I pulled back the curtain and my three remaining patients had gone rather pale. I couldn’t help but smile. They turned paler still. The sight of a grinning male nurse with an enema in one hand and a roll of toilet paper in the other must have been pretty frightening.
‘That’s bloody murder, what you done in there, boy,’ said Simon, his voice trembling.
Daryl made the sign of the cross. I imagined bursting into a macabre sort of laugh, but held myself in check.
I approached my next victim – Daryl. He had nowhere to go; he was trapped in the corner.
No one got away that night.
Several years after this incident, I found myself in a urological ward in a large London hospital preparing to give some men their pre-surgery enema when the doctor in charge asked me what the hell I was doing.
I explained that this is what we were instructed to do at home.
‘That went out with the dark ages; it hasn’t been used in years, unless there is a specific need.’
What our surgeon had prescribed was fine, but procedures and protocols change, and some doctors don’t change as quickly as others – certainly not quick enough for Joe and the rest of the lads.
Dr Baker
Like most professional environments, in hospital wards you have to learn to work with all sorts of people, even people who may be difficult or even unpleasant to be around. However, sometimes when the work pressure is particularly intense, cordial relationships are not always possible. When this happens in my line of work, everyone can suffer.
Dr Baker had been the head urologist at the hospital for many years. He had worked so long and so hard for the local urology patients that nearly every man over fifty knew of him. The old men only talked good of Dr Baker, and I can’t say that I blame them. He was the only urology surgeon that the city had, and he had saved a lot of lives and improved the quality of many more.
The New Zealand government had decided that the urology waiting list needed urgent attention. Many elderly men were pottering around their homes with a tube up their penis for more than a year, and during that year, many of these men had also presented to the local emergency room with blocked catheters, urine infections, bleeding, or a combination of all three.
The solution was simple. We got funding for 40 extra prostate operations, which would need to be performed over three weeks, on top of an already full surgery list.
Forty prostate operations is a huge amount to undertake in three weeks. Performing this many would keep two or even three normal urology surgeons busy for that time. It isn’t just a matter of doing the actual surgery; it’s also a case of making sure patients recover with as few complications as possible.
The ward only had 26 beds. Considering a common stay for a prostate operation was between four and seven days (and that doesn’t take into account the extended stays due to complications such as excessive bleeding or infection), this certainly seemed a tight schedule. It was nice of the government to give us the money, but it would have been nicer still if they’d given us some additional doctors and nursing staff to get us through those three weeks. Instead, all operating fell upon the shoulders of Dr Baker.
Dr Baker went into a prostatic trimming frenzy. He would begin operating at seven in the morning and when five o’clock came around he just kept on snipping away. Time meant nothing to him – he continued to operate well into the night. He reminded me of Dr Frankenstein working feverishly in his lab. The theatre staff said they had never seen him quite like this before, he was manic – and even more-short tempered than usual.
With such a large volume of patients being put through the system, the amount of work for the nursing staff, as well as the junior doctors, was also immense. We were overrun with patients. Everywhere I looked I could see them comparing notes, deciding whose urine looked the least blood stained and whose the most. The old boys were pottering around cautiously, always careful not to stretch their urine bags too far, get tangled up in the tubing, or forget the whole thing altogether. It always made me cringe with sympathy whenever I saw someone forget their catheter bag and then be literally pulled up short by their manhood.
To make matters even worse, we still had other non-urological patients to care for. There were still the odd general surgical patients as well as the medical patients, plus two days a week we had to take new patients from the emergency room. I had a tough job making sure I didn’t forget about my non-surgical patients, but there was one person who felt the brunt of the frenzy more than anyone.
Lisa was the urology registrar working under Dr Baker. She had been working for him for six months as part of her surgical rotation and she was having a pretty tough time of it. The problem was not just the work, but because she was female. Everyone knew Dr Baker was irritable with his female staff.
‘I can’t keep on like this. There’s too much work to do for one doctor,’ Lisa declared.
Lisa was in tears after the Saturday morning ward round. Lisa wasn’t the first and definitely wasn’t the last female doctor to cry after a ward round with Dr Baker. At his best, he was barely tolerant of women, but in the event that something was not done his way, then any woman involved would get a verbal battering. I’d sometimes make the same mistake as a female colleague, like leaving the catheter tubing on top of a patient’s leg, instead of under it, and he wouldn’t say a thing.
No one knew why Dr Baker behaved this way towards female nurses and doctors, although there were plenty of theories. Mine is that he felt women should be subservient to men. I got this impression from the way he would order women to do tasks, but he would ask me politely. At other times he would only ask me to do certain jobs, complex jobs which he usually did himself, like flushing blocked catheters. I could easily see Dr Baker working in a ward 20 or 30 years ago, where nurses had firm boundaries to what their jobs entailed, and where the ward sister controlled the place like a military barracks. I could even imagine him having the nurses standing at attention while this god-like being did the ward rounds.
All that really mattered was he made an already challenging job much more difficult and unpleasant.
‘I can handle working for such an unpleasant man,’ Lisa began, ‘but he’s left me to do it all. I hardly ever see him.’
