Confessions of a Male Nurse (11 page)
Isabel had been working in Alabaster Ward since she had graduated from college two years earlier. As I had slightly more experience than her and had travelled a bit, she sometimes turned to me for help. I tried to support her whenever I could, but there are some things a man should never be asked to help with.
‘Can you please tell her I’m busy?’ Isabel begged of me.
She was referring to Mrs Livingstone, quarantined in room 12.
‘I don’t have time to listen to her stories.’
Mrs Livingstone was in a private room because she had Methicillin Resistant Staphylococcus Aureusor (MRSA). This is the hospital superbug, which is so often being discussed in the media and parliament. It was unknown whether she had the bacteria present before coming in, or if she had acquired it while in hospital, but it soon became apparent that something was wrong after her operation.
Mrs Livingstone had had her right lower leg amputated from below the knee and when it didn’t heal and began to ooze pus, swabs of the site came back positive for MRSA.
‘But you enjoy her stories,’ I said to Isabel, ‘and besides, you love the chance to talk French.’
Mrs Livingstone only spoke French with Isabel, because she believed it to be a more cultured language – a sign of class. Looking at Mrs Livingstone sitting in her wheelchair in a public hospital, it was hard to believe she was once a high society woman.
‘I must have heard each anecdote a dozen times by now,’ Isabel moaned. ‘She’s very interesting, especially when she talks about the numerous married men she has had. But once she starts, I can’t get out the room.’
I promised Isabel that I would share with her the burden of responding to Mrs Livingstone’s call bell.
‘Oh, it’s you,’ Mrs Livingstone always said this when I answered her bell. ‘Is my nurse available?’
In Mrs Livingstone’s mind, Isabel was her own personal nurse and nothing we could say or do would change her way of thinking.
‘She’s busy right now,’ I said. ‘Is there something I can help you with?’
‘Well, it’s not important. Well, maybe it is. I need to ask Isabel something.’
‘I can take her a message,’ I offered.
‘No, it’s not that important. Just tell her to come see me when she is finished.’ I was promptly dismissed.
‘What did she want?’ Isabel asked when I saw her next.
‘She wouldn’t say. Said she would only speak with you. When you’re free of course,’ I said with a wry smile.
‘Don’t laugh at me!’ Isabel exclaimed. ‘She treats me like a favoured servant. You don’t know how lucky you are.’
Isabel eventually made the effort to go and see Mrs Livingstone. She was in there for at least 15 minutes and when she came out, she looked flustered. She grabbed my arm and took me into the office.
‘What’s wrong?’ I asked.
Isabel began to laugh. She laughed so hard she had tears streaming down her face. It was a while before she was in a condition to answer me.
‘She’s worried about MRSA,’ Isabel began.
I nodded my head. ‘So? She’s had it for a while,’ I replied.
Isabel began laughing again.
‘She wants to know if it has spread. She wanted to show me . . .’
Isabel paused as the laughter became too much.
‘You’d better get to the funny part.’
‘I didn’t know how to answer her, so I said I would ask you to take a look,’ Isabel said, sitting down to catch her breath.
‘Where does she think it’s spread to? I’m happy to have a look.’
‘She wants to know if she has MRSA on her clitoris!’
‘What . . . ? Where . . . ? How?’ I asked, immediately regretting it, because it set Isabel off into another bout of hysterics.
I didn’t go and have a look at Mrs Livingstone’s MRSA, although Isabel eventually did.
She said that everything looked fine.
As bizarre as Mrs Livingstone’s request may sound, it’s very difficult for most people to talk about something so intimate, and so embarrassing. The fact that she made this request of Isabel only emphasised how worried she actually was. And as hilarious as the situation sounds, when your health is concerned, there is no such thing as a silly question.
At 28, I felt I knew a thing or two about nursing. None of the women in front of me looked older than 22 or 23; rather young (at least I thought) to be in charge of a surgical ward.
