A doctor once told me that I had a portfolio career. As my working life as a nurse in the NHS draws to a close it seems to me more like a patchwork quilt, assembled from many knitted squares. Beginning in a psychiatric rehabilitation ward, I moved to acute admission in the old Crichton. I dipped in and out of that ward undertaking secondments: to the Clinical Research Department, a Lecturer/Practitioner role, Care of the Elderly, Patient Safety and Improvement. Then full circle, I moved back to rehabilitation nursing, this time interwoven with forensic threads. Knit one, purl one.
Recently I’ve been on a partnership working secondment, with seats on the IJB and the RCN Board. I have needed to insert some elasticated fabric into my knitting, as this has stretched me in directions unlike anything experienced before.
With retirement imminent it is inevitable that I reflect on the whole quilt, the completed work, and remember the dropped stitches, the unravelling I’ve seen, the piecing together, the mending. Some squares have faded with time but others remain vivid.
The Quiet Man. This inpatient was polite, smart, of late middle age. He wore his depression like a waistcoat watch, well-hidden in a little pocket. You could just catch a glint of it if you really looked. One Friday he went home for the day. This wasn’t unusual. He would typically return before 9 pm. When he didn’t appear, staff phoned him. No answer. They phoned his family. No, he didn’t have plans to come home that day, he had informed them explicitly. Alarm bells rang and rightly so. He never returned. He had chosen a way out of his deep, silent despair. Our thoughts of course went out to his lovely family for their loss. But today my thoughts are also for us, the staff who nursed him, the doctors who treated him, the domestics who cleaned his room, the ladies at medical records who received those final ward documents. I wonder if they still mourn him like I do over twenty years later.
Miss M. Mute, traumatised, psychotic, she hardly ate or slept. I was on a spell of night duty and would sit by her bed, talking to her, after giving her medicine. She would listen intently, not responding. ‘Looks perplexed’ were the words used most often to describe her in nursing notes. After about a week she was out of bed when I arrived for night shift. She glided around the ward, keeping close to the walls, vigilant. One evening I took chocolate éclair sweets in. I gave three to the nurse and three to the nursing assistant, saying to Miss M as she passed, ‘I’m leaving these three sweets on the table for you.’ She neither slowed nor acknowledged me. A short while later the nursing assistant bounded into the office, ‘She’s taken those sweets.’ In mental health nursing it is often not diagnostic tests that expose signs of improvement, but observation and engagement. Nurses can usually pinpoint turning points – medication has started to work, trust has been gained – and I have never forgotten the night of the sweets. Each Christmas I’m reminded of Miss M when I hang the tinsel angel she made for me before her discharge.
Nursing has presented me with many patterns to follow, using different weights and colours of wool, some challenging designs. Although all secondments have been worthwhile, I’ve always chosen to return to hands on nursing, the role I rate the highest, the role I value, the one I will miss the most. Knit one, purl one.
Val Douglas RMN, DipN, BSc (Hons), MSc Research (nursing)
I am a specialist Physiotherapist within the reablement service STARS ( short term assessment reablement team)- and my main role is to promote exercise and well being in the community- my target audience- not lycra gym bunnies, but over 65 year olds who normally have a long term condition who are recovering from a spell in hospital, and likely do not own trainers or know what a squat entails. Who am I to advise to join a swimming group, attend low impact exercise classes or complete a rehab programme when I do not complete myself? Instead I walk to the park, climb up woods, I cycle with my children, I chase after them endlessly… so we need to think different about activity.
We support service users to identify their goals through good conversations. We also support them to develop, retain and regain their skills by understanding what matters to them- this may not often happen initially but over the course of the reablement process from our support workers, we build relationships and find getting to know them and their families/carers imperative for helping them identify their goals.
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