Lisa went on to explain that aside from this morning’s ward round, she hadn’t seen or been in contact with Dr Baker all week. He wouldn’t answer her calls, and made no effort to contact her. She felt she had no support and was worried that she would make a mistake.
I asked Lisa if she’d let me tell the other nurses how she felt. She was reluctant at first, but when I explained that she wasn’t alone, female nursing staff had admitted to having problems with Dr Baker, she agreed.
Everyone was furious, and instantly agreed to do their best to help Lisa get through the next three weeks.
The problem was, it wasn’t only Lisa who was being affected by Dr Baker’s behaviour. The hectic period was shaping up to be just as crazy as we’d imagined, but what we hadn’t expected was that Dr Baker would start to act a little crazy himself.
It was late that night that Dr Baker visited to check how his patients were. Well, they were asleep, like all good patients should be at 11 p.m. It was cruel, but I had no choice, so I turned on the light. Two of the old boys never noticed a thing and kept on sleeping, but the other two patients in the room woke with a start.
Dr Baker was keen to check the irrigation system on each of his patients. This system involved a bag of fluids, which were slowly infused up the catheter, flushed around the bladder, and back out the tubing again. The catheter in these cases had two, sometimes three separate channels to allow this to happen. Nearly all Dr Baker’s patients had this in place. It wasn’t until moving to London that I discovered that this practice was not the standard for everyone any more but usually reserved for the more serious cases where there is heavy bleeding.
Dr Baker always liked to give the tubing a gentle but firm, steady tug. He would then adjus
t the rate of the intravenous fluids as well as the irrigation fluids before wandering over to the next patient, usually without washing his hands, and having a pull on their tube.
His patients didn’t know what was going on. Wouldn’t you be a touch confused, waking up in a strange environment to find someone pulling on your private parts?
The last few nights had been bad enough with Dr Baker turning up at 10 p.m. to do a ward round; 11 p.m. was going too far. Dr Baker needed to be told to do his ward rounds at a more appropriate time, but I didn’t have the courage to stand up to him.
‘Tell the charge nurse,’ Sheryl suggested one night at 11 p.m. when Dr Baker had just left. ‘She’ll have a word with him.’ Sheryl had been working on the ward for five years, and was a valued member of the team, but she wasn’t ready yet, either, to confront Dr Baker herself.
When we told our charge nurse what was happening, the first thing that came out of her mouth was, ‘He’s mad.’
She told us we did not have to accompany him on ward rounds at such ridiculous times and promised to speak to him.
Still, however, the following night Dr Baker came around at 11 p.m. and no one had the courage to protest. We weren’t sure how he would react to a forward approach, so instead we came up with another strategy that would keep us out of harm’s way and prevent us from having to do the ward round.
‘He’s coming, quickly everyone, move.’
Every nurse in the ward disappeared into the woodwork. Some hid in the sluice room, some in the treatment room, while Sheryl and I hid in the kitchen. Great plan – we were hiding like a bunch of disobedient kids. The girls were even giggling like school children.
In the silence of the night, the clip clop, clip clop, clip clop of Italian designer shoes could be heard restlessly pacing up and down the ward. Suddenly the kitchen door swung open – we were going to be caught! However, by some miracle Dr Baker didn’t bother to look behind the door. It must not have occurred to him that anyone would try to hide from him. As the door swung closed there was a collective sigh of relief.
‘This is bullshit,’ Sheryl said. ‘We’re supposed to finish at 11 p.m., and I’m not wasting any more of my time.’
She decided she was no longer going to avoid Dr Baker and followed him out. I wanted to stay hidden, but with a morbid sense of curiosity, I crept out to watch the confrontation. It was the least I could do to support her. I wasn’t alone; all the nurses crawled out in meagre comradeship.
‘We have been instructed not to do rounds with you at these times,’ she opened, with impressive assertiveness.
Dr Baker was silent. I almost thought he was going to have a heart attack. His face didn’t register anything at first. He took a step closer to Sheryl. I thought for a second that he would hit her.
‘You won’t have a job after today, none of you will,’ he hissed.
Sheryl turned her back on him and walked into the office. The battle was over and Dr Baker stalked off.
The next night, no one knew what to expect: would he turn up late again? Six, seven, eight, nine o’clock went by and he didn’t arrive. Things didn’t look promising; I felt sure he was going to do his late night rounds again. Ten o’clock passed, then eleven, and still no sign. Dr Baker didn’t turn up at all that night. In fact, he didn’t come for the next two weeks.
The entire ward workload fell upon Lisa’s shoulders. She had to decide who was well enough to go home and how best to treat the complications that surely arise when so many operations are performed.
We did all we could to help her out, but she still came close to breaking down – she would turn up each day looking exhausted, her shoulders slumped, her eyes puffy.
I don’t know exactly how but we managed to get through all those operations without anyone dying. When the last of the operating patients was discharged, Lisa promptly quit her job. She headed to a bigger city, where she found a consultant who didn’t mind having women on his team and knew how to adhere to the rules. I was pleased to discover she stayed in the surgery field, although not urology; she was one of the bravest and strongest doctors I had ever met.
III
London calling
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.
Filling in
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.’
Confessions of a Male Nurse Page 7
