what we see and treat frequently as medical emergencies.

So the point of this post is to firstly encourage people to recognise a potential emergency and act swiftly by commencing CPR if necessary and calling triple 000.

Second point to this post is to try and encourage people to recognise what may not constitute a medical emergency and encourage people to seek medical advice from a GP if appropriate. The result of people attending a GP as opposed to attending the ED will mean less of a financial and time burden on the public health system, freeing up more resources (staff, equipment, beds) for patients that really require emergency treatment. The benefits to the individual who presents to the GP as opposed to an ED may include shorter wait times to be seen, having readily available follow up care and seeing someone in their local area. Some people may not attend their local GP because of the rising costs involved in visiting the doctor. It is worthwhile shopping around as several local doctors still bulk bill, that is, charge it to your medicare card, or waiver fees for people on pensions and those with health-care cards. Most local doctors can order x-rays, give prescriptions, referrals to specialist and do some minor procedures such as sutures for small lacerations. If you find a good one that can do all this for you stick with them for good continuity of care.

I guess there will always be that case were it just isn’t clear whether the situation is bad enough to require attending an ED and in that case I would say just come in!! Better to err on the side of caution and get checked out than leave it to late!! However if you are told that there will be a wait and you find yourself sitting there for hours and hours……and hours please as difficult as it is refrain from becoming agitated and aggressive towards the staff. They are trying their best to see everybody in a timely manner. The emergency staff are restricted by the resources available to them, they are often under-staffed running without enough nurses and doctors on board due to continuing health budget cuts and further complicated by limited bed spaces.

Yes our health-care system is one of the best in the world and yes we are still struggling to provide more timely care to the public, however now would be great to suggest that we spare a thought to those in third world and less fortunate countries than ours that don’t even get the, dare I say it, luxury of waiting for hours in a waiting room knowing that they will receive free treatment from highly skilled health-care workers……. So if anyone feels the need to become abusive towards those that are getting underpaid and overworked to provide you with good health-care treatment perhaps a more effective method of venting would be to write a letter to our State Government, those that write the polices and provide the funding for a system that is obviously already stretched to its capacity and is struggling to meet the needs of the population.

Now I do not want to blur the lines here about whether or not one should attend and emergency department as I said previously if in doubt check it out!! I am simply trying to explain what, how and why we do things in an ED.

I myself at times have been known to attend an ED when it was probably unnecessary……perhaps even recently….perhaps because I was too tired and unsure to diagnose my own kid with a virus as opposed to measles….

So maybe Ill take my own advice and go back to relying on my GP for as much as possible or subscribe to my other theory of…..

Hopefully this helps clarify how an emergency department works even just a little bit.

Now for a very deserving shout out to all my amazing colleagues, I know at times, we will be punched, spat at, threatened, insulted, overworked, underpaid and left exhausted but please don’t stop doing what you do!!

ED nurses, doctors and allied health workers, ward clerks, clerical staff and security all do an amazing job to keep things running smoothly while assisting in saving lives!!

Keep up the awesome work guys, without you so many would not have survived!!!!

Peace, Love and Happiness 😮 xoxoxoxoxoxox ❤ ❤ ❤ ❤

Posted in All The Bits In Between, Birth, Death, Family, Fun, Health, Nursing

Friendship

Posted on by nursenoosha

Growing up I attended a small local public school in Bondi, it had a great community feel and most of the children that went there lived in the area. Friendships were formed between nearly everyone at the school, being a small school it was easy to get to know and be mates with everyone. As we local kids got older most of us attended the same local high school, again a fairly small school. Friendships were still maintained and some new ones were formed. There never appeared to be any significant social dramas, no obvious issues with bullying and over all everyone seemed to get along quite well often hanging at the beach together in the afternoons and on the weekends…….

