experiences

My 19 year old self reflecting on a traumatic event as a student nurse

As a student nurse, it was drummed into us how important it was to regularly reflect on things that happened during our times on placements. The following was a reflection that I wrote when I was 19. This happened during the lead-up to my mental breakdown.

(Names have been changed to protect identities).

During my fourth placement, on my alternative branch (adult) I had been taking the same men’s bay of 6 patients for about 3 weeks. I had become familiar with all patients, and their conditions. Four of the six patients were bed bound. These patients were either confused or unable to speak. One of the other patients, James, was a stroke patient, with a right sided weakness and expressive dysphasia. The remaining patient was the only one who could move around independently, and communicate well.

Eddie was an 85 year old man who was being treated for a urinary tract infection (UTI). He was also known to have a 7.5cm aortic aneurysm. He was slightly confused, and had been having hallucinations for some time. Due to being confused, Eddie often tried to get out of bed as he was fed up with being on bed rest.
On one shift, I had spent most of my time in this bay, watching the patient’s who were known for trying to get up, and doing hourly observations on a very poorly patient. Eddie had tried to get out of bed again, as he wanted to look for his sons who were due to visit. After confirming with the nurse earlier in the shift, I had told Eddie he would be able to go out in a wheelchair with his sons. After putting him back to bed, I left the bay for a few minutes and heard James shouting for me. This was extremely unusual as James did not like to speak unless he had to and he also struggled to say what he wanted to say due to the expressive dysphasia. I went back in, to find Eddie shaking, and clearly having difficulty breathing. As there was no response when I spoke to him, and no pulse I pulled the emergency buzzer and shouted to one of the health care assistants to get the sister, Jane.


Jane checked for a blood pressure, and immediately shouted for somebody to bleep the crash team and bring the resuscitation trolley. Within seconds, there were doctors around the bed, trying to get a line in and take blood. They had quickly started bagging and compressions.
As I stood watching, I could feel myself shaking. Everything was happening really fast and I was so shocked that a minute earlier, Eddie had been completely fine. I stood with one of the health care assistants, and said to her that his feet were already white. That was when it became clear that he would probably not survive. Though he was making some respiratory effort himself, there was no output, and after a few cycles the anaesthetist asked me if I would take over doing compressions. With their help, I managed to do a few cycles, until I became tired, and then stood back to let somebody take over. After many cycles, there was still no output, and so the doctor’s agreed to attempt to shock Eddie.

After one shock, an output was found, however it was still too weak and his respiratory effort seemed to be failing more and more.
Potassium levels in Eddie’s blood were checked, and it was agreed that if they were within normal limits, resuscitation should be stopped (normal levels indicated that it was likely that the aneurysm had ruptured). After another few cycles of compressions, and blood results which were normal, it was agreed that they should abandon resuscitation.
The doctor asked if anybody had any strong objections, and I wanted to tell them to carry on. They had got an output after shocking him, so I had thought he was going to be alright, and so my instinct was to tell them to keep going and to shock him again. However, Eddie had an aneurysm and even if he had survived, he would most likely be brain damaged. After stopping resuscitation, Eddie carried on making some respiratory effort for a few minutes.

I went in with the Doctor and another nurse to break the news to Eddie’s sons. They were really strong, and both agreed to go and sit with him while he took his last breaths. Eddie passed away with both his sons holding his hands. When they had left, I helped Jane lay out Eddie’s body and clean him up. I found this to be a very peaceful thing to do, and was pleased that I had been given the chance to do it.


Afterwards, I went to see how the other 5 patient’s were doing, including those who may not have been aware of what was happening. James was crying. He was obviously distressed, as he was the only one who saw Eddie during the first few seconds of what was happening. I explained to James that he had done really well in shouting me. Though he had difficulty in communicating, he still managed to speak a little and he felt the need to reassure both himself and me, by saying that Eddie had lived his life, and that this was his time. After a chat with James, and after calming him down and settling him to bed, I went off to carry on helping the health care assistants. Walking past the office, Jane shouted me in, to ask if I was alright. At this point, it hit me and I realised what had just happened. I was in shock and in a way blamed myself for not being fast enough or noticing something was going to happen. Jane reassured me that I had done well in raising the alarm so quickly, as well as participating in the resuscitation. She also claimed that Eddie would not have felt anything, and that it was comforting that he died with his sons there. After telling me I had handled the situation really well, she also told me that she had seen me check the other patients were ok and said that this was a nice thing for me to do.

