Grace
Thanks for all the kind words about my first attempt at blogging my current experience. A bit of a sideways swerve with this one as a few of you asked me to go into more detail about the lady I mentioned who I encountered on my first older people’s ward.
I’d not really had any experience of dementia before. My grandfather had developed it very late on in his life, but I’d been shielded from any realistic understanding or experience as he didn’t live close by. So when I met Grace on the ward, she was my first proper encounter.
As I mentioned, it was a busy ward with a mix of older people who were admitted with either physical ailments or due to mental ill health or often, both. On reflection, the layout and logistics of the place placed much or almost all of the onus of care on meeting the physical needs of patients as it was a medical ward first and foremost.
It meant staff were always busy, with around 30 patients all with varying needs, many needing assistance to wash, dress, eat or drink. Time was always against offering any real meaningful interaction, however well meaning and caring staff were.
Grace struggled in the busy environment. She would find it hard to stay still and would try to leave the ward, constantly searching for someone, seeking reassurance and asking questions over and over again, regardless of whether an answer was forthcoming from anyone.
As I was a first year student Psych nurse, on only my second placement, I was hardly going to be much help on the medical side of things. Having passed out a couple of times during the very few biology classes I ever went to, blood, needles and open wounds were definitely not my thing!
So with a shrug and a sigh from some of the senior staff who definitely viewed student psych nurses as an inconvenience, I was told to spend time with Grace and not to let her leave the ward. That was pretty much the remit I was given for the shifts.
There’s no magical story to tell of discovering some remarkable facts about her, nor of making any massive breakthroughs in her care.
What I learned, much through trial and error, were what some might say are some of the basics of good psychiatric nursing, or the essentials of communication, that were to stand me in good stead for my new career.
Grace’s repetitive questioning was about seeking reassurance and comfort. Her constant ‘wandering’ was as much down to the busy and noisy environment as it was to her confusion, disorientation And anxieties this brought.
I learnt a huge amount about the importance of non verbal communication and how much it can help a person when you get it right. Your facial expressions, tone of voice, general demeanour on approaching someone can have such an impact.
I’d get a tremendous feeling of satisfaction if I got a smile from Grace, or better still, if she were able sit and relax a while next to me. That would draw scowls from some of the staff, just another typical lazy student nurse, sitting around when there were temperature rounds, toileting and beds still to make........ah the ‘culture of task based care*’.........something I grew to view and later understand as an enemy to good dementia care
*as a rapidly ageing former psych nurse, in the early days of my career, it wasn’t unusual to find staff on older people’s wards had been made to work there by Hospital management, after misdemeanours, drug errors or other disciplinary issues, to ‘retrain’ or as a punishment. That’s not to say there weren’t many brilliant, motivated and caring staff also!
I’d not really had any experience of dementia before. My grandfather had developed it very late on in his life, but I’d been shielded from any realistic understanding or experience as he didn’t live close by. So when I met Grace on the ward, she was my first proper encounter.
As I mentioned, it was a busy ward with a mix of older people who were admitted with either physical ailments or due to mental ill health or often, both. On reflection, the layout and logistics of the place placed much or almost all of the onus of care on meeting the physical needs of patients as it was a medical ward first and foremost.
It meant staff were always busy, with around 30 patients all with varying needs, many needing assistance to wash, dress, eat or drink. Time was always against offering any real meaningful interaction, however well meaning and caring staff were.
Grace struggled in the busy environment. She would find it hard to stay still and would try to leave the ward, constantly searching for someone, seeking reassurance and asking questions over and over again, regardless of whether an answer was forthcoming from anyone.
As I was a first year student Psych nurse, on only my second placement, I was hardly going to be much help on the medical side of things. Having passed out a couple of times during the very few biology classes I ever went to, blood, needles and open wounds were definitely not my thing!
So with a shrug and a sigh from some of the senior staff who definitely viewed student psych nurses as an inconvenience, I was told to spend time with Grace and not to let her leave the ward. That was pretty much the remit I was given for the shifts.
There’s no magical story to tell of discovering some remarkable facts about her, nor of making any massive breakthroughs in her care.
What I learned, much through trial and error, were what some might say are some of the basics of good psychiatric nursing, or the essentials of communication, that were to stand me in good stead for my new career.
Grace’s repetitive questioning was about seeking reassurance and comfort. Her constant ‘wandering’ was as much down to the busy and noisy environment as it was to her confusion, disorientation And anxieties this brought.
I learnt a huge amount about the importance of non verbal communication and how much it can help a person when you get it right. Your facial expressions, tone of voice, general demeanour on approaching someone can have such an impact.
I’d get a tremendous feeling of satisfaction if I got a smile from Grace, or better still, if she were able sit and relax a while next to me. That would draw scowls from some of the staff, just another typical lazy student nurse, sitting around when there were temperature rounds, toileting and beds still to make........ah the ‘culture of task based care*’.........something I grew to view and later understand as an enemy to good dementia care
*as a rapidly ageing former psych nurse, in the early days of my career, it wasn’t unusual to find staff on older people’s wards had been made to work there by Hospital management, after misdemeanours, drug errors or other disciplinary issues, to ‘retrain’ or as a punishment. That’s not to say there weren’t many brilliant, motivated and caring staff also!
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