Or was this all just on the surface, a giant friendship facade or fairytale. Did I forget to mention the bitching behind each others backs about how so and so stole blah blahs boyfriend and how he said you said blah blah so now she’s going to get you……. Friendships, like any relationships, intimate, family or other, are hard to establish, achieve and maintain. I still in my adulthood find myself nursing the broken heart of another failed friendship. So why does this happen? Perhaps I have unrealistic expectations of how friendships should go?!

I see one woman’s facebook who is always going overseas and having weekends away with her girlfriends and they all look so happy and joyous. They look like they are having an amazing time with not a care in the world, like a bad word could never be said between them……Who are these lucky people that have known each other their entire lives and support each other unconditionally through breakups,marriages, births and deaths?!

I feel I have a few close friends (probably could count them on one hand) that I could count on to be there for me through those times and I mean really count on!! The type of friend that you can call on any time of the day or night and they would be there for you immediately. I believe I’m that type of friend, however sometimes I feel  like I’m the back up friend, the friend that only gets called if no-one else is available or because I’m the ‘fun’ one, or the one that will pretty much do anything with and for you…….

So how do I let my friendships develop like this and then dissipate, well I think I start out being the fun one that will do anything for you and then after awhile it becomes exhausting so I become burnt out which in turn leads to boring. Boring leads to no longer fun to hang with or be around.

Another natural progression Ive observed in friendships as one gets older is the tendency to get caught up in the busyness and chaos of everyday life and forgetting to touch base with friends until it seems like to much time has passed and then the friendship seems to have been lost.

Sometimes I see friendships lost or strained due to new relationships being formed. People who were once great friends loose touch when one of the people in the friendship begins a new relationship with someone and then all their time becomes tied up with their partner. So what is the etiquette here?, Do you let the person know that you miss spending time with them? Is it necessary as an adult to tell a mate that you miss hanging out with them the way you used to? Is it immature? How does one maintain a once perfectly good friendship with someone once they have begun a new relationship? Are adults even allowed to long for normal healthy friendships? Why does it feel so shit when you realise that your in a friendship were perhaps the person really doesn’t care as much about the friendship as you do?

So here’s another friendship dilemma, you’re in a relationship already and have some great single friends who you like to go out with, however every time you do go out with them, they end up spending half the night trying to talk to and seek out other single people and end up completely ignoring you in the process, even though you’re only there to see them. So is it an unreal expectation to want to hang out with a mate or some mates for the night without them ditching you to try and pick up someone?

I don’t know what the friendship guidelines are however I do know that I have one or two friends who although we don’t see each other for months its like we haven’t missed a beat when we do eventually catch up. Then there’s the friends that you also actually do care about who you say to “we should catch up” and they say “yeah for sure we should”. And you never do so you assume its because both your lives are so busy and just like in school you hear that their child had a party or a concert or something that you felt sure you would have been invited to but you weren’t, am I over thinking it or am I just not as good a friend as I thought?

Wow one would think that this whole drama with friendships would be something that we out grow? So I guess that to add further complication to the issue of am I a good friend or not is the idea that friendship does get second place to relationships as we get older. It seems most of my friends will gladly whinge about their partners when they are not around however instantly if they are there the choice between time with them and friends is simple. It makes sense though right, you chose your partner because they have (well hopefully) all the qualities you like in a person so why would you not want to spend all your spare time with them instead of friends?!

Whatever happened to the old analogies of “bros before hoes” or “chicks before dicks” as crass as these expressions are I interpret, and correct me if I’m wrong, that they mean to say don’t replace your mates with a new relationship. In this day and age is this a realistic expectation? Who would rather spend time with their friends than their partner? Is there no middle ground? Wouldn’t life be all the more fulfilling and rich with various people in our lives?

So where is the obvious middle ground, why cant you have your partner and your friends too? What happens if your partner doesn’t like your friends or vice versa? What happens if your partner or your friends force you too choose? Who would you choose, a friend of ten years or a partner of two?