I talked through my feelings with her, telling her that I had felt a small sense of relief when they had got an output after shocking him, only to be devastated when they gave up. The main thing that was upsetting me at this point was that it had all happened so quickly. Within minutes, he had gone from laughing at me after putting him in bed again, to being unconscious, and eventually passing away.
I was amazed at how well Eddie’s sons had taken in the news, however I realise that they knew the aneurysm could kill him at any time.
Though I felt guilty for not being able to help him in the way I wanted, I had to realise that Eddie had “lived a long and happy life”, as his son put it, and that even though it was what I wanted, it may not have been what he wanted. It is important to think about the quality of life for the patient after something like this happens, if they survive.
I was upset that this had happened so quickly, however Eddie would not have felt it and would most likely have been unaware of everything.
Laying out the body was a special thing to do. It was the last thing I could do for him, and I felt honoured to be doing it. However it was still a difficult thing to do, as he looked like he was peacefully sleeping and that he would wake up any second to tell me a joke. Even though I knew he wasn’t alive, I still explained everything I was doing, as did Jane. I felt it was important and though he physically wasn’t there, it was still important to treat his body with respect and dignity.

Looking back, I realise that the crash team, the ward team and myself did everything possible to keep Eddie alive, but it is important to know when to stop and accept what is happening. The staff on the ward, especially Jane, were supportive which I think was a lot of help to me. They understood how it feels to be in the situation I was in and they were all a great support. One of the health care assistants told me that I had done a brilliant job with Eddie that day as she had seen me chatting to him while feeding him dinner.
Eddie was happy on the day he died and had spent most of the day laughing at me when I put him back to bed. Knowing he was happy brings some comfort. Though he was confused and having hallucinations, he was still aware of everybody and everything going on around him.

I would not change anything about this situation if it happened again. I acted rapidly, raising the alarm and getting help. I took part in the resuscitation and stayed strong and calm throughout, even though I wanted to cry. I was there while the doctor told Eddie’s sons, who I also knew from looking after him so much and again, managed to stay strong as they had done. I had laid out Eddie’s body, which I felt privileged in doing. I also took into account my other patient’s in the bay and checked they were feeling alright. I managed to calm James down as well as reassuring him that he did well to shout for me. Most importantly, I spoke to Jane about how I was feeling which was a big help. If I had not spoken to Jane, I would probably have carried on until the end of the shift and then would have got upset when there was nobody to talk things through with. The most important thing is that I learned a lot from this experience and that I can take all this away with me for future experiences.

An unexpected conversation.

Have you ever had a dream where, when you wake up, you can’t shake off the feelings it has left you with? Have you ever felt compelled to double check that whoever was in that dream is ok?

For a couple of years now I have struggled to remember any of my dreams. I only remember through having one or two images from the dream the following day. And of course, a nagging feeling or emotion that I have trouble identifying. I have tried different things to work out what is going on. Why these dreams are happening the way they do, is still a mystery. It’s difficult to understand them when I remember so little.

Many different people have been in my dreams, and though I get a nagging feeling, I am usually able to contain it and move on from it without anything bad happening.

The other night, I dreamt about my ex therapist, who I started working with 15 years ago. For 5 years, we worked through many of the issues I was dealing with. We developed a brilliant therapeutic relationship, although it took me a long time to fully trust him.

I don’t remember what happened in the dream. I just knew he was there. When I woke up the following day, that worry stayed with me and he kept coming into my thoughts. This has happened before, so it wasn’t a surprising occurence that I was unfamiliar with.