‘Let’s get started then, shall we?’ said the girl closest to me. She went on to introduce herself as Anna, before pushing a button on the tape recorder in front of her.
Well, this was certainly new.
‘Excuse me—’ I began.
‘Sshh . . . don’t interrupt handover,’ Anna said, as everyone else glared at me.
I kept quiet and began taking notes.
The tape recording wasn’t the most clear and I was struggling to keep up with the pace of things. I was still writing a patient’s name down, while the recording began spouting out important health information. I looked over at my neighbours’ notes and noticed that they had a printed sheet with everyone’s names.
‘Um . . . excuse . . .’ I began again, but was quickly silenced by four sets of eyes glaring at me.
I made do and got down as much information as I could.
‘It’s a bit different, but it works,’ Anna said to me, when the recording had stopped.
‘Um, yeah, sorry, but I’m missing quite a bit of information,’ I said.
‘Oh, you’re looking after rooms 1 to 12. Don’t worry, Beatrice has been looking after that end. She doesn’t like recorded handovers. She’ll be here shortly to tell you all you need to know.’
I breathed a sigh of relief.
Beatrice turned up a moment later and began her report, without as much as a glance in my direction.
‘Right, let’s get started. Won’t take long.’ She then pulled a slip of paper from a pocket, carefully rearranged the glasses perched on her nose, and began to read.
‘Mrs Dickinson, no change. Mrs Truss, no change. Mr Martin has had a good day . . .’
I cleared my throat.
‘Excuse me,’ I timidly called out.
Beatrice raised her eyes briefly in my direction, then turned back to her slip of paper and continued reading in this manner for all of her 12 patients.
‘That’s my lot, hope you have a good night,’ Beatrice said. She carefully removed her glasses, stood up and left the room.
There was a moment of awkward silence. No one seemed willing to come to my aid. I knew exactly nothing about any of my patients. Anna eventually stood up.
‘All right, we’d better get started,’ she said. The others followed her out into the corridor. I tagged along as well, just in case I overheard something useful about any of my patients. I quickly caught up with Anna.
‘What was that?’ I asked.
To my surprise Anna’s face turned red.
‘Look, I’m sorry, but don’t worry’ – she actually sounded embarrassed – ‘we have a bedside handover next. She’ll tell you what you need to know then. Don’t worry. I need to get my handover now; you’d better go and get to yours.’
Back at the nurses’ station, Beatrice had collected her handbag, put on her cardigan and was about to head out the ward. I cut her off at the door.
‘Beatrice, aren’t you forgetting something?’ I asked.
She looked at me blankly.
‘What about the bedside handover?’ I added.
She was silent a moment.
‘It was all in my report. Said all I’ve got to say. Nothing further to add.’ She paused for a moment. ‘Oh, there’s a man in room 2, we’ve put his mattress on the floor. He’s been asleep for a while, so I haven’t been in to see him recently.’
And with that she stepped around me, out of the door and down the corridor.
I turned towards my colleagues, towards Anna, towards anyone who could help, but everyone had mysteriously disappeared. Either they were hiding, because they were so embarrassed, or at the bedside, getting a handover, which is what I was supposed to be doing.
I didn’t even have a complete list of my patients’ names. I thought of walking out. It was a dilemma that no nurse should have to be in, but one that happens sometimes: care for myself first, and leave, or care for my patients.
If I did walk out, the hospital would want to find a scapegoat. Everything was against me. First, I was new, second, I was from an agency, and third, if things ever went to court, I could never afford to support myself if I was forced to stop nursing while the case was resolved. It would probably also spell the end of my time in the UK.
Instead, I did what I always do at the start of a shift, and that was to eyeball all my patients, and make sure they were all breathing. I could have gone and read each and every patient’s medical file, but decided against it as that would take quite a bit of time.
‘Good evening,’ I said, as I stood in the doorway to room 1. There was no name on the door and she was one of the patients whose names I had missed.
‘Who’s there?’
A thin, wavering voice drifted out of the room.
