At The Risk Of Everything

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So, this was our first week of University classes.
Day one found us having panic attacks.
By the end of the week we were better...mostly.

Ten years ago when we attended university for the first time it felt much less...overwhelming...from what I can recall.

In any case, having compiled all of our homework for this semester into a handy little document, we realize...we're fucked.

There's so much of it. With work, and a relationship, housework, and time to decompress (which we need, to stay relatively sane), and the commute...

It's tempting to play with the idea of being on medication again, just to take the edge off.

Last time we attempted this (University) we
a) were not working, other than work-study (which mostly involved studying)
b) were on prescription meds
c) tended towards marijuana, which helped us focus (yes, focus. We were an A student) - and didn't ever touch alcohol.

Now.
It's different.

In any case...we're saving most of the opinions on our experience of our first week for a future blog post...tonight...tonight we're tempting fate.

We have a lot of writing to do for University, some we want to share with people who read this blog...however, the risk is that an instructor does a content search of something we write after it's already been handed in and graded, and lands here...

Needless to say we have had no luck with employers finding this blog and continuing to employ us; so hopefully all will go well.

This week, when asked to write about what optimistic predictions of the internet I think proves inaccurate, and what optimistic predictions may be realized...this was the response:

The prediction that the Internet and World Wide Web would bring people closer together, and create additional ways of accessing information is one of the most optimistic ideas; and the truth is that with optimism comes pessimism.  

The paradox of the WWW is that while it certainly has been bridging gaps between cultures and people around the world, bringing them together in new ways, it has also separated the very people in shared communities. People are increasingly becoming obsessed with their online lives, pushing those physically close to them to the outskirts while they maintain constant contact with others, often near strangers, around the world. In addition, while the idea of bringing people together across cultures sounds overwhelmingly positive, it is often forgotten that it also brings together worlds that can become increasingly dangerous, bridging gaps between domestic and international terrorists, uniting enemies, growing and fostering hate groups. But then, countless friendships and connections have been created over the internet. It is the ying and yang of The Web. 

While the Internet is full of information, without media literacy and responsibility, it is near impossible for the full potential to be realized, used and properly appreciated. 

For example, The Onion, [is] a satirical news website that often times gets taken literally by people who lead with their emotional response and who often have poor media literacy skills, and often the confusion and anger that arises gets further spread through communication channels over the Internet. 

Optimistically, as people learn how to disassemble information they access on the Internet, and to understand the importance of citing legitimate and valuable sources, access to a network of free learning is possible; which is about the best thing that the Internet can provide.

It's not the best writing, but hey, it's been awhile since we've posted anything good to this blog...

Our first week of classes...under the belt. Only fifteen more to go...

Risk and Closure

It was a fun, amazing and enlightening weekend.

We thought we were taking a risk, not having spoken to anyone in our previous large group of friends since...our "meltdown" (there's really no good way to describe with a word). Some we hadn't seen in over three years, some it has been over two, but we took the risk to go listen to an outrageously talented singer, who we'd known longer than almost anyone else in the city, sing (we had dated one of her drummers for nearly two years). We had been telling James about her since we first met him, and now that he is allowed to travel outside of the United States, he couldn't get us back to the city where we spent the first few months of our relationship, fast enough.

We walked into the venue and she was on stage, we didn't see her at first but James spotted her partially hidden by a column.
Pointing to her he said "There she is." recognizing her from photos we had recently shown him; and just as he raised his finger she looked towards the entrance.
We grabbed James' finger, pulled it down and said "Don't point!", and then retreated towards a side area where we couldn't be seen, leaving James standing there intoxicated by her voice. We could see in his eyes he was hooked. Later he would tell us that it's amazing how good she is, and how she makes it look so easy, and other things, his eyes sparkling with amazement.

At our seat with Fabulous Person we listened to her sing, FP was also impressed, we talked about her voice and we'd bet money James will go talk to her, even though we had told him not to. We had no idea who might be there that we didn't want to see - people who were angry at us for how our friendships dissolved, how we abandoned them, some were angry about this blog - we didn't want to draw attention.

James comes over to the table and says he talked to her, but didn't tell her who he was, only that "My wife told me we had to drive [x] hours to hear you sing." He asked if we'd like her to come over to the table, and we said of course, but it wouldn't be a good idea.