You know what I say, never make someone choose because I suspect that if you do you may well be the one that looses. However if the partner or friend really think your worth it I guess in the end they will make time for you!! So at the end of the day people, young or old my take home message is this, friendship is hard and fickle. So if you have been privileged enough to be classified by someone as a good friend respect and appreciate it.

So saviour the true friendships you have, decide on the ones which are worth fighting for and let slide the ones that seem like too much work with little in return.

And to all those true friends of mine

The ones that have with stood the test of time

The ones that have seen me through thick and thin

Kerry, Kristy, Sue, Alison, Jessie, Maggie, Phill, Brennnos, Dave, PJ and Din

With you guys my feelings I’ve never had to hide

And yet you have remained by my side

All your support, advice and kindness

Has always made me feel like our friendships were timeless

Days may pass without a word spoken

And so this right here is a small token

Holding dear in my heart is this true notion

That despite time and distance our friendships will never be broken.

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Peace Love and Happiness :o)

xoxoxoxoxoxoxoxoxoxoxoxox

Posted in All The Bits In Between, Family, Health, Nursing, Spiritual, Uncategorized

Mandatory Reporting: Legal Requirement versus Moral Obligation

Posted on by nursenoosha

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Recently on a busy night shift I found myself working in the paediatric (with the kiddies) section of the emergency department (ED). Our ED is quite large with various sections including, Triage, waiting room, sub-acute, acute, and resus to name a few areas. All these sections require nursing staff and nurses are allocated to a certain section each shift depending on a few variables addressing things such as skill mix, time of shift, how busy the department is and any other things the manager needs to address.

Staff can check the allocations for the next day to see where they will be working the following shift. I rarely do this, I like to turn up on the shift not knowing where I will be working, I think if I check the day before then I may spend the whole time until the shift starts worrying about how busy it will be or whether or not I’ll cope with where I’m allocated to. Luckily in regards to the coping issue I work with fantastically supportive senior staff and the issue of not coping…well it wouldn’t be an issue, all I have to do is raise my voice for some support and it would be there and if need be I would be reallocated to a different area for that shift. Anyhow I have digressed, so back onto the topic, on a busy night shift I found myself to be in the paediatric section for the night. I was actually really chuffed with this as I always am when allocated to work in paeds because I enjoy working with the kiddies a lot.

I feel very confident working with children and families, I think this in part is because of having children in my life for nearly half my life. I feel I can build a good rapport with parents and try to be a good advocate and carer for my patient and their family. I also always try to address and alleviate any of their fears or concerns in regards to the patients presenting health complaint.

There are often two types of parents that bring their children into and emergency department, those that have used their common sense to deduce that their child needs emergency medical attention and those that just plain have no idea. For example, patient brought in by parents for Asthma, good decision!!! Patient brought in by parents for tiny splinter in finger, no signs of infection, no distress in child, no attempt to get it out and not seen by local doctor………hhhhhmmmm medical emergency? I think not……………

And then there are those children that, well, something just doesn’t sit right! And if the stories aren’t adding up and matching the clinical/physical presentation then something needs to be done, the situation requires escalating to the appropriate services. As health care workers we are bound by the NSW Legislation as Mandatory Reporters:

who are mandatory reporters?

Mandatory reporters are defined in NSW legislation. They are those who deliver the following services to children as part of their paid or professional work:

  • health care – doctors, nurses, dentists and other health workers
  • welfare – psychologists, social workers and youth workers
  • education – teachers
  • children’s services – child care workers, family day carers and home based carers
  • residential services – refuge workers, community housing providers
  • law enforcement – police

Any person with direct responsibility to provide the above mentioned services must report risk of significant harm to children.

Managers, including both paid employees and volunteers, who supervise direct services are also mandated to report.

Mandatory reporters are not obliged to report risk of significant harm to unborn children or young people (those aged 16-17 years). However they are encouraged to make a report if it is appropriate.

http://www.community.nsw.gov.au/preventing_child_abuse_and_neglect/resources_for_mandatory_reporters.html

What does all this mean, well it means that as one of the above mentioned professionals if you have a concern, suspicion or evidence of a child or children being at risk of harm or neglect then it has to be reported to Family and Community Services.

