From The Heart

Inevitability

I am dreading going to work today. My boss may know I have said something now and I am worried she takes it out on me. I wander slowly into the ward looking down at the highly polished floor. A cheery smiling Polish cleaner all dressed in green smiles at me and says ‘cheer up miss, it surely is not that bad.’ I smile back knowing that this cleaner is always smiling. I wished I could be so happy in my work. I say hello to him and say that 'I am sure I will be alright.' I always speak to the cleaners, they provide a great service in the hospital and they often get such bad media attention for our hospitals being dirty. Their salary too is terrible. If your hospital is dirty don’t blame the cleaners they are an easy target, it is down to poor staffing and the nurses extended roles. We are supposed to clean up body fluids, mattresses, beds the lot. It is often difficult to clean everything when there is lack of staff. My priorities are the patients and you may argue that cleaning does affect patient health. It does, but if I have a dying patient while at the same time I need to clean a patient locker. My choice is always the patient. If we do not have enough staff then we must always prioritise. It annoys me that they say also that we never wash our hands. Of course we do and who the hell has time to record our frequency of hand washing with statistics, please get a life! Spend the money on getting us some staff please? Oh and one more thing while we are on this subject, I bet those that design hospitals never regularly burn their hands on the hot taps, most of the wards I am in do not have mixer taps and the water is too hot. Come on those doing the research, let me watch you put your hands under a scalding tap. If you do research you need to account for all your intervening variables like scalding hot taps. Oh, well, I have reached the report room and I walk in. I almost sit down when Sister Poppins walks through the door very harshly. She stares at me in a very frightening way. She does not speak, and just keeps staring at me. I feel on edge and so I just stand looking back like the rabbit staring at the headlights. I observe the red blotches around her nose, she must have been blowing it again she always does that. I also see the pink coloured lipstick that has missed her mouth and strayed into the creases up above her lips. Her hair looks neat today but her eyes are filled with rage. I could almost swear she has the rage virus out of the film 28 Weeks but she is doing her best to hide it. There is a whole lot of psychology going on between us. I feel like we are two angry cats sizing each other up. My anger is through being tortured. I feel hate towards her for what she is putting me through and I am filling up with emotion and I want to shout at her. I just want her to treat me like a normal human being. I would love to write here in words what went through my head but somehow this does not come easy and perhaps only those who have been bullied would understand that. We both gently backed away like two cats, not daring to show our backs.

Rebel with a Cause

She walked out the room. Everyone who was sitting down asked each other what that was about. I looked down at the grey carpet and shrugged my shoulders. I was not part of their team because I was ostracised anyway, she had made sure of that. I was always sent away. Today was no different; I walked away along the corridor to a ward I had not been in. I walk in and it is quiet. I am just in time to hear their report. So perfectly put, with good handover sheets and the nurses verbalising the patients’ conditions. I discuss with the nurse who I am working with, our plans for the general organisation of our shift. She comes over as being really nice. She tells me she is from Africa and she has a lovely manner with the patients. I can tell she really enjoys her job; she is a real nursing gem. We coordinate our work well. One thing, I do notice is that this ward shares facilities with the ward next door. A patient asks me for a drink of water and I go to the shared kitchen. I search everywhere for glasses and jugs. There are none other than a tray with many glasses and jugs on a trolley with a big white sheet of paper on top, with writing clearly marked in red pen, “Everything on this trolley is for the use of patients in ward 14 only” So, rather than annoy anyone, I went back to the other nurse and asked what we do for jugs and glasses. She said, that we just need to search around and that the staff on the other ward gets annoyed if we use their equipment. I search everywhere and I go to the main kitchen. All I see are tea cups. This is insane, I am searching everywhere for a container to get a glass of water and there is a trolley with jugs on it. Do we not share the same hospital? So, my patient should become dehydrated and do without water? Not on my duty they won’t. I go back to the kitchen and take a jug and glass from the trolley, feeling like a real rebel. Oh and if they complained when they counted their glasses and jugs I left them a little note to say, ‘I am sorry but I took the glass and jug because I thought we all work for the same NHS and patients come first.’ This insanity is rife in our hospitals. This equipment belongs to our ward and you can’t use it. Let us thrash this nonsense out, so we have a pot of money that goes to the NHS and it obviously gets shared out between services. So, wards have their own budgets and they want to keep what they have bought for their own patients. So, there is perhaps some logic in what they are trying to achieve but it has created room for nonsense and utter misery when trying to care for patients. How about we have a central store in a hospital and if we need equipment we go and get it, that’s more logical. Why are we short of anything in the first place? It’s crazy that we have nurses hoarding sheets, towels and other items to stop it being used by any other wards. Stop this insanity now!

