Confessions of a Male Nurse (8 page)
Following in the footsteps of so many of my friends, I decided to do something that has almost become a rite of passage for young New Zealanders. I went to England. I didn’t go there for the best of reasons. I didn’t go to further my career, and I didn’t even go for the money. I went to join my mates in the great big party city that is London.
The problem with New Zealand is it’s so remote, and very expensive to travel to and from. Fortunately, Kiwis can get a two-year working holiday visa to the UK. The goal is to work, travel Europe, then go home and maybe start a family. Once you have a family, you won’t be going back to the UK, because very few nurses can afford the thousands of dollars it would take to travel with a family there.
I was even luckier than most of my fellow expats. My friend Chris had a room to rent in Hammersmith. I’d spent six months working with Chris back in New Zealand. She was always telling me how great London was, and how she loved her job. I just hoped I would like it as much. Secretly, I was worried about being out of my depth. I felt confident that I’d learnt how to be a safe, effective nurse, but I was a young nurse with little over two years’ experience, and I’d only ever worked in one hospital. Now I was going to be working in new hospitals in a whole new city. Things were going to be very different.
I arrived in London and called the nursing agency I was going to be working with for the duration of my stay. The woman on the other end of the phone was called Tracy, and she was to be my main contact person when it came to finding work.
From the moment I had decided to head to London, Tracy’s agency had led me, step by step, through everything needed to make this transition happen. They had helped with visa information, nursing council registration, they would have helped me with housing if I’d needed it, and advised which hospitals suited my skills best.
Soon after arriving in the UK, I discovered that there are countless agencies based in London, importing nurses from all over the globe: Singapore, the Philippines, South Africa, Australia and Europe. They all have their own reasons for working in London, but one common link is that most of them do not want a permanent job; the money is just too low.
At that time, hospital staff rates varied from £7 to £10 an hour for a junior nurse. As an agency nurse, I would be starting on £12 an hour.
‘Well, do you think you’re ready?’
Tracy had asked this question several times in the last few days. I didn’t know if I ever would be ready, but the holiday was over. Only two weeks in London and I had already gone through half of my savings.
‘I’ve got a night shift in a minor injuries department,’ Tracy told me.
I was going to protest. I didn’t know much about treating injuries, no matter how minor. One of the most common misconceptions about nursing – apart from the fact that we’re all women – is that we know how to treat your common cut, bruise, scrape, burn, etc. While there are nurses who are great at taking care of these things, the average nurse working in a general ward will never see them. We only see the serious stuff that makes it past the emergency room doors and into our ward. The problems I was used to dealing with were things like heart attacks, strokes, chest infections, lung diseases, and on the surgical side, abdominal, vascular and urological surgery. As you can see, it’s not particularly practical stuff for out-in-the-community. I hate to say it, but at this stage of my career, the average parent would know more about treating minor cuts and scrapes than me.
But Tracy had more to say.
‘It’s in south London, not far from where you live. They’re really short staffed. They said they don’t need a specialist nurse. A ward nurse would be fine. No pressure, but south London is nice. It’s quiet. I’ve heard good things about this hospital. It could mean a line of work for you.’
Tracy had explained that if a place liked you, they would often offer you more work. Eventually, I agreed to take the shift.
My watch read 7.40 p.m. I was 20 minutes early. It wasn’t planned that way – it was my lack of familiarity with the London transport system. At least I’d be making a good impression. I opened the door to the minor injuries unit, ready to be greeted by grateful staff with warm smiles . . .
‘Are you my lover?’
An elderly woman stepped in front of me, her face drawn in a very serious expression, gazing at me, searching for an answer.
‘Ah no, excuse me a moment.’
I stepped around her. The department was overflowing with people. Patients were sitting on the floor, in wheelchairs, leaning against walls, even sitting on each other’s laps. I waded through the human flotsam, searching for the telltale sign of a uniform, but couldn’t find anyone. Okay, that wasn’t exactly right. I couldn’t miss the two police officers with the very angry looking teenager handcuffed between them.
I made my way towards the reception desk, where I found the receptionist besieged by a group of patients. I tried to slip between the bodies without drawing attention to myself.
‘Get to the back,’ a voice bellowed at me.
I looked up to see a big man with an angry expression and a child cradled in his arms.
‘I’m the night nurse,’ I said.
His expression softened and the crowd parted before me.
The receptionist didn’t waste time with the niceties.
‘Thank God you’re here,’ she said. ‘It’s been chaos.’
I considered turning and running as far and fast as I could.
‘Where’s the nursing staff?’
‘You’re it. The other nurse went home sick and the agency couldn’t get us anyone else at such short notice. I’ll show you how to use the computer and put patients into the system.’
Even though this was my first shift in a new country, it seemed a bit strange that the receptionist was the one giving me the handover.
Ten minutes later, I had been shown how the computer worked, where the toilets were, where the treatment room was, where the doctors’ room was, and where the main emergency department was in the building next door. Then, I was left on my own.
‘I know you’re busy, but how much longer do you think we will have to wait?’ the police officer asked me.