It is a difficult situation when one finds themselves in a situation where they see, hear or sense that a child may be a victim of harm or neglect. Further to this is the unspoken emotional response to ones suspicion or findings. That moment where you feel like there is a giant stone dropped in your gut, the moment when you feel like you might be sick or lose your shit and start crying or demanding answers as to how and why this could happen to an innocent child?!

Then quickly followed by the moment where you regain your composure as a professional and think through your legal obligations. What have you seen, heard or suspected that has led you to consider making a report, are your concerns significant enough to warrant making a report? If you find yourself asking these questions and wanting to discuss them with someone a great first port of call is your Nurse Unit Manager. Discussing your concerns with a senior staff member can help you decide if your concerns warrant a report to Family and Community Services. If between the two of you,  you require further advice in regards to the matter then contacting:

Child Protection Helpline on (02) 133 627 (for mandatory reporters)

or

Child Protection Helpline on (02) 132 111 (for general public)

Above numbers are useful resources and will advise you of actions that may need to be taken. There is also an on-line service that requires you to fill in some information in regards to the nature of your concern and upon completion of this a report will be generated with action recommendations if any.

http://sdm.community.nsw.gov.au/mrg/app/summary.page

Now this is all very useful information as a mandatory reporter if you are certain about the facts you are putting forward, however what happens if your unsure and you are just going on things you have seen that don’t seem right and things you have been told that don’t add up? What do you do? What would you do? How would you respond if you found yourself in a situation where you thought the safety or wellbeing of a child was being jeopardised? All legal requirements aside……If you weren’t quite sure about your concerns? Colleagues or others that you had discussed your concerns with alluded to the fact that they thought you may be over reacting or that you should stay out of it? What would you do then? If you had that gut feeling and nagging doubt that something was not right with this poor child/children, would your moral obligation negate all the advice you had received?

http://www.keepthemsafe.nsw.gov.au/

Keep Them Safe is a government initiative that promotes a shared approach to child wellbeing, to encourage all members of society to be aware and accountable for children’s safety and wellbeing. It is not just for mandatory reporters but for everyone. To promote awareness of the tragedy that lies beneath the surface of so many children’s lives. Unfortunately children at risk of harm and neglect are out there in our communities. So what do we do? Who are we to say if someone is mistreating a child/children? Are we passing judgement on another persons parenting if we have suspicion that they are not providing the best protection or life choices for their child/children? These are some of the moral dilemmas that one may face if they have concerns regarding a child/children’s wellbeing.

Once faced with this situation my first response as a humanitarian, mother, carer, empathetic human being would be to address my moral obligation! How could I live with myself if I did nothing? How would I feel if I did nothing and as a result of my inaction the child/children were put at further significant risk of harm or worse even death? How could I live with that on my conscience? If my concerns were unfounded and no further action was taken, then was there any harm in me reporting my concerns? Is it better to report something based on a few small concerns, than not to report at all? Of course it is!!!! It would not matter to me, if ten people told me I was overreacting!! If I had a concern for welfare and it played on my mind, my moral obligation would be enough for me to warrant reporting it.

The Legal Requirement versus Moral Obligation debate doesn’t weigh to heavily on my mind because as I’ve said if it was against my morals not to report something then why would I not?! However the Legal Requirement is a bit of a loop-hole for Mandatory Reporters, a kind of skip to the end of your moral dilemma card. As a Mandatory Reporter if you come across a patient, child/children that you have a concern for in regards to neglect or harm then you are legally required to report it. The next steps that need to be taken are no longer decisions made by you rather ones that are made by Family and Community Services. Therefore if Family and Community Services were to advise you to contact your local police immediately in regards to the child/children you are reporting about then this is action you must undertake! Furthermore if Family and Community Services then dispatch a child protection team to take over the case that you have reported your concern about, then you relinquish your responsibility/care for the child/children to the new team involved.

