Cup of Tea

Once I started university, it was only a matter of weeks before our first ward placement started. Some of the girls had already been working at the hospital as Health Care Assistants and were fully accustomed to the routine of ward work. But for those of us that weren't, the experience was extremely daunting. For much of the shift it felt like I was wandering aimlessly, with no real idea of what was expected of me. As has been the case for many years, the wards were running on low staff numbers, so the nurses just didn't have the time to guide us through a whole shift. I was relieved back in the classroom, when I realised I wasn't the only one who felt this way. One of the lecturers who had interviewed me told us this was very common and that when she was a ward sister she used to keep a washing up bowl at her nurse's station. When the nurses were dealing with patient needs that required qualified staff, she used to ask the anxious student nurse to go and get that bowl. It served no other purpose than to allow the student to feel useful and part of the team. This was reassuring but didn't help when actually faced with real life issues on the wards that sometimes needed immediate action.

My first experience of this was in theatre. I had accompanied Steve, a 40-something male patient down from the ward and had taken my place to watch the procedure. I usually liked surgical placements as there was a defined sequence of events - prepare the patient, walk to theatre alongside them, change into scrubs, watch the operation, assist them to recovery and eventually go with them back to the ward. It felt more meaningful than pottering about on a medical ward with no confidence and no clue of what you were supposed to do. On this day, I had watched the anaesthetist expertly sedate Steve before he was intubated. Normally, this looked like a quick and easy part of the theatre experience but this time a panic spread. One of the Drs started yelling at me, 'Tilt the bed, tilt the bed, he's aspirating!" At this point I had only been a student nurse for a month and had been told nothing of tilting beds. I looked at him feeling embarrassed and useless while one of the staff nurses hurriedly pulled at something on the bed. Once Steve was safe, she calmly and kindly explained to me that there are levers at the end of each hospital bed to tilt them head down. This is to prevent stomach fluid entering the lungs which can occur during intubation. Once the operation was over, I discussed the situation with the ward sister. She too was very supportive and reassured me that if I hadn't been taught, how could I know? She asked me to remove Steve's cannula later that night which I did, according to him 'like a gentle angel'. This only went a small way in making me feel less foolish that day.

As time went on, I began to find my way in hospital work and a cameraderie with the other student nurses. One evening on a geriatric ward, Kelly, a fellow student, and I were turning the patients. Turning means to change a patient's position, if they are unable to do so themselves, in order to avoid pressure sores. I had stolen my sister's shoes without her knowing as she had some really nice DMs and when you're forced to wear the uncomfortable polyester student uniform, nice shoes is all you have. I was on one side of the bed facing Kelly preparing to turn Betty onto her right side. She was a tiny lady so this should have been a swift and easy manoeuvre for us. However, as we rolled Betty, the movement caused her to land what can only be described as an enormous human cowpat in front of my foot. With the momentum of the move, I had no time to change direction and stepped directly onto it. I froze and looked up at Kelly who stared at me and said 'You've just stepped in it haven't you?'. We both burst out laughing and I had to wriggle my foot out of the shoe and leave it in the pat, while I hopped around to find wipes and a clinical waste bag to deal with it. I managed to get the shoe clean but never told my sister. Sorry Charlotte.

During our second year we had a placement working in A&E. This was obviously more fast-paced than ward work and was deliberately scheduled at a time when we'd become a little more experienced. I remember two patients in particular from this placement who had an impact on me. The first was a man called Anthony, brought into resus by ambulance. He had been found collapsed at home and nobody was sure how long he had been there. Anthony was quickly moved onto a bed and I was told to begin chest compressions. I looked down at this poor soul before me. He was mottled, blue and had clearly been lifeless for some time. There was no way I was arguing with a Dr though so did as I was instructed. Compressions need to be done with straight arms to allow your body weight to provide the strength (something that always annoys me when I see it done badly on TV). This means that you need to be significantly higher than the patient so another Dr brought me a stool to stand on. We worked on Anthony, with me compressing and a Dr providing oxygen through a resus bag and mask. Until you've done CPR you don't realise how tiring it is and, knowing this was a futile task, I was tempted to slow down or stop completely. However, I was clearly visible to the other staff, being raised on my stool so was determined to keep going. Despite our efforts, Anthony sadly couldn't be revived and was pronounced dead.

The second patient was George, an 84 year old man who had come in with abdominal pain and was clearly unwell. I remember him being very pale, clammy and short of breath. He was quickly diagnosed with a ruptured abdominal aortic aneurysm and needed emergency surgery to repair it. Despite the pain he was in, he had a very gentle nature and while I was waiting with him to go to theatre I asked him how he was feeling. He'd been kept nil by mouth since his arrival and told me he'd feel a lot better once his surgery was done, and that he was looking forward to a cup of tea. I accompanied him, along with two doctors, into the lift up to theatres and waited until he was sedated. I couldn't stay to watch the procedure this time as this wasn't my surgical placement and I had to return to A&E. Before my shift ended, one of the doctors, who'd been with us in the lift, came to find me. He gently explained that, because the rupture was so severe, the surgeons were unable to repair George's aorta and he had died on the operating table. I felt so sad for his family who had to deal with his sudden passing. And it bothered me for a long time that George never got his cup of tea.


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