I didn’t really want the police to leave. I didn’t want to be left alone, unprotected, facing a sea of impatient patients.
But, I had to start somewhere. I motioned the officer to bring the girl to me.
The girl had received a blow to the head and had some clotted blood on her right temple. I went in search of the doctor to see what he wanted done. I returned five minutes later.
‘There seems to be a slight problem,’ I confessed to the police officers. ‘I can’t find the doctor.’
The officers didn’t look impressed and sat back down with their charge.
‘Are you my lover?’ The elderly woman snuck up behind me and caught me by surprise.
‘No, I’m not. What can I do for you?’
She didn’t answer and went on her way in search of her lover.
‘Hey, we’ve been waiting three hours,’ a man called out. ‘I don’t care if he’s a copper.’
The man making the fuss was sitting on the floor, his hand wrapped up in a blood-soaked cloth.
‘I’m sorry, really sorry. I’ll get to you as soon as I can,’ I apologised and went to hide behind the reception desk.
I wasted 15 minutes trying to gain access to the computer system, before I had to give up. I had no idea where to begin. I hadn’t even seen anyone yet. I looked over at the pile of patient files and grabbed the first one.
‘Mr Fraser,’ I called out into the waiting room.
A 19-year-old male stood up, along with two females. One was his girlfriend, the other, a middle-aged woman, his mother. I led them into the treatment room.
‘What seems to be the problem?’ I asked, as Mr Fraser sat down on the edge of the bed.
‘It’s a bit personal,’ Mr Fraser said. ‘Can you close the door?’
I shut the door and pulled the curtains. Mr Fraser took down his trousers and lay on the bed in his underwear.
‘I have a problem with it,’ Mr Fraser said.
‘It? You mean your penis?’ I asked.
‘Yeah, it,’ he said again.
‘Ah, I can ask the ladies to leave if you like.’
I was feeling awkward with the women peering over my shoulder at this man’s crotch, so I can only imagine how he felt.
‘It’s okay. Just fix me up,’ he replied.
‘What happened to it?’
In response, Mr Fraser took down his underwear and stretched his penis to its full length.
‘Can you see it?’ he asked.
I had to peer forward.
‘I can see a small scratch, Mr Fraser. It doesn’t look too serious.’
‘Not serious. She bit it!’ he said accusingly, looking past me at his girlfriend.
‘I didn’t do it on purpose,’ the young woman pleaded. ‘I said I was sorry.’
Back home I had seen two patients with bite wounds who were admitted for intravenous antibiotics. Human bites were quite serious.
‘You’re going to need to see the doctor,’ I said to Mr Fraser. ‘You’re probably going to need a course of antibiotics.’
Mr Fraser looked at me in surprise. ‘You’re not the doc?’
I shook my head.
‘The doctor seems to be missing. Grab a seat in the waiting room and I’ll make sure he sees you as soon as I find him.’
Mr Fraser, his girlfriend and his mother headed back out into the waiting room.
Without a doctor I couldn’t do anything that required a prescription. I couldn’t even give paracetamol. I went next door to the main emergency department to find out what the hell was going on.
‘Who are you?’ asked the charge nurse when I wandered into the department. Her name tag read Sister Monroe.
‘I’m the nurse in the clinic next door,’ I said, not even trying to hide the anger in my voice. ‘And I’m all alone, without another nurse, and the doctor seems to be missing.’
The nurse looked about to say something, but I didn’t give her a chance. ‘The waiting room is full. The police are there. I’m being stalked by a very sweet, but very crazy old woman, and the only patient I saw was happy to show his mother his penis.’
After my rant the charge nurse made a few phone calls to find out what the hell was going on.
‘The doctor should be there shortly,’ she told me. ‘He thought he started at ten. He’s a locum. I’m sorry that this has happened. Just hold the fort until the doctor arrives.’
It was 9.15; I decided that honesty was the best strategy.
‘Excuse me everyone.’
All eyes turned in my direction.
‘We have a bit of a problem tonight.’
I explained the situation to the whole waiting room, from the missing doctor, the inability to get another night nurse, to this being my first ever duty as a nurse in a new country.
‘If you really think you need to see the doctor, you’re welcome to wait, although it might take another four or five hours to get through everyone. Personally, I would go home and get a good night’s sleep.’
It shouldn’t come as a surprise that nearly everyone left the department. There were certainly a few disgruntled people, but fortunately no real anger directed at me.
At ten the doctor walked into the department.
‘So quiet,’ he said, with a smile on his face. ‘Should be a nice night.’
Despite such a brutal first shift, the next two weeks went well. I found work in a mixture of general medical and surgical wards, and while the system was different to what I was used to, the illnesses and treatments were pretty much the same. There was, however, one incident of note.
Mrs Thornton was a very large woman. Every time she sat on the bed the springs would squeal in protest. To get her lying on the bed, I had to grab hold of her legs and lift them up as they were too heavy and swollen with fluid for her to do it herself.
‘You’re a gem,’ she said when I performed this service.
Tracy had managed to find me two weeks of work at one of London’s most prestigious hospitals. Mrs Thornton was in the hospital because she had cellulitis of her right calf and was in need of some intravenous antibiotics.
