Nurses' Day, Nurses' Stories

I was out of the country for the last week, and so missed the chance to post something for Nurses Day on Sunday the 12th. However, visiting the RCN website, I see that they have gathered up the stories of many nurses, a collection of heartfelt pieces about how nursing feels from the inside - much better than anything I could say.

Here is one of the stories, reblogged from their website. I particularly like the way it captures how a nurse's involvement with a patient can be life-changing for the nurse, too. You can read all of the stories here

Being human

posted on the RCN website by Dave King 

There have been some deaths that have had an impact on me over the last few years. My mum, my uncle, his wife and their daughter, and my brother-in-law.  And Sean.

I first met Sean when I had been qualified for but a few years, in the early nineties, and was working as a staff nurse on a locked ward in a large hospital, where it felt like we played darts, table tennis and football for much of the day, and tried to keep control of the ward for the rest.

I don't honestly remember where Sean was admitted from, and don't feel inclined to find out, because that's not the point. I have a few strong memories of him: he was young, wirey and fit, with a head of shaggy black hair. He could climb a drainpipe as if gravity hadn't been invented, and persuading him to come down from the roof of the Victorian institution was not an unheard of event. On one occasion he came down (in his own time, as was always the case) on the 'wrong side'; the side where the rest of society lived. Luckily for society I was there, waiting; recently trained in Control & Restraint (C&R - look it up in the history books), and ready to fulfil my responsibilities under the Mental Health Act (Section 138).

The tussle began as might have been predicted, but quickly took an unexpected turn. Sean started to cry. They hadn't covered this on the C&R course. If Sean had put me in a neck lock, I was prepared. But crying? This was a new one.

Being a conscientious mental health nurse removed many options, but a sense of humanity seemed to leave me with one solution. It was obvious. I hugged him. I hugged; he cried; support finally arrived, and we returned to the ward.

A less clear memory of Sean occurred when he was found cutting his forearm in his bed space, and we intervened. The scenario unfolded safely enough, but, afterwards, a colleague informed me that I had been cut, pointing to the wounds on my arms. It quickly transpired that the sweat and the duration of the restraint had resulted in some of Sean's scabs transferring themselves from his arms to mine.

Fast forward about 15 years. Our careers had separated. Sean has spent time in a high secure hospital, and I have been a charge nurse in a medium secure service for some years. Sean is making good progress and has an identified discharge pathway, it could be a couple of years, but things are looking good. I have been charged with managing our service's new Long Term Medium Secure Service, and Sean has agreed to advise on the admission process from a patient's point of view. His advice is succinct; "Tell 'em how it is straight; don't mess them about; as long as they know the score, they'll be okay." And so it proved to be. Sean the service use expert.

A few more years and Sean had been discharged. A flat, a job, a girlfriend. An unexpected illness and a tragically early death. After all his hard work, Sean hadn't had the time to enjoy the fruits of his very hard labour.

The patients, staff, family and friends who attended his funeral felt a deep and genuine sense of loss. That included me, and it also made me begin to wonder about the way in which being a forensic mental health nurse can affect us, and how (if, indeed, we do) we manage to remain personally balanced and undamaged by the work we undertake. Human.

We feel the impact on us of the acts of others. I wonder if we understand that we, too, can leave an impact on them.

Story: I See You

This is the final part of my four-part ICU story. The last word goes to the patient...

Harry

Dreadful. Just dreadful. One time Valerie was by the bed and she’s holding on to this arm that’s lying on the sheet beside me and I say, whose arm have you got there and she says, it’s your arm, Harry. Giving it a little squeeze, and saying can you feel that, can you feel my hand and the arm can feel it, but it’s not part of me.

The things they did to me in there. Pushing knives under my skin, a poker down my throat. Cackling while they did it. But Valerie says no that was dreams, no-one was laughing or torturing. They saved my life. My brother Vincent says it’s amazing what medicine can do these days, just amazing. We nearly lost you Harry, raising his glass high.

The dreams weren’t like any dreams I had before. They were all the time and more real than real. I was always looking for something and there was always someone coming after me. On and on and on. Underwater most the time. I swam right up to the pit of blackness. I can’t explain it properly, but it was like myself I was looking for.

