Judging Success

I put a lot of effort into my work today. I did wonder if it was going to be worth it. By the end of the day I found that no only was it worth it, but that I want to do more.

I gave my first official drug education talk to the school kids. I have had 'unofficial' talks with the kids about drugs, but this was in front of a class of around 16 teenagers. I'm normally nervous when I talk to groups, but today was different. In fact today went real well. I didn't have a planned speech, just some keywords to trigger memories. Some of the memories that those keywords triggered were from my days dealing with teenagers in the psychiatric unit, some triggered memories of friends that have come undone by drugs, and some memories were from the good old emergency room.

I was asked to give a presentation by the social studies teacher, because the kids had just finished a week studying drugs. At the end of the week each kid had to give a presentation about a certain drug, eg Marijuana, Heroin, Cocaine etc. They had some great facts and figures, and the teacher thought that it would be a great way to finish this module with a drugs talk by the school nurse. The teacher said I had a whole free class to say anything I wanted. I decided to use my memories to give the kids a real life picture of what drugs can do.

The kids sat and listened attentively. No one fell asleep that class. No one made jokes. There was no chatter in the back of the classroom. I've never had a more attentive audience in my life. Time became meaningless as I delved into my memories about teenagers ruined by Marijuana. The kids were horrified to find out that Marijuana wasn't harmless after-all, especially to growing teenagers. They were even more shocked to find out that the person on the street selling cocaine is probably selling more battery acid than cocaine. They were disbelieving at first when I said you can't trust anyone, even your so called friends, because no one gives a shit when it comes to making a buck or getting fix.

I was a little surprised that the kids had no idea that heroin tends to stop people breathing. They didn't know what schizophrenia's was and they all cringed in their seats when I told them about a fourteen year old boy called Jake, who could see the spiders crawling on the floor, hear the rustle of their legs on the wooden floorboards, then feel the spiders as they crawled on his skin and then sank their fangs into him.

I wasn't there to scare the kids, although some probably were, but I talked about odds, or risk factors. Like a man asking his doctor what he can do to stop himself having a heart attack, I explained that everything in life comes down to increasing the risks or decreasing the risks. In the case of a heart attack, the risk factors are diet, exercise, weight, smoking. I explained that mental health is no different. It comes down to risk factors, several of which I discussed with the kids. You may be fine, and you may be ok, or perhaps your friends, but you increase your chances of things going wrong.

Never in my life have I talked for forty minutes so easily. I was incensed. I was a man on a mission. I ended up speaking to three classes that afternoon, three forty minutes sessions. And then I began to doubt. I'm not the expert. Maybe I've gone about this the wrong way. Who I am to educate about such things? I'm not qualified.

After the doubt came the belief that I had wasted my time, as well as the students time. No one really cared. They were quiet because my stories were entertaining, that was all. Then it happened.

I was back in my office when a 16yr old boy approached. "Excuse me Mr' asked the boy, "Do you have a minute?" he asked. I nodded my head, "Come in and grab a seat" I replied. The boy came in, shut the door behind him and grabbed a seat. "Can I ask you something?" he asked, "About your talk" he added. "Sure, ask anything you want" I replied.

I won't say anymore, as what the boy told me is of no importance to no one else but myself and the student. But what is important is that my talk made a difference, at least to one person. It was the best encouragement that I could ever have received. I realized then that even if I spoke to dozens of kids in a dozen different meetings, but I only made a difference in one life, then it is all worth it. Who knows, I may have even saved a life.

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This should never happen to a man

"Ah, I have a big bloody problem" said Mr Jones to nurse Brooke. Nurse Brooke was young, blonde, and just out of college. She had been accepted straight into the emergency room immediately post graduation. This was the hospital's new orientation policy and it was not too popular with some of the staff. The problem was that many nurses felt she should spend at least a year or two in the wards first. But Brooke's easy going personality and good looks, soon won over even the most hardened emergency room veteran. Especially the doctors.