There are policies and procedures in place in different ED’s that can be used as GUIDELINES on how to manage the care of a child/children that require a mandatory report being submitted regarding them. These are guidelines and should not be used to determine whether or not a report should be made. What determines whether or not a report should be made is your legal and moral obligation!!!!

Why would you not want to look out for the best interests of the child? Why would you not want to make them safe? Don’t ever feel like your making a judgement call on the family! Don’t ever not report because it’s too much paper work! Don’t ever not report because you don’t want to have to go to court in the future! Don’t ever not report because you’re not 100% sure of the facts because no-one ever really can be!!!

So if a Doctor or anyone ever second guesses your actions and says “Who made a Family and Community Report and who rang the Police at four in the morning?” And “Show me where in the policies and procedures manuals it says to take that action”? One can turn and say to them “it is OUR professional responsibility and legally required as mandatory reporters to escalate this case for further assessment” AND “it is also my moral obligation to provide protection to a child/children who may be at risk of harm or neglect”!!!! Or if someone says to you “remember not to let your emotions guide you, we are professionals” again respond with “Yes and as professionals it is our legal requirement to report it”. Try not to doubt or second guess your decisions and actions, let your legal requirements and morals guide you!!

As I said in the beginning I do really enjoy working in paediatrics and I hope I never have to experience cases like this. However if I do, I can assure you that I will speak out for those that cannot speak for themselves, I will break the shroud of secrecy and silence!! I will advocate against child abuse in any form!! No other persons opinion will sway me into subscribing to the behaviour of ignorance is bliss, what may be bliss for some, may well be hell for others!!

I hope for a world where people love, protect and rejoice in the beauty and innocence of children. A world where everyone recognises the vulnerability of childhood and as a world-wide community work together to always provide children with safety and protection; nurturing lives, filled with love!!!!

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Peace, Love and Happiness xox 🙂

Posted in Death, Family, Health, Nursing, Spiritual, Uncategorized

Death: World Suicide Prevention Day

Posted on by nursenoosha

Death. When is a good time to talk about it. How does one bring it up. Will it ever be a topic not enveloped in secrecy, fear and sadness?

I guess for some cultures it may not be viewed like this. However in ours it is. What is even harder to discuss is, the untimely death. What is an untimely death, what constitutes untimely?

Who decides whether a newborn, an older adult or some one in their younger adult life that passes away suddenly should have their passing as labelled, untimely? When is there a predictable time or a set time for death………………………….

As painful as it is for me to discuss at times it still needs to be discussed…….. Yes there is a predictable time or even a set time for death. We see it set when were are about to switch off life support machines and we see it in the future looming ahead of a patient after they are given a terminal diagnosis…………………………

But perhaps the most emotionally painful kind of death that can be labelled as both untimely and with a predictable or set time for death is that of a suicide victim………….

If one is to think about it, if one can tolerate thinking about it, one can only draw the conclusion that if a person they have known who was generally known to be of sound mind committed suicide then surely they must have known that death was imminent. If they had such clarity then why did they still take their own lives?

People assume that the suicide victims must have felt so sad and helpless that they just no longer had any desire to live. Does sad and helpless constitute, depression or  a mental health issue that may or may not have been diagnosed or treated? This kind of death raises so many questions and leaves so much heartache and often unanswered questions for those left behind…….. I call those lost by taking their own lives suicide victims because in a way that is how I see them, victims of their own demise.

The first question always asked after one learns of someone committing suicide is, Why? The why, Ive seen so many times is often answered with, because they felt sad or hopeless, like nobody cared enough to help them. The next statements I often hear is “if only I had, noticed, tried harder, done something differently” And to this I say “I’m sure you did everything you could” “because if they really truly no longer wished to live, they would have found a way to end their life, no matter how hard you tried to make them stay”………………..

http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Suicide_family_and_friends

I work with some amazing people and we are confronted by death regularly and no one is ever really immune to the harsh reality that death can be painful, emotionally, and people get left behind to deal with the pain. At our busy emergency department we see people present with suicide attempts and attempts at self harming and with every presentation like this we provide them with a review by a medical officer as well as a psychiatric specialist. The medical doctor treats the physical component of their presentation, such as did they cut their wrists or overdose on some form of medication. The psychiatrist assesses their mental status and determines if they are of sound mind or not and here, right here, has got me thinking about why I am not a mental health nurse…………….

