A nurse is a nurse first, and a woman (or in my case, a man) second. At least, that was the thinking of my mentor, Cherie. One of Cherie’s favourite sayings was, ‘If a woman has to go down there, then so do you.’ Maybe that was why she made me go after that suppository. In Cherie’s world of nursing, there was no gender, just doing the job and doing it well. My problem was I never expected to be doing this particular job, in this particular area of nursing.
I had applied to work at the hospital as a general nurse on the new graduate programme. I expected to be offered a ‘normal’ nursing job in a surgical or medical ward. But I couldn’t turn down the offer of a full-time job. They didn’t even interview me for the position. Maybe the personnel manager was too embarrassed to admit that she had made a mistake. Maybe this was the reason no one seemed to like me, especially Sharon.
‘Stop daydreaming: pull your finger out your arse and do some work.’
The calm way in which Sharon said this left me speechless.
‘And close your mouth, you look stupid.’
Sharon seemed satisfied that she had made me look the fool and moved on down the corridor in search of her next victim. Only four weeks into my nursing career and I was learning to avoid my charge nurse at all costs. I looked over at Cherie.
‘I have to tell you something you won’t like’ – Cherie was never afraid to speak her mind – ‘Sharon doesn’t like you . . . a lot.’
With my self-esteem at an all-time low, I began to go about my rounds.
I knew that I knew nothing. It was a good thing really, as
too much
confidence can be harmful.
It won’t come as a surprise that I struggled with some parts of the job already. Things were unfamiliar, and it was usually vitally important that I got them right. The latest problem in front of me was called erythromycin. It’s an antibiotic, and in this case it needed to be injected straight into a vein.
‘What are you waiting for?’ Sharon asked me, as she entered the treatment room and saw me standing with a syringe full of intravenous antibiotic.
‘I’m waiting for Cherie,’ I replied cautiously.
Hospital policy stated that all intravenous medicines needed to be checked by a second person, but I felt a bit useless standing there doing nothing because mine had already been checked.
‘Let’s have a look. I’ll check them for you.’ Sharon began to look at the drug chart.
‘It’s already been checked,’ I replied. ‘I’m just waiting for Cherie, because she has to watch me administer it.’ Again this was hospital policy.
Sharon rolled her eyes and quietly cursed. I’d said the wrong thing.
There was an awkward silence; a silence which I hoped would last, because I knew when Sharon spoke it wouldn’t be to say how conscientious I was.
Sharon finally broke it with a calm voice, though I could sense the anger building:
‘Are you a registered nurse?’
I wasn’t sure whether to answer. Was it a rhetorical question? I knew there was more to come, so I just nodded my head.
‘Well, start acting like one,’ she added, her voice rising up an octave. ‘You can’t have someone holding your hand all the time. Take some initiative.’
I left the treatment room in a hurry and approached my patient.
Here I was standing at the patient’s bedside, with a syringe full of antibiotic that I’d never given before. Policy stated that I needed three months’ supervision before I could give these medicines on my own, and I was just nearing the end of my first month.
My mind was chaos turning over silly thoughts, crazy thoughts, even suspicious thoughts. Was Sharon trying to set me up to fail? What if something went wrong? I wasn’t even aware of all that could go wrong. If something did happen, no one would back me. Sharon would deny everything. What could I do? I knew what I should do . . . but I couldn’t risk facing the wrath of Sharon.
I slowly opened the intravenous valve and began to insert the syringe. In my nervousness I fumbled the syringe and it fell on to the bed. Was it still okay to use? I didn’t know, but Sharon would kill me if she saw me drawing up another antibiotic. I inserted the syringe and gave the antibiotic, because it was easier to do this than create a scene. I watched the patient’s chest to monitor her breathing. I felt her pulse . . . did it skip a beat? No, I was imagining things.
I waited anxiously those first few minutes, silently praying that nothing went wrong. Thank goodness my patient didn’t know how nervous I was, but even more importantly, thank goodness she didn’t have a clue that I wasn’t supposed to be doing this yet, even if my charge nurse had ordered me to. After five minutes, I figured that if anything was going to happen, it already would have. The one thing that even new nurses know is that with intravenous medicine when something goes wrong, it tends to happen pretty instantaneously.
I’d got away with it, this time, but would I always be so fortunate? One month in and life as a male nurse was already proving to be a minefield.
The words looked all the same. The handwriting was horrendous: this could only be the writing of a doctor.
‘Can you make this out?’ I asked fellow nurse Jen, handing her the medical notes.
‘You’re hopeless,’ she responded in a tone of voice that seemed only half-joking. ‘You need to take some initiative. There won’t always be someone around to cover for you.’
Jen was yet to help me even once, and I would never ask her for help if there was anyone else around to ask.
‘I’m not asking for much,’ I replied, ’just some help interpreting the writing.’
As Jen tried to decipher the notes, I could see a frown forming. She was having as much trouble as I had been.
