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

Mental Health Month

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Hello beautiful people,

October is Mental Health Month.

http://www.mentalhealth.asn.au/

On a professional level, as a nurse, to me this means promoting good mental health, making sure people take the time out to let go of stress, relax, unwind, clear your thoughts and enjoy life for a moment. Reflect on where you are in life and whether or not you are in fact happy and experiencing good mental health. Mental Health Month also means promoting understanding and awareness for those in the community that live daily with Mental Illness.

The emergency department is often a place where those who are experiencing a mental health breakdown will present for treatment. Often these patients present scared, paranoid even, delusional, timid, aggressive, intoxicated and possibly even physically injured through self harm or assault. Plain as day these patients present in an incredibly vulnerable state!! I would like now to be a timely reminder to health-care workers to self reflect and remember your commitment to provide non-judgemental, compassionate, professional care!! And if you feel you are burnt out and cannot cope with a patient that is experiencing a mental health breakdown, then for your own mental healths sake, step aside and let one of your colleagues take over!! I feel disheartened when a patient with a mental illness who has self harmed or is paranoid and non-compliant is being judged by health care workers!! If you cant provide holistic care then don’t be there!! A person may appear to you as someone aggressive and yes you need to protect yourself however imagine how terrified they must be feeling to be reacting in such an inappropriate way. Mental Illness is just that, its an illness, they are sick and need help they do not choose to have these feelings, thoughts or behaviours, they are not well!! Its pretty rare that someone would consciously make the decision to behave in a paranoid, inappropriate way or self harm.

Anyway I’m no mental health expert, in fact I must confess that I find it confronting too at times, however more so because I feel sad at my lack of understanding of mental illness. There is just so much to know and sometimes the person that knows the most is the person that has been living with it for years.

Today I was invited to the premiere of a community film called ‘Voices Speak, Lives Change’ it was the project of a group called ‘Working from the ground up’ initiative of Sydney University and University of New South Wales in a collaborative effort with various other groups. The film was shown at the Ritz cinema in Randwick.

http://www.jnc.org.au/Publications/WFGU_Flyer.pdf

The motivation behind the film was to promote, raise awareness and (hopefully) to initiate action/change in the challenges faced by people with Mental Health Issues living in Social Housing in the Eastern Suburbs. The movie interviewed and touched on the lives of thirty four volunteers/participants willing to share their lives and stories in a very personal way.

http://www.jnc.org.au/

On a professional level I can distance myself from the emotional roller-coaster that may try and drag you into its thrilling ride of highs and lows, professionally I can resist the temptation.

On a personal level I will always love someone with Bi-polar………..

http://www.blackdoginstitute.org.au/public/bipolardisorder/causes.cfm

Mental Illness is like a cancer that wont go away, it can be treated but its laying dormant there under the skin, buried beneath the haze of medications, therapy and sometimes drugs and alcohol. Its not my area of expertise because I never wanted it to be.

I only want to know the person I love for who they are and not what their diagnosis is.

I know you and that is all I need to know, I know the highly intelligent, very artistic loving creative woman. I know the great cook, patient mother, loving, giving, self sacrificing soul. I know the poet, the song writer, the singer, the digital media producer, the ever creative being. I know you have Bi-polar and you don’t mind talking about it and of course neither do I, however you are so much more than just your diagnosis.

The movie was great and heart breaking at the same time, people in the community with mental illness who at times have felt vulnerable and powerless were given a voice!! They spoke of feeling lucky to live in such a nice area with beautiful beaches, they also spoke of feeling targeted and unsafe at times. This made me feel sad that people felt unsafe in their own homes because they are misunderstood. They requested community awareness about how their behaviour is sometimes out of their control and at times like this they need help not judgement.

Mental Health Month is not just about asking someone if they are okay or assessing them for a diagnosis, its about really reaching out to each other. To ensure you achieve good mental health yourself and to help others feel good and achieve and maintain good mental health too!!

http://www.mentalhealth.asn.au/images/MHM2012/mhm%20factsheet%20final%20text%20with%20graphics.pdf

For all that you do in our community as a volunteer to help others despite knowing at times you may need help yourself, for all your courage in promoting Mental Health Awareness, I will always be in awe of you!! 

