Category Archives: Self care

Guinness, the Mourne mountains and COVID-19 recovery

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In January 2021, Lecturer in Education, Conor Hamiltons’ dad contracted Covid. In this blog post, Conor reflects on the impact of not being connected to him during his illness and on using his Dads connection with the Mournes (and Guinness) to  aid his recovery.

By now just about everyone on the planet is aware of Covid-19. Very few have been untouched by its grasp. Since March 2020 we have all had to change the way we live our lives, be it work, school, shopping, exercise, face to face socialising or visiting family. We have missed parties, pubs, restaurants, holidays and foreign travel. Parents became teachers. Nurses and doctors became unlikely superheroes. As nurses and nursing students some of us were redeployed from our normal day to day jobs to frontline nursing and caring for the sickest of those affected. Personally, I was redeployed from running endoscopy lists in a Day Procedure Unit, to night shifts in Covid Emergency Theatre and having to run from Theatre to the Respiratory Ward or E.D. to intubate the sickest patients and bring them to ICU via the CT scanner. I would be lying if I said I wasn’t affected. We all were whether we care to admit it or not. I know some of those patients sadly didn’t make it. I took my work home with me every morning and I thought about little else until I went back in again that night.

My family remained untouched directly by Covid until January 2021. My parents are both in their seventies. My mother has multiple comorbidities but my father is an ex-marathon runner, and indeed clocked 2 hours 38 minutes for the distance in the mid-eighties. He still walks ten miles a day, and loves hiking in the Mournes. For almost a year they isolated and did everything by the book. My family and my brother’s family visited the back yard and spoke to them through the glass window of the porch. They exercised once daily in Loughgall Park or Gosford Forest Park and stayed within a short radius of home. Shopping was all done online. Yet somewhere over the Christmas period of 2020 Covid caught up with them. Mum had mild flu-like symptoms. Dad initially had the same, but on 7th January his chest became tight and the GP was called. He was ill, but not ill enough for hospital. We were told to monitor him overnight and ring 999 if he deteriorated. Being a typical man, he went off to bed assuring us he would call if he got any worse. At 8am the next morning, my mother found him almost blue, struggling to breathe with oxygen saturation levels below 80%. He didn’t want to go to hospital so he decided to tough it out overnight and hope it would clear up. He was blue-lighted to Craigavon Hospital and the paramedic said had he waited another hour he might not have made it.

So began a month of no contact with dad other than text messaging and passing messages via nursing staff. Dad doesn’t do technology so Facetime, Whatsapp and all those other video messaging services were out the window. It was this very week that I started as a Lecturer in Nursing at Queen’s and I also tested positive for Covid four days after my first vaccination. So, mum was on her own, dad was in hospital and we were all isolating. It was a pretty busy and stressful week. Having been called out to 2 North Respiratory a number of times to help intubate patients while working in Covid Emergency Theatre, I could picture the scene and appreciate what was going on around him.

Dad continued to deteriorate over the next two weeks to the point where he was put on CPAP and told the next step was ICU and ventilation. He found the CPAP intolerable and not only was he physically deteriorating, but mentally he had reached rock bottom. His friend from school, over 60 years ago, had passed away suddenly overnight as a result of Covid in the bed next to him. Dad then developed pulmonary emboli (clots on his lungs). At his lowest ebb, he rang my mum one morning and said he didn’t think he would make it out of hospital, and gave her his bank account details – that’s how we knew he was really sick!

Not knowing how to lift his spirits, myself and my brother David decided to set him a goal. We promised him we’d have a pint of Guinness on top of Doan (one of the smallest peaks in the Mournes) when he recovered. Every time we spoke to him on the phone between then and his discharge weeks later, we reminded him of the goal. For six weeks after discharge either myself or David would call for dad, no matter what the weather, and take him for a walk at 6pm. He started with 400 meters on 8 litres of oxygen pushing a rollator. Again, being a proud man, known around Armagh and beyond for his marathon exploits in the eighties, he would not go out in daylight with the rollator – this was all done under cover of darkness, wearing a big hat and a buff! Over the six weeks we weaned him off the oxygen and increased the distance gradually. Eventually he was walking six miles non-stop with no oxygen. On 1st of April he rang and said he was ready for Doan on the 3rd – I thought it was an April Fool prank, but no, he was ready. His two youngest grandchildren were there to set an easy pace, and in just over 2 hours we had walked the four miles to Doan and made it to the summit. I had three cans of Guinness with me and three glasses to fulfil the promise. That’s him below with the pint…. on Doan. It was a perfect day. It wasn’t a bad pint either. Just before we took this photo we met two of the anaesthetists from Craigavon who were delighted to see him up there. I think they got a bit of a lift from seeing the benefits of their work.

