A Little Bit of Me

Jottings and Writing, miscellanous misgivings

The trainee

6a00d83451c60269e201053716d284970b-800wiThe young novice trainee stood anxiously at the doorway to the ward. Her second day in practice and she was terrified. Well terrified didn’t really describe it. She was filled with a mix of wonder, excitement, fear, trepidation, pride, amusement, and horror. No more nursing of mannequins who were eternally grateful for any small thing you did for them and only spoke gentle words of encouragement and never complained or grumbled when a needle slipped or a hand accidentally poked an eye. Today, a real patient. One you could talk to; share life’s experiences. She hoped she got someone interesting. An interesting conversationalist and an interesting disease. Yeah! That would be great. Her supervisor gently placed her experienced hand on her back and gently whispered in her ear.

“Mr Symonds is an early stage dementia, CVA, and cardiac failure. His wife, bless her, has finally been persuaded to go home for the weekend and get some well-earned rest. You will find Mr S demanding. He slips in and out of his dementia and, as you can probably imagine, he is not altogether happy with arrangements.”

She tactfully withdrew as the young trainee edged toward the elevated bed where a humped sheet indicated the presence of the patient now known as Mr Symonds. She gingerly tapped him on the shoulder. An arm shot out, caught her under her left breast, and momentarily left her breathless. She could smell it before she saw the dark stain on the bed. He turned over quickly and she was confronted by a wild eyed man of about seventy with dishevelled hair and grubby pyjamas that gaped open and revealed a browned singlet and a scruffy patch of grey chest hair,

“Whadda ya hell. Damn and damn goddamn bloody doctors. Can’t you let a man get some sleep?”

She reeled back form the combined smell of urine and another stench that came from his mouth. She thought that this man had not bathed or attended to his cares for a decade but she clenched her jaw and introduced herself according to the manual protocol.

“Good morning Mr Symonds. May I call you Mr Symonds or would you prefer your Christian name?”

“ Call me what you fucking want you dimwit. Just get you arse over here and clean my bed. Its wet.”

With that, he slumped back on his pillow and extended his arms into the air as if offering himself to some God that only he could see on the ceiling. He started humming to himself and she thought she recognised some old fashioned tune. She tried to turn her olfactory equipment off. She remembered the TV program from the night before where morticians had rubbed their nostrils with Vaseline (or was it lavender?) to avoid the smell of the dead and she wondered if there was some nursing equivalent.

“Well hurry up. I haven’t got all day. I’ve got to go out shopping with the wife later this morning and there are the cows to move and the back paddock needs to be sewn for the spring.” He started off his humming and she turned back the bedclothes.

It was worse than she thought. The urine had not only soaked the bed but had pooled on the mattress and dripped through. Mr Symonds toilet kit was unfortunately under the bed and the urine had dripped into it as well. She pulled the sides of the open kit apart and saw the bright yellow over the soap, hairbrush, razor, and toothbrush. She shuddered and had to swallow hard. As she came back up level with the bed, she saw that Mr Symonds had struggled out of his pyjama bottoms and she was greeted with the sight of his uncircumcised, flaccid, but very large, penis. Her newly professional eye saw that it was badly discoloured and she guessed correctly that the uridome that Mr Symonds was supposed to wear had either slipped off or had been removed. He saw where her eyes rested and he seemed to mellow.
”Bloody thing was giving me gype so I took it off.”

She started to have real doubts about what she was doing. Her head had been filled with the glamorous image of coiffured women (and sometimes the token beautiful man, preferably not gay) sweeping through the wards, handing out platitudes to grateful patients who were all dry and only barely sick and made wonderful conversation. Unfortunately this, her second experience, had completely disavowed her of this.

Just then, as if accompanied by the sound of heavenly trumpets, a white coated, stethoscope toting, young man entered the room. The young novice looked up from her position about level with the bed. Her immediate thoughts of rescue from her awful predicament were immediately dashed when the young house surgeon, barely out of nappies himself, surveyed the scene before him, and exhaled a long and dignified breath.