For all that you’ve been through and continue to go through, despite how weak you feel at times, you will always be one of the strongest people I know!! 

People remember this, the neighbour crying out for help, the person on the bus next to you or the patient you are treating is someones family member. A grandparent, mother, father, sibling, aunt, uncle or cousin, someone somewhere loves them and though their behaviour may be challenging they should be treated with respect and afforded the same sense of self dignity as you and me. Please people remember don’t antagonise someone who is already mentally vulnerable.

Mental Health Month is about everybody being allowed to feel safe and happy in their own lives!!

For you sissy, love you dearly, remember when you use to sing this to me xoxoxox

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Peace, Love and Happiness 🙂 xoxoxoxoxoxoxoxoxoxox

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

Self Reflection

Hello beautiful people,

These last few weeks have been so eventful that it seems I have barely had time to sit and quieten my mind. The ups and downs, highs and lows in life wash over us like the constant undulating waves in a choppy ocean. One can start to feel sea sick and emotionally overwhelmed with what life throws at us. At this point I feel its time to stop still on the shore and look out at the sea and source out the calm peaceful energy that one needs to remain centred in rough tides.

Self reflection is a concept that was taught to us all throughout our studies at University. The concept of being aware of the self in relation to ones professionalism, surroundings, mannerisms, behaviours and interactions with others is something that we are taught to be aware of and self evaluate in regards to these areas. However it is something I have always endeavoured to do throughout my life as I have always felt the eyes of society judging me (and not in a paranoid way of course). So many young women are socialised and raised with constant media barrage portraying images of how women should look and behave and on numerous occasions throughout my life I have been told things such as “shouldn’t you loose some weight”, “a lady shouldn’t speak like that” or “girls shouldn’t dress like that or play that game” and to this I would always say ‘really, why?” “Where is the rule book and where in it does it outline how a girl should behave”? I guess Ive always gone against the grain when it comes to how a woman should behave. I speak out for those that don’t have a voice, I’m strong minded and opinionated and I openly show affection! For some reason these qualities I openly embrace seem to make people feel uneasy, so I see its self reflection time again….

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As far as I see it if I’m not hurting ANYONE then why cant I do what I want? These kinds of statements and images have lingered in mind and I have seen the long term damage to other women that I have been close to, be ruined by the random need for others to pass judgement or expectation on other women!!

I by no means am perfect and in regards to recent extensive self reflection have been wrestling with the notion that perhaps I am a massive hypocrite……… I always wish for peace love and happiness for all, I truly do from the bottom of my heart, with the utmost sincerity I feel the pain of so many others when I know I shouldn’t and I wish them peace and happiness despite not knowing whether they really deserve it or not.

My best friend and I used to refer to ourselves as bleeding hearts or rather crassly as “hire a griever” because we are so emotional and forgiving at times that we could attend the funeral of a complete stranger and be reduced to tears in mere minutes. However, here’s the hypocrisy………..

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If you were to hurt me or anyone I cared about I would probably rip your head of with a barrage of verbal abuse in about zero to no seconds and then…….. (And yes I know there are people out there that can vouch for this) …….. Five seconds after that moment of judgement and anger I will be crying at the guilt I feel and the pain I feel in regards to my reaction and the possible pain my victim may be feeling….

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Upon self reflection I am tough, I am a survivor, a survivor of way too many things to be on this page…… At times I am judgemental much to my own disappointment!!! The best and most honest part of me is my kindness and compassion!!! I feel proud to say that at least most of the time the good wins over the evil in me!! I don’t want to be racist or prejudice and I certainly don’t ever want to judge people, its not my job to.

There have been so many sad and challenging things happen lately in our lives and in our city that the heated discussions around me are flying rapidly, like a whirlwind of theories and opinions vying to win. Why does one person do one thing one way and another do it a different way, who is to say which way is right, it is human nature for us to all behave differently. At the end of the day though wouldn’t the world be so much of a better place if everyone could stop taking themselves so seriously and realise that we ALL deserve respect and peace!!

