Sun 11 April, 2004 (Easter day)
At last, freedom!. After my decision last night to stop the morphine, and a good discussion with the doctors, they have recommended that all my drips and drains can come out. Except one.
By mid-day the nurse had removed all the lines going into my arteries, and the catheter that was draining my bladder. About a metre of narrow-bore silicone tube came out of the end of my penis. I don't really want to think about how they got it in there in the first place.... Only the drain from my abdomen remained.
At about lunchtime, the chief physiotherapist came to my bedside to investigate my injuries and see if I could walk. She found me a walking frame (sometimes called a Zimmer frame) and watched approvingly as I hobbled around the ward, blood-filled drain bag tied to my leg.
For the first time I could start exercising my legs and take a look around the ward, finding the various toilets, bathrooms and other facilities. It felt really good to be mobile once more after five days confined to my bed or the adjacent chair. More importantly, I could take a shower and feel properly clean for the first time since the accident.
Although the drain remaind attached to my abdomen, I was able to get about by tying the blood-soaked bag to the walking frame. Now that I had no catheter, I had to be able to get to the bathroom when I needed to urinate.
Lunch was some excellent roast lamb with roast potatoes and then my wife and her family came around for visiting time, bringing easter eggs, chocolate and other gifts. The best of all was from Steve, my brother-in-law who brought a Kensington lock. I asked my wife to bring in the laptop so that I could start writing some of my experiences. The lock made sure I could leave the computer unattended with minimal risk of it being stolen. That machine became my key method of avoiding boredom over the days that followed.
Life was starting to look very good indeed.
Tradition has it that nurses are angels. I am not going to argue with that. Probably of all the communities I have ever seen—typically 5000 people work there at any time--St George’s Hospital is one of the most racially integrated.
Among the doctors, there are many Asian faces, as well as Caucasians—though few of the doctors are black. Among the nurses, however, one might come across any kind of racial origin. West African, East African, Chinese, Filipino, Irish, Polish, Caribbean, Indian. You name it, there will be a nurse from that background. I will not say they are all the happiest of individuals or the hardest working, but for Londoners in a job that is not well-paid, even with London weighting and unsocial hours top-ups, they are, on the whole, a hard-working, diplomatic, caring group of men and women.
Diplomatic, because they are constantly dealing with members of the public who the rest of us prefer to avoid. Take Shane, for example. Shane is the kind of guy you avoid, even when he is sitting next to the the last vacant seat on a tube train. He arrived in Accident and Emergency at about 3:30 in the morning of Easter Day, telling everyone that he had a kidney infection. By 10 o’clock in the morning, he was on our ward, with his sharp, streetwise Liverpool mind, and making life very difficult for Felicia.
It was not his first time in hospital, because he knew all the rules, and knew what he wanted. Anticipating surgery, or perhaps as some from of medical revenge, a doctor had put Shane on the punishing 'nil-by-mouth' regime. That means, as you might imagine, nothing to eat and nothing to drink. To keep him nourished, he had a drip in his arm, supplying a glucose mixture. Shane wanted something to eat. Shane rolled himself a Rizla. Shane wanted a pair of slippers. Shane wanted a cup of tea. Shane was going to pull his drip out. Shane, above all, wanted attention.
Felicia, a large African nurse, sat with Shane for hours at a time, keeping him under control, not antagonising him, but not giving in to his incessant comments and questions and demands. A diplomat, indeed.
Eventually, Shane saw a doctor, lay on the bed all day, had two pasties and a plate of chips for his tea, put another pastie in his pocket and discharged himself with, so far as I could tell, very little treatment, except a lot of patience, and filling meal.
Hard working. St George’s is a teaching hospital. Many of the nurses are completing their training. There are two shifts, the day shift and the night shift. There is a hand-over at about 8 o’clock, morning and evening, when the outgoing team briefs the incoming team on each patient. Each nurse has a day off for each day they work. Holidays and sickness aside, it therefore takes four teams to keep the ward permanently staffed.
The night shift has an easier time of the thing, as the patients are mostly asleep during the night hours. The day shift can fit in their work life with their personal life. Some nurses prefer nights; others prefer days. Officially, they are supposed to alternate, but in practice, they work it out among themselves as to who works mostly on nights and who mostly does day shifts.
Once qualified, many nurses leave regular, full-time employment to work in the nurse bank, a sort of emergency supply, to cover for sickness and holiday. The hourly pay is better, but the work is, in theory at least, less reliable. In practice, of course, there is as much work as you want, but not necessarily of the type you might prefer. However, when one of the more senior nurses "retires", she often gets to choose where the nurse bank sends her, and she remains on more or less permanent assignment to her preferred department. It looks like an unofficial way of boosting a senior nurse's income.
Even with the nurse bank, there are often staff shortages on the ward. It is not easy for any of them to take a rest while working. Without the patients, of course, things would be easy. The patients however, are constantly there. Needing a wash; spilling their food, vomiting, missing their bedpans, demanding a drink, refusing their medicine, needing attention.
And then there are the doctors. Weekends are less pressured, but during the week, the doctors arrive at eight o’clock or so, and spend a few minutes with each patient, using doctors' shorthand among themselves, with little reference to the patient they are meant to be treating. The doctors recommend treatments, the nurses have to pick up the pieces, sometimes explaining doctorspeak, always trying to book the appointments in X-ray, endoscopy, physiotherapy, neurology. And all the time, having to make the beds, clean the floor, wash the patients.
You get to see that each individual has a kind of personal rhythm. The top consultants all work fast, walk fast and talk fast. Everything they do runs at a frenetic pace. Their juniors are not quite so fast, but they have a good pace about them. Among the nurses, some run on fast rhythms, some are a bit slower. The auxiliaries, who clean the floors and toilets all tend to run on the slower rhythms. It’s not that fast is better than slow, or vice versa, but you need all types. The place would grind to a halt without the consultants, but it would also stop pretty quickly if the food was not served, or the toilets were not cleaned.