A few days later, and I woke from another dream that he was in. Again, I don’t remember the content. I just remember him being in the dream, and waking up to that awful feeling. I tried, again, to dismiss it. But eventually, as the day went on, my feelings got the better of me and I emailed him to check in.

Our emails were nothing out of the ordinary. The general pleasantries having been covered, we ended up talking about our therapy days. It was interesting to hear his perspective from that time. For all this time, I have only had my own perspective and my own memories of our therapy. With a lot of those memories being vague, and some even missing, it was interesting to discuss his perspectives also.

When I think back to that time, I can see I was in such a dark and difficult place. But I never realised how deep that ran. And I never really realised how he saw things. He mentioned that he often worried that he had pushed me too much through difficult sessions. I reassured him he never did that. I remember it being much easier for me to be pushed. I struggled to simply offer up information and so there were many times where he did have to push me, where he had to ask me questions in order to get anything out of me. There were days where I was just so overwhelmed by emotions that I would shut down. Not just mentally either; I would feel physically paralysed. Sometimes I could hear him asking me questions, trying to help me ground myself, trying to get me to move my eyes, to stop that fixed stare. And even though I could hear him, I was stuck, within myself. On the inside I was screaming for him to help me; banging on the internal walls I’d built around myself and screaming as loud as I could in the hope that he would hear me. On the outside, I was still, my eyes fixated on the same spot, unable to even nod or shake my head in response to his questions. Eventually he would help me to regain control.

I remember when he would try to reassure me that it was possible that things could improve and that I wouldn’t always feel so bad. And sometimes I would question his hope and optimism. I would reply that he was just telling me that because he would never dream of telling me that I was doomed, and that things won’t get better. Calmly, he would explain that he genuinely believed what he was saying. I never believed him and I never accepted his hope or allowed him to express it without biting back at him. Though I do know that he meant everything he said in that regard; he really did believe that I had hope of moving forward from the trauma I’d experienced.

In his own words he recently described me as being, all those years ago, ‘tormented’, ‘closed down’ and ‘hard to reach out to’. And in retrospect I see that 100%. He also told me that he didn’t know if I would survive, which made me realise how lucky I was. I was lucky to have not purposely killed myself. And I was even luckier that I didn’t accidentally kill myself through self-harm, overdosing, ligaturing. My life could have been wiped out and I wouldn’t be here today to share my experiences. And now, 15 years on from when I first met this person, I can happily say he was right. His fear that I may not have survived was very real and he had good reason to have the concern. I don’t think he was the only one with that worry.

When you are in the midst of depression and other mental health problems, it is near impossible to ever believe you can get through it and have a better life.
I am living proof that it is possible to survive. Never be afraid of reaching out when you are struggling. There will always be somebody who is willing to help, support and guide you. I would give anyone my time if they needed it or asked for it. Plenty of people have given me their time throughout my life when I needed it. And I believe that is partly why I am still here today.

You never need to suffer alone❤️

Choices. Just; choices!

I came across this meme on Facebook earlier and thought it was very apt. At the time, I had just been having a conversation about my recent changes in attitude. The fact that I’m striving to improve myself, be healthier, look after myself more. And that all this work I’m doing is “for” me; nobody else is asking these things of me; they are things that I am hoping will improve my overall health and general wellbeing. And I have realised, nobody can do it “with” or “for” me. People can encourage me, support me and give me feedback but ultimately it is only me who can do it. Because I am the one who is making these choices, with choices being the operative word.

Everything we do, we choose to do. We “choose” to eat to survive or to enjoy the taste etc. We choose to go out, stay in, drink alcohol, smoke; basically everything. I know some people may argue this, some people have said they don’t “choose” to work and they “have” to work to earn money to survive. That’s a fair point, however you’re still choosing from those 2 potentials; do you choose to work to survive, or do you choose not to work and risk the consequences of that whatever they may be. You choose the lesser of the evils, but that doesn’t mean the lesser evil will be a great alternative.

