Michael Alexander: Confessions of a Male Nurse

My first day was spent following Cherie around. I was introduced to every patient and shown where everything was: the fire escape, cardiac arrest alarms, cardiac arrest trolley, treatment room, sluice room. I was handed a three-inch-thick folder of policies and instructed in the use of the computers, admission and discharge procedures.

All I really wanted to do was get my first patient and see if I could do the job. I went home that first day forgetting everything Cherie told me.

My third day on the job and I still didn’t feel the slightest bit at ease. In fact, I was feeling worse. Driving to work each morning, my mind was in overdrive thinking of the things that could go wrong, of all the ways that I could stuff up, and today I was getting my first patient.

‘I’m going to give you Mrs Stewart,’ Cherie said to me. ‘She’s day one post an abdominal hysterectomy. It will be good experience for you.’

Before starting on the ward the only time I had to think about a uterus was in the class studying anatomy books, and now here I was helping a patient recover from having one of the most intimate parts of her womanhood removed.

Forty-three seemed quite young to be having a hysterectomy, but at least Mrs Stewart already had three kids, so hopefully she wouldn’t feel too bad about her surgery.

‘Good morning, Mrs Stewart,’ I said, as I walked in the door. ‘I’m your nurse for the day. How are you feeling?’

Even hooked up to an infusion of narcotics, her shocked expression made it clear that the last person Mrs Stewart expected to see in a gynaecology ward was a male nurse.

She soon got over her shock. She had other things to worry about, such as the tubes sticking in her arm, the urinary catheter, and an abdomen that had been sliced open and sutured up.

‘I don’t know. How should I feel?’ she asked me. ‘I can’t feel anything. I’m numb from the stomach down. I had prepared myself for some pain.’ She sounded almost disbelieving.

‘It’s the miracle of the epidural,’ I replied, trying to sound knowledgeable, without actually having the faintest clue as to how effective epidurals normally are.

‘Well it’s amazing. I never thought I would feel this good. I wish I’d had this when I had my kids.’

I nodded my agreement and kept silent; there really wasn’t a lot I could say.

The shift seemed to go better than I’d expected, although this was probably due to the bright spirits of Mrs Stewart, as opposed to any particular skill on my part. Still, she didn’t seem completely at ease in my presence.

‘I can’t wait to tell my husband I’ve had a male nurse looking after me.’

Mrs Stewart had made this remark at least a dozen times over the course of the day and it seemed a bit forced, almost as if she was still trying to convince herself that it was okay to have a male nurse. Never mind, I was sure she would feel better about it by tomorrow; at least, I hoped so, because tomorrow was going to be a lot more challenging, for her as well as me.

The next morning, Cherie informed me that Mrs Stewart was to have her epidural removed.

‘It’s pretty straightforward,’ Cherie explained, ‘just pull.’

I was expecting something a little bit more detailed, but ‘just pull’ sounded easy enough.

‘Oh, and make sure you give her some analgesia straight after you take it out. You want to have something working before it wears off,’ Cherie added, before heading off on her own rounds.

Epidurals are not something nurses learn about in detail, although they’re pretty simple to follow. A needle is inserted between the vertebrae of the back, into the epidural space. The epidural space is a membrane that surrounds the spine. A plastic tube is threaded along the needle and into this space. The needle is removed, while the plastic tube is left in place and an infusion of analgesia is slowly pumped. This keeps the patient completely pain free from about the navel down.

All I had to do was ‘pull’ the tube out.

Thankfully, Mrs Stewart was philosophical about having the epidural removed.

‘I’m not looking forward to the pain, but I guess it means I’m making good progress,’ she said.

‘Oh, don’t worry, Mrs Stewart. We’ll give you some medicine before the epidural wears off. You’ll be fine,’ I said, as I picked up her drug chart.

She seemed comforted by my words. I looked at her drug chart to see exactly what sort of analgesic I could give, but decided it would be better to ask Cherie. As Cherie was the nurse guiding me, she was the person I was to go to with any problem, no matter how big or small.

‘We usually give a Voltaren suppository,’ Cherie answered when I asked her. ‘It’s long-lasting and tends to work really well. You’ve given one before, haven’t you?’

I had given one before, but only to a male patient. Somehow, during my student training I had managed to avoid having to go near women’s private parts. I explained this to Cherie, and her face brightened with a smile.

‘Well, there’s not much difference. You can’t go wrong.’

I wasn’t so sure.

The epidural was removed under Cherie’s supervision and it really was as simple as she had described, a slight ‘tug’ and it was out, no resistance, no trouble. A bit of iodine and a transparent dressing and everyone was happy. To make the most of a good opportunity (that is Mrs Stewart held on her side by Cherie and her bottom facing me) I prepared to give the suppository.

‘Stop,’ Cherie said, as I had one hand on Mrs Stewart’s upper cheek, while the other hand was ready to do the deed.

‘What’s wrong?’ I asked, frantically trying to think what I had done wrong.

‘Aren’t you forgetting something?’ Cherie asked me.

Under pressure my mind remained a blank.

‘The jelly – the lubricant – you forgot to put some on your finger,’ she said, in a slightly exasperated tone of voice.

‘Oh, yeah right, sorry,’ I replied, as I squeezed the tube of jelly a little too hard. So hard that I managed to lather up not just my finger but both of my hands as well. Cherie rolled her eyes but kept silent.

I hadn’t even begun to insert the suppository because with my rubber gloves soaking in lubricant I was struggling to hold up her cheek with one hand and the suppository in the other. The cheek kept slipping down and covering the target. I looked up to see an amused (and slightly bemused) looking Cherie.

‘Let me help,’ Cherie said as she grabbed hold of Mrs Stewart’s cheek and held it up.

‘Here we go, Mrs Stewart,’ I said as I went for gold.

I heard Cherie stifle a gasp. I suddenly felt nauseous.

With far too much lubricant on my hands, the suppository had missed and gone in the wrong hole. At least Mrs Stewart didn’t seem to notice anything because she was still numb from the remains of the epidural.

‘I’ve never seen that happen before,’ remarked Cherie.

I looked up into her face and gave her a ‘What now?’ sort of look.

She made a hooking gesture with her finger.

‘You must be kidding,’ I mouthed back at her. There was no way I was going searching in ‘there’ – it even crossed my mind that ‘searching’ in ‘there’ could be a form of abuse. My only hope was that it hadn’t gone too far. One thing I was sure of was that Voltaren was pretty rough on the stomach, and I began to worry what it could do if left in such a sensitive place.

I needed to move fast because this felt wrong. I looked up at Cherie again and shook my head. There were some things a man should not do and this was one of them. But Cherie motioned for me to hurry up and get on with it.

‘You’re a nurse now,’ Cherie whispered quietly, as if this meant I had an open licence to dig around in women’s private parts.