I couldnt think rationally. I tried to help Mr Kent again; this time he didnt speak to me, instead he made a loud moaning noise, a noise that spoke volumes. His stroke was progressing rapidly.
It felt like forever before the other nurses rushed in to find me standing there doing nothing immobilised by shock; racked with guilt. The doctor was called and I left the room on the verge of tears. I was in no state to see any of my other patients. I knew if I went in to see one, I would no longer be able to hold back the flood.
Worst of all is that part of what Mr Kent said was true: the stroke probably was the end of him. Even if he survived, the effect the stroke would have on his mobility would be a huge blow, especially with a prosthetic leg. Once mobility is gone its never good; its a very slippery slope, especially in the aged.
Looking back now, I realise that Mr Kents stroke had nothing to do with either me or with the new aspirin. However, in Mr Kents mind, I was to blame. If he is still alive today, he probably still blames me, probably genuinely believes it was my fault. That is not a nice feeling, but I have come to understand that there are some things you cannot change and I can live with it.
I left work that day feeling as miserable as I ever had felt in my life. I was still battling with tears. I was only 21 years old, and just like Mr Kent had said only a short time ago, still a boy really.
The meaning of teamwork
Mr Simpson was 45, fit, and an avid golfer. His biggest worry was whether he would still be able to play after the surgery he was having the next day. I explained that if all went well in the operating theatre, there should be no reason why he couldnt continue to play golf.
Mr Simpson was by no means my first surgical patient, but he was the first patient that I had prepared for his type of operation. He was going to have a femoral popliteal bypass graft. Basically, the circulation to one of his legs was rubbish, and the surgeon was going to put in some new plumbing that would fix the problem. If the surgery wasnt performed, Mr Simpson could eventually lose the leg.
As horrendous as my recent experience with Mr Kent had been, I felt happier in my new environment. It certainly helped that I wasnt dealing exclusively with sensitive matters pertaining to female health, but the main reason things felt better was because of the team I was working with.
As horrendous as my recent experience with Mr Kent had been, I felt happier in my new environment. It certainly helped that I wasnt dealing exclusively with sensitive matters pertaining to female health, but the main reason things felt better was because of the team I was working with.
Katie was the nurse in charge for the shift, and she was great. Katie was always there to lend me a hand. Whenever I needed help with a wash, a lift, a wound dressing, advice of any kind, she was the person I turned to. Katie had already asked me several times if I was going to be okay looking after Mr Simpson on my own, and after reassuring her that I felt I could cope, she made it clear that I could come to her for help or advice, no matter how trivial. Knowing I had some support gave me a rare feeling of confidence.
Everything went smoothly and Mr Simpson was wheeled to the operating theatre at 7.30 in the morning. I didnt see him again until one oclock that afternoon.
How was it? he asked me for the third time in the last hour. With leftover anaesthetic in his system and a pump infusing him with intermittent morphine, that sort of thing was to be expected. I reassured him all went well.
The next day Mr Simpson was a bit livelier, and asking about when he would be able to play golf, but I still would not give him a definite answer.
By the second day post-surgery, Mr Simpson was in fine spirits, mainly because there was live golf on the television. I left him in peace and reminded him to call if he needed anything.
Thirty minutes later Mr Simpsons bell went off.
My leg feels worse; its more painful than normal.
Up until now his pain had been well controlled, so it was a bit of a surprise that it should start being a problem now.
I began to examine his leg, worried at what this could mean. I checked the pulses in his foot, to make sure the blood was still getting through. I examined his calf and his thigh. Thankfully there was no swelling. As a precaution I went to search for Katie and get her opinion.
I never got a chance to chat with Katie as I was distracted by the call bell of another of my patients.
Mr Dexter was one of my medical patients. He had pain in his chest, caused by angina. Simply put, the arteries supplying the heart were not letting enough blood through, resulting in poor oxygenation of the heart muscle. Its the lack of oxygen that causes the pain.
Mr Dexter had a small bottle of spray which he was supposed to squirt under his tongue whenever he had chest pain. The medicine dilated his blood vessels, including the ones that supply the heart. Hopefully this would allow more blood and, therefore, more oxygen to the heart muscle.
He explained that he had given himself a dose five minutes ago. I instructed him to give himself some more spray. It works very quickly, within moments of taking it. I waited the recommended five minutes to reassess.