Cellulitis is a bacterial infection of the skin, it generally occurs on the limbs, and it is often triggered by a cut or graze. Unlike a simple cut or graze, it affects the deeper layers of the skin as well. The infection can work its way deeper into the body. It’s pretty serious.
I looked at her drug chart.
‘There seems to be a slight error’ – Mrs Thornton looked worried – ‘Oh, it’s nothing to worry about, just a slight typing error on the drug chart. Be back in a bit, got to have a chat with the doc.’
‘Excuse me,’ I said as Dr Hitchcock, the doctor on duty that shift, walked by me in the corridor.
‘I’m in a hurry,’ he replied, barely glancing in my direction before continuing past me without stopping.
I had been warned by two of the regular staff nurses to be careful around Dr Hitchcock. He was straight out of Cambridge and didn’t listen to the nurses. They said that he thought he was a cut above the nursing staff.
Junior doctors who didn’t listen to the nursing staff were a danger, not just to their patients, but the nursing staff as well.
‘Excuse me, doctor,’ I shouted, chasing after him.
I stepped in his path, forcing him to stop.
‘It had better be important,’ he said, not even trying to hide the disdain in his voice.
I held the drug chart up for his perusal. ‘There seems to be some error with your prescription.’
He began to scowl, and didn’t even make any effort to grab the chart.
‘It will have to wait. I have more important things to do right now.’
With that he stepped around me and wandered off down the corridor.
I stood there holding the drug chart, wondering what sort of trouble I would get in if I gave the medicine that he had
in
correctly prescribed, the correct way. I went and checked with Sue, one of the experienced staff nurses.
‘Don’t do it,’ Sue said, without any hesitation. ‘You really have to get it fixed. You can’t trust anyone, especially not that prick.’
Sue’s words surprised me, but made sense. I had to remember that I was in a very big hospital now, and I was a stranger and a temp; no one would support me if I messed up.
I went in search of Dr Hitchcock. I would force him to spend the 30 seconds it would take to correct the error.
Let me explain the problem. The patient, Mrs Thornton, needed antibiotics, which the doctor had prescribed as a deep injection into the thighs or buttocks. The injection is big and has been banned in many places. There is a risk of infection, abscesses, necrosis, plus lots of other things, not forgetting it’s very painful. The antibiotic in this case could have been given intravenously, especially as the patient already had an intravenous line in her arm. I could technically have given the injection into the muscle, as it is still allowed in some places, but for me, it felt the wrong thing to do.
I caught up with Dr Hitchcock in the staff office.
‘I’m sorry to interrupt,’ I said, standing over him as he sat at the desk chatting to one of his colleagues.
He looked up with that same look of annoyance on his face. I placed the drug chart on the desk in front of him.
‘I don’t want to disturb you unnecessarily’ – I tried to keep the sarcasm out of my voice, but I don’t think I succeeded because his expression showed even more agitation – ‘but this will only take a moment.’
He glanced down at the prescription I indicated. ‘What is your problem?’ He looked genuinely confused.
‘Well, can you please change the antibiotic to intravenous? She’s even got a line in already,’ I added.
Dr Hitchcock sat there in silence for several seconds, before he eventually responded to my query. ‘If a doctor has prescribed it that way, then it is to be given that way.’
With that said he handed me my chart, turned his back on me and continued the conversation with his colleague.
When a nurse gives a medicine that is wrongly prescribed, then that nurse takes some of the blame – actually the nurse can lose their job, while the doctor gets a verbal telling off, so it is important to clarify anything you are unsure of. We all make mistakes, but the way to reduce errors is to be willing to listen to advice. I knew that one day Dr Hitchcock would stuff up, it was only a matter of time, but I was worried that he would stuff up big time now and I would be involved. I have seen an abscess form at the site of a deep injection and I’ve seen the abscess worsen and eventually cause an infection that affected the whole body.
Half an hour later the registrar, a senior doctor, came to the ward and I wasted no time getting the change I needed.
‘No problem,’ the registrar said. ‘I don’t know why he prescribed it that way, that’s very rarely used.’
As the registrar seemed rather friendly, I told him about the problems I had been having with Dr Hitchcock.
‘Leave matters with me,’ he said, sounding very pissed off, ‘I’ll have a word with him, right now.’
I wanted to stay and watch the action, but instead went to give Mrs Thornton her now overdue antibiotic.
After dealing with Mrs Thornton, I caught up with Dr Hitchcock again.
‘I have another problem.’
It wasn’t really a big problem, another minor prescription error, but I couldn’t resist hurting the man when he was down.
‘What is it now?’ he hissed.
‘One of your patients has had a bad reaction to the enema you prescribed him.’
‘He’s had a reaction to an enema?’ Dr Hitchcock responded, sounding incredulous, although I can’t say I blame him, as I’ve never seen anyone react to an enema.
I explained what the problem was.
‘Well, you did prescribe the thing orally instead of rectally, and it didn’t go down too well.’
Dr Hitchcock called me something rather unpleasant but it brought a smile to my face to leave him standing there seething.
