Sometimes current simple reflection turns to deeper thinking. I remember giving this photograph the title ‘Cognition’. In reality, because of it being a foreground of a clearer/sharper image to a background of fogged/unfocused status, it was exhibiting a larger story title. Cognition leading to dementia.

Cognition to dementia. Living to dying. Long term illness with short term symptom exacerbation. Reflecting now. Peoples’ strengths. How they present with future unlooked for scenarios impacting on their lives. Depending on long term intensity or transient acute occurrence.

Writing in nurse reflection was always difficult. No ‘journal style’ meanderings. Journalling nowadays in retirement is heavenly and light. There are no current writing of subjects with deep analysis or self performance questioning regarding self ability, growth or learning. The working theme titles back in nurse role were of how you did well or badly. No in between. Reflect and critique or praise on ones self. Not on life itself. Certainly not how a badly performing fountain pen caused angst to the day.

Title: ‘My Sheaffer Taranis pen caused ink bleed-through on the back of the page in the patient’s notes and the doctor on the ward round complained and put a line through the offending back page with ‘unusable!’ written across it. Question. Why did the exclamation mark on the end of ‘unusable’ make me feel so upset?’. Not a real scenario by the way.

Sometimes reflection involved technical skills alongside nurse philosophy. Sometimes interactions with people. Separation of the ‘other person’ in the writing inclusions was never an option. How you yourself handled something of intense nature would always include how the other person contributed or reacted to the scenario. Either positively or negatively.

I have nursed a fair few people with varying degrees of dementia. Mild to profound. Confusion with them having self humour attached to cruel and chaotic. It’s an experience that provides much thought regarding possible future considerations should it happen to yourself.

I have nursed many in palliative care and end of life also. Again, your own thoughts go to death and dying. Watching people pass away involves a mixed self response of the most extreme emotions. Too deep to put adequate words to.

I have nursed many people with Acute Symptom Response to Chronic Illness Presence. Nursing and encouraging them back to as close a homeostatic status as is possible. Acute impactful symptom occurrences in numerous long term conditions gave insight to the inherent courage that can exist alongside the emotional frailty responses attached to the human psyche.

There are no explanatory words for myself to attach to such self witnessing of others experiences. Only quiet reflections on what was witnessed. How a nurse contributes. How the person you nurse copes and how they exhibit the type of responses that can be described as truly admirable. The Staff Nurse role? Complicated in it’s holistic entirety. Did it make me a better man? No, not at all.

What the nurse role has actually made me realise, is that…..if self vulnerability is to be unavoidable, then there is no clear future plan to put in place as a pathway to coping. Your own responses are your tools for getting through. Dementia is quite the different story though. Out of the coping ideal for a planned strategy to be possible. I quietly think on those people who have left the most profound impact simply because their dignity shone brightly. I have also thought of the people that have had dementia impact upon them and how their self dignity was stripped away. In extreme cases….. they have no control.