He went off and talked to her again shortly, coming back to the table he said that she had recognized "me" the minute we walked into the bar, and that she would come over and talk soon.

Nervous. Butterflies. Deep breaths.

When she came over we gave her a big hug. It's been three years since we last saw her, and the last time was on a girls trip to a U.S.A. city for the 4th of July...where yours truly had almost got hauled off to the drunk tank for passing out in the hotel bar washroom and then refusing to leave, after a night heavy with substances and alcohol. There's more to the story, but to keep it short...that was her last memory of us. Great.

We asked her about everybody else, what they were up to. To find out she hasn't seen most of them in just about the same amount of time...we were stunned. She mentioned people she hadn't talked to; she mentioned how one of the last times she had talked to The Non-Bestie she was pissed because of this blog; she mentioned how two of the girls had come and had a drink and left without, apparently, talking to her.

She mentioned how funny it was that "I" showed up this weekend...she had just been reading my blog this week

More shock.

We're so glad we went to hear her sing. We're so glad we got to talk to her. We're looking forward to hearing her sing again.

What we risked, was a lot of confrontation, ridicule, a lot of awkwardness, a wide-range of things, from the most important group of people we had ever had in our life.
What we got, was closure.

She bought us a shot, let us gush over how much we miss hearing her sing; we stayed and "closed down the bar".

Maybe the cracks we begin to feel, to see, in the the web of relationships...wasn't out imagination and paranoia after all. Maybe after New Years that final year when we lost touch with everybody, because we stopped texting and calling them, and they us, for the most part, was just...what was going to happen.

Anyway.

We spent part of every day of our trip with Fabulous Person, we had a great time, great conversation, and we're so glad we finally got to go back. We're planning another trip for October.

The city itself, our favourite neighborhoods of downtown, have changed a bit, but it still remains the same: Familiar, comfortable, cultural, unique.
Home.

Home, never to be home again.

Our Guest Blogger Writes About How Risk Feels

We apologize to Kerry for not posting this entry sooner, when she wrote it and sent it to us the 22nd of January. We hope that she will comment at the bottom and provide an update on the patient she mentioned.

As always we are thankful for an entry from a woman we admire (and we get to meet this weekend!). Today was a paranoid day, one in which we were reminded about the risk of social media (it's all on our Tumbr post).


Did we mention Kerry is a wicked cool UK mental health nurse, has a published book AND her own radio show where she recently interviewed @Nick_Twist of Twitter, and New Jersey, fame? Did we mention she is beautiful, witty and is delightfully honest and blunt? Check out her website: www.kerrystott.com.

Risk...how it feels. For us sometimes it feels like drowning...but in the end we don't and it's an amazing feeling of life. It's how we feel almost every time we press 'Publish' on this, and some of our other, blogs. It never feels like a mistake. Without the risks we've taken over the past year we'd be miserable, and some of us living no life on the outside at all.

And now...Kerry Stott writes...

How Risk Feels

Oh. My. GOD! She’s going to die!!!!!

We all die, there is no getting away from that fact but in this day and age we are some what divorced from death and dying, it is whispered about in hushed tones.  We don’t talk to bereaved people for fear of upsetting them or hurting them.  I work daily with people who want to die, who feel so crap that they want to kill themselves.  There is plenty written out there about managing risk but no about how it feels like to deal with it on a daily basis.  This post is about just that and how I react and the process that I go through so I can sleep at night.

Life without risk is no life, or at the very best a half life.  I like taking risks; it makes life that bit more exciting and fun.   It’s why I do my job, it’s fun and challenging and interesting partly because the risks involved are huge and someone could lose their life if I get it wrong. When I have a patient who is suicidal I do everything I can to reduce the risks of them killing themselves but ultimately if someone does want to die they will find a way.

When someone dies that I, or one of my colleagues, has been nursing there is an investigation. The NHS has a ‘no blame’ culture, which means that you do not get fried if someone in your care dies.  In real terms it is a blaming-no blame culture and you get your arse kicked until your nose bleeds, hauled over the coals and generally chastised as though you had done nothing to prevent it.  So there is a high level of anxiety that ensues when someone wants to kill themselves.  For me to work effectively I have to be able to manage that anxiety, find somewhere to put it.