In moments of desperation, when my world had crashed down around me and almost buried me alive, I ‘chose’ to hurt myself. The only options or choices I could see at that very moment were: I hurt myself right now to relieve the feelings or I kill myself to permanently stop the feelings. I could never see other options in those situations, where I can now (for example, an alternative option could have been I could have tried to tolerate those feelings a little longer, reminding myself that they were thoughts and feelings and they could not hurt me). So I’ve realised (just now by writing this very random post), that problem solving is quite important, in order to try to see the other choices you have. Opening up your mind, slowing down your thoughts, reassuring yourself. Maybe then try to take a step back from it for a few seconds and consider your options. That 10 or 20 seconds when you take a step back and assess the situation properly, could potentially distract you enough to really reduce your urges or feelings. That is not easy, but try just by reminding yourself every day to use that 10 or more second step back from things so you can gather yourself.

Well now you have a choice to make. Try the above or don’t try the above. Further choices along the way, if you do try, do you give up after 1 failed attempt or do you keep practising until it gets easier? If you ignore the above, is there anything else you can try that might help? Or would you choose not to end the cycle at all?

All choices that come with their own consequences; positive & negative. Which is the lesser alternative? Is that a lesser alternative for the short-term? Or is it the lesser alternative for the long-term? Sometimes we have to choose harder options in order to improve things for the long-term. That means pushing ourselves out of our comfort zones, making choices we might not usually make and trying things that might fear us to death.

Choices choices choices 🙂

Borderline Personality Disorder: We found love in a hopeless place; literally!

Relationships have always been a sticky subject with me. To be quite honest I’ve always preferred being single, and even as a teenager, was never really interested in finding a boyfriend (or girlfriend for that matter). This was possibly a lot to do with previous experiences in relationships; I usually always gave in to my partners and they usually had full control of the relationship. Even if that meant I wasn’t happy; their feelings were always put before mine (which I believe is called ‘subjugation’ sp?).

I’ve had a number of relationships, some short term, some long term. Nothing ever too serious. The fear of commitment was far too much for me. I much preferred being on my own, enjoying ‘me’ time at home on an evening, not having to check with your partner before agreeing to go out in case they’ve made plans for us etc. And I very clearly remember discussing this in a group setting about 2 years ago; “I don’t ever want to get married, I don’t want kids, I’m happy as I am and that’s that”. Anyone dared suggest otherwise I’d freak out.

There was one person in this group who I considered to be a friend. We’d not long known each other, but I instantly felt comfortable around her because she was just so laid back and chilled out. I admired people who were like that; because it was something I could never be… I did not “chill out” and was always on the go, worrying about something, feeling tense. I could never have the attitude of “don’t worry, it’ll be fine”. Being friends with her really helped me to be able to start doing that and now I’m so laid back I’m horizontal at times. I don’t worry half as much as I used to. I don’t stress about the little things like I did.

We were very good friends and I could tell her anything, with her feeling the same about me. I didn’t have any ‘feelings’ for her in the beginning. And, in my mind, I was ‘straight’; the thought of being in a relationship with my friend who also happened to be female just never entered my mind. Then eventually, just before Christmas 2014, I realised I was falling in love with her. I did have feelings for her and I loved her and wanted to be with her. You can imagine, I was pretty dumbfounded at this point; what the feck do I do now?

At first I tried pushing those feelings away. It was scary to think I might be falling for a female; I wasn’t ‘gay’. The feelings grew stronger and after finally discussing it with my CPN, I managed to work through my anxieties and fears, before coming to terms with the fact that actually, you really can’t help who you fall for. Never in a million years did I expect I’d be settling down with someone of the same sex, but it’s happening.

We told family and a small selection of close friends just after christmas 2014, and have been together since. I can honestly tell you, I have never been in a relationship like this and it certainly isn’t dysfunctional. In almost a year of being together we’ve not had 1 single argument. We talk things through, we’re honest at all times; if I piss her off she’ll tell me (in a kinder way) and vice versa. There’s nothing we ever need to argue about; if we disagree about something we’ll discuss it and work through it or agree to disagree. I absolutely love her to pieces, she is my world. I’ve never met somebody before who I felt I could spend all my time with and always be happy. Of course, we both have our own time too as that’s important, but I much prefer being in her company. She has, at times, carried me through the past couple of years, and I’d be utterly lost without her. And now I think, so what if she’s a female; I love her and she loves me and we are happy together. It’s taken a good few months for me to be able to finally tell the world we’re together, because of my fears of what other people would think mostly. But in all honesty, our happiness is much more important, and I don’t want our relationship to be a secret anymore. She is my world, she makes me laugh, I feel safe with her, she treats me as an equal; all the things I’ve never had in previous relationships.