‘Is that you, Jim?’
I walked into the room to see a frail, elderly woman sitting on the floor beside her armchair. She looked up as I entered.
‘You’re not Jim. Who are you?’ she asked suspiciously.
‘I’m the night nurse. You look like you could do with a hand,’ I said, as I bent to pick her up off the floor.
‘You’re not Jim. Get your hands off me. Help. Help,’ she began shouting feebly. I backed off and knelt down beside her.
‘It’s okay. I’m not Jim, but I’m here to help,’ I said in a calm, quiet voice. She sat staring at me in silence. I felt telepathic. I could almost see the turmoil in her mind; the confusion, the indecision, the fear and the desperation. She finally broke the silence.
‘Where’s Jim?’ she asked again, her voice even more uncertain than before.
‘I don’t know where Jim is. Do you know where you are?’
She looked up at the bed beside her. A full ten seconds passed before she answered.
‘I’m in hospital. You’re not Jim. Who are you?’
She sounded less afraid.
‘I’m the night nurse. We need to get you off the floor. Will you let me help you?’
As soon as I said that, she looked behind her, her hands feeling the legs of the chair supporting her.
‘Well, it’s about time. I’ve been here long enough. The service in this place is terrible. When’s dinner? Have I missed dinner? I’m going to lay a complaint. The service is terrible,’ she repeated.
I couldn’t have agreed with her more.
The unnamed woman let me help her get up off the floor. She didn’t seem to have any injuries and was able to support her own weight. I tucked her into bed.
‘You’re a good boy, Jim,’ she said to me, as I headed out of her room.
I needed to get her checked properly, she could have broken a hip, but I also had to see my other patients.
Everything was quiet, although this could be because all my patients were dead. It would have been useful to know things like who had had surgery. Or who was going to surgery. I suppose I could ask my patients what was wrong with them, but that approach doesn’t tend to instil a sense of confidence.
I entered the next room. This was the guy Beatrice had put on the floor. Mr Mason the name said on the door. I entered the room and was almost knocked over by the stench. I stifled the urge to vomit. Lying on the floor was the cause of the stench.
Mr Mason was lying on his side, on the vinyl next to his mattress; his back was to me, and he was unclothed. Where were his clothes? Why was he naked? In a way, it was just as well he was because he was covered in excrement from head to toe. There was old caked-on faeces that had to be at least several hours old. It was on his face and in his hair. There was fresh solid faeces from the neck down, oh and some loose greenish faeces came out of his back passage right then. The floor was covered in excrement. Oh shit, I was standing in it already. I didn’t want to go near him, let alone touch him.
‘Help,’ he muttered.
I tiptoed around to the other side of the room, to where he could see me. I looked at his face, but he didn’t seem to notice me. He was shaking from the cold, but I didn’t reach out to touch a limb. He probably had hepatitis C. In fact he probably had the works, hep A, B and C.
‘Help,’ he called again, still not seeming to see me standing right in front of him.
‘Mr Mason,’ I called out to him, but he didn’t respond. ‘Mr Mason,’ I said, a lot louder this time.
Mr Mason briefly glanced in my direction, but didn’t bother to reply.
Mr Mason was homeless. We’ve all seen them, even though we try not to, sitting in doorways sipping methylated spirits, sleeping on the pavement, or begging for a penny.
He couldn’t have been very old – 35 at most – but his body was emaciated and covered in sores. I could see several oozing sores on the inside of each arm where he had obviously been searching for veins to inject. His hands kept on scratching at them, sometimes drawing fresh blood. His hair was overgrown and tangled. I didn’t get too close, in case any of his head lice made the leap over to me. I’m allowed to be revolted, as I’m sure Beatrice was, but that’s no excuse for leaving any patient in such a condition. I was going to need some help.
I left the room to track down the two nurse assistants on shift with me.
They were at the other end of the ward, hanging around Anna as she was handing out patient medicines.
‘I’m going to need your help,’ I said to the two assistants.