"Well, that's what we're here for Mr Jones, fixing problems" Brooke explained. Mr Jones didn't look at all comfortable with Brooke. He wouldn't make eye contact and kept looking at the floor while grasping his privates. "I don't suppose there's any men around are there?" Mr Jones asked "I've got a problem down below, if you take my meaning, and it's fucking sore." Brooke felt the heat rise up her neck and turn her face bright red. "Ah, sure, I can get a male to have a look. But I really don't mind having a look. I'm a nurse, after-all." Mr Jones briefly made eye contact with Brooke "Trust me, it ain't pretty. But if you can help with the pain, go ahead." By now Brooke's cursiosity was well and truly aroused and she was almost eager to have a look 'down below.' "Well, ok then" Mr Jones began to unbutton his trousers.

I was seeing a patient in the bed next to Mr Jones and had heard everything. I was very curious myself as to what was going on 'down below' but kept out of the way as Brooke had everything under control.

"Oh my god" exclaimed Brooke. "Bloody hell. Be gentle woman" exclaimed Mr Jones. "I'm so sorry. Oh my god. What happened?" asked Brooke. "Don't touch a thing. Don't touch a bloody thing" said Mr Jones. "I'm sorry. I won't touch a thing. Here, let me just put a bit of gauze on it" offered Brooke. Brooke then emerged from behind the curtain and came over to me, her face pale in shock. "Ah, I think you'd better have a look" Brooke said. I wasted no time and went to look at Mr Jones' privates.

"How did you do that?" I asked Mr Jones. I was staring at a very bloody, mangled stump of penis. "Do you know what a Prince Albert is?" asked Mr Jones. I nodded my head, my face wincing in sypathy because I knew what he was going to say next. A Prince Albert is a chain that is threaded down the penis and is then pierced through the wall of the penis and the chain is then joined to form a loop. "Well, it fucking got caught didn't it. It damn near ripped the whole thing off" he said. It didn't really matter how he ripped it off, but I had to know "Ah, but how did you rip it off?" I asked. He lowered his voice so only I could hear "Ah, caught in some machinery, that's all." There was nothing more he would say and nothing more I could do, so went and got the doc.

Doctor Kassner was the senior doctor on duty that night and he was very talented with a needle and thread. Between Doctor Kassner, myself and nurse Brooke we spent the next hour suturing Mr Jones' penis back together. He was then admitted to the ward for overnight observation and sent home the next morning.

Two weeks later Brooke and I were working together again when Mr Jones came in to have his sutures removed. He certainly looked a lot livlier than his last visit although this was probably because his penis hadn't fallen off and he could pee normally. In fact he was in such good spirits that it was with tongue in cheek Brooke advised him that he should not get another Prince Albert. "You're bloody kidding right?" said Mr Jones.

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Moral vs Professional Nursing

Again, we have people complaining that if I can’t do something, a specific nursing task because of my beliefs, then don’t be a nurse. That sounds a little intolerant? The nurse who said this obviously hasn’t thought about all the good things that people can do, without going against their values/beliefs.

Nurses are supposed to be tolerant and caring, but so often we and intolerant to each other. Another important thing is compromise and working things out together. If you have a good team of nurses working together, then it is together that you can work with or around people’s weakness/strengths.

Why does everyone leap down my throat when I even mention about nurses not doing ’something’ I’m not talking about picking and choosing patients, I’m not talking about refusing vital care, I’m just getting people to think a bit about their own values and beliefs and how it blends in with their care, ie Does it affect you.

If you say it doesn’t then you either can’t see it, or you’re lying. It’s our beliefs/values that make us who and what we are, they influence us in every decision we make. Even if it means making the conscious decision to go against our beliefs/values to do what is needed for a patient. By making this decision, we are automatically incorporating our beliefs.

Everything is compromise. It would be nice if those people so willing to suggest I should end my nursing career, just because I dare mention that my own values/beliefs could influence my care, could be a little more caring towards another nurse as well as look at ways of compromising with their colleagues.

The question that needs to be asked is: “Where does professional responsibility end and Moral obligation begin?” For example, a doctor may believe in Euthanasia, while you don’t. The doctor asks you to administer a bolus of morphine. Or perhaps instead of administering morphine, they just withdraw care. What is your obligation? What helps you decide how to react and choose what to do?