What’s your Poison?

I spend the majority of my shift taking disorientated patients safely back to bed as they go for a wander. Many of them are at risk of falling and are so fragile that if they do fall they will break a bone. I give an elderly patient her medication, she is very confused. She asks me if I am a poisoning her. I smile and pat her gently on the shoulder and say ‘of course not but I am sure it will taste like poison.’ She looks up at my face which is very close to mine as I am leaning over smiling at her. She says, ‘I know you wouldn’t poison me dear, you have a very nice caring face.’ This fills me with warmth. I go through and speak to a male patient who has written some questions for me on a piece of paper. He asks why he is not a candidate for an operation as he has been told by consultants that he will not be fit enough for it. I look at his history and note he has a very bad heart condition. I say that I do not quite know the specifics of what the consultant said but my guess could be due to his heart problems. He informed me of languages he spoke and mentioned his big academic background. I looked at him and could see that he was now very frail. He seemed very proud of his academia. I showed an interest and asked about his languages. I got him to teach me some words and he smiled at his opportunity to use it. He told me I was a real tonic and that nobody in here speaks to him. Sometimes we can be so busy that we just deal with the physical ailments of a person that we ignore the whole person. The man smiled and I wished I could speak longer but had to deal with other patients. It was just nice to see him smile. Smiling is a good healer. It is a pity I could not do more for another patient. The lady was too ill to be resuscitated and would not make it if the doctors made any attempt. This side of nursing can be sad. We need to comfort these patients until their heartbeats are no more. This lady had terminal cancer and there was nothing more that could be done. The other nurse and I noticed how she was deteriorating. I quickly phoned her husband to say that his wife was very poorly and he must come quickly. While awaiting the husband, the patient slowly slipped away while we both held her frail soft hands. There is always an air of serenity and death always emits the same odour but it is not a foul odour, it is just death. We quickly tidied the patient up and changed her clothes to make her presentable. I brushed her hair and gently closed her wide open mouth. Music plays..."Thoughts Of A Dying Atheist, Muse"

Eerie whispers
trapped beneath my pillow
won't let me sleep
your memories

and I know you're in this room
I'm sure I heard you sigh
Floating in between
where our worlds collide

scares the hell out of me
and the end is all I can see
and it scares the hell out of me
and the end is all I can see

and I know the moment's near
and there's nothing you can do
look through a faithless eye
are you afraid to die?

it scares the hell out of me
and the end is all I can see
and it scares the hell out of me
and the end is all I can see

It scares the hell out of me
and the end is all I can see
and it scares the hell out of me
and the end is all I can see
Love Hurts

Birth and death bring opposite emotions but are both inevitable in life. We need to present death to the relatives with great care as it has lasting closure on an individual’s life. When the husband appeared I knew the patient was already dead and so I calmly asked him to come with me to the relatives’ room, knowing I had to tell him the bad news. It is always such a long walk. The silence to the relatives’ room is always so difficult. I imagined their long life together and how difficult it would be for this man left without his wife. I sat him down in the room and I sat close to him. He stared at me searching my face in desperation. I went through the sequence of events and told him with great care. I sat for a little while just listening to him talk while the news digested inside him unfolding like a flower in spring opening up for the first time. Tears rolled from his eyes and I knew my words came like boulders hitting him deep in the heart but I could not lessen them. I could feel my own emotion as usual and the knot in my stomach as I felt my own brown eyes glass over. I put my arm on his shoulder. I said that his wife is waiting on him if he would like to say goodbye. His family joined him as they came rushing up the corridor to hear the bad news. They all broke down in tears. I escorted them to the patient. I put down chairs for them and told them they can spend as long as they like. This was now their time, I patted the husband on the shoulder gently showing I care and left the room. I wanted to wrap my wings around them all and make their hurt go away but love hurts.