It’s the worst thing I’ve ever experienced. Only most of it didn’t happen.

I try to put it together. I start with getting flu, and I remember the ambulance, then it goes into strangeness. Voices, snatches of things. I can’t tell anyone about the worst things. Just can’t. Then her face, bright and big as the moon coming down from the sky to hover over me. Cecilia. Really, the loveliest face, pulling me up from dark water. Nurse Cecilia. I see you, she said to me, that’s where you are. I … see … you. Holding me safe in her eyes.

God must have plans for you, says Vincent, on to his second whiskey. I can’t have a drink yet, now, maybe ever. He talks like this to say he likes me, to say he’s relieved. My wife and daughter look shifty when he talks about me nearly dying. He thinks it’s okay cos I didn’t, but they both get this funny embarrassed look and I know then they thought I was going to.

I can’t get from one side of the room to the other without hanging on the furniture. I don’t want to go out and get asked how I am. I find myself looking through the blinds at the empty street and worrying about who’s out there. Like whatever I was looking for in those dreams, well now it’s looking for me.

Everyone thinks I’m a cranky old bugger, that I should be kicking my heels up with joy. Valerie looks like five years have passed in three months. She’s no kicking her heels neither. I’m sleeping downstairs anyway, a bed behind the sofa cos the stairs are hard to manage. I keep the telly on through the night.

Dawn comes down and sits on the bed, squashing into me, but it’s nice. We’re watching The Matrix, I seen it before, but now when I see that boy inside that huge space like the belly of a monster and him and those others with tubes coming out of them. I start to shake. Y’okay? says Dawn. I try a laugh, that’s me, I say, me in the hospital.

And she sits up real straight and says, Dad, it’s the very opposite. Your machines were feeding you, not feeding off you. She’s so sure of what is what, her voice pat pat pat, even though we’re talking crazy stuff.

You’re not in love with that nurse are you? She’s moved her eyes back to the telly. I want to tell her how it was, but how can you? Ach, there were loads of nurses, I say and anyway I don’t love anyone but you and your mother. And Zippy she says, to lighten it up. Zippy’s the cat. And Zippy, I say. And she puts her hand over mine, hiding the bruising and says, be quiet, there’s a good bit comes next. 

Two Paths

 

For today, another of my own stories, another part of the ICU tales - this time the wife's story. You can find the other parts here - The Nurse my Father Loved and Cecilia

After a couple of days, they stuck a sheet of paper to the wall beside his bed. Who I Am it says at the top, and underneath there’s a photocopied photo of him smiling. It was taken at his parents’ 50th anniversary, and he’s wearing a suit. It was the best photo of him I could find, but I’m not sure it gives the right impression. It makes him seem like the kind of man that wears suits. And smiles.

Harry is lying propped up on the bed with a ventilator stuck to his face. His skin is almost the same colour as the sheets. He is sleeping or unconscious, but I can see his eyes flicker under the lids. Cecilia, his nurse, is at the end of the bed, filling in his charts. There are a lot of charts. If I look at her, she will talk to me, so I don’t look. I look at the page on the wall.

Who I am

Name: Harry Dignan Age: 55. Occupation; Human Resource Manager

Likes: Music (classical and jazz), Hillwalking, Cinema.

Dislikes: Pop music, football talk.

People: wife Valerie, daughter Dawn, brother Vincent

I stopped writing at two dislikes, but I could have gone on. Audi drivers, Tories, our neighbours on either side, stewed tea, me talking during his favourite programmes, everything our daughter wears, people on the news who add ‘going forward’ to the end of their sentences. The likes section was harder and it’s ended up as bland as a personal ad in Saga magazine. I don’t know the last time he went hillwalking, it wasn’t this year or last. But he did used to love it, and maybe it kept him healthy. He’d leave home in the dark to get to some far Monro, knocking things over in bedroom getting dressed.

Who I am. Right now I’m not sure he knows who he is. 

It should really be headed Who My Family Think I Am. The charge nurse who asked me to fill it in said, ‘We want everyone working with your husband to see beyond his illness to the person’.