What if you were working in a country as an aid worker and female circumcision is commonly practiced? What would you do? What if the patient is accepting of this, even wants this as in her culture this is expected? I’m pretty sure you would be in a moral and professional dilemma.

Overall I am disappointed at the reaction of my fellow nurses, to questions which are supposed to make you think.

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An Unexpected Hurt

I never thought I'd be a nurse. I had no great yearning to heal the sick and comfort the dying. I went into nursing because I thought "Why not?"

After twelve years I don't know what else I could be. I can't imagine not knowing what I do about looking after others. I've even forgotten what it must be like to not know about health and not have an understanding of illness.

What I have found is that I can deal with many sad and traumatic events, and even though it makes me unhappy, I often can keep myself separate from it. But there are times that really do get to me, and it's often the unexpected things. Let me explain...
I remember quite a number of years ago an elderly Scotsman called Mr Donaldson. All the time he was in hospital he never had a visitor. His wife had died several years earlier and his two children lived abroad. He hadn't seen a family member in three years. It wasn't that they weren't close, it was just that neither sons or father could afford to visit each other.
Mr Donaldson had a bowel resection and the formation of a colostomy. He went home two weeks after his surgery. When he went home he looked reasonably well, although understandably weary.

It was near christmas time, and in my part of the world Christmas means summer. This Christmas the whole town was on the street watching as the national pipe band competitions take place. For a whole two hours pipe band after pipe band filed by dressed in full Scottish regalia, kilt, dagger and all.

I was enjoying the parade, and then I saw Mr Donaldson, standing in a shadowed doorway at the back of the crowd. He looked even more pale than when he left. He looked even more thin and stooped. I was close enough to see what looked like moisture in his eyes. His eyes never left those of the pipers. He was wearing a kilt.

I found myself near tears. It felt like this parade was just for Mr Donaldson, as if it was some final farewell.

Another week later and Mr Donaldson was back in hospital. He was anemic, his colostomy wasn't working, and he was coughing up a lung. They took him to the operating room where he died.

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My Final Thoughts in regards to the male/female nursing issue. I've received a lot of grief from other nurses about genearlly not doing female catheterizaion.
I want to tell one more story, which I hope you read. It may really give you some food for thought.

As a student nurse, the school had problems finding a kindergarten placement for me. The kindergartens around the city didn't exactly have a problem with a male nurse, but the parents whose children went to the kindy did. When I finally found a placement, I was warned by the women who worked there that if certain parents come to see/collect their kids, that I should try not to be seen. Some of the parents only sent their children to that kindy because there were no male staff. What is my point?

The point is, we live in such a society where gender does matter. We live in a society where 99% of sexual assault victims are female. In an ideal world, a nurses gender shouldn't matter, but this is far from the case.

Now, when I began my first job, I received a letter in the mail saying I was accepted and was to spend 6months in ward 16. I had no interview, and I do wonder if the hospital management thought my name a female name. I was sent to the gynaecology ward. It was a job, I couldn't turn it down, plus after six months I would be transfered to another ward.

Now, every single patient in that ward was shocked when they realized they had a male nurse. Sometimes this was voiced to me, and other times the patient didn't say anything, but you could tell from their body language, the look in their eyes, their tone of voice, their general discomfort, that they didn't want a male nurse. Even when they said it was alright, most times they were still uncomfortable.

Now, as a new graduate with this extra hurdle, I had a problem. How did I get around this problem? I began by being far more sensitive to my patients privacy than the rest of the nurses in the ward. For example, when checking a surgical wound for a abdominal hysterectomy patient, I would put a towel over their genital area, and make sure I only saw the wound. When assessing PV bleeding, I had a brown paper bag at the bedside they could discreetly put the pads in and I could check them after. Of course I would ask them how much bleeding they had, but we all know how subjective this can be.

Patients did come to appreciate me and my efforts. I never once saw any of the other female nurses do the little extra things I did to make a patient comfortable. In fact, learning to do these things, was one of the best thing that came out of my time in the Gynae ward.

