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 21st 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
I like being ready for anything
Any madness

I like holding onto to their distress
And smiling into the abyss
I like seeing the depths of their despair
I like being ready for anything
Any madness

I like washing women who bleed in public
Her vulnerability and being close
I like peering into absent souls
I like being ready for anything
Any madness

I like the young men on legal highs
As they scramble my reality and cause a scene
I like how we tumble into the fray
I like being ready for anything
Any madness

I like watching and closely observing
As I bandage wounds and consider cuts
I like to stop them killing themselves
I like being ready for anything
Any madness

I like it when they shuffle off their mortal coil
And the drama of their end
I like that it is over
I like being ready for anything
Any madness

I like having the keys and locking doors
I like that I can leave and take off my nurse’s face
I like to forget their tormented worlds
I like being ready for my life
My own madness

Deborah Ritchie is a senior lecturer at Nursing Studies, Edinburgh and has a background in psychiatric nursing.



It’s the little things that count …

Corrienne McCullough

I walk into the four bedded bay, the late morning sun casts a beam of light across the linoleum floor.  Squinting to see I scan the room slowly, left to right and back again.  The curtain is drawn around the first bed to my left and muffled voices can be heard through the patterned material “… if you just shuffle your bum to the edge of the bed…  that’s it…. good… now hold on… John can you hand me that zimmer frame over please….”.  I continue into the room beyond the bedspace with the curtain and there is Moira sitting up in her chair.  I lean towards Moira, smiling politely “ Hi Moira I’m Carrie the research nurse from the rehabilitation study, do you remember me from last week?”.   Moira instantly screws up her face, searching through different uniforms and faces visiting in the past week.  After a few seconds the muscles in her face begin to soften whilst the corners of her mouth widen, drawing up tightly into her cheek bones and leaving a warm friendly smile.  A twinkle appears in her eyes magnified by her glasses “Oh yes, hello Carrie I do remember you…”

Pulling up a red plastic chair and clearing some space on the bedside table amongst energy drinks, grapes, a paperback book and a radio, I carefully place down the blue ring binder folder and digital hand grip dynamometer* that I have brought with me.  I am just about to sit down on the chair when Moira stops me, reaching out with a bruised, wrinkled, shaky hand “…the nurses are awful busy today, they’re short staffed… can you move my chair back a bit… I’m sitting out in the middle of the floor here… oh and my glasses, yes my glasses can you help me clean them… I can’t see a thing out of them… I’m really sorry, you come here to do your job and I am giving you extra work to do…”.  I reassure Moira whilst moving her chair back as far as it can go and explain that there is a drip stand poking out from under the curtain around the next bed space “there we go, is that ok….now… what would you like me to do with your glasses?”.  Moira directs me over to the sink, pointing diagonally across the room “run them under that cold tap”  I pause for a moment thinking to myself, I’ve never cleaned glasses with running water from a tap before, then from the corner of the room my thoughts are interrupted with a familiar voice shouting “they’ll be ok… I’ve done it before…”.  I gingerly rinse the glass lenses under the tap as instructed and return them to their owner for inspection.  “ONE more thing Carrie before you sit down ... and if you don’t mind… can you sort the pillow at my back?”.
Now we are ready to begin…

*Digital hand grip dynamometer – measures flexion of the wrist, providing an accurate reading of hand grip strength




Corrienne McCulloch is a nurse with a background in intensive care.  She is currently undertaking a PhD in Nursing Studies alongside working as a Critical Care Research Nurse.






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