I pick up my rucksack and throw it over my shoulder. My shift is finished, my shift was difficult but I worked with a nice nurse. My meeting with my bosses and my union is next week. I wonder what to have for my tea, I have not eaten much today and my mouth is dehydrated as usual, we had no water dispenser let alone a cup to drink out today. I drive off, thinking of the relatives I left behind and how they will be left to cope. I turn on music by Incubus and the song is Love Hurts.

Tonight we drink to youth
And holding fast to truth
don't want to lose what I had as a boy
My heart still has a beat
But love is now a feat
(as common as a cold day in LA)

Sometimes when I'm alone I wonder
Is there a spell that I am under
Keeping me from seeing the real thing

Love hurts.....
But sometimes it's a good hurt
And it feels like I'm alive
Love sings
When it transcends the bad things
Have a heart and try me
'Cause without love I won't survive.

I'm fettered and abused
Stand naked and accused
Should I surface this one man submarine
I only want the truth
So tonight we drink to youth
I'll never lose what I had as a boy

Sometimes when I'm alone, I wonder
Is there a spell that I am under
Keeping me from seeing the real thing


Love hurts
But sometimes it's a good hurt
And it feels like I'm alive
Love sings
When it transcends the bad things
Have a heart and try me
'Cause without love I won't survive

Love hurts
But sometimes it's a good hurt
And it feels like I'm alive
Love sings
When it transcends the bad things
Have a heart and try me
'Cause without love I won't survive

Love hurts, oh
Love hurts
Without love I won't survive
Love hurts, oh
Love hurts
Without love I won't survive

A Birds Perspective

Today, I have a meeting with my union steward. I have reached the pinnacle of what I can endure. I am up here on my own, looking down and seeing what goes on and like history that can’t be changed so too does my outlook. It is cold up here and I know no one cares so long as I fit in to the cogs of the big machine which operate in the wrong direction to that of the caring conscious. This act which I have learned so well, does not fit me like a glove, but is like the mask that was designed for another face and it keeps slipping down on me. This mask is the mask with the big black tear and black painted smile. I am sitting on a rock and I cannot fly away and so I wait until the time when I can come down from here. I sit and mull over my regret. I go along a section of corridor which has many different offices and a row of little shops as though I am in a shopping mall. The shops are in the wrong location, they have no place here. This hospital is all about making money from the sick, the company that owns the car park wants as much money as possible. It is all sewn up and it is endorsed with yellow double lines all around the outside of the hospital, just in case any of the bleating sheep stray from the flock and try to escape the payment. The sick and their families are herded in to make the payment to the company that sits on a wealth that is stolen on opportunistic illness and disease. Gaining profit from the sick could only be dreamed up and acted upon by people who have no conscious and it is the quintessence of all evil. I knock on the door of the Union office and am ushered in. I tell my steward everything but the words are hard to find and I feel it comes over, like gobbledygook. I am trying to say that I am being bullied but instead I pick out example after example. I feel confused and my emotions run high. I have not been eating properly and my sugar levels will be low. I see that the steward knows what I am saying and listens intently. My steward reminds me of a wise owl and has a wealth of information. I am in the situation whereby I must fight or flight. I feel I do not have the energy to fight and my body is warning me that I must run away. Still, I know in my head that I must fight back. I know my fight is against an army and not just one person. I talk until I can talk no more which is something quite unusual for me. Conversation is a commodity we all take for granted and we can iron out the most minuscule of detail with it.

Let The Battle Commence

I go back home and pour coffee into my cup and consider my fight. I do feel apprehensive like a soldier getting ready for battle. I need to meet my bosses and we need to talk this out. I evaluate what I need to say and it goes round and round in my head like a tornado about to hit a little village. Until then I need to stay calm, the calm before the storm.

Was That You Henry?

