Holiday relaxation in Cumbria – good for the mind, body and soul

The last week has not been about nursing or university at all, as it was officially a designated holiday week.  Time away from the normal every day routine is essentially good for the mind, body and soul.  Without rest, relaxation and leisure time, plus an occasional complete change of scenery, our brains and bodies can become tired and stressed from the effects of everyday life.

wigton

For the last 7 days therefore, I have been in North Cumbria and the Northern Lake District, with my partner and two of our dogs, staying in a beautiful converted barn, near the market town of Wigton.  Situated on a working farm, the cottage was an ideal holiday base, and was extremely comfortable and well-appointed inside.  Upon arriving, there was even a lovely welcome basket of homemade cake and biscuits, eggs from the farm, jam & marmalade and wine; plus milk, butter and orange juice in the fridge, and bread, cereal, tea, coffee and sugar in the cupboard.  I have never been to a holiday cottage before, where the owner has left some basic provisions, plus much more extras besides.  It was therefore a wonderful surprise, and saved us having to rush out to find a shop, in order to get some basic essentials.

The Lake District is a place that I really love spending time in, and I am also fairly familiar with it.  Many years ago I did my teacher training in the old St. Martin’s College in Ambleside (now part of the University of Cumbria), which was then an associate of Lancaster University.  Ambleside is a beautiful Lakeland village at the edge of Lake Windermere, with an abundance of traditional slate cottages, amidst a green valley backdrop of mountains, often with low cloud covering, and cascading crystal-clear waterfalls meandering down the hillsides.   In the past I have often taken a boat from Ambleside to Bowness-upon-Windermere; spent some time at the latter, before catching a boat back to Ambleside.  The next lake along the road is Rydal Water, and then Grasmere Lake and village.  This area is lovely for leisurely walking, and two homes of the poet, William Wordsworth, can be viewed along the way – namely, Dove Cottage and Rydal Mount.

I have also enjoyed spending time on the other side of Windermere in Hawkshead village, and then on to the Grizedale forest.  The quieter Lake Coniston and the Old Man O’ Coniston are also worth a visit, as is the Ravenglass steam railway and the tiny pretty village of Boot.

My favourite lake, visually, is the wild and isolated Wast Water, with its dramatically steep scree slopes.  I love to approach it from the Hardknott and Wrynose Passes, which are stunning, challenging and untamed, in equal measures.  While my favourite lake, for walking around, is Ennerdale, with its varied surround of forest, open path, green fields and rocky outcrop.

walk

This past week’s holiday was focused on a less familiar part of the county and was a very different but enjoyable experience.  We revisited some old favourites of the Northern Lakes, including Derwent Water at Keswick, the Borrowdale Valley, including a glorious walk along the river from Grange to Rosthwaite village, and the nearby Bassenthwaite Lake.

derwent

derwent2

We also revisited Ullswater Lake and the villages of Glenridding and Patterdale.  The journey’s approach was newly found territory through the sheep festooned fells and single track winding up and down roads of Mungrisdale; absolutely magnificent.  Newly found coastal discoveries, this time, included Allonby and Silloth.  The former had a fabulous stretch of five miles of sandy beach, while the latter had a charming seafront park, a promenade and direct access to miles of coastal path.  Both places had excellent views across the Solway Firth to nearby Scotland – the Dumfries and Galloway area.

sheep

beach

Another charming find was the village of Caldbeck, complete with duck pond, ancient watermill, riverside and church.  We found a really enjoyable walk which mainly followed the course of the river, across a few fields and some intermittent woodland.  The destination was another charming village called Newmarket Hesket, which apparently is a favourite of Prince Charles when he visits the county.

ducks

caldbeck river

church

market hesket

To make the holiday even better, we have had hot dry weather every single day.  Accompanied by sun cream, hay fever tablets, daily picnics and ice-creams, it was absolute perfection.  Our two dogs had a marvellous time too; what with lakes to paddle in, footpaths to follow and beaches to run along; they are tired, happy and satiated.  For a good balance of physical and mental health, for humans and canines alike, a week in Cumbria was wonderfully recuperative.

dogs swimming

dogs

On the way home I treated myself to a visit to the village of Sedbergh, an old favourite of mine, which is on the borders of Cumbria and the West Yorkshire Dales.  Sedbergh is one of England’s book towns, and I love ambling around the various book shops and finding some hidden literary treasures.  My enjoyment was great as I lost track of time, only for it to be broken by the sound of one of the dogs impatiently barking by the door, accompanied by my partner – no pressure!

With one further week of holiday away from university, it is now back to some preparatory nursing studies and recommended reading, and I am also going to take my turn in curating the university nursing Twitter account.  Last week also, I found out that I had passed both of my optional modules (End of Life/Palliative Care and Supporting families & carers) with really respectable marks.  These basically equate to 40 credits towards my degree, and one third of Year Two passed.

