Nurse Stories: Writing by Nurses

Ahead of His Time

1980’s

Rehabilitation ward they called it

But few ever left alive

Edward

Let’s call him that

Wordlessly seeing out his days

Silent with his fragile dignity

Early shift

Time to get Edward up

Talking – monologue

Not expecting any answer

Gardening

Edward's job in years before

Lettuce and the problem of slugs

Slug pellets, salt rings, jars of beer

Tried them all

Any suggestions?

“Don’t grow them”

A silence broken!

But instantly returns

Forever, for Edward

I don’t grow lettuce now

Such ecological wisdom

Didn’t think like that in the 80s

So ahead of his time

Few words, big lesson

That has shaped my life

Work with, not against

Thank you Edward.

First published in Gilliard J. & Marshall M. (eds). Time for Dementia. Hawker Publications, London. 2010

This poem was reproduced with permission of its author, Professor Charlotte Clarke, Head of School here at Health in Social Science, University of Edinburgh

The Stories

People like to hear the funny stories about mental health nursing. They’re fascinated by the man who thought he was pregnant with a dragon, or the woman who called all the nurses by saints’ names (I was St Bernadette). The man who was convinced aliens were landing in his back garden is exactly the sort of person who comes to mind when we think about madness, and as for the time I spent twenty minutes chatting to the self-styled Reverend Bill under the impression that he was one of the hospital chaplains… The next time we met, Reverend Bill told me he was working for the CIA.

Mental health care is full of silly, quirky incidents like this, and told with a due regard for confidentiality they make good dinner party anecdotes. You have to be careful, though, when talking to people who aren’t nurses. It’s a good idea to edit out the bits where the humour gets a little too dark, like the do-it-yourself suicide pack, or the one my colleague told me about being asked, after an arson attack, why she hadn’t filled in form Q7 at the time of the incident. She took a black marker pen and wrote across the form ‘because I was on fire’. Nurses usually find this story hilarious.

The thing is, the funny stories aren’t really all that funny. The man who was pregnant with a dragon had just spent his 21^st birthday in the hospital secure unit. He was on anti-psychotic medication, couldn’t go out unless escorted by a nurse, and kept getting into fights with other patients. The woman who called me St Bernadette was a sweet tempered, gentle person who was being regularly held down and injected with medication against her will.

One day I spent an hour talking to the man who believed in aliens. Take a moment and imagine what that would be like; being convinced that aliens really do exist, and they’re coming for you. Unable to sleep because the slightest sound from the garden confirms that the aliens are out there. I can still remember the white-faced, tremulous expression on his face as he tried to negotiate a world in which no-one believed his most awful fears.

Most of the stories of mental health nursing are the hidden-under-the-bed stories. The tales which nobody wants to hear. Occasionally they’re funny, but mostly they’re sad or scary. Perhaps that’s why I find it difficult to explain what mental health nursing is all about. Among ourselves, health workers tend to tell stories where the humour is blacker than a pint of Guinness (rumour has it that paramedics are the darkest), but it’s difficult to communicate with outsiders. Even among nurses there are divisions. In my experience hospital nurses were the worst, community psychiatric nurses were still fairly robust, but I found that once I moved into primary care my tolerance for the Guinness stories was considerably diminished. They started to feel disrespectful and uncaring, even though I understand the important work they do in helping nurses to assimilate some of the suffering they witness. In the end I left clinical practice before I had managed to work out how to tell my story of being a mental health nurse; and even though I carry with me the people I met, and the fragments of lives which I witnessed, I still don’t quite know how to tell that story.

Jessica MacLaren has a background in mental health nursing and is currently undertaking a Phd at the School of Health in Social Science at University of Edinburgh.

Healthcare practice, warts and all

Marion Smith

The room felt comfortable and warm, its incumbent at ease with her dark blue uniform, familiar accoutrements and practised smile. But there wasn’t a welcome for us.

