Ah no, excuse me a moment.
I stepped around her. The department was overflowing with people. Patients were sitting on the floor, in wheelchairs, leaning against walls, even sitting on each others laps. I waded through the human flotsam, searching for the telltale sign of a uniform, but couldnt find anyone. Okay, that wasnt exactly right. I couldnt miss the two police officers with the very angry looking teenager handcuffed between them.
I made my way towards the reception desk, where I found the receptionist besieged by a group of patients. I tried to slip between the bodies without drawing attention to myself.
Get to the back, a voice bellowed at me.
I looked up to see a big man with an angry expression and a child cradled in his arms.
Im the night nurse, I said.
His expression softened and the crowd parted before me.
The receptionist didnt waste time with the niceties.
Thank God youre here, she said. Its been chaos.
I considered turning and running as far and fast as I could.
Wheres the nursing staff?
Youre it. The other nurse went home sick and the agency couldnt get us anyone else at such short notice. Ill show you how to use the computer and put patients into the system.
Even though this was my first shift in a new country, it seemed a bit strange that the receptionist was the one giving me the handover.
Ten minutes later, I had been shown how the computer worked, where the toilets were, where the treatment room was, where the doctors room was, and where the main emergency department was in the building next door. Then, I was left on my own.
I know youre busy, but how much longer do you think we will have to wait? the police officer asked me.
I didnt really want the police to leave. I didnt want to be left alone, unprotected, facing a sea of impatient patients.
But, I had to start somewhere. I motioned the officer to bring the girl to me.
The girl had received a blow to the head and had some clotted blood on her right temple. I went in search of the doctor to see what he wanted done. I returned five minutes later.
There seems to be a slight problem, I confessed to the police officers. I cant find the doctor.
The officers didnt look impressed and sat back down with their charge.
Are you my lover? The elderly woman snuck up behind me and caught me by surprise.
No, Im not. What can I do for you?
She didnt answer and went on her way in search of her lover.
Hey, weve been waiting three hours, a man called out. I dont care if hes a copper.
The man making the fuss was sitting on the floor, his hand wrapped up in a blood-soaked cloth.
Im sorry, really sorry. Ill get to you as soon as I can, I apologised and went to hide behind the reception desk.
I wasted 15 minutes trying to gain access to the computer system, before I had to give up. I had no idea where to begin. I hadnt even seen anyone yet. I looked over at the pile of patient files and grabbed the first one.
Mr Fraser, I called out into the waiting room.
A 19-year-old male stood up, along with two females. One was his girlfriend, the other, a middle-aged woman, his mother. I led them into the treatment room.
What seems to be the problem? I asked, as Mr Fraser sat down on the edge of the bed.
Its a bit personal, Mr Fraser said. Can you close the door?
I shut the door and pulled the curtains. Mr Fraser took down his trousers and lay on the bed in his underwear.
I have a problem with it, Mr Fraser said.
It? You mean your penis? I asked.
Yeah, it, he said again.
Ah, I can ask the ladies to leave if you like.
I was feeling awkward with the women peering over my shoulder at this mans crotch, so I can only imagine how he felt.
Its okay. Just fix me up, he replied.
What happened to it?
In response, Mr Fraser took down his underwear and stretched his penis to its full length.
Can you see it? he asked.
I had to peer forward.
I can see a small scratch, Mr Fraser. It doesnt look too serious.
Not serious. She bit it! he said accusingly, looking past me at his girlfriend.
I didnt do it on purpose, the young woman pleaded. I said I was sorry.
Back home I had seen two patients with bite wounds who were admitted for intravenous antibiotics. Human bites were quite serious.
Youre going to need to see the doctor, I said to Mr Fraser. Youre probably going to need a course of antibiotics.
Mr Fraser looked at me in surprise. Youre not the doc?
I shook my head.
The doctor seems to be missing. Grab a seat in the waiting room and Ill make sure he sees you as soon as I find him.
Mr Fraser, his girlfriend and his mother headed back out into the waiting room.
Without a doctor I couldnt do anything that required a prescription. I couldnt even give paracetamol. I went next door to the main emergency department to find out what the hell was going on.
Who are you? asked the charge nurse when I wandered into the department. Her name tag read Sister Monroe.
Im the nurse in the clinic next door, I said, not even trying to hide the anger in my voice. And Im all alone, without another nurse, and the doctor seems to be missing.