Be your shelf
It’s raining! The big wet drips hit the ocean like bombs. I stand at the shore looking out. Each drip has a sound of its own making the rain noisy but like a song. A man comes up to me and asks what I am doing. To be honest I do not know. I watch the sea swirl and the wind blows through my blond hair which is getting long now and blows across my face into my mouth. I look out and see someone on a boat, they are being thrown about and the sea is very stormy. An elderly lady comes up to me in a red waterproof anorak and asks me the time. I look for my watch but it is gone. ‘I do not know the time,’ I say. I look into her face and it is a patient that I cared for but she had died. I look into her eyes and they are big and blue. The lady looks very well. I ask her what happened to her. She says, ‘don’t worry dear, I am alright, you helped me come here and my family are with me but I am concerned about you.’ I said, ‘oh I am alright too.’ The lady said, it’s ok dear I know how it is don’t be scared, I am not one of them, you can be yourself, it’s so important to be yourself.’ I can’t be myself,’ I said, if I do I am doomed.’ The voice grew deeper saying, ‘be who you are.’ Me, how could I be me? I awoke and my mum was shouting at me. ‘Mum what are you doing?’ I shouted. ‘I stupidly stayed with you last night and your shelf has fallen down on your bed.’ My mum said. ‘You are lucky it did not land on your head.’ My shelf, myself, I think! I lie there for a few seconds thinking about my dream. I have books lying on top of me and one falls to the floor as I turn around. I hear my mum pottering about, what a bad idea having her over because my house will be rearranged again. ‘Forks on the left, knives to the right in the cutlery drawer.’ she always says. ‘You need to go in there and you need to tell these people what for.’ ‘Yeah, what does that mean exactly?’ I say, as I switch the television on. ‘Tell them that you are not taking the bullying anymore.’ Who exactly do I say this too?’ ‘Your boss, or her boss,’ she replied. She just does not understand, if only it was that easy. The fact is my boss is bullying me, how can I say? Bullying is normal in nursing. How wrong, how sad, that in a caring field it is normal to be bullied. My mum has ironed my uniform and it feels like cardboard as I get changed for my shift. My mind wanders back to my dream. I know I can’t be myself in nursing because they will bully me all the more. I need to appear like them. I wander through the corridors of the hospital and I bump into Elias the porter. He asks how I have been and I smile in my usual way. I tell him I am alright and he asks how Sister Poppins is treating me. He has a cunning smile as he asks about her, he says he has been in her ward a few times recently and she was moaning at him about taking so long. Elias never says a bad word about anyone; he wears typical porter clothes for the NHS, blue trousers and light blue top. He always looks tired. He shrugs his shoulders and says that he hopes I have a good day. We part in opposite directions. I make my way to the ward and as I walk in, there is the usual smell which is quite distinctive to my ward but there is also an overpowering smell of coffee. I go past the nurses’ station and Sister Poppins looks up at me, I still smile and feel stupid for doing so but let my smile fade away under a cloud. She does not say anything to me, nor does she smile back. She still stares at me as though she were about to tell me something bad but she doesn’t. She watches me walk past her. My gaze turns from her to the office door which I open with a heavy heart.
“Don’t be Horrid Henry.”
As I open the door, I see a familiar nurse auxiliary. I am so pleased to see a face I know, it can make my day better. He has a little mischievous grin and is often up to childish jokes but he is not nasty. He reminds me of the children’s cartoon character Horrid Henry. After handover he works with me with my patients. We get the patients up and make the patients beds. He talks incessantly joking the whole time. He is laughing saying that he needs to pull a prank on Sister Poppins. He laughs calling her scary Mary. He said the last time he was here she was shouting at him for leaving the toilet light on. She has signs on all the lights that they must be switched off. In fact she has signs everywhere, on cupboards and walls. One sign reads that tea and coffee is for patient use only, meaning staff need to take in their own. Another sign reads big lists of duties that staff must carry out on night duty which is stuck on every available wall. On the desk there is a sign that staff must not place any drinks there. We get on with our work and it is nice to have a laugh. The patients smile too, they really cheer up when there is someone who is very friendly. I hear this voice shouting, yoo hoo over here dear. I go over to a patient and she says, ‘I do not want to cause a fuss with my hotel bill but I think they have overcharged me.’ I smile and say do not worry your stay in hospital here is free.’ She says that I must take something and she will have her secretary write me up a cheque. Then she turns and asks what is on the hotel menu and will she need to dress for dinner. I look at her face and she has been eating chocolate after chocolate and it is all over her face. I ask if she would like a shower this morning. She keeps going on that the service in this hotel is wonderful. I just smile and know that she is confused but at least she is happy. She has various pictures beside her of her family. I look at the pictures and wonder how her life once was before she became ill.
