Right, lets get started. Wont 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.
Thats 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, wed 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 Annas face turned red.
Look, Im sorry, but dont worry she actually sounded embarrassed we have a bedside handover next. Shell tell you what you need to know then. Dont worry. I need to get my handover now; youd 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, arent 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 Ive got to say. Nothing further to add. She paused for a moment. Oh, theres a man in room 2, weve put his mattress on the floor. Hes been asleep for a while, so I havent 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 didnt 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 patients 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.
Whos 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.
Youre not Jim. Who are you? she asked suspiciously.
Im the night nurse. You look like you could do with a hand, I said, as I bent to pick her up off the floor.
Youre not Jim. Get your hands off me. Help. Help, she began shouting feebly. I backed off and knelt down beside her.
Its okay. Im not Jim, but Im 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.
Wheres Jim? she asked again, her voice even more uncertain than before.
I dont 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.
Im in hospital. Youre not Jim. Who are you?
She sounded less afraid.
Im 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, its about time. Ive been here long enough. The service in this place is terrible. Whens dinner? Have I missed dinner? Im going to lay a complaint. The service is terrible, she repeated.
I couldnt have agreed with her more.
The unnamed woman let me help her get up off the floor. She didnt seem to have any injuries and was able to support her own weight. I tucked her into bed.
Youre 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 doesnt 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 didnt want to go near him, let alone touch him.
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 didnt 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 didnt seem to notice me. He was shaking from the cold, but I didnt 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 didnt respond. Mr Mason, I said, a lot louder this time.
Mr Mason briefly glanced in my direction, but didnt bother to reply.
Mr Mason was homeless. Weve 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 couldnt 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 didnt get too close, in case any of his head lice made the leap over to me. Im allowed to be revolted, as Im sure Beatrice was, but thats 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.
Im 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. Ill send them down your end in a while, she said.
We always start at this end. Youll just have to wait a little, said one of the assistants, obviously emboldened by Annas words. I looked at the name tag, Susan.
Im sorry, but that will have to wait. I need you now, I said.
Anna wasnt eager to lose her two helpers.
Is it urgent? Cant 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 dont 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. Ill leave you to it.
Both girls looked pale.
You might want to wash your shoes, Susan. Youre 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. Ill 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 youre doing, but this added complication was proving a real problem.