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Respect and peace on an individual level and on a global level!! Self reflection is an amazing thing when the world is spinning and I feel I have lost sigh of who I am and someone appears to be insinuating that I am a fraud or a stupid hippie I take time out to engage in some self reflection. So to clarify, I am not a fraud, I am who I am and yes that is ever changing and I may be a bit of a hippie but I’m certainly not stupid 🙂

I try most of the time to be up front and honest because I believe that its important to be who you want to be free from judgement, hatred or envy. I am never really envious of anybody because quite frankly I think its pretty awesome to be me, if anything I would just like to be a better version of me, perhaps a little skinnier, less chaotic or spontaneous… and even so immediately after writing those words I think, in whose opinion, cause really its the chaos I thrive on that makes me, me 🙂 Are these negative thoughts and self talk all laying dormant in the subconscious filed away under the category of ‘previous insults’ to be used and brought forward when feeling flat, insecure or unhappy…….

I do prefer honesty from others though there is a way and a way, if you do not agree with someone’s actions voice it in a way that may be constructive to future actions, not destructive. You do yourself and your cause no good by behaving badly. If you feel strongly about a certain event, that may or may not have directly invovled you try to discuss it with someone that may have first hand experience or information on the incident that may be able to discuss, educate or even enlighten you to the true facts, please do not engage in ideal gossip or misguided anger.

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At very rare times as Ive said I do judge but briefly and then I feel sadness because who am I to think I am better than anyone else!! Usually my judgement is not based on the belief that I think I’m better than anyone else it is usually motivated by the belief that my behaviour or life choices are better than others. So are they? Am I really a better person because I would never encourage my child to carry a placard condoning violence?  Or because I really try hard not to live my life participating in petty gossip?  There are always two sides to every story and I will usually only know my side until I go out of my way to truly find out and understand the other side. I have no time for secrecy, spying or passing judgement!! I would much rather be out there in the world living it, feeling it, breathing it!!! I would much rather have a heated debate about what you think of my opinions that have you judge me behind closed doors where I am not afforded that chance to defend myself. Perhaps even allow me the chance to take on board your judgement and use it to self reflect and maybe even better myself. Yes some things we say or do will unintentionally hurt, shock or offend others but it is their reaction to our behaviour, so are we suppose to change our behaviour due to a persons response?……..

Perhaps we should at least self reflect on our behaviour if it shocks or offends someone. Should we change or stop if it hurts someone? If it hurts them emotionally? If it hurts them physically? Some people may respond to this question with a definite yes! However some people can move on from their emotions being a little bit hurt, others may not be able to. It seems fair to say that no-one should be allowed to physically hurt another person, no self reflection needed, just don’t do it! (Unless your that way inclined of course, boxers etc).

So what I am trying to say is, we all need to take time out occasionally to sit back and partake in a little self reflection. We all find it so easy to pass judgement on others and assume that our way is the right way but what is right for one may not be right for another.

There are some behaviours I see in people that as I said earlier initially frustrate me and make me wildly angry and then instantly I feel sad, sad for them that they feel so empty or frustrated themselves that they feel they need to behave in such a desperate way! Every human deserves to live in peace, free from judgement and fear. Free from feeling that if they don’t look or behave a certain way that society may not accept them. Never judge a book by its cover, try turning the pages to uncover the layers of what could be a beautiful soul. Never go on hear say or subscribe to the theories of the masses, find out the truth or the facts and decide for yourself. That’s what I always try to do, I always endeavour to make people feel safe enough in my presence to show me who they really are, no facades. I don’t want false interactions, I always try to live by ‘what you see is what you get’. If I’m feeling great I will tell you and if I am feeling sad I will tell you. I know to some its hard to be who they really are and they may be more private and prefer not to show their true emotions and that is okay too. At the end of the day though we are all human and we all experience widely the same kinds of emotions and I feel that as a global community if people could learn to express themselves emotionally more freely and without judgement the world would be a better place. It would be a better place because people would quickly realise that they are not alone with their feelings, so many others may feel the same way and this can lead to people being able to support each other better.

