Donkey's Ears

My first job as a practice nurse was working for an Irish doctor. In my interview he didn't ignore my young age or lack of general experience but assured me that practice nursing is, in itself, a speciality that he thought I would have no problems adapting to. I just needed the right support. He provided me with guidance and training from the lead nurse at the surgery, Breeda, who was also Irish. She was small, about the same height as me, with a gorgeously warm and bright personality and sparkling, open round blue eyes. She was so welcoming and friendly and gave me all the time I needed to learn many new skills. I had observed most of these skills and done some of the procedures under supervision during my degree but doing them independently with just me and a patient in the treatment room was a different ballgame. Breeda took me under her wing for a whole month so I could really get to grips with what practice nursing entailed. The surgery also supported me by sending me on all the necessary courses I needed to learn the things you didn't get taught during initial nurse training in 2004. I studied travel health, cervical smears, contraception, wound dressings, ear syringing, child immunisations and management of chronic diseases such as asthma and the ever-overwhelming diabetes.

It wasn't long before I started to realise how varied practice nursing is. In a single day, we would see patients ranging from birth to death's door and were confronted with all manner of symptoms. One of the more unusual incidents was when I walked out of my treatment room and met an old man sitting in the waiting room absolutely soaking wet. From head to toe he was dripping. I asked him who he was waiting to see and he stared at me bewildered. His son then hurriedly entered the waiting room to tell me that his dad had, against his advice, driven his mobility scooter along the sea wall and had fallen into the water below! On reflection it sounds hilarious but the poor man was understandably very shaken. After being checked by the doctor it turned out he hadn't done any damage to himself. The same could not be said about his scooter.

Working with Breeda taught me how strong the nurse-patient relationship can be. If people have lived in the same place for some time, they get attached to their GP and get to know the nurses and reception staff. Breeda knew so much about her patients, not just medically but personally too. She would ask them how their cruise had been, or how someone's unwell husband was that day, or laugh with someone about something silly their dog had done. It helped that she was so engaging and genuinely interested and, while I watched her, I quickly picked up the importance of listening. Her patients loved her and it was partly because she didn't rush them and hustle them out of the room. She made them feel valued.

After the initial month sitting in on Breeda's consultations, I started running my own clinics. It was at times daunting but she had been so patient, thorough and kind that I felt as prepared as I could have been. I took inspiration from her and made sure I gave time to each patient and really listened to their concerns. Sometimes they had come for something very routine so didn't really have concerns but they would still chat to me and give me an insight into a slice of their life. As I sat there with all manner of people in front of me, it hit me how much the details of their lives mattered. Working in a hospital or hospice makes you focus on a patient's immediate illness or condition, and unfortunately not always the person as a whole. Tom and Jay had taught me how small joys could still be found even in life's darkest times and now these people were teaching me the importance of appreciating normal, day to day life. I was only 23 and hadn't long left my teens and the student mentality of partying inbetween college assignments. Before I qualified I was already engaged, so as soon as I'd finished my degree, all my attention had been on wedding preparation. My adult life until that point had been a whirlwind and I hadn't really stopped to take it all in. Sitting with these patients listening to them talk about their baby or their favourite food or a party in the family or a holiday made me realise how all of these things mattered. Life is full of joys that can be found in the ordinary.

Another revelation for me was that sometimes I didn't need to do a thing for a patient to make them feel better. I just had to listen. There have been many times when someone has left thanking me for all I've done and saying that seeing me really helped. At first I was a bit baffled by this as I had just sat there nodding encouragement or offering a box of tissues. Sometimes all a person needs to do is say their worries out loud to a listening ear and suddenly they are put in perspective. And sometimes a person just needs to know that their concerns aren't silly and to be reassured that what's troubling them will often turn out fine.

I clearly remember one lady, Renee, an 84 year old who had become her husband's carer. She saw me as she was worried she'd found a lump in her breast. When I examined her a rush of panic washed over me. She hadn't just found a lump, almost her entire breast was a tumour. I remained calm on the outside and told her I would need the doctor to take over her care. This was a patient who I was scared wouldn't turn out fine. She saw one of the female doctors at the practice and after Renee had left, she quietly told me that she would refer her but that she expected nothing more than palliative care. Considering Renee's age, I sadly agreed. To my huge relief and delight, Renee was seen almost immediately by an oncologist who scheduled surgery. She had a mastectomy and, after her recovery, was well enough to continue looking after her husband. Thankfully, we had been wrong and the surgery had saved her lovely ordinary life.

I was blessed again at this practice by another great team. Each member of staff had a job to do and they did it diligently while enjoying a good working atmosphere. Breeda and I always had our coffee break in the main office, which meant I got to know the receptionists quickly. Two of them I really gelled with because of their fun nature. There was Meryl, the most loyal Barry Manilow fan ever to have lived. She'd met him a few times and regularly had parties with friends to celebrate his music! She'd travelled to America several times to see him in concert and was completely in love with him. She even had a "pass" from her husband in case the chance ever arose for her to get amorous with Barry! And there was Carrie, a tiny, vibrant, slightly loopy lady with short burgundy hair, black eyeliner and a hoarse smoker's voice. I will always laugh when I think of the time Dr Li had told us in his strong Chinese accent that he'd been seeing a patient for donkey's years. Carrie hadn't understood and asked me in worried and whispered tones how ever do you treat someone with "donkey's ears?!".

I couldn't have asked for a better introduction to practice nursing than the one that this surgery gave me. I would never have become the practice nurse that I am without Breeda's kindness, interest and training. She prepared me for all I would encounter over the next eleven years. If you ever stumble upon this blog Breeda, I thank you from the bottom of my heart.

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