Who are we to determine that if a person wishes to die that they must clearly be mentally unwell and out of their right minds…….. I don’t like to see any one die, me more than most, I am hypersensitive, a compassionate soul, that feels more empathy than most should, I’m a sympathy crier, I will cry if you are crying, just as soon as I see the pain cross your face I will feel it in my heart, almost as if it was my pain……….. However, if your pain was because you no longer wanted to live and people had tried to “fix” you several times of your dislike for life then who are we to force you to live because the thought of death is far to painful for us but life is far to painful for them……………….

I have looked into the eyes of a soul that was so completely broken, several “failed” suicide attempts under his belt, no legs, chronic pain, a shell of a man and absolutely no will left to live. So what did we do, “fix” him, bandage his wounds, give him pain relief and medication to “fix” his mood so he would no longer prefer the thought of death to life…… Even though this thought had plagued him for so long that it was apparent that every chance he could get, he would attempt to end his own life.

And now just to turn the table of this discussion completely on its head I bring the issue of suicide far more closer to home than I would ever have liked to deal with………………

Its easy to justify trying to understand why someone would prefer death over life in a professional capacity, looking at their injuries, their quality of life and even their mental health. However the lines become blurred and emotions run high when its someone you know/ knew. All you want to do is cry………. And you become the person with the question “Why?” And your rational mind tries to talk you out of trying to over think it and self talk includes such quotes as “remember the good times”, “she would want you to keep on being happy and living life smiling” and despite your head telling you all these rational things your heart and soul are crying crying crying………………………

You may not have spent a lot of time with a person in your recent past. You may have been only on a chat passing in the street basis, and you had said “we should catch up” and it seemed flippant but you actually meant it. And then you hear the news. They are gone……… However you shared a past, memories, lots of good ones. You are no longer in their social circle. You are shattered none the less by their tragic and extremely untimely death……………

I held my daughter in my arms as tight and for as long as I could and we cried together for the loss of someone we both once knew and cared about a lot…………..Some many questions. So much pain. So much love pouring out for a beautiful soul that was lost way too soon!!

And the constant question of “why?”

The constant statements of “If only” And then there is the stages of grief, Denial, Anger, Bargaining, Depression and Acceptance.

http://grief.com/the-five-stages-of-grief/

We cried for the friend we once had, we cried for the friend we no longer had, we cried at the thought of her pain and sadness, we cried for her family and the pain they were (are) going through……………….And I believe we will cry until we need too……………….I guess acceptance hasn’t been reached yet……………How does one accept that one so young, so beautiful and outwardly so happy did not want to live…………………Sometimes the pain of this thought seems to much to bare and its easier to just switch off.

Every story has a take home message and everyone deserves someone to love them, listen to them and be there for them. So listen to the ones you love, truly listen, be there for them if they are sad and show them how much they are appreciated!!

People need to remember that everyone has at least one person in their lives that truly loves them, that really wants to be there for them, that no matter how bad things seem, with love, guidance and support things can get better.

Life can get better, no matter how bad it seems, it can only be uphill if you’re already at the bottom. Look up and ask for help!!!!!!!!!!!!!!!!!!

If your feeling sad, low, lost, lonely, anxious, scared, victimised, bullied, vulnerable, abused, hopeless or just plain over it, find that small glimmer of inner strength and SPEAK UP!! REACH OUT!! Have faith that one day soon you will feel ok!

