Emotional resilience and the realities of nursing children and families.

Hello, it’s been a while. I’ve been AWOL due to an intense final placement of first year and scrambling to get all my bits signed off so I will be okay to pass into second year.

I just wanted to write and reflect on the effects of the emotional strain that often happens in a profession as person orientated and hands on as nursing. My last placement was different to my other ones in the sense that it was emotionally hard going. My previous two placements were in a tertiary hospital, but my last was in a secondary hospital situated in a deprived area. The difference in demographic was massive.

I have always thought of myself as being someone who finds it easy to be non-judgemental. As a human being, it is easy to judge and stereotype someone from the off, but it’s most important that you don’t stigmatise. This placement tested my ability to do that to the extreme. So what was it then? In stark honesty, the role of nursing as an advisor was more prominent, such as advising parents about oral and personal hygiene, nutrition and various other issues. It also brought home how much hardship families face in this day and age – but this would be going into very unstable territory regarding government policy and cuts. This made me wonder about the relationship between social services and healthcare as it would be beneficial to have some training in the process of benefits claiming and what people are entitled to. I am sure we could have a family liaison worker or something along those lines to bridge the gap. We treat the medical needs of the child and then send them off back home. This was also an issue with the vast amount of adolescents who came in with mental health conditions, overdoses and suicidal tendencies. They were sent home when they were “medically” well, the relevant referrals were made, the correct paperwork filled out. But I couldn’t help thinking about these families and teenagers who were struggling with life and the realities of poverty, abuse and health needs. What happens next for them?

This wasn’t the only struggle I had. Many families left their children in hospital for days without visiting. Some said it was because they had other children at home and/or they couldn’t afford to travel to the hospital. A play specialist did her best and the nurses all really tried to make time for children who were on their own for most of the day but it was very difficult to do so. Even as student nurses, the ward was so busy that we found it hard to find time to spend with these children. I don’t have a judgement to make about this, it is what it is. Some cases I found terribly sad.

Finally, substance misuse was rife. Parents often admitted smoking cigarettes and drugs whilst pregnant and around their children. There were a few cases of alcohol fetal syndrome and associated complications as well as babies who were withdrawing from drugs their mother had taken during pregnancy. I have always thought of myself as unshockable, but this did shock me. However, a lot of the time I did feel sympathy towards the mothers because they had a real problem with substance misuse and most of the time they were so ashamed and guilty for what they had done to their babies. This broke my heart a lot because I wanted to be able to support the mother (much of the time these babies were in the care of social services and parents were allowed supervised visits). You can see the endless cycle of self loathing and self medicating. Again, I felt powerless to help. I have experienced parental substance misuse in the tertiary setting, but I felt it was more pronounced in secondary, probably because the hospital was very community focused and it felt more “personable”.

From writing this, I guess my struggle was the support we can provide as nurses. We are usually the first port of call when there are concerns with children and young people. I have always been someone who wants to save everyone and I think this placement was a reality check. You can’t save everyone but you can certainly try your best. Despite the issues I had, I really enjoyed working in this setting and would be happy to go back because the staff there were so good and I learnt so much about social and people skills. I think this is of importance and the epitome of nursing. You may have all the clinical knowledge but without good people skills you aren’t going to make a positive impact on someone’s life.

I hope I haven’t stigmatised or caused offence with this post.

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