Change.

It's been nearly 6 weeks since I started my new job and moved house. To be honest I've had my moments when I've thought I'd made a huge mistake. I don't know if that is normal but I guess it's natural to have some doubts. Moving to another county away from everyone and everything you know is tough. I miss my old life sometimes but then I think of the new one I have in front of me. I'm still getting to know my new surroundings but so far it is ok. Living next to a main road is a bit noisy but I can sleep through anything. I've had a couple of run ins with downstairs but I try to be patient with them. I don't think it's unreasonable to ask someone to turn their music down when it is making your crockery rattle. I try to keep my noise down to a minimum but I have to admit the last time they had their music loud I found some heavy metal radio station and pumped up the volume. Two wrongs don't make a right but I wanted them to realise how loud their music was. I love my new flat other than that. It wasn't left in a great condition but I've cleaned it up nicely. I have a new futon and wardrobe so I have even more to cart the next time I move. Hopefully that won't be for a while.

As for work I really enjoy it. Obviously there are positives and negatives but there are with anything. The variety you get in the ED is great as it really challenges you especially when you are new to it. I feel more settled now and that I know what I'm doing a lot better. There are still times when I feel the need to ask for advice but that is nothing to be ashamed of. I'd rather ask for advice than do something wrong. Emotionally it can be difficult to deal with at times due to the nature of the things some people come in with. I've never had to deal with things like miscarriage, overdose, intoxication, drugs etc. Learning to cope with these things is a continual learning curve as every case is different. I feel like the opportunity I have is an amazing one and I must embrace it. Nursing on a ward is nice in some respects but you just deal with one speciality. It is only when you go to ED or somewhere similar that you have the opportunity to be exposed to every speciality. As I was told recently, an ED nurse is a jack of all trades. This is what makes it so exciting to me as there is so much to learn and I love learning. I have noticed that there is a specific pattern of certain complaints and then you get a spattering of everything else. The other thing that can happen is you get loads of one complaint. For example I had a run of chest pains, I've had a run of trauma and a run of children. This is why I love it though. I definitely made the right decision but it's just taking time to adjust to it.

Now I have settled in at work what I feel I need to do is get out and about. I'm not the most social person and am quite happy with my own company but I think I should make an effort to do something. There's a sports centre near my flat so I may go and investigate but so far it's only been a thought. It's the next thing on my list of things to do though. One thing is for sure and that is I'm glad I took a chance.

What it feels like to be intubated

I had my operation on the 13th May and it all went well. It took me hours to come around from the anaesthetic but apart from that it was ok. One thing that was a little distressing was being conscious when they took the breathing tube out. It was a LMA (laryngeal mask airway) rather than an ET tube (endotrachial tube). ET tubes enter the windpipe whereas LMAs don't. Even so it wasn't a nice experience and out of the four operations I've had this was the first time I remembered them taking the tube out. I was only meant to be in hospital overnight but due to a minor complication I had to stay in a little longer. The problem was retention which is known post anaesthesia but uncommon in females apparently. Let's put it this way I will have a greater respect for any of my patients that have or require a catheter. Apart from the embarrassment of having it inserted you have to think about every movement because believe me you do not want to tug on one of those! How people pull them out with the balloon inflated is beyond me. Two days after my operation was when it really kicked off. I only know what I've been told of the Friday and what happened after I regained consciousness. At 07:30 I was found with a GCS of 3. For anyone unfamiliar that is completely unresponsive to anything. Normal functioning people have a GCS of 15. The doctors did sternal rubs which are incredibly painful and for days after I had a bruised chest. Nothing. The patient opposite said it was quite scary seeing me in this situation. The doctors didn't know what was going on and were escalating it up the ranks. Eventually I was taken to HDU (high dependency unit) where the decision was made to intubate me (put me on a ventilator). I was transferred via ambulance to A&E resus at another hospital, had a CT scan of my head to make sure there was no bleed and taken to intensive care. It freaks me out that all this happened and I have absolutely no recollection of any of this. My first memory was hearing voices and the feeling that something was in my mouth. One of the first thing I remember hearing was 'Are we going to have to cut her pyjamas off?'. I can't really remember seeing anything until I was extubated (tube taken out) and on oxygen. I vaguely remember my friends being there but not much else. I obviously started to get agitated as the staff kept telling me I was ok and that I was in ICU. As I became more aware I felt a need to breathe but I couldn't. At regular intervals my chest filled with a pressure which felt so awful. I realised I was intubated and on a ventilator. The pressure I was feeling in my chest was my lungs filling with oxygen. The more awake I became the more agitated I got and I remember bringing my left arm up towards my face but was repeatedly knocked back down by the nurses. Even though the ventilator was breathing for me I felt like I was suffocating because my natural breathing reflex was again present but there was a tube blocking my airway preventing me from taking my own breaths. If I thought that was hideous it was nothing compared to what came next, suctioning. The nurse passed the suction catheter down the ET tube and as soon as it touched my windpipe it triggered a coughing/gagging reflex. Of course I couldn't cough and the feeling was horrendous. In between the awful feeling of the suctioning there would be the pressure of oxygen being forced into my lungs. Being so out of control was almost unbearable and created a sense of panic. Not only had I woken up in a completely different ward in a completely different hospital, I had woken up intubated. Despite the reassurances of the staff telling me it was alright it really didn't feel like it. When the moment came for them to extubate it felt like such a relief. It was terrible feeling the ET tube being pulled from my windpipe, it felt like it would never stop. Then more suctioning but this time with a Yankeur and a great deal of coughing. To take breaths myself and be back in control was, well, I can't describe it. I just can't describe how it felt to have my lungs fill but to not be breathing. I couldn't work out what the intense pressure was to begin with. It was almost like the sensation you get when you wretch before vomiting. An involuntary reflex, which it was essentially, but it wasn't my stomach contracting. A short sharp burst of pressure rather than a natural slow inhalation. Of course I couldn't speak after the trauma of being intubated. It took days for my voice to return to normal. I am incredibly grateful for everything that was done to help me but it truly was one of the most distressing experiences of my life. I woke up with an arterial line and four large bore cannulas attached to various things. I still have the marks from where they were inserted three weeks on. They must have dug around a lot to find the artery in my wrist because it took nearly two weeks for the pain to subside. Fortunately it was only a short stay in ICU and I was transferred back to the hospital I came from to the relief of the patient opposite me. She was just glad to see I was ok. I'm used to emergency situations (dealing with them as opposed to being the cause of them) so I couldn't really appreciate how terrifying it must be for other patients witnessing something like that. I total I was in hospital for 10 days and I must say the majority of the time I was treated very well. I had my stroppy moments but I think it was frustration. It was difficult trying to remain a patient and not to put my nurses hat on and occasionally I would turn nurse but I think it's unavoidable when you are in this situation. One thing I am sure of is that this will make me a better nurse. I have experienced things that nurses don't normally experience. I've felt things that nurse don't normally experience. Nobody knows the reason for my what was essentially a coma. I have my theory but it will remain just one of those things.