You genuinely just cannot help who you fall for. Love came along when I least expected it, and has brought me a long way in my recovery from mental illness. I don’t think anyone needs to be out looking for ‘the one’, I think they’ll find you one day when the time is right for both of you!

The consequences of impulsivity

Yesterday, myself and some friends had a discussion about impulsive behaviour, and it made me see just how difficult it can be for people to understand those with borderline traits or PD. When I was more impulsive in a way that was damaging to me (taking overdoses, self-harming, spending too much money, wreckless behaviour etc.), I just didn’t seem to care about the consequenses of my actions. There were times when one minute I felt brilliant, and the next minute I felt dreadful and believed I wanted to die. My emotions would literally rocket from nowhere and I’d feel sudden, extreme and overwhelming emotions. Looking back on it, I realise it was because I bottled everything up. Then I’d get to a point where I was literally full inside from head to toe of emotions and feelings I didn’t like and they’d spill out. It felt so hard to control; in fact when this happened, I’d self-harm to release the emotions a little (this was where I was impulsive). I realise now though, that I did always have some element of control, because I could always hold it until I was alone. I never self-harmed in front of anyone else, and it was very rare for me to do it if somebody was in the house with me.

If you think about impulsivity being something you just ‘do’ without thinking about; we’ve all done it at times, and in positive ways too. It’s something that happens so fast, with me it happened so fast at times (or most of the time) that I didn’t realise what I was doing until I’d actually done it.

My emotions would go through the roof, lead to some kind of impulsive behaviour (usually self-damaging) and then as quick as they came on, once I’d acted impulsively, I felt OK again. I say OK, but what I really mean is I felt more in control of my emotions. I didn’t feel like I was going to ‘lose it’ when I was around other people. On the outside I could be with somebody and look like I was feeling fine, then 2 minutes after leaving them, I’ve hurt myself; that would mess with people’s minds. “Why didn’t you tell me you felt like that?” people would ask me. I never knew the answer, and would always reply with “I don’t know”. There have been times where I’ve took overdoses thinking that I wanted to die; when in fact, I just wanted somebody to help me, so desperately. I could never see that until now. I never wanted to die, but acting impulsively, I never thought of the consequences. I never actually thought beforehand that I could have accidentally killed myself. It would be half way through overdosing I’d think; “Shit what am I doing?”, panic and would ask someone for help or take myself to hospital. People question your motives and so many times I’ve heard “if you really wanted to die, you wouldn’t have come for help”. Well you know what, that’s actually very true, but to say that to somebody when they’re feeling so shit gives them the impression that you don’t give a damn. It’s invalidating. It’s not acknowledging the pain that person is in at that time, or was in at the time of harming themselves.

Impulsive behaviours have commonly already happened by the time I’ve known about them. I never ‘wanted’ to hurt myself, but I didn’t feel in control of it. I was stuck in a vicious circle of feeling bad, self-harming, feeling bad, self-harming. BPD has so many negative associations. I’ve often heard the words ‘manipulative’ and ‘attention-seeking’. Once again comes the spectrum; we can all be manipulative, and all are to some degree. The same goes for seeking ‘attention’; we all have done or do this, to varying degrees, using different behaviours. Perhaps using the word ‘attention’ isn’t very accurate, or is a little bit of a broad term. If you look closer, there is a need in that person that is not being met, and they don’t know how to ask for somebody to meet that need. It could be approval-seeking, seeking reassurance from others, seeking emotional support, seeking comfort, seeking company – there are a million and one things it could be. One thing is for sure, whenever I did things that others saw as attention-seeking (self-harmed) I saw as my way of releasing my inner pain. For me, and for most who self-harm, it was very private and the only people who ever saw my fresh wounds were medical staff (GP, walk-in centre nurses, A&E staff). The only times those people might have seen a wound, was if I’d gone too far and needed stitches, or if I had an infected wound. Probably 90% of the times I’ve harmed myself, I’ve dealt with it alone and not need to tell anyone about it. So really, if I was attention-seeking, I was doing it so wrong!