Mannequins and Collage

mannequins

This week was the end of the first semester of Year 2, and the End of Life/Palliative Care and Supporting Families and Carers optional modules came to a conclusion.  In order to summarise and finalise each module, special activities had been prepared in each of the last lessons.

In the End of Life/Palliative Care module, we went into the high fidelity simulation labs and worked with one of the mannequins – ‘dummies’ – and one of the lecturers.  The mannequin was a 43 year old man, ‘Vinnie’, who was dying of cancer.  He had been rushed into hospital the night before, and his wife, our lecturer, had been near his bedside ever since.  Vinnie was unconscious but apparently comfortable, as he had been given morphine to treat his pain.  Our job, as student nurses, was to look after Vinnie and his wife, ‘Jackie’, for the afternoon.

Our group consisted of 20 student nurses and we all formed into ten pairs of two.  A pair at a time, we went in to talk to Jackie and to check up on how Vinnie was doing.  The rest of us were able to watch each pair as they looked after the couple, through a camera in the classroom.  When each pair returned, we were able to discuss each scenario and how Vinnie and Jackie were progressing in their journey.  We then decided as a group how the next pair might move on in their discussion with Jackie, and their efforts to keep Vinnie comfortable.

mannequin 2

The afternoon was marked by a series of developments, with the first one being Jackie’s reluctance to accept that Vinnie was dying.  She then became concerned about the cannula on Vinnie’s arm and how it was looking sore.  This was eventually resolved by removing it, as the IV fluids did not need to be connected.  The next concern was that Vinnie might be getting dry in and around his mouth from the oxygen mask, and so the mask was temporarily removed.  His breathing got worse, and so the mask was put back on.  Later however, it was possible to completely remove it, and so then regular mouth care was able to be given.  This consisted of a damp sponge-ended ‘lollipop’ stick and some Vaseline applied to his lips.

Jackie went through an emotional rollercoaster of painful acceptance regarding Vinnie’s impending death.  It was decided that Vinnie’s brother should be called, as he was living a few hours away in London.  A decision was also made to bring in the couple’s two children, but this eventually did not materialise.  The question of whether Vinnie had a DNAR (Do not attempt resuscitation) in place was also raised and discussed.  Jackie thought that a DNAR was absent, but she had to be told that it was in fact actually recorded on Vinnie’s notes.  Through the shock, she was able to accept that it was probably the most dignified course of action for her very poorly and dying husband.  Jackie went out for some air, and just after she left, Vinnie’s breathing started to deteriorate.  A panic pursued, as it was realised that there was no mobile contact number recorded for Jackie.  It was feared that Vinnie would die in her absence, but in fact it was just his breathing that was changing, as he approached just a little nearer to death.  Fortunately Jackie soon came back and Vinnie’s breathing pattern changes were explained to her.

 

Later on, Vinnie started to groan very loudly, and it was realised that he was experiencing breakthrough pain as his morphine wore off, and so it was therefore decided to administer him some more morphine.  Vinnie soon settled back down, and further measures were taken to keep him comfortable.  Two nurses changed his incontinence pad and cleansed his skin, as a decision had been taken not to use a catheter.  Another two nurses washed his hands and face, and gave him some more mouth care.  Jackie began to give him mouth care too, and she sat holding his hand and intermittently crying and kissing him.  Our lecturer’s acting abilities were extraordinarily realistic!  When Vinnie’s breathing finally stopped, the last two nurses (and I was one of them) could do nothing except comfort Jackie at a distance, as she buried her head in Vinnie’s chest.  Jackie sobbed, turning away from everyone, and the other lecturer, the ‘clinical nurse specialist’, came in to confirm the death and to tell Jackie that Vinnie had indeed died.  It was amazing how realistic the situation seemed, as once we student nurses were in the ‘ward’ environment, it just all felt so real, and we were able to completely forget that we were actually being watched on a camera.

I had secretly been dreading the end of life simulation activity, and many of the other student nurses had felt the same way too.  On the day however, it was actually a really valuable learning experience, as things are never usually as bad as what one originally thinks.  The learning was not limited to taking part in the simulation; it was actually valuably extended through watching our other student colleagues, and through discussing the scenario progression and outcomes as they emerged in real time.  The optional End of Life/Palliative Care module has been exceptionally good, and is one that I have found really valuable as a future potential dementia nurse.