You can hardly argue with that. I can’t argue with anything, I can hardly hold the thread of what they’re saying, even though I should know. All I can do is sit here. Talk to him, they say, he may be able to hear you. Everything I can think of to say feels useless before it even gets out of my mouth. I can’t even cry. Dawn doesn’t want to visit. I know it’s because she’s scared, not heartless.

Ever since they pinned up Who I Am, I think of Harry waking up, seeing it and taking issue with everything I wrote. I think of Harry waking up, but I don’t believe he will.

It’s like there’s a path that goes one way, towards funeral arrangements and a big blank afterwards, and there’s the path that goes to having him home, but not as he was before. I don’t want to go down either way, that’s the truth.

I was nurse myself. Gave it up when we had the baby. I don't know if I've the strength to be one again, even for Harry. I haven’t told anybody here that, though one or two of them have looked at me closely when I’ve used certain words. Nurses have a way of recognising each other – the steady eye, I think that’s what it is, or the slanted humour. I don’t want them to know I’m a nurse because I don’t want them to tell me too much.

When I can’t sit anymore, I go to the visitors’ room and make a cup of tea, look out the window at the car park. The consultant and Cecilia are suddenly standing there beside me, asking if they can have a word. It’s cold in the room. The consultant has yellow curly hair. She’s young, but as she’s talking to me, I’m looking at the crease between her eyes, thinking how deep it is.

She’s asking if I understand.

‘No,’ I say, and she starts over again.

‘We’re decreasing his sedation.’ she says, ‘Gradually.’

‘You’re letting him go?’

‘No!’ says Cecilia. ‘He’s coming off the ventilator. It’s good news.’

Good news. I feel like I’m going up in a fast lift. Cecilia has her arm around me. Steady. Sitting down now. The consultant gone. I realise that my hand is gripping the bare skin of Cecilia’s arm. Her skin is soft like a child’s. I almost tell her that. I want to babble about her skin, about baby oil versus moisturisers, but I can’t because nothing in me is joined up.

She lets go of me, and I press myself into the padded back of the sofa. My mouth opens and salt tears dribble into it. Cecilia turns away, then back. In her hands is a big white burst of tissues, lovely as a flower.

New Writing

I'm very happy to be publishing some more new writing on this blogsite, work that has arisen from workshops I gave within the School of Health in Social Science (of which Nursing Studies is a part) and also a poem sent to me by Denise Taylor, a nurse and writer based in the Borders. You can find Denise's poem along with a memoir piece by Marion Smith under the 'Writing by Nurses' tag above. 
Strictly speaking, it should read 'Writing by and about Nurses', as Marion's story deals with the patient's perspective, and a nurse you wouldn't choose to encounter.

In a similar vein, but a very different setting, Eliane Du's remarkable true story below, has at its heart our expectations about how healthcare professionals will treat us, and the painful shattering of those illusions.

The Doctor With A Gallon Of Water

By Eliane Du

We generally believe that doctors are meant to save lives within their power and ability, but from my experience that is not always the case.

Several years after the Vietnam War ended, my mother decided to leave the country taking her four children with her. It was a drastic decision, but like many Vietnamese “boat people”, we had to risk everything, including our lives, to find a new life. Our transport was a 19½ feet boat crowded with over 285 refugees.  I was about nine years old and was too young to understand how dangerous the journey was.

The night we left Vietnam, my mother dressed us in two layers of clothes and I was given a canteen of water to carry for the family. When we got on the boat, I was immediately separated from my family and was put to sit at the bow. My older brother and sister were pushed down to the lower deck.  My mother and youngest brother along with other children and mothers could remain on top.  

I was very seasick and the horrible smell from the diesel engine made me vomit. Terrified of moving around, I tried to lie still and go to sleep. I woke up with a terrible fever: I tried to look for my canteen of water but someone must have taken it while I was asleep. Our boat tossed and turned heavily in the strong winds and ferocious waves. A big storm was coming and everyone started to panic.

