Michael Alexander: Confessions of a Male Nurse

‘Are you sure I need to drink all this?’ Mrs Knight asked me, after I had prepared the medicine for her to drink. At 79 years of age, Mrs Knight was quite a surprisingly sprightly little lady – a dedicated member of the local women’s walking club. Unfortunately she was having some women’s problems and had needed to be checked out.

‘I’m quite confident,’ I replied – trying not to put too much emphasis on the ‘quite’.

But Mrs Knight was still unsure about drinking two litres of salty water, and her hesitation was making me doubt my instructions as well.

After I poured the first glass, I stayed to watch as Mrs Knight took a mouthful of liquid.

‘Urrrgh.’

She almost choked. When her coughing fit passed, she looked me straight in the eye: ‘I can’t drink that stuff; there has to be another way. Besides, why do they want me to have an empty bowel? It’s not my bowel that’s causing the problem.’

She had a point and as I couldn’t come up with any answer other than the nurse in charge told me to, I thought I had better check again.

‘Mrs Knight’s refusing to take the drink,’ I began to explain to a very angry looking Jen, my voice tapering to a near whisper. ‘She doesn’t seem to think she needs it.’

Jen looked ready to hit someone. I held Mrs Knight’s medical file in front of me like a shield. She grabbed the file and looked at the notes again.

I didn’t see the look of shock that must have crossed her face, but I couldn’t miss her outburst.

‘You bloody idiot,’ she yelled at me. ‘What have you done? How much did you make her drink?’

Oh shit, what was wrong? All I’d done was what she’d told me to do.

‘Not much, not much at all, not even half a glass,’ I stammered. ‘I was only doing what you instructed.’

Obviously this was my screw-up; Jen certainly wasn’t going to take any of the blame.

‘I said colposcopy . You don’t know what a colposcopy is, do you?’

Thankfully, Mrs Knight didn’t drink her two litres of bowel-cleaning liquid and she was sent for her colposcopy, which was a look up the front side, not the back.

I kept silent – embarrassed and fuming at the same time. Jen had definitely said colonoscopy, but it was my word against hers, a new grad against an old hand. I would not win this argument.

Every ward needs to have senior, veteran staff members around that inexperienced people like me can turn to. I knew that Jen was a good nurse and could normally be relied upon to make the right decision, but sometimes impatience, being too busy, or even not liking a colleague can cloud a person’s judgement. Thankfully, this is not too common.

After six months of putting up with a charge nurse that disliked me, and patients that looked at me as if I was from Mars, I had doubts about how much longer I could go on. But there were times when it all seemed worth it; times when I connected with a patient, and could physically see the difference I made.

‘You seem to know a lot about wounds,’ Sharon said to me one day.

Her comment caught me by surprise, because I really didn’t think that I had any particular skill or knowledge about wounds.

‘Not really,’ I replied, trying to figure out if she was thinking of a particular patient that I had done a good job on. With my mind still a blank I came up with a rather non-specific reply, ‘I just like to keep things simple; back to basics.’

She nodded her head as if I had said something wise. ‘I’ve heard some good things about what you’ve been doing with Mr Mannering’s feet. You’re not afraid to do what needs to be done and I like that.’

I thanked Sharon for the compliment and went about my business, surprised and confused. This was the first time Sharon had ever said anything nice to me.

Mr Mannering’s were by far the worst toes I’d ever had to dress. I couldn’t help but wonder what Sharon was thinking when she said I’d done a good job with his feet. His toes were black, completely and utterly rotten. The dressing was doing nothing useful, although the gauze between the toes was helping them from sticking to one another. I was simply keeping the rotten things covered until he got his foot, or even whole lower leg, amputated.

Due to a bed shortage, Mr Mannering was the only male patient in the gynaecology ward, and he sat upon his bed like a king upon his throne: he had everything at his fingertips and everyone at his beck and call. His room had a television, radio, electric bed, a great view of the hospital rose garden, and, of course, his nurse call bell within easy reach.

‘Has the newspaper arrived yet?’ This was Mr Mannering’s regular way of greeting me in the morning. I was never offended that he didn’t say good morning or good to see you. Mr Mannering spent all day on his bed; the only time he left was to be taken in a wheelchair to the toilet or the shower. For Mr Mannering, the morning newspaper was very important: it was a key part of his daily routine and his way of staying in touch with the outside world.

The newspaper also proved to be a convenient tool for me, providing a useful distraction from what I was about to do next.

‘Shall we get started?’ I asked.

Mr Mannering looked up from his paper and gave me a nod.

Whenever it came time to change the dressing on his toes he always made the same simple request: ‘I don’t want to see them. I don’t want to be put off my breakfast.’

As well as using the newspaper as a diversion, I put a couple of pillows on his shins to act as a barrier, in case he looked up at the wrong time and caught a glimpse of his feet.

I placed a piece of gauze between his big toe and the next.

Mr Mannering had had problems with his feet and the lower part of his legs for five years. He was diabetic, and over time the diabetes had affected his circulation. As a result, he had been battling with leg ulcers, but things had suddenly come to a climax when his toes had turned black.

‘Could you get us another cup of tea when you’re finished down there? Oh, and some biscuits as well?’

‘Yeah, just give me a moment, I should be finished soon,’ I replied. As I tried to pry apart his rotten toes, the thought of food didn’t seem quite right.

Mr Mannering chose this moment to inquire after his feet.

‘So how’s it looking down there?’ he asked, almost nonchalantly, just as if he was asking about the weather.

‘It’s not looking good,’ I replied. ‘But at least it doesn’t look any worse.’

There was no point being overly optimistic or pessimistic in my response, because no matter what I said, he responded the same way:

‘Well, you seem to know what you’re doing. I’ll leave everything in your capable hands.’

The little toe was the hardest to dress: it was too small, so the dressing wouldn’t stay in place.

I tried to pull his toes apart, so I could have another attempt at slipping in the piece of gauze.

Then… oops.

I could feel bile building up in the back of my throat. Somehow I managed to stop myself from vomiting, but I couldn’t completely hide the sound of air being brutally forced up through my throat and out my mouth, as my stomach clenched.

‘Everything all right down there?’ Mr Mannering had lowered his newspaper and was looking me in the eye.

‘You look awfully pale,’ he added. ‘Are you feeling okay?’

How did I feel? His little toe was resting between my fingers. I’d pulled it off. On the bright side, at least he wasn’t bleeding, although the smell from the foul, yellow-green-black pus seeping from the stump was making my stomach lurch again.

‘Well come on lad, speak up.’