I posted this photo on the Mourne Mountains Hiking Facebook page and it was picked up by a member who is a journalist for the Irish News. They ran a story about dad’s pint of Guinness on Doan and stated that the photo was “the” photo of the pandemic. The Newsletter then picked it up. BBC Radio Ulster rang and did an interview with us on their morning slot. It went to my dad’s head a bit and he started practicing his signature for autographs. We were told last week that the story had made it to newspapers in India, via Canada. Good news seems to travel fast. It seems everyone wants to grab a positive story from the pandemic.

I’m extremely proud of my dad. He is back to walking eight to ten miles a day with his wee rucksack on his back. He takes a stick now, just for a bit of peace of mind. I’m not sure if he takes any Guinness though. If nothing else this wee tale shows the benefits of goal setting in recovery. I’m not sure what would have happened to dad if we hadn’t set him a goal. I’m not sure if it was the goal that helped him recover, or the fact that he realised he had given mum access to his bank account. I like to think it was the goal. He has since changed his bank account password. Set yourself goals in life – believe and you can achieve. Never give out your bank account details. Stay safe.

Steps in the right direction

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In this post Alison Smart & Deirdre O’Neill reflect on embedding self care into the nursing curriculum and introduce the all school walking challenge.

It isn’t too long ago as a deputy charge nurse that I remember struggling to sleep knowing that our staffing levels the next day were not met and wondering how that ICU patient was doing after their surgery. We as a profession of Nurses & Midwives can often deal with very difficult situations and forget about ourselves amongst the maelstrom. This issue has resurfaced in a profound way over the last 12 months of the pandemic with working from home making it very difficult to switch off – I’m sure a lot of you can resonate with this. 

In addition to our career pressures, you are the go-to person for friends and families. Therefore, it is imperative that we, staff, students and the profession as a whole start to look after ourselves and carve out time on a daily basis to fill that cup so we can pour from it in the future. This couldn’t be more true in Northern Ireland – we have a workforce crisis within nursing, so we need to do all we can to manage our well-being and in turn increase recruitment and retention. 

With the introduction of the new curricula, I thought this was the perfect opportunity to embed and promote “Self-Care for Health Care” within the School of Nursing. Due to the new NMC proficiency of ensuring you are in good health this seemed like an ideal opportunity to put this into practice in Year 1 Professionalism in Nursing. 

Each week the students discovered a new activity to undertake, placed visibly within the module material for the week (see Box 1). Students were then asked to reflect and identify how they felt before the activity and how they felt after. 

The feedback received from staff & students was overwhelmingly positive with one of the standout highlights being the step challenge. 

“It is easy, effective and we can all do it” 

“Loved it, got me out and about again” 

“I felt so good after my morning walks”. 

We virtually climbed Mont Blanc and Jo Mc Mullan stormed in front when we headed to the Mediterranean and raced up Corsica (220,000 steps in January). We used a clever and easy app (SQUADS) that allows a forum to message, input steps, share motivation and a healthy dose of competition. 

After speaking with colleagues & sharing the app. Deirdre O’Neill tried it out with Year 2. Let’s hear how they got on: 

After hearing the success of the walking challenge in year one I could not wait to pitch the idea so the students on their return to phase five. With the help of Chloe Gardiner (year two student nurse) a challenge was set up each week for all of us to complete. We divided into three teams and competed against each other encouraging each other to win the weekly challenge.  Initially the challenge was only too last six weeks but because we all see the benefit of not only daily exercise, but we were also able to connect with each other in this virtual platform.  Students were encouraged to share photos of their walking sceneries, so we had pictures of forests, beaches and country lanes.  We saw snow falls and the beginning of the touches of spring.  Each week at the start or end of class we would share our walking stories and because of the laughter and connection it has brought us we will continue the challenge when the students begin their next placement.  