I had brought my two children to the verruca clinic for dry ice treatment. I had done my best to prepare them for the pain of little smoking sticks, but pain applied with clinical precision through verbal encounter had not occurred to me.

The nurse looked us over as we walked into the room, and raised her chin in immediate disdain.

“Oh, one’s a boy. They always make such a fuss. Your girl will be fine, they take it in their stride. I hate having to treat boys: they’re such wimps, writhing around. The girls do so much better.”

Words and blood rushed to my brain, practice knowledge jostling in my throat, diverse retorts elbowing each other on my tongue. Was I mum or healthcare researcher? What knowledge, what standards should I apply? Who was I here?

I opened my mouth; I closed it again.

She was the one with the little smoking sticks.

The treatment was administered. I don’t believe I imagined the increased time she held the nitrogen to my son’s foot. And yes, he writhed. Then it was done, and we were ready to go, my girl duly lauded, my boy decried.

I paused as I ushered my children from the room, chest heaving as I took a determined breath: and changed my mind again.

So who was the wimp? Was it sensible to leave her venom unchallenged, in case she justified her opinion through her handling of the next poor lad? I could imagine the day’s succession of sniffling, limping boys with cratered feet and incinerated verrucas. Or did I sidle out meekly, cowed by the power of a uniform and an expertise that we might need on another occasion? Of one thing I was confident: how to address the experience with my children on the way home. In that, the expertise was mine.

Perhaps I was right not to make more of the situation at the time: my children remember it vaguely, and do not recall the aspect of it that troubles me. So why write about it now, all these years later?

J.C. Scott, a political scientist, notes how subordinate groups create out of their ordeals a “hidden transcript”, a subterranean critique. So this is mine, my nugget of rebellion, safely tucked away on a blog in another country.

Marion Smith studied English Language and Literature at the University of Manchester before completing an MPhil in Linguistics at the University of Cambridge. She worked in academic publishing for some years before returning to Cambridge to write a PhD on the sociology of language and pain. After subsequent work in research, publishing and teaching, she moved to Edinburgh in 2005, and is now Postgraduate Research Coordinator for the School.

Happy Hour

Denise Taylor

Vodka is my ally

We need an anaesthetist

I’ll stop if I want to

Get the haematologist

No-one can smell it

Frank haematemasis

I can control it

Oesophageal varices

I’ll stop if I want to

No IV access

Maybe tomorrow

Can’t get a venflon in

None of your business

She’s going to exsanguinate

Hidden in the shopping

Can’t get a blood pressure

Hidden in the laundry

Cardiac Arrest

I’ll stop when I want to

Hasn’t got an output

Can’t live without it

Gonna have to tube her

Helps me to cope each day

OK Bag her

I like it

Compressions

I want it

No output

I want it

No output

I want it

No output

Vodka is my ally

Call it.

Time of death 2347hrs.

Denise Taylor was a critical care nurse for many years but had to take ill health retirement with severe back problems. She is now concentrating on her other passions of writing and photography and has recently completed a Creative Writing diploma with the Open University. She is based on the Solway Coast in south west Scotland.

I am with you

Rosemary Mander

I taste my iced water knowing that is all I’ll get.

When I hold your hand I can feel the heat of how hard you are working. I rub your back persuasively. With a cool damp cloth I wipe away your sweat. I help you to push away the wet hair which is matted on your face. When will your hair ever be dry again?

I listen to your breathing. I hear you hold your breath for a heartbeat. What does this tell us? Are you making it? Are you getting there?

I see your face become confident. The aura of fear has now gone. You know what is happening within your body. Better than I do. I smell the dry sweetness of the fluid that has started to come away.

Yes, we are getting there. The three of us. She is about to be with us.

About Rosemary: “I am Emeritus Professor of Midwifery, which means that I am able to spend my time writing and researching and doing a little teaching, but I have recently ceased practising as a midwife.”

Liking the Locked Ward?

Deborah Ritchie

I like walking back into shabby wards

And putting on my nurse’s face

I like how I check myself for harmful objects