I know my honesty and openness emotionally can make people uncomfortable, Ive seen people blush in my presence or even had them request I “tone it down a bit”, however this is pretty rare mostly people respond well to my random hugs, of course using self awareness and reflection I don’t hug patients, unless they go in first lol 🙂

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I guess this process of regular self reflection always leads me back to thinking am I being the kindest most understanding, compassionate person I can be because these are the qualities that mean the most to me. Of course sincerity is right up there too because there is nothing worse than someone showing a persona that is calm, kind and non-judgemental just to hide that they are really thriving on sitting on their private make believe pedestal looking down their noses at people and passing judgement every chance they can…… Am I sometimes guilty of being part of this group? I have a gorgeous friend who’s catch phrase is “Don’t they know who I think I am’? (Copyright to PJ 🙂 ) and I think this is fabulous and appropriate to her and I laugh every time I hear it and yet to know her is to know that she will extend kindness to anyone that reaches out to her. I believe its ok to be self complimenting and appreciative, what is so wrong with being proud of who you are? Why do people feel threatened by those that exude confidence? Yes there is a difference between being confident and arrogant, however who determines what behaviour fits which category? What one person may interpret as arrogant another might view as a strong sense of self confidence.

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Taking a moment to self reflect has made me look at aspects of my personality that may be misconstrued as arrogant. Yes I think I’m awesome!! No I don’t think I’m better than anyone else!! Yes at times I feel like I am less than others, especially when I feel they are negatively judging me…… However I quickly remind myself that for whatever reason at that moment they feel they know me well enough or they have the need to pass judgement on me and it is there prerogative to do that and mine to walk away with my head held high maintaining my sense of self dignity and self worth.

Am I self evaluating enough? Have I called you a bitch recently? Maybe…. I can honestly say that if I have then I didn’t mean it and now regret it and probably feel really bad for hurting you. Especially because my main motivation in life is to be a healer not a deliverer of pain. I truly want peace, don’t you? I want my children to be raised in a community where it is ok to be praised, loved and supported! Recently there has been a debate circulating around regarding whether or not we are setting our children up for failure by over praising them? To this I say WTF? I again undertook some self reflection on this topic. Am I a boastful parent? I don’t really think so, I recognise their achievements and praise them for them. I try to always praise them so they have good self esteem and feel confident enough within themselves to make good life choices. Why would you not want to praise your children? Do people really think that by praising them we are setting them up with false hope or expectations? Is it unrealistic to say, ‘hey of course you can be anything you want to be” Why cant they be anything they want? Are we wading into a debate that has become to politically correct? All children are innocent victims of their environment and learn by what the elders around teach them. If we teach them that they are limited by our opinions of them then of course they will not strive to be better than a mediocre version of themselves.

So many areas of self reflection lately, politics, religion, parenting, nursing, professionalism, relationships, freedom, judgement and ME!

Politics always fascinate me and I have always undertaken to learn as much as I can about the various political parties and movements to keep track of where my state, national and Global community might be heading. To this all I have to say, somewhat ambiguously, some people in power inspire and impress me and others….well…lets just say they scare me.

Religion also a topic I have forever been fascinated by, I have as well as a few of my friends throughout our lives delved into several different religions trying to find the one that fits us best. The outcome of this being that there doesn’t seem to be one that completely envelopes all that appeals to my system of beliefs. I believe in a God (perhaps because the thought of no God and no heaven is too painful for me) that is a nondenominational God that does not pass judgement on people based on gender, race, sexual preference, cultural and spiritual beliefs; A God that protects all children from abuse and neglect, providing them unconditional love and protection always; A God that commits to ending all this pain and suffering that is becoming so prevalent; A God that will instill respect, compassion, love and Peace in the hearts of ALL humankind!! I pray to GOD THAT A GOD LIKE THIS REALLY EXISTS!!