My mother was worried that I might fall overboard without anyone noticing, so she managed to persuade the people around to help and bring me over to her side. Right next to us sat a doctor and his wife. My mother asked him about my condition as I lay dehydrated. I could not take my eyes off the big gallon of water that was placed beside him. I whispered, “water”.   He looked at me and said that I had a high fever. Poor mother, she tried to beg him for a small cup of water but he refused to offer any. Eventually he poured out a little water using the tiny lid from the gallon and gave it to me to stop her from nagging. I was shocked by the amount of water provided, especially from a doctor whom I thought should be kind and helpful. I looked at him and tears were rolling down my face, but he was not bothered. I forced myself to sleep so that I would not think about the gallon of water.

I dreamed that I was happily playing in the sand with the neighbor kids. Suddenly, a big wave dashed in, knocked me down and carried me out into the ocean. I was waving my hands but no one paid attention. The waves kept pulling me under and I struggled to keep my head above the water.  I opened my eyes and felt terrified. It was only a dream but the thought of drowning made me shiver. Around the boat, dark fins loomed up through the water. My mother said softly, “sharks” and told me to pray hard and I again drifted into unconsciousness.

I was woken by something cold going down my throat. My mother was trying to squeeze some lemon juice into my mouth. Someone had thrown us a few lemons and that was how I survived for the next four days before we were saved by an oil tanker. I remember how much I enjoyed those lemons: every single piece that I could get from the little fruit. There was no sour or bitter taste in them but only juiciness and deliciousness and they were far better than the doctor’s gallon of water.

Photos from the journey:

This was the boat on which we left Vietnam. It was 19 and a half feet long and carried  more than 285 people

The rescue by oil tanker. Passenger had to board by ropes and a net.  I remember my mother was almost crushed between the two boats when trying to climb over. Fortunately, someone saw what happened and helped to lift her up!

Eliane Du is originally from VietNam. She has lived in Malaysia, the United States, and the United Kingdom. She received her BA degree from California State University Northridge and an MSc degree from the London School of Economics. She is currently doing her PhD at University of Edinburgh in the department of Clinical Psychology, School of Health in Social Science. Her research interests are in E-Mental Health and Human-Computer Interaction. Before starting her PhD, she had worked as a Software Quality Assurance Engineer for Autodesk Incorporations: an inventor of AutoCAD application and their 3D visual effects, media and entertainment software were used in Avatar movie

Story: Cecilia

This new story, Cecilia, is a companion piece to my previous story here, The Nurse My Father Loved 

The wife brought me chocolates. She didn’t just leave them at the desk; she came right up to me in the ward.

‘Harry wanted to get you something,’ like she didn’t have a part in it, was just a means of getting the chocolates from him to me.

They were fancy, in a box like a gold brick with a little cardboard tag tied on the ribbon. Her sulky-looking daughter hung back at the doors of the unit, wanting to be away. I knew her name the other day, but I’ve forgotten now. She’s like a lot of teenagers that visit here, resenting having to look at so much illness and dying, and I’d probably feel the same in her shoes. Harry’s being moved to a general ward tonight, things are on the up for them. I search my head for the wife’s name.

‘You didn’t need to do that, Valerie,’ I say, but it comes out more harsh than I meant. I meant it like a thank you, not a brush off. Now I’m annoyed.

‘But I did,’ says Valerie, holding my eye, and I’m embarrassed, a bit, even though I’ve nothing to be embarrassed for.

He’s been with us for five days, out of it most of the time, a little delirious. When we removed his breathing tube yesterday he kept staring at me with eyes big as a boy’s, his cracked lips moving, trying to tell me something. I gave him sips of water, told him to take it easy. His hand in mine.

He started to cry then and I held on, telling him where he was, that he was okay.

He said he’d been living under the sea. People say all kinds of things when they’ve been sedated. They have dreams they can’t wake up from, nightmares often.

‘There’s been someone with you all the time,’ I said.

‘I know,’ he said, ‘you were with me.’

‘Well, not every shift – ’

‘They were trying to catch us, but you swam so fast. Pulling me through the water. Your lovely tail.’ His eyes dropped to my hips, where my tunic meets my navy trousers. He frowned. ‘Your tail….’

‘You need to rest yourself now.’ I said, but I couldn’t help smiling.

I passed by Frances at the desk.

‘Bed five dreamed I was a mermaid. He said my tail was lovely.’