I work as part of a multi disciplinary team and one of the first things we do if there is serious risk involved with a patient is to ask advice.  The reason behind this is so that it prevents some half brained, power mad nurse doing what they want to patients and getting away with it.  It is designed so that there is a pathway of correct procedure to follow.  This procedure is examined and updated with each suicide or near miss so it is a robust way in which to work safely because it has been tried and tested.  It promotes, hopefully, transparent working so that should anything happen then everything is above board and can easily be seen and reviewed.  It helps to have more than just one person dealing with the problem as different people will bring different solution and options to the table, possibly things that I have not thought of.  Different people within in the team have distinct specialities and therefore their knowledge area is different to my own.

So here I am with a patient who wants to die. I have asked my colleagues for their input. I generally ask other teams for their input too, usually the Crisis Team but if they have physical health problems too I will include the GP, district nurse, the hospital; I may even include the police.  I can usually tell when I think that I have done enough because that gnawing feeling in the pit of my stomach goes, or at least subsides.  The next thing I need to do is document it.  There is a saying in the NHS: ‘if it’s not written down, it didn’t happen’.  Quite a lot of my time is spent documenting interactions, highlighting risk.  Unlike general nursing there are no short cuts, not short hand way of writing it down…good job I can touch type!  It is the first thing that they look at if someone dies (my trust call it a Serious Untoward Incident – SUI) is the paperwork.  By looking at the paperwork the investigator can see what was done and if there is anything that should have been done (AKA blame).  If the investigator is good, they will acknowledge the pressure that people are made to work under and that the patient had some form of input in their choice to die, if they are bad then the blame gets slopped about, people go off sick with stress and it is a nightmare.

The thing that complicates matter, which no one will even acknowledge, is if they nurse/clinician/doctor/health care professional likes the patient.  I know we are supposed to like everyone equally and treat everyone equally.  Everyone I work with strives to do that but we would not be human if we did not get on better with some people than we did with others.  THAT is the distressing part: coping with, dealing with, handling the fact that someone who you would possibly be friends with if they were not your patient, wants to die.

I have always said that the day I stop caring will be the day that I quit nursing.  I don’t think you can be a good nurse and not care.  However, caring should come with an emotional health warning; you can get sucked into the drama, become emotionally over involved when emotional distance is required.  This emotion comes at a price; normally that I think about work when I am not at work; worrying, going over and over things in my mind, have I done enough, could I have tried harder, could I have done it better?  Wearing away at me; grinding at my soul.  It is very draining and has a knock on effect in my private life.  It eats away at the time I spend with my family and how much thought and effort I put into them rather than my patients.  It is not fair of me to do that to my family, but they understand that I try to keep it to a minimum.

Like any other nurse I have had my sleepless nights worrying about patients, calling the Crisis Team in the morning to ask if they are still alive.  In my mind if I have done EVERYTHING I can possibly think of, then the rest is up to the other professionals I have involved and the patient.  As I said at the start, a life without risk is no life, there must be some form of choice to end it or to stay.

Today, I had a patient who will, in all probability die. I have spend days running around people, shouting, crying, getting VERY stressed.  Documenting every conversation so that should I end up in an SUI I can keep my job, that someone who has not had all this stress, worry and anxiety can tell me that I did everything I could.  It is very cold comfort, but it’s the only comfort I have.  It helps me sleep at night, helps me walk away at the end of a hard day and switch off.  But not tonight, I started this post at 3am, because I couldn’t sleep due to worrying.

Kerry x ((@kerrystott))

Kerry's Past Entries:
2012

• Our Guest Blogger Writes About Psychiatrists, Are They Devil Incarnate
• Our Guest Blogger Writes About Personality Disorder
• Our Guest Blogger Writes About Therapeutic Alliance

2011 

• Our New Guest Blogger
• Our Guest Blogger Writes About Depression
• Our Guest Blogger Writes About "Us & Them" Mentality
• Our Guest Blogger Writes About Suicide
• Our Guest Blogger Writes About Endopsychic Energy
• Our Guest Blogger Writes About S.A.D.
• Our Guest Blogger Writes About Anxiety
• Our Guest Blogger Writes About Fear (National Breast Cancer Awareness Month)
• Our Guest Blogger Writes About Insomnia
• Our Guest Blogger Writes About Personal Problem Solving