TODAY IS SUICIDE PREVENTION DAY!  

http://suicidepreventionaust.org/

http://www.timeanddate.com/holidays/un/world-suicide-prevention-day

And although we may have already lost some to untimely deaths we take comfort in the thought of being watched over by such beautiful angles.

SO LETS SPREAD THE MESSAGE TO PROMOTE SUICIDE PREVENTION!!!!

No-one deserves to feel like they have no other option, death is NEVER the only option!!

If you were a terminally ill patient you wouldn’t resign yourself to living only to meet your death, you would choose to live life to the fullest!!

Live every moment as if it was your last!!

If your sad reach out to someone for support and if you suspect someone you know may be feeling sad reach out to them, a simple “are you sure you’re ok?” to start the conversation.

No-one deserves to feel blue all the time, so if you do, call someone who can talk to you and help you through!!

Reach out and support each other to help prevent another life lost to suicide!!

Go forward with Peace, Love and Happiness in your hearts xox 🙂

http://www.beyondblue.org.au/index.aspx?

                                 R.I.P PRINCESS MELISSA

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Birth To Where Is My Courtesy Phone Call?

Teenage Pregnancy Advice

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Hello Beautiful People,

So it seems at this stage the most fitting place to start is birth, yes at some stage long ago I was born and as wonderful and exciting as I am sure my birth was, I don’t really remember much however I am sure its a story that I will back track to eventually.  Due to my constant complaining to my obstetrician about the social pressures surrounding being another statistic joining the growing trend of pregnant teenagers in society, coupled with the fact that my once size eight to ten sporty physic had ballooned out by nearly twenty…..yes I said nearly twenty kilos and I could barely walk five feet before I felt like my pelvis was going to break, my doctor approved me for a non medically required labour induction two days before my due date.

It was a summers day, Friday morning February 25th, it was around 7:00am as I packed a leather patch work bag that my mum had loaned me for the hospital and I was 17 years old. Yes, you heard right I said 17, while most girls my age where playing sport, finishing high school and going out to parties I was waddling around packing my bag preparing to give birth http://www.motherhood.com.au/ . I had spent the better part of the last three to four months avidly reading every book on parenting I could get my hands on. All the judgement, scorn and lack of support I had felt directed my way in relation to my ‘unplanned’ pregnancy had motivated me to be the best possible mother I could be. I had red a million books on labour and giving birth and even had a birth plan!! I felt well prepared as though I had armed myself with knowledge and knowledge was power!! Hhhmmmmm I have since discovered that only knowing how to achieve inner peace gives you power…….

My mother and I stepped out into the cool crisp air to enter the taxi that was waiting for us outside our government rented house, leather patchwork bag in tow. At the age of 17 I knew that an induced labour involved some form of artificially stimulating a woman into giving birth, for me that artificial stimulation was via the use of Intravenous (into the vein) Synthetic Oxytocin. http://www.birth.com.au/Induced-labour/Oxytocin-for-induction-about#  Upon arrival to the hospital we were ushered into a delivery suite were I was told to put on a white standard hospital gown, I had routine bloods, baseline vital signs taken and a cannula put in my left arm through which the Synthetic Oxytocin was given. This synthetic hormone is used to stimulate uterine contractions, so we waited and waited and waited some more……. And to that I say, people if your going to a birth be prepared to wait a lot longer than you think most times!! Take books, laptops, phones, music, cards whatever you can that is easily packed away to pass the time away!!

From the early hours of the morning until just after midday we barely saw a nurse or midwife and when we did I was met with noticeable hostility and questions such as “what are you doing having a baby you are just a baby yourself” or when I tried to talk about my birth plan and preference to not using drugs, I was laughed at. I had also not yet the entire morning experienced a single niggling of pain. When the midwife finally came in and we discussed that there was no pain the decision was made to turn up the amount of Synthetic Oxytocin I was receiving………… Holy shit!!! I had gone in with the grand plan of no pain relief, no intervention and no-one in the room except for the people I expressly wished to be there!!!

