Never in Twenty Years

Where should the line be drawn? It's only a rehabilitation hospital, not much more than a rest home really. They're not my thoughts, but from what I've seen and heard, that is the impression I get from the staff working there. It just goes to show how much the staff, the nurses that is, can make or break a place.

The hospital looks nice. It looks modern, both on the inside and out. It looks clean and looks well stocked with all the equipment needed to help patients recover from a multitude of ailments. It even passed my bathroom inspection. One of my most important criteria when it comes to judging a suitable ward environment is if they have a big, open, wheelchair accessable shower and toilet. You may think there are other more pressing priorities, but when you've got ten patients to wash before lunch, an easy access shower is a big deal.

The staff looked experienced. They all had grey hair and over a cup of coffee would relish any chance to relive nursing stories, especially horror stories, from days long past. They remembered the days when doctors' were gods, nurses servants, and patients did as they were told. Unfortunately they nearly killed a patient due to complete ignorance.

Mr Jones' chest pain began at 8pm, but he only told the nurses at midnight about his pain as it had suddenly become worse.

"We don't do that here" said Rose. I ignored her remark and placed the oxygen mask on Mr Jones' face. "You can only use the nasal cannula, were' not permitted to give any more oxygen than that. You need to take that mask off now." Rose was standing at the end of the bed, where she had stood for the last ten minutes, not helping me in the slighest.

I had given the patient his GTN (angina medicine) with no effect. His ECG (heart tracing) showed ST depression in all leads (sign of heart not getting enough oxygen) and had called the doctor who was coming in from home and was twenty minutes away. The doctor had given me specific insturciton on what to do, and I followed them exactly. It wasn't hard to do as I was doing what I had done thousands of times before in all my previous years in many different wards, and often in the emergency room.

I had the oxygen up high and asked Rose where the intravenous equipment was. "We don't do that here, this is a rehabiliation hospital" Rose repeated. I realised that I had to do this on my own. I used the IV equipment from the emergency resuscitation trolley and quickly inserted the tubing into a vein. I then drew up some morphine, Rose very reluctantly consenting to sign the stuff out of the locked cabinet with me because "We don't do that here" she said again.

The oxygen helped get the pain from the an 8/10 to a five and his ECG showed some improvement, but it wasn't quite right yet. I administered the first of the morphine, 2mg to start. Within five minutes the pain was down to a 1/10 and the ECG looked almost normal. By this time Dr Gates arrived.

Dr Gates was also a new doctor, only in his second week on the job, so he was caught off guard by Rose. "I'm not at all happy about this. I'm going to have to speak to the head of department. You can't do that here. I know you're the doctor, but we've never done this. It's a rehabilitation hospital."

By the time Dr Gates had extricated himself from Rose Mr Jones was pain free. He had a look at my collection of ECG's and congratulated me on a job well done. Rose was there, arms crossed, face red in fury as Dr Gates said this. "In twenty years we've never done this" was all she could say. Twenty years and you've never saved a life?




I guess after twenty years in one place, with