I wrote a few months ago about being on the other side of the bed when my father became ill. Always a strange dynamic when your role in the family changes and you find yourself almost being a parent to a parent. The first wave of the pandemic had hit us and we were coming through the other side but the aftershocks were still very much there and it was strange having to liaise and support through the restrictions and limitations the pandemic threw up.
Then here we are entering our second wave but with the encouraging news that the vaccine is now available and hopefully this time next year we will have turned our backs on C-19 and only have it as a memory of “do you remember 2020?” Despite entering wave 2 life was starting to get back on track, the children were all back at school and settling into a routine finally. Work was settled and no longer the fear around “what ifs” – we were learning to live with the pandemic and coming to terms with the fact that it would be with us for a while yet.
The bakery continued to be busy throughout both waves and still is, we are now providing to a number of businesses and the most difficult aspect is not having enough hours in the day rather than worrying about not having enough work! Life felt different… Life felt still cautiously hopeful… We were adjusting to the new normal that was developing.
About to start on a set of night shifts I thought I would clear my head and take the dogs out for a walk. It was a freezing afternoon – lots of fog but a good bit of self-care before the commute into London to do my on-call work. All was going well, even boisterous Raffles was exploring but recalling well, having a friendly play and then returning to me to tell me what a good boy he was. Rolo lolloped along, happy to be on the show but as ever struggling to keep up – his arthritic bones slowing down play much to Raffle’s disgust. In my mind I thought shall I go straight home or just nip to the yard – give Connie a cuddle as I wouldn’t see her for a couple of nights? My gorgeous mare has kept me sane throughout lockdown and before, providing wonderful escapism for a ride around our countryside forgetting all the strange things that were occurring in the rest of the world. Her life is simple – hay, grass, food, quick brush, hack if you really want to, more food, more hay, more grass – oh to be a horse…! As it was foggy I decided to cut through on a footpath – well trodden and have lost count of the number of times I have walked down there. I don’t know if it was the shock of the dogs actually walking to heel, or if it was that I didn’t want to walk any. more but something went horribly wrong. One minute chatting to the dogs and then the next in slow motion a slip in the mud – ok this is ok… I’ve got this.. have I got this… oh bum I haven’t…that hurts. Before I even collapsed on the ground the sound of a “CRACK” was all it took to know I had done something bad. Pain was intense – more so than when I broke my ankle a few years previously and then as I looked down at the foot – you know when you see the shape the only place you are going is A&E! Raffles immediately took control of the situation, intuitively sat down beside me and didn’t murmur – Rolo however as senile as ever proceeded to jump on me – why you lying down mummy – and in doing so knocked my leg with his full weight – good job no one was around – language rather blue!!. My phone for once was a) charged and b) had a signal and c) someone at home answered ( 3 miracles! ). With the help of a Good Samaritan, he, my son and my husband managed to get me up and carry me to a bench where we attempted to see if an ambulance could come to my aid. As many are aware they are as rare as the proverbial currently and especially in the current climate. Overstretched services and not enough to go around, I was not a priority and so faced a 5-hour wait. We made the decision to try to get me in a friend’s car and travel ourselves – it was a bit of a job but we managed it and I was grateful to be on my way to help. I suspect the A&E staff had assessed me prior to arriving in the actual dept as I screamed my way in, carried by my friend and husband in semi-fireman’s cradle as this time hopping on one foot wasn’t an option.
Leaving me at the door, Andrew found it tough – you are on your own now due to restrictions and have to trust that strangers will look after you. For him, he had to trust that these strangers would look after his wife. My first realisation was how so many of the patients that I have triaged into hospital during the pandemic must have felt, scared, vulnerable and in pain trusting that people would be kind. I was going to have to go it alone. My only priority was to get pain relief – I knew what the X-rays would show but was anxious as unlike my ankle a few years previous this had felt and sounded very different and before I left Andrew to be taken to triage all I could do was say I was sorry – here we were again. lt also did make me realise because as nurses we are so familiar with the surroundings and how things work at hospital I think we are all too dismissive of how massive it feels to be in other people’s hands. Everyone was fantastic and despite being very busy were very approachable and supportive, reassuring and calm but it wasn’t the same as having your loved one by your side and the emotion took over – not sure if I was crying from pain or from fear. I know how the system works, and I can recognise what everyone’s jobs are before they introduce themselves and what they will be doing for me as I take on the persona of a patient. I understand the terminology and, I think, can advocate for myself pretty well, I am lucky, many other patients coming through A&E at the same time as me may not have that insight and must be terrified. .It also really does surprise me how quickly you adopt the “patient” role, how immediately I handed myself over to others, without question but with the expectation they would make the right decision for me and all would be fine.