So, when nurses say we are nurses first, and men/women next, I find insensitive. I wonder if the nurses who say this have given thought to the way society is. I know as nurses we try to be above this, but it must be taken into consideration.

Now, as to my not catheterizing women. One nurse said "Why do you need a chaperone? Do you think you might do something bad?" The nurse who said this wasn't thinking about the world we live in. A chaperone is needed, even the male gynaecologists need one, at least in New Zealand.

This then brings up a practical issue. Why have two people to do a job that only one, needs to do. Why have a women standing watching me do a very invasive, intimate procedure on a woman, when I could be doing something useful to help her, while she does the catheterization.

Another scenario for those mothers out there with 16 year old daughters. In many countries 16 is the legal age of consent, and you are considered an adult. Imagine if your 16yr old daughter was approached by a male nurse. You, the mother is not there at the time. It is explained to her that she needs a catheter. She is nervous, but gives her consent. Is she nervous about the procedure, well probably, but I bet she's a damn sight more nervous about having a guy go down "there". She's probably so nervous that she doesn't realise she can say no, even if you say that you can get a female nurse. How would you, as the mother, feel about this?

Needless to say I would absolutely refuse to do this on a young, teenage girl, no matter what, even with a chaperone. It would not be right for the patient and it would not be right for me. I find it so strange to be called sexist because I care what my female patients think. I find it strange to be called sexist because I incorporate my values and beliefs in my care. Isn't that what makes us good nurses, using our values/beliefs to help provide great care.

For those who say that I shouldn't be a nurse because I "Don't do it all," I say to them, Is there anything you won't do because of your beliefs/values? And is all the good, the people that I have helped, the happiness and sadness that I have shared with patients in the last twelve years, is that now meaningless?

I'm sorry to hear that I shouldn't be a nurse because I don't "Do it all." I guess I'm just a failed nurse.

A caring nurse

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A Lesson in Life

"What are they doing here?" said Shannon, "They shouldn't be here. It's an emergency room for goodness sake" she added. I nodded my head in agreement, "Yeah, can't they see we're too busy" I added my two cents worth. At the time I had only been working in the emergency room for six months and I like all good junior staff, I was mimicking my seniors. You see, the problem was that we were ridiculously busy, with every bed full and the waiting time somewhere over four hours.

"I wish we could turn them away" Shannon said. Shannon was an incredibly skilled nurse. She had been working in the emergency room for over twelve years. Not only did staff turn to her when they needed help, but many junior, and not so junior doctors had even sought her advice. "Oh well, they'll just have to wait. Maybe they'll choose to go to their family doctor when I tell them that they will have to wait four hours" Shannon didn't sound hopeful.

What had Shannon so irked was that a mother had come in with her two children, aged four and six, both whom had diarrhoea, and both of whom could have been treated by their family doctor. There were always GP patients turning up to the emergency room and many, if not most of the nursing staff had at some stage vented their varying degrees of annoyance at this to one another. I genuinely felt this way myself at one time. But then that all changed.

A number of years ago one of my young nephews got sick with an ear infection. He ended up at the family doctor's clinic. One hundred dollars later he was sitting at home taking his antibiotics and analgesia. The doctor's fee was sixty five dollars, while the medicines took the other thirty five. My sister could afford it, but at the weekend he got worse and we had to see the emergency doctor. This time one hundred and fifty dollars was spent. Fortunately he got better. Unfortunately my other nephew developed an ear infection as well, and cost another one hundred dollars. We're not rich, we are just a normal family.

Now, when I see people in the emergency room who probably could have been dealt with by their own doctor, I am a different person. I'm a much more understanding person. It's not just about the money, it's about coming to the understanding that people often don't know where to turn to. They come to hospital for many reasons but they all have one thing in common. They are worried. For example: Why would you bring yourself to hospital in the middle of the night when all you have is diarrhoea. It's because you don't understand, maybe even you're scared. Sometimes people just need some simple reassurance and some education.

I do still look up to nurses like Shannon and I do still turn to my seniors for advice, but I no longer parrot their cries of despair at the inconsiderate GP patients. I haven't confronted them about their attitude, and it's too late now as I work elsewhere, but during my last several years in the emergency room I did my best to make those often less urgent patients feel at ease and feel important. I guess it's all about caring.