Due to popular demand and with momentum on our side we are holding a walking challenge for staff and students alike as part of QUBbeWell week. The challenge will consist of a Race up Corsica Canyon (69,750 steps) from Monday to Friday. We invite you all to come on board and join the fun. All you need to do is open the link on your phone and join the squad. 

We have also secured some great prizes including a six-month PEC membership in collaboration with Queens Sport and a two-week meal supply kindly donated by Primal Fox Nutrition. In addition to the first 3 people to reach the virtual summit, we have also got a prize for the best picture from all your walks, so get snapping! 

Any questions regarding the app, well-being material or if you fancy a chat, just get in touch a.smart@qub.ac.uk or d.m.oneill@qub.ac.uk

All in this together….staying connected

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In this post Pauline Cardwell, Year 2 Lead and Lecturer in Children’s and Young Peoples Nursing, reflects on the difference connection can make.

It is hard to believe we are almost 10 months into this pandemic event, which has caused each and every one of us to review and reflect on every aspect of our lives, personally, professionally and as a community.  This evolving and uncertain period of time has challenged us as individuals and has also afforded us some real opportunities to create and deliver on new ways of working, providing engaging and inspiring learning activities, whilst being mindful of the human cost individually, whilst ultimately remembering we are all trying to navigate this difficult and unpredictable time.

Essence of nursing

Nursing has always prided itself on being a caring and compassionate career, where at the heart of its DNA is the privilege to care for individuals and communities at vulnerable, challenging, difficult and joyous times in their lives. This act of caring is the essence of ‘what we do’, to hold the hand of someone who is frightened or scared of the journey ahead or celebrating the end of a successful treatment plan, a newfound independence, a recovery made, or a new life delivered. Whilst this may be the essence of nursing it can sometimes require a heavy payment. We have all seen so many images of those heroes after a demanding, draining and sometimes devastating shift and still we come back and do it all again.

Every one of us has paid the cost in a plethora of ways. The worry of supporting each other, hoping we can deliver a curriculum fit for the future and as educationalists caring for our students. I experienced this acutely one day in November where I unexpectedly was contacted by a student in distress, they were overwhelmed at the acuity and challenging clinical environment they were currently working in. The student was upset, tearful and visibly distressed, the wise ward manager had asked them to take a break and suggested taking a walk outside to assist in reducing the stress they were feeling.

The power of connection

It was a bright, clear day and I reassured the student I was here to listen and asked them to explain what they were feeling. I felt the need to assist the student to achieve some grounding and perspective of what they were feeling, and I asked them to describe what they could see and if there was any greenery around. The student allowed me to view their surroundings and I noted a tree nearby and asked them to do something for me, I asked the student to go to the tree and rest their palm against the trunk of the tree. Initially, they were reluctant to carry out the activity, I reassured them I was with them and encouraged them to go ahead and trust me. We then both closed our eyes and I asked them to focus on their breathing. I then began to talk quietly and calmly to the student asking them to consider how the tree had lost its leaves and looked ‘dead’ essentially but also consider that come spring the tree would bud again and burst into life once more. I noted their breathing patterned had calmed and their speech was not as rushed as previously. Eventually we concluded the conversation when the student felt able to return to their shift.

Making a difference to others

Reflecting on this event, I feel grateful I had the opportunity and privilege to support this student at such a personally vulnerable time for them. On further consideration I truly appreciate that this is truly a momentous time for our professions, we are courageous, we are caring, we are compassionate but ultimately, we are human. So, my wish for us all as we move forward and hopefully to a more ‘normal’ way of life is to; be kind to ourselves and others, be keen to learn, develop and progress and to be confident we are capable of delivering, growing and most of all making a difference for others.

#proudofourstudents #IloveNursing

‘Practicing what we preach’: Teaching mental health and wellbeing in a pandemic.