In the Supporting Families and Carers module, we gathered as a whole group and then split down into smaller groups of about five students.  Each individual had previously been instructed to bring along a recorded sheet of feedback from a service user’s family member or carer, on our recent placement, which consisted of their comments on our performance as a student nurse.  Focussing on this information, we had then been previously told to write a piece of reflective writing on this feedback using a reflective framework model such as Gibbs, Johns, Schön or Kolb.  I personally used the Gibbs model, which I feel is quite a simplistic, but functionally useful guide.  Reflection is considered to be an essential part of nursing, as it helps a nurse to look closely at what she or he does well or can do better in the future, and why that is so, and how it can be achieved.  As a mature student perhaps, I feel that I naturally reflect in my head most of the time, but I am receptive to trying written reflection and want to give it a go.  As requested for the session, I had produced a piece of reflective writing for the lesson.

hands

In our small groups, we discussed and shared our prerequisite feedback and reflections, and thus learned from each other’s experiences.  Our lecturers then explained about the reflective art that we would be producing that day, via a collage.  They showed us examples of art that had been produced in the Brighton area for an exhibition called Sick, which, as the name implies, was connected with health issues and the expression of these through artwork.  The examples were very inspiring and we prepared in our groups to create our own expressive contributions, regarding what people like about us as nurses and what makes these people’s experiences good.  Collecting a large sheet of paper, some different coloured marker pens, some sequins, furry bobbles and glue, etc. we set to work as a group.

poster 1

We decided to draw a central family group of a mum, dad, child and baby, all very brightly coloured in.  We then recorded lots of captions about what people like about us as nurses.  These consisted of examples such as ‘being a good listener’, ‘reading stories to the children’ to ‘cooking eggs or pancakes in the morning’.  All of the captions were decorated with bullet point furry bobbles and glittery sequins, and it all looked really bright and busy.  When the time duration came to an end, we all felt really satisfied about what we had achieved, and felt that we had suitably summarised the learning journey on the module.

clock

 

Our other colleagues had produced some lovely expressive collages too, and so after mounting each art piece onto the wall, each group explained the thinking behind their creation to the rest of the class.  As a bit of fun, we all marked each other’s work, awarding our favourite a 4, then the next best a 3, a 2 and then a 1.  The winning group had a bag of edible goodies, but unfortunately it was not our group!  Other examples of artwork included a rollercoaster of emotions and a pair of glittery caring hands.  All of the creations were lovely, and the activity made me feel a sense of overall belonging to the group and to our profession as future nurses.  It was fun and valuable at the same time.

rollercoaster

Afterwards we had a surprise visit from the Head of the School, who was very interested and complimentary about what we had done.  The artwork, I believe, is now being displayed and shared within the university.  What a great end to the optional modules!

communication

 

Back to University

The first semester of my second year is now almost over.  My favourite placement, so far, was passed with great enjoyment, and was signed off by my tutor earlier this week.  My two assignments for my optional modules were submitted then too.  One was regarding end of life, or palliative care issues, while the other was regarding families and carers, with a particular focus on dementia. 

There are now just a couple of lessons of the optional modules left, and these are mainly taking place in the simulation rooms alongside the patient mannequins.  These are basically high tech dummies to practise on, and they can talk, breath and have vital signs along with many other tutor programmable functions.  These were one of the first things that attracted me to my university choice, but as mental health nurses, I think that we do not get to use them perhaps as much as the adult nurses do.  They are a great teaching resource to have on site though.

As I prepare for my next semester and module, which is titled Mental and Physical Health and Wellbeing across the Lifespan, I picked up the set reading books which I had pre-ordered from the library.  Before the module starts, I am trying to read as much as I possibly can, in order to get a feel of what this topic is about.   This next semester is quite a crucial one, as we have a three hour anatomy and physiology exam at the end.  As this is potentially quite a factually intensive subject, this knowledge is a little daunting, so I am trying to get a head start.  With this in mind, I have read about 75 pages of one of the books already, and am finding it really interesting.  I have previously found anatomy and physiology really fascinating, but there is such a lot to remember.  It is a positive sign however, if you actually enjoy something, so I will just try to approach it with interest and enthusiasm.

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Before starting the first of the set books, I had just read a brilliant book about the topic of dementia.  The book is called The Nun Study and the science of old age: How we can all live longer, healthier and more vital lives – Aging with Grace, and it was written by Dr. David Snowdon.  The publication was recommended to me by one of the psychiatric nurses at the placement that I have just finished.  I had told him that one of my main areas of nursing interest was regarding caring for patients with dementia.  I am so glad that the nurse told me about this book, because it really was a fabulous and fascinating read.

I will not tell you too much, just in case you would like to read it for yourself, but Dr. Snowdon basically set up a long term research project of 678 nuns, ranging in ages from 75 to 106.  The nuns agreed to take part in annual mental examination tests to assess memory, concentration, language, visual spatial abilities and orientation to time and place, and they also agreed to donate their brains for examination and dissection when they died.  I will not say much else, but some of the nuns had Alzheimer’s disease, while others did not; so Dr. Snowdon and his team had a combination of diseased brains and healthy brains, to look at and compare.  If you are interested in dementia, then I would urge you to read this book.

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I will now get back to completing a couple of tasks for university.  I have just finished some essential Year 2 work regarding the Nursing and Midwifery Council, and I now just have a reflective piece of writing left to complete regarding family and carer input during my placement.  I will then continue with the anatomy and physiology reading…