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I'm a Sexless Professional

I'm a professinal, at least that's what my colleagues say. But what does that exactly mean?
I recently had a discussion with some fellow nurses, all Amercican nurses, and told them that there are certain things that I am reluctant to do as a nurse. One of those things was the female catheterization.
"That's sexist" was one of the more polite remarks I recieved, while one of the more rational arguments was "We are professionals. As long as we behave in a professional way, then we should all have to do the same job." The group of women all agreed on this point. "So, does that mean we are nurses first, then man/woman second?" I recieved some confused looks, then eventually recieved a "Ah yes, well not exactly yes. No, ah Yes." I have asked this same question regarding catheterization of several male nuress, and they all agreed with the women.

Am I the only male who thinks that it is harder for a female patient as well as for a male nurse to do such an intimate procedure? Am I the only nurse who thinks that gender does matter? What harm does it cause if I choose not to do a procedure when there are capable people around who could do it just as well, plus make it easier for the patient.

And what does being a "Professional" mean? From what I'm hearing from others it sounds like I am a sexless machine capable of doing it all because that is what I am paid to do.

Instead I think of myself as a caring carer. I have my faults and biases. I make mistakes and I sometimes let my feelings help make my decisions. But I have a big heart and I do the job because I care first. I enjoy making people laugh when they're sick. I enjoy being able to make a difference in people's lives. I also do the job recognizing my faults, and if I ever think that my views/faults may jeopardize a patient, I know to get someone else to take over that patient's care.

I guess I'm not a very successful Sexless Professional. But I can live with being called sexist and unprofessional, just because I sometimes refuse to do female catheterization. I'm sure there's a lot worse things I could be.

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I think I'm an Elitist

Yeah, I'm quite comfortable saying that I tend to think less of people from wealthy backgrounds. It's this school that does it too me. More specifically, dealing with the parents of the kids whose health I'm trying to look after.

"I want a real doctor" a parent said to me today, "And then I'm going to sue the school." The woman was from Russia. She had begun the conversation by yelling and screaming, but after hanging up the phone on her several times she seemed to get the picture. "And why would you want to do that?" I asked innocently. It turns out that several Russian girls, along with forty other students, went on a school trip to France. The three Russian girls had shared a hotel room and it wasn't until the end of their three day stay that they noticed some itchy spots on random parts of their body. When they came back to school myself and the rest of the nursing staff concluded that they were bites, bed bug bites that is.

"How dare you send my daughter to a cheap hotel.." I interrupted her "Ah, I'm just the nurse, you need to talk to the headmaster" I explained. "Well, the medicine your school doctor prescribed didn't help at all. I want a real doctor. I'm going to take my daughter out of school to see a specialist." I can't imagine what good a specialist would do, except tell them to wash their clothes and bed linen, but I didn't argue. Wealthy parents, especially wealthy eastern European parents tend to like to throw their money around.

The above scenario is not unique. In fact many parents of the above mentioned ethnic group always begin a conversation by yelling, accusing and then threatening, although it does explain why the Russian Mafia do so well, if this is how the average Russian behaves.

But in reality these children and their parents aren't the average Russian. The average Russian/Eastern European I've met tends to be down to earth, honest and hard working, as well as rather poor. What I do know is that these wealthy parents made a lot of money very quickly over the last 10-20years. It's just a shame they've lost their values, although I suspect many of them had none to begin with. It's also a shame that money can't buy common class.

