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 didnt 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 patients 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 didnt know how nervous I was, but even more importantly, thank goodness she didnt have a clue that I wasnt 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.
Id 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 scapegoat
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.
Can you make this out? I asked fellow nurse Jen, handing her the medical notes.
Youre hopeless, she responded in a tone of voice that seemed only half-joking. You need to take some initiative. There wont 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.
Im 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, dont you? she asked, with more than a hint of condescension in her voice.
If its 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 Jens gaze, worried that I had gone too far.
I took another look at the writing. I wasnt 100 per cent convinced that it said colonoscopy. I knew shed 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.
Ive 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 youre 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 womens walking club. Unfortunately she was having some womens problems and had needed to be checked out.
Im 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 cant drink that stuff; there has to be another way. Besides, why do they want me to have an empty bowel? Its not my bowel thats causing the problem.
She had a point and as I couldnt come up with any answer other than the nurse in charge told me to, I thought I had better check again.
Mrs Knights refusing to take the drink, I began to explain to a very angry looking Jen, my voice tapering to a near whisper. She doesnt seem to think she needs it.
Jen looked ready to hit someone. I held Mrs Knights medical file in front of me like a shield. She grabbed the file and looked at the notes again.
I didnt see the look of shock that must have crossed her face, but I couldnt 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 Id done was what shed 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 wasnt going to take any of the blame.
I said colposcopy. You dont know what a colposcopy is, do you?
Thankfully, Mrs Knight didnt 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 persons judgement. Thankfully, this is not too common.
This little piggy
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 didnt 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. Ive heard some good things about what youve been doing with Mr Mannerings feet. Youre 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 Mannerings were by far the worst toes Id ever had to dress. I couldnt help but wonder what Sharon was thinking when she said Id 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 Mannerings regular way of greeting me in the morning. I was never offended that he didnt 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 dont want to see them. I dont 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 youre 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 didnt seem quite right.
Mr Mannering chose this moment to inquire after his feet.
So hows it looking down there? he asked, almost nonchalantly, just as if he was asking about the weather.
Its not looking good, I replied. But at least it doesnt 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 youre doing. Ill leave everything in your capable hands.
The little toe was the hardest to dress: it was too small, so the dressing wouldnt 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 couldnt 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. Id pulled it off. On the bright side, at least he wasnt bleeding, although the smell from the foul, yellow-green-black pus seeping from the stump was making my stomach lurch again.