How bad is the pain now?
I didnt get a chance to hear how the pain was, because the call bell in Mr Simpsons room went off, and continued to go off. It wasnt stopping. I ran to his room.
Oh shit, its agony, Mr Simpson said as soon as he saw me.
I looked at his thigh and knee and placed my hands on them. I could feel something hard in his thigh. It wasnt swollen to the naked eye, but I could definitely feel a lump that wasnt there before. It was also hot. By the time I went to feel for a pulse in his foot, the other nurses on duty that shift were in the room.
Katie took charge, and within minutes had the doctor at the bedside. Katie told a terrified Mr Simpson that his graft wasnt working, and that he needed to go back to theatre.
The head surgeon was urgently called back into hospital. During the next hour, myself, the junior doctor and the registrar made what preparations we could to get him to theatre. That hour was probably the most terrifying in Mr Simpsons life. There was a chance that he would not only never play golf again, but possibly lose the leg altogether.
When he finally left for the operating room, the last of the adrenaline left my body and I felt physically and emotionally drained. It was also at that moment that I remembered Mr Dexter and his chest pain, as well as my other four patients that I hadnt seen in all that time. I ran to Mr Dexters room, expecting to find him either clutching his chest in agony or dead.
He was sitting up reading his book. Are you okay?
Why shouldnt I be? he replied.
I briefly felt relieved, but I rushed to check on my other four patients. Their medications were late
but theyd all had their meds. They were comfortable. All their needs had been taken care of.
Katie and the other nurses had seen to every one of my other patients.
This kind of generosity was not to be unique. Over the next two years I learnt that, in this ward at least, it was normal; the nurses worked as a team, and always watched out for each other.
Big man, big heart
Part 1: Who is Mr Groom?
Feeling part of a team was what made nursing truly enjoyable for me. I no longer dreaded going to work each day. I didnt have that nauseous feeling in my stomach whenever I had to approach a senior member of staff. The biggest improvement was in the confidence I felt about looking after more challenging types of patients, which was fortunate because I was about to encounter one of my biggest challenges yet.
Are you okay having Mr Groom again? asked Carol, the nurse in charge.
What could I say? No, Im worn out, hes too heavy, too much work?
I had been looking after Mr Groom for what felt like forever and was hoping for a bit of a break, but whenever it came time to allocate his nurse there was always a silence in the office.
My adventures with Mr Groom had begun four days ago. I had just returned from my days off. The problem with coming back from time off is that you are at the bottom of the priority list when it comes to picking and choosing patients. To be fair, everyone is generally pretty reasonable when allocating patients, everyone takes their share of the demanding ones, but every now and then there comes along one patient whom no one really wants to be responsible for.
The first time I had met Mr Groom, I couldnt believe my eyes; before me lay a sweating, rippling, heaving mass of flesh, covered almost head to toe in traditional Maori tattoos. He was one of the most obese men that I have ever had to look after. He must have been at least 180 kilograms.
Carol tried to be encouraging. He needs someone strong and youve done so much for him; youre good for him.
I didnt see exactly how I was good for him. We were too different. I come from an average white family, from an average white part of town. Mr Groom is an ex-member of Black Power, a gang with offices throughout New Zealand. Not a group to cross even an ex-member they eat boys like me for lunch.
Good morning, how are you? I asked Mr Groom.
At the sound of my voice he rolled over towards me, the bed springs protesting beneath him, and greeted me with a huge, gap-toothed grin.
Morning, he replied, then, after pausing to catch his breath, Could be better, bro.
Poor Mr Groom, he was only 35 years old, but he looked ten years older and had all the problems you would expect in someone twice his age. I could tell just from looking at his swollen legs, that it wasnt all fat there was fluid in them, a sure sign of a failing heart. Just to prove myself right, I poked my index finger into his ankle and left an indentation that faded away very slowly. Mr Grooms joints also looked swollen and I wondered how much longer they would put up with being abused, before giving out completely.
Mr Groom had never been in hospital before, but hed developed a bad case of pneumonia. In most 35-year-old men, a case of pneumonia would probably not need hospitalisation, but because of his weight he needed to be with us, especially now, because it looked like his condition was deteriorating.