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Trust no one, part 2

I was woken early from my sleep by the phone. It was only nine o'clock and I had been asleep only a hour. "Were sorry to call, but it's urgent" said the woman on the line. It was Sheryl, one of the nurses from the agency. "What's wrong, what's happened?" I asked. I wasn't worried yet as I was couldn't think of anything that I had done wrong. "It's about last night. The hospital is furious" Sheryl said. "Can you give me some idea what it is all about?" I asked, still not too worried at this point. "You'd better come in, it'd be easier that way." It wasn't the answer I wanted. "Listen, give me some idea, or I'm not coming in. I should be asleep, and you want me to spend the next hour traveling to your office, worrying what on earth I have done." After several seconds of silence Sheryl spoke. "They said you prescribed and gave your own medicine, and the wrong dose as well." I felt my stomach lurch. "I'll be right there."
When I arrived at the office I was immediately taken to the manager, Miss Smith. She was very direct and didn't waste any time. "According to the charts you gave a patient voltaren 100mg. She was prescribed only 75mg twice daily. Plus you wrote on the chart that you gave 100mg. You're not supposed to write on the chart." I couldn't believe it. "I phoned the doctor, he prescribed it over the phone. I even phone the night nurse supervisor to make sure that it was ok to take a verbal order." Miss Smith nodded her head, "But what about the 100mg of voltaren? !00mg twice a day is too much." "But she missed out on her morning dose, and we had no 75mg suppositories, so we gave her the 100mg. The doctor did say it was ok." Miss Smith didn't look too happy at my words.
"And can you name this doctor involved, or the night supervisor?" asked Miss Smith. My mind was a blank. I'd had to phone three doctors as well as two night supervisors, none of whom would come to the ward. I shook my head. "Well then you're going to have to find out the doctors name. We've also contacted both night supervisors and both deny ever receiving your call and state that they do not allow verbal orders over the phone." I was struck speechless. My head was in a whirl. I felt that this wasn't really happening. Surely I would wake up in bed and find it was all a bad dream. "Well screw them, screw them all, this is bulshiit, utter lies" I was in a rage now. I have rarely felt so utterly full of wrath. For the first time since I had seen her, Miss Smith looked sympathetic. Perhaps she actually believed me. "Is this normal protocol? Am I supposed to carry out my own investigation? Am I supposed to ring around the hospital and interrogate the doctors and nurses. You've got to be kidding. It's my word against two senior nurses. I don't stand a chance. They are covering their own butt, that's what they are doing."
Miss Smith did believe me, and over the course of the next 24hrs the matter was dealt with. I was not to work in that ward again, or to be in charge again. I do find it ironic that I had never been asked to be in charge and was not only put in charge without my prior knowledge, but was left without another registered nurse to work with.
Eight years passed before I worked at that hospital again, this time in the emergency department, and guess what, they do take verbal orders, hospital policy does allow it. But I no longer take any verbal orders. I learned my lesson the hard way. When you're an agency nurse, you can't trust anyone, especially when the shiit hits the fan.

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Trust no one, part 1

Four years as an agency nurse in London means four years of trusting no one. My worst experience happened at one of London's most prestigious hospitals.
I turned up to work the night shift. The agency had said the hospital was desperate for another nurse. Not exactly encouraging words to hear, but I knew not to take offense. I took the job.
"Thank goodness you're here. It's very good of you to come at such short notice" said the nurse in charge of the afternoon shift. "Have you worked here before?" she asked. I shook my head. "Well I'll show you round then give you a handover." She then introduced me to Sheena and Irene, two nurse assistants that were on for the night with me. Sheena was from another ward and had only worked the occasional shift in the ward. She was only slightly familiar with the place, while Irene was an agency worker as well and had never even set foot in the hospital let alone the ward. "Ah, where's the other nurse?" I asked, naturally assuming that I had another registered nurse to work with. The charge nurse looked a little surprised, "Ah, didn't the agency tell you?" she said. I shook my head. "We couldn't get another nurse. You're our RN. You're inc charge tonight." I felt like I was in some kind of bad dream because this just couldn't be happening. I took the tour de farce with the charge nurse then began my shift.
Sister Grant in the side room was an seventy something nun in need of some pain medicine. According to her drug chart she had not been given her morning dose of voltaren. Voltaren is a analgesic similar to Ibuprofen. The drug was to administered as a suppository, or bullet up the backside. I was presented with several problems:
1. I was not going to near the private parts of a nun. She would be horrified.
2. She was prescribed 75mg of Voltaren twice daily. According to her chart she had missed the morning dose. The patient also said she had not had it.
3. We only had 100mg suppositories. I could give her the 100mg as she had missed her morning dose, but would need to get the prescription changed.

