Orla intercepted me before I had accomplished the first part of the mission: Mr Davenport is back from theatre. The nurse needs to handover now, shes really busy.
Mr Davenport had just had some of his bowel removed, as well as a large cancerous growth. He had a pump full of morphine, with a cord and a button attached, which he could press to give himself a dose. Its called patient controlled anaesthesia, or PCA.
His observation chart showed that his blood pressure was low and the doctor had ordered ten-minute checks for the next hour. But worst of all was his respiration rate, which was low, because of the morphine. A normal respiration rate is 16 to 18 breaths per minute in an adult. His were ten breaths a minute.
I responded to the low respiration rate by removing the button for the morphine pump from Mr Davenports hand. I called in my assistant to help as we got him washed, changed the bed, replaced his dressing, all the while keeping an eye on his breathing. By the end of the hour, his respiration rate was up to 12 breaths per minute. It was still on the low side, but high enough to be considered safe.
An hour later I returned to Mrs Olsen.
I can see youre busy. Well try the shower another time.
Mrs Olsen wasnt angry, and didnt seem surprised, although there was obvious disappointment.
Weve still got time. We could even do it in the afternoon.
I was determined not to let her down.
But I did let Mrs Olsen down that afternoon.
Fortunately, the next day none of my patients were scheduled for theatre.
Is lunchtime okay? I asked Mrs Olsen, already knowing what the answer would be.
Mrs Olsen agreed and when lunchtime came around, instead of taking my break, I began preparations for the shower.
Fortunately, the next day none of my patients were scheduled for theatre.
Is lunchtime okay? I asked Mrs Olsen, already knowing what the answer would be.
Mrs Olsen agreed and when lunchtime came around, instead of taking my break, I began preparations for the shower.
I encountered my first obstacle.
I cant find a chair that will fit in the shower, I said to Mrs Olsen. Do you think you could stand? I asked.
Mrs Olsen was not deterred.
As long as youre there to hold me, well be fine.
I wheeled her to the entrance to the shower. I briefly left her sitting there as I went in search of Orla. There was a six-inch step that Mrs Olsen would need to hop over, and I didnt want to risk her falling.
Ill go at the front, you at the back, Orla ordered me.
Once she had seen the task in front of us she eagerly joined in.
Youll be sure to catch her if she falls. Orla was only half joking, but Mrs Olsen was in fine spirits and thought the whole situation amusing. In fact, this was the most energetic Id seen her.
With Mrs Olsen squeezed between Orla and me, we got her over the next hurdle and into the cubicle.
I cant get out, Orla said, her head peering at me from behind Mrs Olsens back.
We can all have a shower together, said Mrs Olsen, making us all laugh.
Im going to squeeze behind you. Suck in, Orla said, as Mrs Olsen pressed herself against the wall, making just enough room for Orla to squeeze past.
With Orla out of the way, the shower began in earnest. Mrs Olsen rested one hand on my shoulder while she held a black, rubbish-bin bag off the floor. The clean rubbish bag was the most practical thing to use to keep her foot dry.
Thats bliss, Mrs Olsen crooned. Turn it up a bit please.
I turned the heat up a notch.
Perfect. I could stay in here all day.
We stayed for ten minutes, before I wrapped her in towels and, with Orlas help, eased her over the now wet, slippery step and wheeled her back to bed where she could get changed.
I feel like royalty.
Mrs Olsen had not stopped at just having a shower. She hadnt put on her old hospital gown and instead put on her own clothes from home. For the first time since I had met her she had make-up on, and perfume. From that moment, it seemed as if Mrs Olsens perspective had changed. She began focusing on the future, on getting out of this place.
I finally began to see a change in her wound. It did begin to heal. It dried out and slowly crusted over, although it still took a very long time.
Mrs Olsen continued to make an effort with the small things, like putting on some perfume, or her own clothes, a touch of make-up, or doing her hair nicely. She began to ask questions about how she would cope at home, and exactly what resources the hospital would put in place while she recovered. She also made more of an effort to get out of bed. And although she wasnt exactly nimble, she eventually managed to take herself to the shower and wash herself, although I did, of course, make sure everything was set up.
She was a new woman.
A positive attitude can have a huge physical impact on healing. It may not be the happy, positive thoughts that do the healing, but in Mrs Olsens case, the right attitude helped motivate her to make an extra effort.
MRSA where?
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 Im busy? Isabel begged of me.
She was referring to Mrs Livingstone, quarantined in room 12.
I dont 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 didnt 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. Shes very interesting, especially when she talks about the numerous married men she has had. But once she starts, I cant get out the room.
I promised Isabel that I would share with her the burden of responding to Mrs Livingstones call bell.
Oh, its you, Mrs Livingstone always said this when I answered her bell. Is my nurse available?
In Mrs Livingstones mind, Isabel was her own personal nurse and nothing we could say or do would change her way of thinking.
Shes busy right now, I said. Is there something I can help you with?
Well, its not important. Well, maybe it is. I need to ask Isabel something.
I can take her a message, I offered.
No, its 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 wouldnt say. Said she would only speak with you. When youre free of course, I said with a wry smile.
Dont laugh at me! Isabel exclaimed. She treats me like a favoured servant. You dont 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.
Whats 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.
Shes worried about MRSA, Isabel began.
I nodded my head. So? Shes 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.
Youd better get to the funny part.
I didnt 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 its spread to? Im 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 didnt go and have a look at Mrs Livingstones MRSA, although Isabel eventually did.
She said that everything looked fine.
As bizarre as Mrs Livingstones request may sound, its 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.
Deep shit
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.
Lets 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 dont interrupt handover, Anna said, as everyone else glared at me.
I kept quiet and began taking notes.
The tape recording wasnt the most clear and I was struggling to keep up with the pace of things. I was still writing a patients 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 everyones 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.
Its a bit different, but it works, Anna said to me, when the recording had stopped.
Um, yeah, sorry, but Im missing quite a bit of information, I said.
Oh, youre looking after rooms 1 to 12. Dont worry, Beatrice has been looking after that end. She doesnt like recorded handovers. Shell 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.