The nurse looked about to say something, but I didnt give her a chance. The waiting room is full. The police are there. Im being stalked by a very sweet, but very crazy old woman, and the only patient I saw was happy to show his mother his penis.
After my rant the charge nurse made a few phone calls to find out what the hell was going on.
The doctor should be there shortly, she told me. He thought he started at ten. Hes a locum. Im sorry that this has happened. Just hold the fort until the doctor arrives.
It was 9.15; I decided that honesty was the best strategy.
Excuse me everyone.
All eyes turned in my direction.
We have a bit of a problem tonight.
I explained the situation to the whole waiting room, from the missing doctor, the inability to get another night nurse, to this being my first ever duty as a nurse in a new country.
If you really think you need to see the doctor, youre welcome to wait, although it might take another four or five hours to get through everyone. Personally, I would go home and get a good nights sleep.
It shouldnt come as a surprise that nearly everyone left the department. There were certainly a few disgruntled people, but fortunately no real anger directed at me.
At ten the doctor walked into the department.
So quiet, he said, with a smile on his face. Should be a nice night.
The ego
Despite such a brutal first shift, the next two weeks went well. I found work in a mixture of general medical and surgical wards, and while the system was different to what I was used to, the illnesses and treatments were pretty much the same. There was, however, one incident of note.
Mrs Thornton was a very large woman. Every time she sat on the bed the springs would squeal in protest. To get her lying on the bed, I had to grab hold of her legs and lift them up as they were too heavy and swollen with fluid for her to do it herself.
Mrs Thornton was a very large woman. Every time she sat on the bed the springs would squeal in protest. To get her lying on the bed, I had to grab hold of her legs and lift them up as they were too heavy and swollen with fluid for her to do it herself.
Youre a gem, she said when I performed this service.
Tracy had managed to find me two weeks of work at one of Londons most prestigious hospitals. Mrs Thornton was in the hospital because she had cellulitis of her right calf and was in need of some intravenous antibiotics.
Cellulitis is a bacterial infection of the skin, it generally occurs on the limbs, and it is often triggered by a cut or graze. Unlike a simple cut or graze, it affects the deeper layers of the skin as well. The infection can work its way deeper into the body. Its pretty serious.
I looked at her drug chart.
There seems to be a slight error Mrs Thornton looked worried Oh, its nothing to worry about, just a slight typing error on the drug chart. Be back in a bit, got to have a chat with the doc.
Excuse me, I said as Dr Hitchcock, the doctor on duty that shift, walked by me in the corridor.
Im in a hurry, he replied, barely glancing in my direction before continuing past me without stopping.
I had been warned by two of the regular staff nurses to be careful around Dr Hitchcock. He was straight out of Cambridge and didnt listen to the nurses. They said that he thought he was a cut above the nursing staff.
Junior doctors who didnt listen to the nursing staff were a danger, not just to their patients, but the nursing staff as well.
Excuse me, doctor, I shouted, chasing after him.
I stepped in his path, forcing him to stop.
It had better be important, he said, not even trying to hide the disdain in his voice.
I held the drug chart up for his perusal. There seems to be some error with your prescription.
He began to scowl, and didnt even make any effort to grab the chart.
It will have to wait. I have more important things to do right now.
With that he stepped around me and wandered off down the corridor.
I stood there holding the drug chart, wondering what sort of trouble I would get in if I gave the medicine that he had incorrectly prescribed, the correct way. I went and checked with Sue, one of the experienced staff nurses.
Dont do it, Sue said, without any hesitation. You really have to get it fixed. You cant trust anyone, especially not that prick.
Sues words surprised me, but made sense. I had to remember that I was in a very big hospital now, and I was a stranger and a temp; no one would support me if I messed up.
I went in search of Dr Hitchcock. I would force him to spend the 30 seconds it would take to correct the error.
Let me explain the problem. The patient, Mrs Thornton, needed antibiotics, which the doctor had prescribed as a deep injection into the thighs or buttocks. The injection is big and has been banned in many places. There is a risk of infection, abscesses, necrosis, plus lots of other things, not forgetting its very painful. The antibiotic in this case could have been given intravenously, especially as the patient already had an intravenous line in her arm. I could technically have given the injection into the muscle, as it is still allowed in some places, but for me, it felt the wrong thing to do.