Her mouth twisted up on one side, but she didn’t lift her eyes from the computer. ‘I heard. Are you sure he meant mermaid? You could’ve just been a big fish. Like a tuna.’

By late afternoon he had his head on straight, but he was still looking at me in that way, you know, sentimental. We’d shared some adventure in his head, something that might have seemed like years to him. When I leaned near him to check his lines, he said.

‘I should have married a girl like you.’

There were a lot of things I could have said to that. Like how if he thinks this is what I’m like at home, he’s sorely mistaken. Like what about his perfectly good wife, breaking her heart over him in the visitors' room. Some men get the idea that it’s to do with them, not with your job.

I’m good at what I do. Give me the sickest person in Scotland and I can take care of them. You do get attached sometimes, but it’s often to ones you lose, and we lose people in intensive care, that’s just the way it is. I work here because you get to take care of one person, properly. On other wards you’re running around chasing your tail, things you haven’t done yet stacking up in your head, never getting to the end.

Harry’s a lucky one, out of the woods. Too many days I’ve drawn the curtains around a bed and unhooked a quiet body from all the gubbins. Line by line. Cannulae, electrode patches, nasogastric tubes, ventilator tubes, catheters, drains. I cast them off from the machines to be themselves again, just a person. I tell them what I’m doing, all through last offices, even though they are already gone. I like to do it this way. Some nurses get nervous and chat about what they’re having for their tea. I hate that. I prefer to do it on my own.

Harry's wife is still in with him when my shift ends. He’ll be gone tomorrow, but I skip saying goodbye in case he starts to get soppy again. I don’t want her seeing that. I go behind the desk and find that someone has opened the box of chocolates. I take two for the bus stop and stand a moment, scanning the ward as it quietens towards night. The whooshing of the ventilators comes to me like the sound of waves.

Story: The Nurse My Father Loves

My father got sick last week. It started as flu, then the whites of his eyes turned yellow. I was standing in my parents’ bedroom, watching him trying to get up off the bed. I’d been meaning to ask him for some money to get to college

‘How are you?’ I said.

‘I don’t know how I am.’ His eyes wandered the room.

I never did go to college that day. At lunchtime, the ambulance came to take him, and I stayed in my bedroom, couldn’t watch them carry him down the stairs. They put him in an intensive care unit and phoned us to say his kidneys and liver were failing. David Doran next door told me this wasn’t good. He’s studying medicine, said he’s practicing telling people bad news.

My mother visited my father for most of every day, but I didn’t go. No one said I had to. Anyway, my mother said he’s delirious, that he doesn’t know what’s happening. So how can he miss me?

Five long days, and he starts to get better. I go in to see him. He looks dreadful, suddenly smaller. His skin has blue shadows and his hair is wild as if he’s been thrashing around on the pillow. He doesn’t have the tube in his mouth anymore, the one my mother told me about, but his voice is whispery and cracked. There’s something he really wants to say. He makes my mother lean down close. I’m expecting something profound, a rare public declaration of love, maybe, or an insight from the threshold of death.

He forces the words out. ‘Buy … chocolates … for Cecilia.’

We don’t know any Cecilia. I wonder if he’s still delirious.

‘Who?’

He raises the finger with a plastic clip on the end and points it towards a dark-haired nurse standing at the bed next door. She’s talking to a male nurse, and as she turns smiling from whatever he’s saying, she notices us staring. She raises a hand and wiggles her fingers. Cecilia.

My cheeks go hot. In the week I’ve let him out of my sight, my father has formed an attachment to a stranger. It comes to me that this Cecilia would have been touching him, washing him, intimate with his body in a way I don’t want to think about. And now he’s telling my poor mother to buy her a present, this woman who has taken our places in his heart.

But my mother just smiles and kisses his cheek.

‘We’ll go get them now.’

I force myself to kiss him as well, even though I’m angry, and starting to think this father who has come back is not the same as before, this new one given to falling for young women and sudden physical breakdowns.

Outside the hospital, the world looks just the same, but my mother insists the day has gotten finer. She hums and looks up at the sky as we walk to the shops on our humiliating mission, her silky scarf trailing from her hand.