More Water Please!
We organise many patients and the heat in the ward builds up. I am so dehydrated. I feel a little faint and stop what I am doing. Horrid Henry says he will get me a drink of water. He comes back a few minutes later saying that if I want water I will need to walk to the kitchen. Mary Poppins would not allow him to bring me some water. I go to the kitchen feeling light headed. I always wished we had a water dispenser on the ward; it’s such a basic need. I drink lots of water until I feel myself return to normal. I take my lip balm out my pocket and put it on. Because I have been so dehydrated and it is so hot I need to carry lip balm around to stop my mouth becoming dry. It is known as one of the basic essentials of nursing by many nurses. I go back to my patients but Sister Poppins stops me. She tells me that I should never walk away from my patients. I inform her that I was dehydrated and Horrid Henry tried to bring me some water. She said that there is no eating or drinking on duty in ward areas. She said that in future if I require a drink then I must ask permission to leave the ward. I know she is just picking on me and I look up at her and want to say something but know I can’t. I go back to my patients. Sister Poppins keeps coming through to check on me and keeps telling me off for little silly things. I really can’t take this ward anymore. Horrid Henry says, ‘don’t worry about her, I will get her back.’ ‘What do you have in mind?’ I say. He just laughs, he is an enigma. The day passes over with all patients doing well and a few will be going home in the morning, which is good. It’s always the nicer side of nursing.
Honest it wasn’t me.
Before my tea I need to go to an office to collect my pay slip, Horrid Henry is already on his break and another nurse will be covering for me. Sister Poppins has just left. I realise I am walking behind her in the corridor but she is still a little distance away. I then hear shouting, ‘Sister Scary Mary, Sister Scary Mary.’ It’s a non-descript voice and I look around but nobody is there. In fact, nobody is now in the corridor other than Sister Poppins and me. The voice gets bigger, ‘Sister Scary Mary!’ Sister Poppins turns around and sees me walking behind her. ‘Oh no’ I thought, she thinks that was me shouting. Sister Poppins stands for a second looking horribly at me and then walks away. This is not funny. I go back to the ward and Horrid Henry has finished early, so I don’t know if that was him shouting.
And they’re off
Sister has introduced taped handovers on the ward. They have become the new ‘in thing’. I really hate taping my voice and allowing others to hear it. Why tapes? Sister said that it is a breach of confidentiality having handover sheets. These are sheets of paper given to each nurse on duty prior to going on the ward to work. It informs the nurses about the patients and has basic information on it to ensure continuity of care. Handover sheets when done correctly fit nicely into the pocket and are a little bible to keep nurses right throughout the day; we can tick things off and add to them as the day goes on. The crazy thing is that everyone listens to a handover on a tape and takes notes, creating their own improvised handover sheet anyway. The situation is worse on tape and information can be lost. Nurses wanting to get home as quickly as possible speak as quickly as they can. It is like listening to commentary for a horse race as the nurse gets quicker and quicker. ‘And they are coming up to the finishing post and little Mrs Smith has developed a leg ulcer.’ It’s often hard to hear anything and taking down basic names and much information can be lost or misinterpreted. Nurses from other countries say that they hate the tapes because often English is not their first language and they are self conscious about their voice on tape and often they find it hard to understand the fast handover. I just want the handover sheets back with any updates vocalised personally to the nurses taking over. If it works don’t fix it, as they say. I go home into my car, its cold, its dark and I am exhausted. I hate my job. I need to look for something else. I think about what other opportunities I could have. I think about a nice little desk job or even just working in a shop. Anything has to be better than this. I start to think about the little elderly lady in my dream. She said that I need to be myself. I love caring for people but I just can’t do it because of the bullying. I need to hide the real me in my job. The real me is the caring person who is the real nurse. I am a nurse hiding behind the wall I have built to protect me. When the bullying can be stopped I will knock my wall down and the Angel of the NHS will be revealed.