November 1 1999
Rural Outskirts Nurses’ Home
CARPOOL C74 4QW
Thank you for your reassuring phone call, which laid a balm of words upon my flayed feelings. It was good to hear that my days as a calm, confident, and ethical male leader are yet to come – even if they are still some years off!
I have been assigned – my first student nurse assignment – to a chronic chest diseases ward and am still in the grip of some considerable cultural bewilderment. On my initial shift (an early) I was allocated to the weekly urine testing of some 35 patients and remain unsure as to the actual sense of this. Does everyone’s urine really need testing? Am I allowed to ask any questions? Indeed, is thinking really encouraged? It does seem to me that only patients with specified conditions (diabetes springs to mind) need their urine testing every single week . . .
The other thing that caught my attention was the reams of ‘observations’ paperwork festooning the end of every bed. It was really hard to find the most current chart. And I am far from certain that it is really necessary to perform 4-hourly observations – temperature, pulse, and blood pressure – on practically everyone. Does anyone ever review the frequencies with which such measurements are necessary? Is there a page for summaries in the Kardex? I am tempted, Auntie, to pipe up but, at present, I am the lowest of the low and am positively petrified by the sight – and never mind the handling – of multiple pipes and tubes going into, and coming out of, some of the most ill of individuals.
One of the ghastliest things that has happened so far is that I was asked to wash, and dress, a lady with emphysema. And Auntie, do you know, she was too white and breathless even to stand up. I tried to be kind and reassuring, naturally, but I felt shocked by the depth of her disability and suffering – which did not seem to be much mitigated by the flow of 24% oxygen being piped to her through a mask. Later on that day, the same lady was pushed past me in a wheelchair. And she said, “Oh nurse. Do you think I’m going to die today?” I immediately replied, “Oh no Mrs Summersby. You look okay to me.” Well she did. She died that day. And I was mortified. In fact I think I am a changed man.
I was so changed, in fact, that when something similar happened a week or two later, I did speak up. An elderly man was sitting on the side of his bed, clutching an oxygen cylinder and gasping through a mask. And then I heard another student nurse (even more callow than myself) say, “He’s only breathless because he’s panicking.” Before I could even monitor a conscious thought, I found myself snapping back, “No. He’s panicking because he’s breathless. That is quite a different thing.” He was another one who expired within the next 24 hours, so I hope that girl learnt a lesson!
More cheeringly, Auntie, the young doctor, Thule, whom I may have mentioned before, overheard my remarks and – do you know – I think she may have smiled . . . I have not seen her at ‘Med Club’ and I think she may have more discernment than to attend a setting so redolent with alcohol, sweat, and sex. Perhaps I will start attending the library instead; I want to know more and the atmosphere is soothing in there – not to mention actually warm – which is a great improvement upon the nurses’ home.
Your loving – and learning – nephew