Michael Alexander: Confessions of a Male Nurse

For the first time in the two weeks that I had been doing Mr Mannering’s dressings, I heard a note of concern in his voice. I thought of the words he had said a moment earlier: ‘I’ll leave everything in your capable hands.’ I don’t think he meant it quite so literally.

As I crouched at the end of the bed, unable to think of anything to say or do, I had a vision of holding up his toe and offering it to him.

‘We have a slight problem,’ I finally said. ‘But it’s nothing to worry about – really.’

Mr Mannering leant forward. ‘What’s wrong?’

‘It’s your toe; your little toe,’ I began to explain. ‘It’s come off.’

‘Come off, what do you mean come off? Toes don’t just fall off.’

He had a point, toes don’t generally fall off.

‘Well, I pulled a bit too much and it just, well, came away in my hand,’ I said.

Mr Mannering took a minute to collect his thoughts, while I was still kneeling at the end of the bed with his toe between my fingers.

As the silence grew, I tried to justify my actions in my head: It really isn’t my fault. His feet are rotten. He’s going to get them chopped off anyway; surely he realises this.

I looked at Mr Mannering’s face to try to gauge his reaction. Then I heard a strange sound. It couldn’t be… but it was. Mr Mannering was laughing – a deep, throaty, contagious laugh. I found myself joining in.

‘They’re going to chop it off anyway, lad. You’ve just made their job a bit easier,’ he said to me.

‘Ever thought of being a surgeon?’ he added and broke into another round of laughter, as if this were a great joke.

‘Well, what do you want me to do with it?’ I asked – the discussion finally coming around to practicalities.

‘Well, I don’t want it,’ he said. ‘Throw it in the rubbish.’

It didn’t seem quite right throwing it in the bin – after all, it was a body part – but then again, a pretty gross part, so in it went.

Two days later, Mr Mannering went to surgery and had not just his toes, or even his foot, amputated, but his leg from just below the knee.

Mr Mannering had been the first male patient I had worked with as a registered nurse, and it was as if I had seen a light of hope at the end of a long tunnel. I found myself not only comfortable working with Mr Mannering, but actually enjoying it. This was just as well, because my time in the gynaecology ward was nearly up. I had received word from management that, as part of the graduate programme, I was to be rotated to a general surgical and medical ward. I just had to survive one more week.

Six months after graduation, I was moved to Ward 13. I knew from the very start that it was going to be challenging, but hopefully in a good way. It was a small hospital and space was at a premium. The ward had surgical patients, medical patients, and urology patients.

The surgical cases often involved abdominal and vascular surgery, as well as urology surgery, which is anything to do with the kidneys and their associated plumbing. While the medical patients were a mix of everything. It was only in the years to come that I would learn that this set-up was not very common (although it happened often enough because of a shortage of bed space). It was certainly not ideal, but one huge benefit of the situation for me was that I gained a whole lot of experience in a relatively short space of time. I began to see things truly from the perspective of a caregiver.

Horrendous, horrible things sometimes happen in my line of work. Things that make hospitals seem like a living nightmare. But good can come out of even the worst experiences, even if it is just a new way of looking at something – sometimes, perception is everything.

Interpretations of a situation can vary tremendously, especially when it comes to a patient’s perspective versus that of a nurse. It’s to be expected that the nursing staff will have a better understanding of health and illness and how the body deals with sickness. What is not always appreciated is a patient’s understanding, or lack thereof, of a particular problem.

‘Get ya hands off it; I don’t want ya breaking anything.’

I put Mr Kent’s leg back in the corner. It wasn’t a whole leg – just the lower part of his right leg.

‘I’ve been living without a leg since before you were born and I don’t need your help now.’

Mr Kent had lost his leg in a motorbike accident when he was 25. He had never married, always lived alone and never had to depend on anybody for anything – well, apart from the prosthesis manufacturer.

I was just trying to help him strap the thing on – speed things up a bit because he was taking so long to get ready. I know it sounds terribly impatient of me, but he looked helpless as he groped for his walking stick while struggling to sit up in bed.

Once Mr Kent had his leg strapped on and was on his feet he was a different person. He was mobile and, if not exactly nimble, he could move pretty quickly.

‘I don’t need to be here, it will pass,’ he kept saying.

And every time, I responded the same way: ‘It’s just a precaution, the doctors know what they’re doing; you’ll probably be home in no time at all.’

Mr Kent was a very strong willed man. He was so fiercely protective of his independence that he would not let any of the nurses help him in any way. The closest he had come to asking for assistance, was pointing his walking stick at the television and saying, ‘Be a good lad will you and change the channel for me.’

But for all his tough demeanour, I suspected he was more worried than he let on.

Mr Kent had been admitted to hospital because he had woken up one morning and found that the left side of his mouth was not quite working properly. When he had gone to look in his bathroom mirror, he noticed that this side of his mouth was drooping slightly.

The hospital doctors were concerned that Mr Kent might have had a small stroke, or even just a TIA (a Transient Ischaemic Attack – a mini-stroke).

‘A mini-stroke, now I’ve heard it all, next you’ll be trying to admit me,’ and of course they did.

Luckily none of Mr Kent’s limbs appeared to have been affected: there was no telltale weakness or paralysis in his arms or legs; and even though his mouth had a slight droop, his swallowing had not been affected.

On the third morning of Mr Kent’s stay with us the doctor decided to change his medicine slightly. For the last five years Mr Kent had been taking half an aspirin a day; the doctor now wanted to give him an enteric-coated aspirin, which has a protective outside layer so it’s less rough on the stomach. It was a good idea of the doctor; Mr Kent should have been on this medication years ago.

Aspirin is one of the most common drugs given to patients, but it can help prevent some serious problems. It thins the blood, thus reducing the risk of clots forming, lessening the likelihood of strokes (clots in the brain) and heart attacks (clots in the arteries that supply the heart).

The only problem was Mr Kent seemed a touch reluctant to take the new enteric-coated aspirin.

‘I’ve made it this far on my own with one leg and I will not be told what’s good for me by a boy.’

I could feel my face turning red as I sensed the eyes of the three other patients in the room on me. I had no reason to be embarrassed, and I certainly needn’t have felt stupid, but I did.

I suppose Mr Kent’s stubbornness was a way for him to stay in control of the situation, but I was resolute: I would make him see reason and win, especially as I had an audience. After all, it was for his own good.