‘It says colonoscopy. You do know what that is, don’t you?’ she asked, with more than a hint of condescension in her voice.
‘If it’s the long, flexible tubey thing, with a bright light that goes a foot or two up your butt, then I guess I do.’
I was just as surprised as Jen that those words had come out of my mouth. I was just a graduate, while Jen had at least 20 years’ nursing experience behind her.
As I took the notes back, I avoided Jen’s gaze, worried that I had gone too far.
I took another look at the writing. I wasn’t 100 per cent convinced that it said colonoscopy. I knew she’d be pissed off if I asked her again, but I had to be certain.
‘Are you sure about that, Jen?’ I asked, increasingly regretting my earlier cheeky remark.
‘I’ve been doing this job since before you were born,’ she replied. I could see the veins begin to stand out on her forehead as she tried to control her anger. ‘You need to listen to your betters, or you’re going to mess up really bad one day.’
Now that I felt so positively reassured, I went ahead and got the patient ready for her colonoscopy.
‘Are you sure I need to drink all this?’ Mrs Knight asked me, after I had prepared the medicine for her to drink. At 79 years of age, Mrs Knight was quite a surprisingly sprightly little lady – a dedicated member of the local women’s walking club. Unfortunately she was having some women’s problems and had needed to be checked out.
‘I’m quite confident,’ I replied – trying not to put too much emphasis on the ‘quite’.
But Mrs Knight was still unsure about drinking two litres of salty water, and her hesitation was making me doubt my instructions as well.
After I poured the first glass, I stayed to watch as Mrs Knight took a mouthful of liquid.
‘Urrrgh.’
She almost choked. When her coughing fit passed, she looked me straight in the eye: ‘I can’t drink that stuff; there has to be another way. Besides, why do they want me to have an empty bowel? It’s not my bowel that’s causing the problem.’
She had a point and as I couldn’t come up with any answer other than the nurse in charge told me to, I thought I had better check again.
‘Mrs Knight’s refusing to take the drink,’ I began to explain to a very angry looking Jen, my voice tapering to a near whisper. ‘She doesn’t seem to think she needs it.’
Jen looked ready to hit someone. I held Mrs Knight’s medical file in front of me like a shield. She grabbed the file and looked at the notes again.
I didn’t see the look of shock that must have crossed her face, but I couldn’t miss her outburst.
‘You bloody idiot,’ she yelled at me. ‘What have you done? How much did you make her drink?’
Oh shit, what was wrong? All I’d done was what she’d told me to do.
‘Not much, not much at all, not even half a glass,’ I stammered. ‘I was only doing what you instructed.’
Obviously this was my screw-up; Jen certainly wasn’t going to take any of the blame.
‘I said
colposcopy
. You don’t know what a colposcopy is, do you?’
Thankfully, Mrs Knight didn’t drink her two litres of bowel-cleaning liquid and she was sent for her colposcopy, which was a look up the front side, not the back.
I kept silent – embarrassed and fuming at the same time. Jen had definitely said colonoscopy, but it was my word against hers, a new grad against an old hand. I would not win this argument.
Every ward needs to have senior, veteran staff members around that inexperienced people like me can turn to. I knew that Jen was a good nurse and could normally be relied upon to make the right decision, but sometimes impatience, being too busy, or even not liking a colleague can cloud a person’s judgement. Thankfully, this is not too common.
After six months of putting up with a charge nurse that disliked me, and patients that looked at me as if I was from Mars, I had doubts about how much longer I could go on. But there were times when it all seemed worth it; times when I connected with a patient, and could physically see the difference I made.
‘You seem to know a lot about wounds,’ Sharon said to me one day.
Her comment caught me by surprise, because I really didn’t think that I had any particular skill or knowledge about wounds.
‘Not really,’ I replied, trying to figure out if she was thinking of a particular patient that I had done a good job on. With my mind still a blank I came up with a rather non-specific reply, ‘I just like to keep things simple; back to basics.’
She nodded her head as if I had said something wise. ‘I’ve heard some good things about what you’ve been doing with Mr Mannering’s feet. You’re not afraid to do what needs to be done and I like that.’
I thanked Sharon for the compliment and went about my business, surprised and confused. This was the first time Sharon had ever said anything nice to me.
Mr Mannering’s were by far the worst toes I’d ever had to dress. I couldn’t help but wonder what Sharon was thinking when she said I’d done a good job with his feet. His toes were black, completely and utterly rotten. The dressing was doing nothing useful, although the gauze between the toes was helping them from sticking to one another. I was simply keeping the rotten things covered until he got his foot, or even whole lower leg, amputated.
Due to a bed shortage, Mr Mannering was the only male patient in the gynaecology ward, and he sat upon his bed like a king upon his throne: he had everything at his fingertips and everyone at his beck and call. His room had a television, radio, electric bed, a great view of the hospital rose garden, and, of course, his nurse call bell within easy reach.