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In this post Karen Galway, Pauline McCarthy, Debbie Duncan and Aine Aventin (with contributions from the module teaching team and Sept ’19 nursing cohort) practice what they preach and reflect on an initiative to protect their own and their students mental health.

Picture the scene: It’s September 2020 and a second wave of Covid-19 pandemic has started impacting our health Service in Northern Ireland. Semester one of 2020/21 in the School of Nursing and Midwifery starts in a few short weeks. Our students face continued uncertainty about the future of their degree programme. Teaching is now online with students on campus for essential skills only. Whether the programme will follow the usual pattern of six weeks on campus and six weeks of placement is anyone’s guess.

Our brand new undergraduate nursing curriculum, developed pre-covid, rubber stamped by the Nursing and Midwifery Council, now needs fleshed out under totally new and by now, clichéd unprecedented circumstances. Learning curves are steep, tensions are high and energy is [at times] low.

One teaching team is focused on a new module; Working inter-professionally to improve mental health and wellbeing. This module isn’t presenting a new topic per se, but it presents a consolidated approach to teaching mental health to nursing students, during the toughest of times. With two Lecturers co-ordinating plus eight teaching staff, the module team must now place a new level of focus on mental health and wellbeing for all nursing specialties; adult, children’s, learning disability and mental health.

Week one focuses on models of mental health and wellbeing, stigma and discrimination along with self-care. We introduce mindfulness, self-care principles for nurses and an overview of how covid-19 may be impacting on nurses’ mental health. Week two considers social epidemiology and inequalities to address risk and protective factors for mental health and wellbeing. We also address communication skills and the basics of a mental state examination. Week three addresses issues related to self-harm and suicidal ideation and prevention. It’s challenging content, for lecturers and students alike, in challenging times, taught under challenging conditions.

We worry about how the students and the staff will manage the online environment. We worry about whether we will recognise who is struggling or indeed over identifying with the content. Beyond our self-care content, we also provide links to support, across the university and in the community and we consistently remind our students to reach out and to practice self-care.

Despite our efforts, there seems no easy way to maintain our connections to the students while we all get used to these new technologies and grapple with a new societal normal. Meanwhile three other modules are in full swing for these year two students. We are still groping about awkwardly with a lot of the processes such as developing a meaningful attendance monitoring policy. The timetable can feel brutal, with students and teaching staff online, in classes for up to 6 hours straight. Still ahead in our module specification is week four, focused on physical and mental health interactions, week five addressing trauma informed practice and adverse childhood experiences, with the final week explaining the symptoms of common mental health problems and an understanding of the stepped care model and other useful supportive responses.

Something about this feels very wrong. We are teaching the students about mental health and wellbeing in the middle of a pandemic, while expecting staff and students to perform as normal. In reality, nothing inside or outside of university life is feeling anything like normal.

Day one and week one involve shell shock and eye strain. The materials are well received but the challenge of online delivery intensifies. After two weeks of teaching at ‘business as usual’ pace, we stop to consider this rock of necessary progress against the hard place of exhaustion, frustration, worry and potential disengagement. We brainstorm on how to give ourselves and the students some space to breathe. Can we alter our timetabling? Can we switch live content to recorded content? Would that help? Can we provide adequate breaks and importantly can we identify students who are struggling?

A few actions were tabled and adjustments made to the format for week three. We decide to cut back screen time. In our mental wellbeing module we replace a live online tutorial with a self-care activity.

Students were notified that the two-hour session would now involve a discussion board, instead of a live session. We sent a simple request that the students go and “practice what we’ve been preaching”. The instructions were to take the time to do something to protect and maintain their mental wellbeing, to post a photo or video and comment about the activity on a discussion board. That amounted to a small concession to the Covid-teaching challenge, but it had a big impact.

Within 10 days the discussion generated 546 posts, 250+ photos of stunning autumn scenes, a variety of video clips, poetry, art, music, pet appreciation, baking and a huge amount of shared joy!