The A&E team were fantastic – a finely oiled machine kicks into play everyone with their role, all getting on with it without direction but all-knowing who was doing what. Immediate analgesia before I could even ask for it in a swanky new device to me – certainly not given 3 years ago when I was in last – Penthrox, like Entenox but so much better!! In a cubicle right next to X-ray meant I was in there within 15 minutes of arrival and within half an hour X-rays were read and diagnosis given, very slick. The male nurse looking after me had only been qualified less than one year and I have to say was a credit to his University and training, as well as his youth! His manner was so reassuring and his skill very high – cannulation in someone dehydrated, in pain and scared is always a challenge but he mastered it with sleek precision – I congratulated him. Terrified me as he explained they would need to stabilise the fracture I begged them not to touch my leg, but again he mastered the situation like someone who had been qualified decades and administered IV analgesia with precision, accuracy and just sufficiently enough to get the job done but not have me away with the fairies, although I was a bit slurry. The orthopaedic team arrived and explained I would be admitted ( thank god! ) with surgery, the next day hopefully, as this needed more than a good pull and some plaster for 6 weeks. Discussion around whether there should be a concern that this was my 4th episode of fractures in 5 years and practical solutions as to how we could assess to move forward. Suddenly the realisation hit me, just as we were feeling we were getting ourselves back on track we would be facing a period of no earnings from me and a longer recuperation than had been anticipated – internal swearing on my part which was a polar opposite to the external vocal that had happened on my arrival!
The next shift arrived and a nurse more my era of qualifying (ok – my age !) took over. The pace could slow down a little now as waiting for a bed may take some time. I fed back how impressed I had been with the newly qualified nurse previously and asked her to tell him the next shift they were on together. So important to give praise as it’s often forgotten or assumed, but means so much I think. We talked about “old style” training and the new student cohort they had through the department and the challenges they faced especially during the pandemic and equally with staffing levels. But she had come to the UK to work over 20 years ago, initially for a short period, but fell in love with the place and never left – a good testimonial indeed.
We talked about that day’s news of the vaccine, fears of patient positives increasing in the last week and also recognising that patients and staff seem more blase about C-19 this wave which we both agreed was quite worrying. Bloods and Covid swab (negative) came back – kind of predictable the latter as weekly tests at work, but always good to know seeing as number 1 son had just finished isolating for 14 days as a classmate had come down with it. The question that went through my head was I may have come in negative but will I leave the same??
Up onto the ward and reality hit – green ward so no covid in my bay but I was the youngest and most lucid there which is rare on both counts! The elderly ladies on my bay were so vulnerable, disorientated and unwell – sad to see. More conversations with the nursing team I think pleased they had someone they could talk to that a) they didn’t have to shout at and b) didn’t forget what they said 5 mins later – mind you that is unusual even for me, must be the drugs!! My nurse for the day looked about 12 and confirmed this annoying youth when she asked me when I qualified promptly following the answer up with “Oh that’s the year I was born” … Oh how we laughed – turns and cries into pillow!!
So, a day later than planned I go for surgery, spoilt by the number of people that came to see me pre-theatre – 3 anaesthetists, 4 surgeons and a plethora of medical students all with their marker pens ready to “mark up the leg” bitterly disappointed as A&E orthpod had beaten them to it. I think I was supposed to guess which one I would meet in the actual theatre which turned out to be a different anaesthetist and a different surgeon – not to worry variety is the spice of life! One thing I wasn’t prepared for was I was awake throughout the whole op – spinal only. I was rather anxious about it but actually really shouldn’t have been as it was incredibly straightforward and meant none of that horrid zoned-out period in recovery. Having said that the anaesthetist did give me an early Xmas pressie which gave me a short little sleep when they were doing the noisy drilling bit for which I was very grateful. I still can remember my first hip replacement surgery I observed in my training – which happened in the Crimean war obviously (!!) the black coming round the corners of my eyes before passing out as the surgeon shouted “somebody catch her”!
Observations from this side of the bed…
A patient is a patient no matter what they do in the real world – same fears and same anxieties
Culture seeps through the walls – there is a great sense of teamwork and mutual respect here which immediately makes you feel safe
Kindness outshines staffing numbers I would say staffing is on the low side here, particularly at night, but when you see them taking their time to sit with a lady who has dementia, helping her have a cup of tea or giving her lunch, showing her respect and reassurance, you don’t mind waiting an extra few minutes for your bell to be answered.
Professionals are vulnerable too Just because you are in the profession doesn’t mean you aren’t vulnerable – I had to ask the sister to ensure a member of the wider team didn’t come and see me this admission. I had met him 6years previously when he was a charge nurse on the ward I was on and again a couple of years later when I returned back. I’m sure to many he is very good, but for me I found him arrogant, patronising and best to be avoided. She handled it sensitively and at no point dismissed my concerns.
Referral to the NMC isn’t obligatory Point 4 shouldn’t mean an immediate call to refer said nurse to the Nursing and Midwifery Council. As in life, we can’t expect to get along with everyone we meet. Equally, we need to appreciate that not all patients will like us. I had to remind myself I have a choice over who does or doesn’t look after me – I don’t have to “take what I’m given” or be worried about saying when I don’t feel comfortable with a member of staff. My decisions need to be respected as long as I am respectful too. Gosh if I feel like this what about the frail elderly lady across from me who can’t?.Despite my feelings towards previous contact I have had with him, even he deserves kindness.
Perhaps if our paths cross again he will have reflected, shown some insight and perhaps even some remediation….