They looked to Anna for direction.
‘They have to finish their work down this end. I’ll send them down your end in a while,’ she said.
‘We always start at this end. You’ll just have to wait a little,’ said one of the assistants, obviously emboldened by Anna’s words. I looked at the name tag, Susan.
‘I’m sorry, but that will have to wait. I need you now,’ I said.
Anna wasn’t eager to lose her two helpers.
‘Is it urgent? Can’t it wait? They really need to finish their work down here.’
Work! They were standing around chatting with Anna, while I was literally in deep shit.
‘If they don’t come with me now I will be leaving,’ I threatened.
Anna instructed Susan and her colleague, Melanie, to go with me. They fell into line, dragging their feet and moaning to each other about how overworked and under-appreciated they were.
We stood staring at Mr Mason, in silence, until I eventually broke the ice.
‘This looks like your area of expertise,’ I said to the two of them. ‘I’ll leave you to it.’
Both girls looked pale.
‘You might want to wash your shoes, Susan. You’re not standing in the safest place,’ I said.
Susan looked down at her feet and dry retched.
I never could and never would leave dirty work to someone else and besides, these young girls looked completely out of their depth. Gone was their condescending, obnoxious demeanour; all I could see were two very worried, even scared young girls. Susan was only a second year nursing student trying to make some extra money, while Melanie had started working at the hospital three months ago.
‘Susan, Melanie, get some gloves, gowns, masks, face shields, waste baskets and a big bowl of water. I’ll give you a hand.’
They were so relieved they virtually ran to do my bidding.
‘On the count of three, everyone heave. One, two, three, lift,’ I said as we tried to raise Mr Mason up into a chair. It was like trying to wrestle with an octopus, as he slipped through our fingers. What was Beatrice thinking putting his mattress on the floor? Cleaning up people like Mr Mason is pretty standard work, if you know what you’re doing, but this added complication was proving a real problem.
Mr Mason chose that moment to slip through our grasp and landed in a kneeling position with his forehead touching the floor and his butt pointing in the air.
‘Don’t move him; clean his back and butt while he’s like that,’ I told the girls as they got stuck in.
It wasn’t the most orthodox technique but it worked. Mr Mason didn’t seem to mind; in fact, he appeared to have gone back to sleep.
Forty-five minutes later the room was spotless, with Mr Mason lying on a clean mattress, clean sheets, wearing clean pyjamas and as far as I could tell, completely shit free. The assistants’ attitude had changed dramatically. They did everything I asked instantly and without question, but I didn’t have time to enjoy their cooperation, because I still had ten other patients to visit.
As I headed home on the bus, I found that I wasn’t tired, despite the long shift. My mind wouldn’t stop going over what had happened that night. I kept on thinking about Beatrice and how the negligence of one nurse left a man lying in his own waste.
I vowed to myself to write a factual, but scathing, letter of complaint to the hospital management.
After waking from a fitful sleep that day, I was no longer so sure. The problem was not a simple one, and I even called in sick that next night, in order to think things over.
It was my word – the word of a transient agency nurse – against that of an experienced staff member, with a lifetime of nursing behind her. If I laid a complaint, they would look at not only Beatrice’s performance, but my own. They would ask why my evening drugs were given after midnight. They would inquire why I didn’t get to my other patients sooner, and ask why I didn’t call management when I didn’t receive a handover. There were so many ways it could go wrong for me, from not doing my job properly, to asking why I didn’t walk out at the start of the shift. That’s what management and lawyers are good at, looking back and picking faults, when they’ve never been confronted with such a situation themselves. They miss the whole caring part of it.
My plea of doing it for the patients, of doing it because I care, probably wouldn’t stand up in court. Although I wouldn’t have to go to court to be screwed because all I’d need was to lose my registration. That would be more than enough.
In the end, I didn’t lay my complaint. I had convinced myself I would end up second best. But a part of me still feels guilty for not. The patients deserved better than they were getting.