‘Has the newspaper arrived yet?’ This was Mr Mannering’s regular way of greeting me in the morning. I was never offended that he didn’t say good morning or good to see you. Mr Mannering spent all day on his bed; the only time he left was to be taken in a wheelchair to the toilet or the shower. For Mr Mannering, the morning newspaper was very important: it was a key part of his daily routine and his way of staying in touch with the outside world.
The newspaper also proved to be a convenient tool for me, providing a useful distraction from what I was about to do next.
‘Shall we get started?’ I asked.
Mr Mannering looked up from his paper and gave me a nod.
Whenever it came time to change the dressing on his toes he always made the same simple request: ‘I don’t want to see them. I don’t want to be put off my breakfast.’
As well as using the newspaper as a diversion, I put a couple of pillows on his shins to act as a barrier, in case he looked up at the wrong time and caught a glimpse of his feet.
I placed a piece of gauze between his big toe and the next.
Mr Mannering had had problems with his feet and the lower part of his legs for five years. He was diabetic, and over time the diabetes had affected his circulation. As a result, he had been battling with leg ulcers, but things had suddenly come to a climax when his toes had turned black.
‘Could you get us another cup of tea when you’re finished down there? Oh, and some biscuits as well?’
‘Yeah, just give me a moment, I should be finished soon,’ I replied. As I tried to pry apart his rotten toes, the thought of food didn’t seem quite right.
Mr Mannering chose this moment to inquire after his feet.
‘So how’s it looking down there?’ he asked, almost nonchalantly, just as if he was asking about the weather.
‘It’s not looking good,’ I replied. ‘But at least it doesn’t look any worse.’
There was no point being overly optimistic or pessimistic in my response, because no matter what I said, he responded the same way:
‘Well, you seem to know what you’re doing. I’ll leave everything in your capable hands.’
The little toe was the hardest to dress: it was too small, so the dressing wouldn’t stay in place.
I tried to pull his toes apart, so I could have another attempt at slipping in the piece of gauze.
Then . . . oops.
I could feel bile building up in the back of my throat. Somehow I managed to stop myself from vomiting, but I couldn’t completely hide the sound of air being brutally forced up through my throat and out my mouth, as my stomach clenched.
‘Everything all right down there?’ Mr Mannering had lowered his newspaper and was looking me in the eye.
‘You look awfully pale,’ he added. ‘Are you feeling okay?’
How did I feel? His little toe was resting between my fingers. I’d pulled it off. On the bright side, at least he wasn’t bleeding, although the smell from the foul, yellow-green-black pus seeping from the stump was making my stomach lurch again.
‘Well come on lad, speak up.’
For the first time in the two weeks that I had been doing Mr Mannering’s dressings, I heard a note of concern in his voice. I thought of the words he had said a moment earlier: ‘I’ll leave everything in your capable hands.’ I don’t think he meant it quite so literally.
As I crouched at the end of the bed, unable to think of anything to say or do, I had a vision of holding up his toe and offering it to him.
‘We have a slight problem,’ I finally said. ‘But it’s nothing to worry about – really.’
Mr Mannering leant forward. ‘What’s wrong?’
‘It’s your toe; your little toe,’ I began to explain. ‘It’s come off.’
‘Come off, what do you mean come off? Toes don’t just fall off.’
He had a point, toes don’t generally fall off.
‘Well, I pulled a bit too much and it just, well, came away in my hand,’ I said.
Mr Mannering took a minute to collect his thoughts, while I was still kneeling at the end of the bed with his toe between my fingers.
As the silence grew, I tried to justify my actions in my head:
It really isn’t my fault. His feet are rotten. He’s going to get them chopped off anyway; surely he realises this.
I looked at Mr Mannering’s face to try to gauge his reaction. Then I heard a strange sound. It couldn’t be . . . but it was. Mr Mannering was laughing – a deep, throaty, contagious laugh. I found myself joining in.
‘They’re going to chop it off anyway, lad. You’ve just made their job a bit easier,’ he said to me.
‘Ever thought of being a surgeon?’ he added and broke into another round of laughter, as if this were a great joke.
‘Well, what do you want me to do with it?’ I asked – the discussion finally coming around to practicalities.
‘Well, I don’t want it,’ he said. ‘Throw it in the rubbish.’
It didn’t seem quite right throwing it in the bin – after all, it was a body part – but then again, a pretty gross part, so in it went.
Two days later, Mr Mannering went to surgery and had not just his toes, or even his foot, amputated, but his leg from just below the knee.
Mr Mannering had been the first male patient I had worked with as a registered nurse, and it was as if I had seen a light of hope at the end of a long tunnel. I found myself not only comfortable working with Mr Mannering, but actually enjoying it. This was just as well, because my time in the gynaecology ward was nearly up. I had received word from management that, as part of the graduate programme, I was to be rotated to a general surgical and medical ward. I just had to survive one more week.