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Self reflection on parenting has brought me to the conclusion that, yes I do swear on occasion in front of my kiddies however they understand and respect the rule of ‘do as I say not as I do’. Yes on occasion they probably eat to much junk food and probably don’t do enough homework. Aside from all of this (without being boastful, only truly honest because I would be the first one to tell you if they were being little shits!) I think it is fair to say that I have parented with a firm loving hand providing them with constant unconditional love. Instilling the knowledge and boundaries in them so that they know how to respect themselves, me and others. They are loving kind compassionate children that would never raise a hand to me or others (except very occasionally to each other but hopefully they will grow out of that). They are average students academically and I am fine with that! They are average sporting participants and I am fine with that too! Parenting for me has always been and always will be about loving, protecting and guiding!!

Self reflection on nursing has led me to the conclusion that yes it was always meant to be!! Despite the hours, the pay, the difficult patients or colleagues aside from my family it will always be my one true love!! Furthermore, yes I could do to undertake some refresher courses especially in the areas of pathophysiology and pharmacology!!

Self reflection on professionalism has driven me to think about how I conduct myself at work sometimes and to be self aware about how I am communicating with people when trying to get a job done. Sometimes my chaotic personality can make things seem more urgent than they need to be……

Self reflection about relationships is ongoing and ever changing, people grow constantly and as I said in my recent Blog on friendships, they can be fickle and fantastic. I feel I’m in a good place right now with my relationships, there seems to be a nice balance of people around me who understand me and I them 🙂

Self reflection about freedom has me drawing to the conclusion that although we are some of the freest people in the world, we are only as free as we allow ourselves to be. I know a few of you understand what I’m truly saying. We are held back by our fears of what others may perceive us to be. We deny ourselves the luxurious freedom of being who we truly want to be for fear of being judged and denied by society.

Which leads me to my final area of self reflection, judgement. Am I a hypocrite? Do I wish for no-one to judge me and yet allow myself to judge others? I truly try not too! I certainly have discovered quickly and this may come as a shock to those that don’t know this about me, but I would certainly much rather sincerely pay another person a compliment than sarcastically refer to them as ‘bitch’ or ‘slut’!!!! Just so you know I don’t think its funny or a term of endearment to refer to me as either of those words, as far as I’m aware they were words designed as insults and as such I can never be comfortable with them being used towards me as terms of endearment!! I am not, have not been and never will be anyone’s ‘bitch’ or ‘slut’. I feel uncomfortable and sad when women think this is an ok and acceptable way to speak to each other. As Ive said before if I have ever said it to you I would have had to been pretty angry to call you that. Is it so ingrained in women that we aren’t allowed to support each other or pay each other compliments or feel self pride? Or is it just the Aussie way now that women can only express mate-ship by referring to each other using derogatory words? Hhhhhhmmmmm maybe I’m too much of a princess or hippie but I doubt it because I know I can be a real bitch when I need to be but it is rarely! Anyway I have digressed of the topic of judgement a little and so to wrap it all up, people are free to refer to each other as they please as long as both are in agreement that it is ok and one is not feeling judged by the other.

Self reflection, is it really all about ME? Of course it is and sometimes taking a good hard look at yourself can be really confronting. Do you like what you see? Have you done it recently? Perhaps your burning desire to constantly judge others comes from your unhappiness with what you see when you look within yourself…..

One of my favourite sayings of all time is “Be the change you want to see in the world” (words written motivated by a speech given by Mahatma Gandhi)

Self reflection is all about me, when I am the one doing it, however it prompts me to look at how I fit and interact within my world and I enjoy analysing how my life is going. I like the challenge of trying to recognise the areas that might need work and addressing them. It is often my biggest critics that motivate me to self reflect and to them I say thank you! Today you have been my muse 🙂

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Yesterday I was Me

Today I am Me

Tomorrow I will be Me

I am the Me

You think You know

The Me I am is everchanging

The Me you think You know

The Me I am always learning

The Me you think You know

How can you know Me?

If I don’t really know Me

Yesterday I am Me

Today I am Me

Tomorrow I am Me

And you think You know Me

So I guess the day after tomorrow, We both shall See…….

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Peace, Love and Happiness 🙂 xoxoxoxoxoxoxox

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

Why go to an Emergency Department

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

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

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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 🙂