However the increase in the Oxytocin put a sudden stop to all those plans!! Within an hour I was in some fairly moderate pain with incredible associated nausea and vomiting. I tried to walk to the bathroom and just felt dizzy and sick. The next few hours of unrelentless pain are somewhat of a blur or maybe even a drug induced haze, filled with lots of happy gas and pethidine!! At around nine thirty in the evening I remember looking at my mum and crying and saying I cant do this any more and then when I looked up away from her face I noticed there were about twenty people in the room, no-one I knew other than the obstetrician and a midwife, I was delirious and vaguely remember being told about med/nursing students and anaesthetists. Before I knew it I was being prepared for an epidural and heard words flying around such as decrease in fetal heart beat and too young for Cesarean……. The epidural was terrifying to say the least, trying to remain still throughout the most indescribable pain, nausea and vomiting was a nightmare, however the procedure was over and successfully done swiftly.

http://www.babycenter.com.au/pregnancy/labourandbirth/painrelief/epidural/

My Obstetrician informed me that my cervix had dilated from two to ten centimetres in less than an hour thanks to the epidural. I was being encouraged to push my baby out by a see of unfamiliar faces with stupid useless analogies like imagine your cervix is a turtleneck sweater being pulled over your babies head…..ummmmm flushed with exhaustion I felt like saying to the midwife who said that “I’m sorry ma’am I don’t know what your cervix looks like but mine sure as hell doesn’t look like no floppy neck sweater”!!!! I had had enough and wanted out of the whole situation that I felt I had no control over. I felt like a victim of circumstance or a teenage pawn in the game of everyone knows my needs better than me…………

And then that was it, I cried some mildly embarrassingly primeval sound and out came this perfectly plump slightly pinkish purple silent baby…….. No crying….omg… there’s no crying and instant panic raced through my mind every movie Id ever seen, every birth scenario I had imagined involved popping out a screaming baby. Did no crying mean no breathing? It was as if my drug hazed brain cleared instantaneously and I could hear my panicked voice asking “why isn’t she crying”? and I was told she was fine but had swallowed some fluid and required a little suctioning. Then swiftly tucked into my arms peering up at me was a little puffy eyed princess, I felt contentment and exhaustion……..

These are still two strong feelings I feel today associated directly with my little puffy eyed princess who has now grown into a gorgeous eyed queen!!! At eighteen, the legal age in this country to go out drinking and night clubbing, I find sleepless nights exhausting half awake half asleep listening out to hear her arrive home safely, arrive home safely to me like she did at her birth…..I doze with exhaustion overwhelming me awaiting my courtesy phone call or text telling me she is ok and on her way. The birth was hard and I have since had far different birth experiences and parenting hasn’t been easy but the reward of having such a beautiful daughter and friend forever is priceless and to all those that judged……… You should see us now!!!! 🙂

What I would like to remind people who are healthcare workers, partners or support people for someone pregnant or giving birth, regardless of age, race, religion or marital status everyone can be scared or feel alone, even in a crowded room. So remember that kindness, non-judgemental support and unconditional love are amazing human tools of emotion that can be used to help someone through one of the most challenging and life changing experiences of their lives. Be an active listener, open and receptive to the persons needs at that overwhelming time, its the everyday heroes that make people feel that little bit safer and happier with their lives. Relinquish the need to express judgement or criticism, negativity breeds negativity.  Aspire to be a person of love, support and peace and if you truly dont feel you can be then perhaps you are not the right person to be at the beautiful, magical and spiritual event of a new life coming into this world, birth, its beautiful and confronting.

And to my baby girl this is for you,

From birth to my courtesy phone call,

Thanks for always making me proud,

For never ever letting me down,

For never making me regret having you around,

For lifting my heart right off the ground,

From the minute you were born without a sound,

Just don’t drop the ball,

And keep me waiting on the line till 6am for my courtesy call,

Cause I’m still the mum after all  xoxox

Peace, Love and Happiness 🙂