People who regularly behave in a way that’s harmful to themselves are actually struggling emotionally. But, because of the way(s) they handle their emotions, they can be viewed in a very negative light; manipulative and attention-seeker. Those are harsh words to use for anyone, let alone somebody who is in turmoil and doesn’t know how to ask for help.

I really don’t know if I’m making any sense so I’m sorry if I’v rambled on a little!

I graduated from therapy

Well, strictly speaking, I’ve got 1 last 1-2-1 session next week, but I had my last group session today and although it was hard knowing I won’t be going back into that kind of supportive environment, it was exciting too. The prospect of a lie-in on a Thursday got the better of me!

In all seriousness this is a huge deal for me. I never thought I’d be able to say that I’ve reached the end of therapy, after 9 full years in services, and feel excited about it. If you read my post about attachments, you’ll hopefully understand a little more about how strong my attachments were with mental health professionals (in particular) who were working closely with me. To finally completely let go of those safe attachments, and that safety harness, is the scariest thing to think of, and admit to. For some strange reason, up until recently, I found it so difficult to just tell it how it is. It just wouldn’t happen for me, until I’d started to develop personally, in my recovery. I was talking to my CPN in my 1-2-1 about 3-4 months ago. I said something (but have no idea what it was) and I realised at that moment that there was a change in me. Literally, out of nowhere, came reels and reels of complete honesty about my life. I admitted to things I’d never even be able to admit to myself, and from that point I felt completely amazing. It is so hard to describe what happened that day, in that 50 minutes, because it’s something that’s never happened to me before. Nothing has ever made me feel as good as I did, and have, from that day. Simply because I stopped pushing the true thoughts/feelings away, and I said them out loud which acknowledged them for the first time, comfirming they were in fact very real. I explained my attachment issues with professionals and admitted that I was terrified of being discharged; instead of persistently repeating “I’m not worried about being discharged at all” (whilst secretly shitting my pants). I admitted that, for some reason, I found it hard to give the professionals all the information they needed, in order to be able to support me better. Instead, I would drip-feed them information, try and hold it all together, until a ‘crisis’ would occur which would usually end up in a hospital admission. I was aware at the time that I drip-fed, and I couldn’t help it. It was my way of keeping myself safe I suppose, and I think now that it’s something we all do to a degree. Not a lot of people go around being 100% honest every second of every day about how they were feeling, we have to build up trust with people and learn when it’s ‘safe’ and appropriate to express our thoughts/feelings. It just takes different amounts of time for others to start trusting people, and I guess the more you’ve been let down by people in the past, the longer it’s going to take you to build up that trust with somebody in the future. It’s a really ‘simple’ psychological defence mechanism that keeps us safe from other people.

While it may take somebody a long time to trust if they’ve been hurt previously, it can sometimes be the opposite too. For me, I’d sit there wanting to honestly answer their questions, (are you having urges to self-harm? Are you safe? Are you feeling suicidal?) and the real answer would come into my head, but they heard the complete opposite to whatever that was. The answers to those questions at that time, by the way, would have been no, yes & no; but the real truth at that time would have been yes, no, yes. Is that confusing to you? I’m chuckling now at the thought of you going to and from the questions to match the answers. To sum up where I’m at now, if I was having urges to self-harm, wasn’t safe and felt suicidal, and I was asked those questions, I wouldn’t lie. I’d be able to express my true feelings in a way where other people could understand them better. Rather than, saying I was fine and then an hour later taking an overdose or hurting myself in some way. It really sounds so simple to me now, but you know what, when you’re in that ‘place’ you feel completely and utterly paralysed by your emotions.