I tried to solve the problem by phoning a doctor. I called the medical doctor on duty that night to come and change the prescription. He said that I needed to call the surgical doctor as it was a surgical patient. I then called the surgical doctor who said it was a gynaecology patient. I called the gynae doctor who told me that because he was a private patient, originally under the care of a surgical consultant, I should call the surgical doctor. Needless to say I was rather confused.
After ten minutes I finally managed to get a doctor who agreed that she was his patient. He was the medical doctor. It turns out that Sister Grant began as a gynaecology patient, which unsurprisingly turned out to be a general surgical problem. The surgical problem was solved but she then developed a medical problem, and was then transferred to the medical team. The doctor then said that he couldn't come to the ward as he was too busy and offered to give me a verbal order to give the 100mg voltaren suppository. I said I'd call him back as I wasn't sure if I could take a verbal order.
I then tried to phone the night supervisor for some advice. I was put through to the first advisor, who advised me that she was responsible for the other side of the hospital and gave me another number to call. I finally got through to the correct nurse supervisor. I explained the situation with Sister Grant. "Can I take a verbal order?" I finally asked. "Yes" she said. I called back the medical doctor and said I would give the 100mg voltaren suppository.
I asked one of the assistants to give the suppository and the problem was solved. Or so I thought.
My real problems began the next day.

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Surely I was never this stubborn???

I first met Shaun at seven o'clock the morning after his surgery. It was a Saturday and the ward was quiet, it looked like it was going to be a nice shift. When I saw Shaun he looked to be in pretty good shape as he was nibbling at something light for breakfast and keen to get moving. He seemed to have had no lasting side affects from his anaesthetic, in particular any nausea, and his pain seemed under control. This was a good sign, it's always good to get patients moving early, but I did warn Shaun to take it easy.

“Take it easy? The sooner I get out of here the better.” Shaun was determined to get out this damn place because it was “full of depressing old people.” I couldn’t do much about the fact that he was sharing a room with three older men, but it wasn’t so bad. Sure one of them had a touch of night time dementia and kept getting up during the night calling out for his long dead wife, but at least he wasn’t in the women’s room. Any time anyone walked into the women’s room Mrs Stewart, the 85 year old nun on prescribed bed-rest because of leg ulcers, kept on calling for us to stop touching her in naughty places.

The first thing that Shaun wanted to do that morning was to have a shower. “No problem Shaun” I told him, “but are you sure you are up to it? Why don’t you wait until a bit later in the day, you’ve only just come out of theatre.” Shaun was not going to wait. I then suggested that he use the large shower room that has a chair in it that he can use, but he would have to wait half an hour as other patients were booked in first. Of course Shaun was not willing to wait; he was determined to use the normal size shower with no seat inside. I suggested to Shaun that this was perhaps not the best idea as the shower is hot, steamy, cramped and with no ventilation, he would probably pass out. Shaun seemed to think that he knew what was best for his body and ignored my advice, he was oblivious to reason.

From past experience I knew to wait outside Shaun's shower cubicle. Five minutes later I heard a ‘thump’ followed by a squealing sound that comes when skin rubs against wet plastic. These were the sounds of Shaun first hitting the wall and then sliding down the wall to lie in a tangled heap on the shower floor. As I helped bring him round I conveniently happened to have a bowl in my hand which Shaun promptly threw up into. I popped him in a shower chair and wheeled him back to bed. He was so pale that he would have made a ghost look tanned and he had broken out into a cold sweat.

As awful as Shaun looked it was nothing serious although I made sure he hadn’t done any damage to his would. Thankfully he hadn’t but he was in quite a bit of pain, what a surprise. I didn’t even pretend to feel sympathy for him but did give him some paracetamol.

Even though an appendectomy is quite a minor operation, it still takes a toll on the body. Not only have you been sliced open and had some innards taken out, the effects of a general anaesthetic can take its own toll on the body, even if you feel well. I have not had this problem with older men or woman of any age as they seem to listen to advice.

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