HOSPITAL BED PERSPECTIVE

My previous post detailed how I found myself turning twenty-six in a hospital ward. Happy birthday (Can you hear the slathered on bitterness and irony? You can? Good).

The experience was unanticipated and has been disorienting, but made even more surreal by that fact that I’m normally the one standing over the hospital bed rather than laying in it. I guess I should thank rhabdomyolysis for allowing me a patient’s perspective. I should, but I’m not going to.

When I chose nursing as a career I had only been inside a hospital three times: when I was pushed out into the world, visiting a sick cousin, and saying goodbye to my dying great-grandmother. Except for my birth, of which I oddly have little recollection, my other visits were short and superficial. I was there to be with family and largely ignored the hospital as a whole.

Therefore, when I came to nursing I came with virtually complete ignorance of the hospital system. This ignorance only became apparent during my first student placement; until this point I presumed the various television shows and movies I’d watched that had taken place in a hospital would have adequately prepared me. This was not the case. Apparently, liberties had been taken when writing those scripts.

My first placement consisted mostly of me learning where to stand so as not to be in the way. I soon mastered this skill. Eventually, I saw the overlapping cogs of the multidisciplinary health team and what my expected role was within them. A hospital can seem a chaos of doctors, nurses, pharmacists, physiotherapists, occupational therapists, cleaners, PCAs, patients, and visiting family members. But there is a pattern in the chaos and it wasn’t long until I knew where to go, what to do, and who to speak to; basically, how to be a nurse. Prior to this I had the skills – I could take blood, hang an IV, administer injections – but now I had the knowledge of how and when to apply them.

By the time I graduated and started working as a nurse the wards were a familiar place. I could recognise people by their roles, I knew what to do when a buzzer went off, how to placate a distressed patient, and the perfect place to stand so as not to be in the way (This skill still came in handy when a herd of doctors descended on one of my patients). Like any well worked in workplace, the hospital became commonplace and I could navigate its walkways with ease.

This did not prepare me to be a patient.

The first thing I noticed as I was lead into the emergency department with a patient name band around my wrist was the casual condescension of the staff. There was no intended insult in this; they’re used to speaking to people with little health knowledge, and often, with limited knowledge of the English language. However, with both medical knowledge and a strong grasp of the English language, the small and simple explanations I was given seemed only to patronise. I immediately scanned back to the multitude of conversations I’d had with patients, and prayed I didn’t come off so bad.

I received descriptions of my condition in language usually reserved for five-year olds. I itched to interrupt and explain that I knew all this, that I was a nurse and the equal of them. I didn’t, as I figured the intrusion into their well-meaning explanation would only serve to paint me as arrogant. However, when the natural segue presented itself, I quickly slipped in the fact that I was a nurse. The change was instantaneous. Suddenly, I was a person again, not a patient.

The next insight was of dependence. Even in my state of physical competence, I was dependent on the whims of the hospital. Food came when it came. If I wanted a shower I had to wait for towels. Doctors and answers appeared on their own schedule, not mine. And I waited.

Working as a nurse is a job of hectic tasks, a never-ending to-do-list that begins when you step onto the wards and ends when you handover with a breath of relief to the new nurse taking over. For a patient though, it’s one long day of boredom. You stare at the same four walls, bounce between the same time-wasting activities, and wait. You get excited when the food tray comes, not because the food tastes particularly good, but because it gives you something to do. You watch everyone rush, and you sit, and wait for the moment when they say you can go home.

In here I’ve seen how miscommunication between staff and patients serve to add to the cloud of confusion and unease. Patients don’t quite know how to phrase their questions and staff have no time to decipher their desires. Presumptions are made, things are missed, and the patient settles back and waits.

The other side of this coin however is how vital and appreciated the staff become. Whether the dependence is enforced or genuine, a helpful nurse is a godsend. A doctor who takes an extra minute to explain what the blood results mean gives a patient an afternoon free of anxiety. Simply having a friendly face and a quick laugh to break the tedium is a gift worthy of a bear hug.

What I hope to gain from this enforced role reversal is a better insight into what my patients are experiencing, and what I can do to ease their pain/anxiety/discomfort/boredom. I’ve been shown the other side of the looking-glass and the details reflected back have shown me the importance of small mercies and kind words.

Hopefully, being a patient will make me be a better nurse.

Thank you, rhabdomyolysis.

Advertisements

THAT WON’T HAPPEN TO ME

This post comes to you from inside a hospital.

I turned twenty-six yesterday.

This was not how I foresaw my twenty-six birthday.

As a nurse I’ve come to terms with the fragility of health. When you see a patient die from a fractured hip, or a previously healthy twenty-eight year old women yellow with jaundice, you quickly realise sickness isn’t just for the old.

Most of us, understandably, fool ourselves into the mindset of, ‘That won’t happen to me.’ We watch documentaries of people just like ourselves come down with cancer, people of the same age, gender, socio-economic status, and race, and we still tell ourselves, ‘That won’t happen to me.’ We mentally scan our body for aches and pains, and when we find nothing we relax in the knowledge that we are, at least temporarily, invincible.

And despite my apparent insight into the illusion of health, I was still shocked when three days ago I stood over the toilet and watched as brown urine trickled out from me. I did the right thing and saw a doctor who took samples of my bloods, but I felt confident the results would be minor; that I would be fine.

Because that sort of thing wouldn’t happen to me.

And even when I got a call from the pathology clinic testing my bloods at eleven forty-five on a Sunday night telling me to go to emergency immediately, I still couldn’t shake the notion that it was no big thing. Sure, I’d go to hospital, and maybe they’d keep me for a few hours, but then they’ll send me home telling me to keep my fluids up and to take it easy.

Because that sort of thing wouldn’t happen to me.

This was three days ago and I’m still tucked away in my little corner of the hospital.

Let me back up and tell you how this happened.

A week ago I was talking with my brother who was telling me of an exercise boot camp he had enrolled into. Five weeks, three hours a week, improved fitness at the other end. It sounded good, and I signed on. Thursday afternoon found me grunting and swearing as I worked through push ups, sit ups, pull ups, planking, tyre lifting, squats, and a light jog. The workout was hard, my arms shook, my stomach tightened, and I felt a little sick. But you’re meant to, aren’t you? That’s how you know you’ve pushed yourself.

I wasn’t concerned despite the fact that for the next two days my upper arms and chest ached. I struggled to lift my arms higher than my head, groaned when I had to reposition myself in bed, and trembled when attempting to take off my jumper. I figured this was the repercussions of a very thorough workout.

Consternation came when urine the colour of cola-flavoured cordial streamed from my body. I opened my laptop and typed ‘brown urine, excessive exercise’, into Google, and quickly learnt a new term. Rhabdomyolysis.

Essentially what I had done was damaged the muscle fibres in my arms and chest to the point that the muscle cells died. Upon the destruction of these cells, proteins are released into the bloodstream. This is not where they’re supposed to go. What I was seeing when I looked down into the toilet bowl was the dead matter of my muscles.

The risk of rhabdomyolysis is that the kidneys are not used to filtering these proteins, and one, creatinine, can build up in the kidneys. Potential consequences: decreased urine output, kidney damage, renal failure.

Let me reassure you that at this point it doesn’t look like I will suffer from any of these afflictions. Although, for the record, the specialist told me he had never seen creatinine levels so high. I’m marking this as an accomplishment; you have to take wins where you find them.

So here I am, on the other side of the looking glass. From nurse to patient. From the lands of the invincible healthy to the wards of the acutely sick. From twenty-five to twenty-six.

And they say exercise is good for you.