Confessions of a Male Nurse

by Michael Alexander

  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.’

  The ego

  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 incorrectly 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.

  Bad news, good porn

  ‘You’re a man,’ someone said to me when I explained that I was the agency nurse for the afternoon.

  ‘Last time I looked,’ I replied.

  ‘I can make good use of a man,’ she added, a thoughtful expression on her face.

  The woman with the acute observation skills was Stephanie, the charge nurse for the afternoon. I took notes while she read off a list of patients, their problems, and divvied them up among the four other staff nurses. I waited for my names, but received none.

  ‘Um, Stephanie, you haven’t given me any patients.’

  Stephanie smiled and nodded her head.

  ‘That’s right. I’ve got a very special patient, just for you.’

  ‘But, one patient?’ I added, wondering what exactly she meant by special.

  ‘Oh, don’t worry. We meant to cancel you, but never got around to it, so we’re one staff up. Don’t panic – we treat our agency staff well here.’

  The patient Stephanie was going to give me was a young man who was away from home, alone, and had been in hospital for eight days. He had just turned 18.

  Stephanie took me to his room and introduced him to me as Jan.

  I immediately found myself unable to take my eyes off him –even though I had known what I was going to see. From the whites of his eyes to his bony ankles, Jan was yellow.

  ‘As you can see, he’s extremely jaundiced,’ Stephanie explained. ‘The doctor is very worried about him. We should be getting some test results today.’

  I’d seen plenty of adults with Jan’s condition, whether due to liver disease, obstruction in the ducts to and from the gall bladder, or cancer, but I had never seen an 18-year-old boy with such discoloured skin.

  The yellowish pigmentation you see in jaundice patients is a result of the liver’s inability to remove bilirubin. Bilirubin is made up of red blood cells which have naturally broken down. It combines with bile (which is produced in the liver) and is normally excreted in the bowel motion (it’s what gives a stool its yellowish/brown colour). If this process is impeded, the build-up makes the skin turn yellow.

  ‘Hello Jan,’ I said.

  Jan looked at me with a smile on his face. ‘Dzien dobry, hello, hello,’ he replied.

  ‘How are you?’ I asked.

  ‘Dzien dobry, hello,’ he repeated.

  I looked over at a sheepish looking Stephanie.

  ‘His English is not the best,’ she confessed. ‘I think he could do with some male company. He’s had nothing but women around since he’s been here.’

  I knew some people who would pay good money to be surrounded by women all the time, but I suspected Stephanie had a point.

  ‘We have an interpreter coming in about half an hour. The doctor is going to give him the results of the tests he has had done,’ Stephanie said before leaving the room.

  What does one say, or do, with a yellow-tinted Polish teenager who has very limited English? Speak slowly and loudly.

  ‘I.Am.From.Neeeew.Zeealllaaaand.’

  Jan looked at me. His brow was knitted in concentration, but there was no sign of comprehension.

  ‘Do.You.Need.Anything?’

  I still saw no indication that he understood, although he was smiling – obviously enjoying the entertainment. I was about to ask something different, when Jan interrupted me.

  ‘You are funny. When the doctor here?’

  His English didn’t seem so bad after al
l.

  Half an hour later, two women accompanied Stephanie into Jan’s room. One had the usual white doctor’s coat and was introduced as Dr Brown; the other was dressed in casual, but tidy clothes. Her name was Kasha and she was the Polish interpreter. No one was smiling; in a flash the mood changed from awkward and amusing, to sombre and serious.

  ‘We have the results back from your tests,’ Dr Brown said.

  Everyone waited while Kasha translated.

  Jan nodded his head.

  ‘I’m afraid it isn’t good news. You have cancer of your liver.’

  After Kasha translated Jan sat there unmoving, silent, staring ahead.

  ‘Can you treat it?’ Jan asked through Kasha.

  ‘We can try. We want to begin treatment tomorrow. I can’t promise you anything. It’s looking very serious and I’m sorry to say, but there is a chance that treatment may not work.’

  Rarely had I heard such blunt words from a doctor. Normally they were a bit more diplomatic, usually waiting until treatment had begun before talking about success or failure. For Dr Brown to be so frank the cancer must be well progressed. Jan seemed to come to a similar conclusion.

  ‘How long have I got?’ Jan finally asked Dr Brown.

  There was no answer.

  I looked at Stephanie, she was staring at the ground. The doctor sat on the bedside and clasped Jan’s hand.

  ‘We don’t know for sure. The sooner we get started, the better.’ The translator stumbled over her words and had to repeat herself. But the answer wasn’t good enough for Jan. He again asked how long he had.

  I could see Dr Brown struggling with an answer, but Jan again insisted on a time frame.

  ‘Maybe a year. Maybe four months,’ Dr Brown finally said. ‘But we don’t know for sure. You could respond well to treatment. It’s just too early to tell.’

  Jan’s calm exterior cracked and tears streamed down his face. I sat down at the foot of the bed, my legs weak. Stephanie and Kasha sat down as well and grasped Jan’s hands in their own. No one spoke.

  Eventually Jan’s whispered voice filtered through: ‘Mum and Dad will be here in two days. Don’t tell them anything yet. I don’t want them to worry.’