“What the hell are you doing down there. Can’t you see this man needs to be dressed…..” (he suddenly got the full force of the stench coming from the bed), “ eeerr and a-a-a-a eeer showered and dressed and taken to breakfast. Get up from the floor and see too it.”

The young novice may have been young and new to her profession but she was well skilled in dealing with males who had ideas above their station. She rose to her full height and fixed him with her evilest look. He momentarily halted in his tracks but, he too, was well skilled in dealing with upstart young gals who thought themselves his professional equal. He had been taught in medical school that all nurses wanted to do was to form professional development groups and leave the care of patients to the untrained and underpaid foot soldier nurse aides. He started to, in the nicest possible way, explain to this young apprentice this fact when she had the temerity to open her mouth.

“I think Mr Symonds needs something to help with his incontinence of urine. Looking at his swollen and reddened genitalia I think that the uridome is causing him great pain and he may be better off being catheterised.”

The house surgeon forgot his token gesture of compromise and exploded in an apoplectic flurry of words and gestures.

“What do you know about catheterisation? You are on what, your second or third year, apprenticeship of nursing and you have the audacity to tell me what I should be doing. I’ve had six years of training and we (he said it like the royal WE) do real hands on training. None of this namby, pamby, feelgood, PR rubbish. Do you possibly think that you know more than ME?”

The young novice secretly glowed inside (he thinks I’ve already done a couple of years training) but she remained steely solid on the outside.

“Yes I do and furthermore I think that Mr Symonds is incontinent more than in the evenings which is the medical assessment I read in the nursing station before I came on the ward. I think he has episodes throughout the day and……. She looked out the side of her eye and saw Mr Symonds face as he suddenly realised what was going on around him.
“ Yeah! I want that cath, cath, thing and I want it now. I’ve got sheep to shear and I’ve the dogs to feed and …..” He trailed off as the house surgeon, seeing his battle lost, turned on his heels, and strode out of the room.

The young novice didn’t feel as though she had won any battles. She looked into the future and saw and endless line of Mr Symonds’ and young house surgeons, and wet beds and catheters and uridomes and her shoulders slumped. She was supposed to be out with her friends tonight celebrating the end of the first semester and she could see that all she would be thinking about was this. This, this…………; she struggled to articulate what it was. She transferred the wet but now happy Mr Symonds into a wheelchair and pushed him toward the shower. He turned in the chair and, winking at her, whispered
You taught that little whippersnapper a thing or to. You stick at it girl. You’ll make a good one. Now where have those dogs gone?”

Two hours later the young novice, returning form her morning break stopped by Mr Symonds room to see how the old gentleman was getting on. She stopped, aghast, at the door to his room. Her classmate was bent over the bed, pulling back the sheets that had been clean only minutes before.

“Someone hasn’t been doing their job properly,” she moaned. ”Fancy leaving you for hours lying in your own pee. How could anyone sleep at night knowing they have neglected someone so badly?”

As the young novice listened to Mr Symonds run through his barnyard stories and as she listened to him alternately curse and compliment her classmate, she thought that she might have some grasp of what the this of her earlier thoughts might be.

Two weeks later the young novice sat in front of her computer trying desperately to bring into focus that morning as she wrote out an exemplar as part of her experienced based practice. At first, all you could think of was the shame and embarrassment of the cold and wet Mr Symonds and her inability to satisfy his needs. She pictured herself in the vast ward with more experienced and qualified colleagues walking past and scoffing her pitiful attempts to wash and clothe this poor man. She saw her supervisors eyes narrowing and rolling as she monitored her pitiful progress throughout the morning and her eyes misted over with the ignominy of it all. Then she started to see other parts of the morning. She remembered the nearly empty IV bag and how she had hooked up a new one. She remembered her correct identification that Mr Symonds was showing signs of dehydration and that his blood pressure was abnormally high and she remembered the reasons for why this would be. She suddenly saw that she had a great deal more knowledge than she had a mere two months ago.

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