A selection of photos and comments from the discussion board

We can confirm that the Sept 19 students are a cohort of dog-lovers, walkers, runners, sports stars, artists, empathetic and caring parents, siblings, children, flat mates and all round philosophers. Contributions were authentic, honest and entertaining personal accounts of how each individual took care of their mental wellbeing, in two hours of me- time, designated for self-care. Reading and commenting on the joy of free time, downtime, the positivity and the creativity was more than a pleasure. It was addictive! Perhaps the discussion board felt like a surrogate for the missing sense of community that the pandemic has taken away. Perhaps it should not be surprising that such a simple idea was embraced in such complicated times.

Acknowledging student contributions
Sept ‘19 undegraduate nursing students: Leon Daly, Shannon Campbell, Cliodhna McIntryre, Marianna Donahue, Deirdre Boyle, Siobhan Duffy, Emma Shields, Chloe Truesdale, Edelle Brown, Caroline Devlin, Roisin McCann, Holly Brown, Megan Elloitt, Roisin Byrne, Orlagh Carson, Santina Campbell, Heather Gould, Caitlin Duffy, Grace Espie. Thanks for allowing us to share your discussion posts and photos.

It would be great to hear how you have managed your own mental health or that of your students since the beginning of the academic year. Comment below- or send us a photo!

The case for disconnectedness

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In this post I argue that, in a connected learning environment, being disconnected is essential to being productive as well as caring for yourself.

Enquiring about the well-being of one of the School of Nursing and Midwifery CPAD students recently she told me the following, ” Some see it as working at home, I feel that I am living at work”. I am sure that she isn’t alone in this feeling.

Over the last seven or eight months initially through necessity-and even now as recommended, we have in effect allowed some of our safest places, our sanctuaries and dare I say it our personal asylums, – our homes- to become part of the rat race that we call work.

We have had to learn new technologies, refine how we work, deal with technological issues and in some cases deliver set content in less hours than previously afforded in our teaching timetables. And this is all with the sword of the NSS hanging over our heads. Pedro Noguera recently noted, “teaching is exhausting, emotionally and psychologically exhausting”. He then goes on to argue “…if you don’t want to give people support, they won’t want to stay in the career. To certain extent I agree. However, this implies that the support should be top-down and here is where I digress from Noguera.

Yes, the employer needs to accept some responsibility to support me, however I also have a responsibility to look after my own health. Working in the Academy and the concept of academic freedom offers the ability to meet work and professional obligations in a manner that is consistent with my obligations to myself and my family. That is why there are times when I choose to wilfully disconnect.

Email + Instant messaging + social media + the world wide web = Information overload = Noise.

Like the proverbial rabbit in the headlights, that noise can become paralysing. It is okay at times to admit that it becomes too much, and at that stage it is appropriate to walk away for a short period of time. School of Nursing and Midwifery Senior Lecturer Dr Derek McLaughlin often talks about, and encourages students to take, guilt free breaks. That can be for as short as an hour or a day or longer. There are times when we need to disconnect from the noise that surrounds us.

Constant digital connection is associated with increased levels of loneliness, anxiety and depression. Disconnection clears the mind, improves concentration and helps focus which in turn increases productivity, I feel better and I get more done-a ‘win win’! In a blog post last year Natalie Cawthorne listed five reasons to disconnect from the digital world.

  1. Greater work-life balance
  2. Decreased symptoms of anxiety and depression
  3. Lower levels of job fatigue and burnout
  4. Reduced stress
  5. Better sleep

It is important to emphasise that the disconnections need to be complete and not simply transferred from desktop or laptop to a tablet and/or smartphone. The ease with which we can inadvertently find ourselves engrossed in something can be frightening. How many of us, attempting to switch off, have taken to a social media site only to find something that you think may be of interest to your students? I do it regularly! The all-pervasive nature of connectedness can be harmful.

I am by no means Luddite or even anti-tech. Those that know me may even say I’m bit of a geek in relation to tech, but I try to engage with it on my terms. I hasten to add not always successfully though.

My colleague and School of Nursing and Midwifery Lecturer Colin Hughes recently recorded a podcast that was published on the RCNi website on why and how nurses should self-care during the Covid pandemic. He talks about the value of routine as one coping mechanism. So my challenge to you, dear reader, is this. Build yourself a routine and make being disconnected from a digital world part of it. In other words, get connected with the physical world around you. You will feel better for it.