Confessions of a Male Nurse

Now, 16 years on, I’m still working in healthcare. I wouldn’t be if I didn’t like caring for others, but I’m only now realising that nursing isn’t just about what I can do for others; nursing is also good for me. Everyone likes that warm feeling they get when they help someone. Well, I really like it, and especially when I’ve done that little bit extra.

Looking after others is all I’ve ever known. I’ve seen people in all states of health, both mentally and physically, and I have come to the conclusion that our bodies themselves are the greatest equalising factors in our inglorious existence. Now, I want to show you what it’s like, what it takes, and what really goes on in the front line of the caring profession.

Why do I want to do this? On the positive side, I want to tell you just how amazing your average nurse really is; I want to prove that a good nurse can literally be the difference between life and death. On a more negative note, this is my chance to make up for the times when I should have spoken out about some of the horrendous goings-on in many hospitals, but didn’t; times when I kept quiet, because of fear, ignorance, or simply being at a loss about what to do.

Introduction (#u99288368-c2dc-581b-8db8-b64de8fcf600)

There is one thing almost all of us are going to be at some point, and that is a patient. One day, most of us are going to need to depend on someone when we are at our weakest. That someone is most likely going to be a stranger and that stranger is most likely to be a nurse.

I have worked with patients suffering from dreadful diseases, some of which I had never even imagined, let alone dealt with, like Guillain-Barré syndrome or motor neurone disease, or horrific cancers that spread through the body. Now, after 16 years, I’ve done pretty much everything – from keeping someone comfortable while their body is failing and the pain is getting too much to cope with, to chasing a confused (and very naked) patient down a corridor. I’ve learnt how to deal with a family who have been told their loved one is not going to make it (which never gets any easier, regardless of whether it is expected or not). I’ve experienced my fair share of emotions: frustration, impotence, despair, at the unfair ways disease and misfortune can strike those most deserving of life; at other times, relief when someone’s suffering ends.

But no matter how much I sympathise, I don’t really know what it is like to be a patient. I have only seen things from a nurse’s perspective, where you can’t afford to get too emotional or involved. I often wonder what it must be like to be on the other side, to be lying in bed, to see things through a patient’s eyes.

The only way I have of imagining is to use my experience of the way people in the past have reacted to being in my care.

What I have noticed, is that a person’s behaviour generally changes as soon as they become a patient. Some people become extremely nervous, which is understandable, and may explain why some pretty silly questions are asked. Does surgery mean I will have to have an operation? Then, there are the people who, during a ward round with their consultant, will nod as if in understanding, but when the doctor leaves they haven’t the faintest idea what is going on. I’ve heard many a patient, when asked by their consultant, ‘How do you feel?’ respond by saying that they feel fine, when in fact they’d spent the morning complaining about their ailments.

Some people suddenly find they are unable to do simple tasks for themselves, like pour their own water or fluff their own pillows, even if they are physically quite capable. Others become so used to being in hospital that they know how a ward runs better than some of the staff. Some become so demanding that no matter how many of their requests are satisfied, they will never be happy, while others are so grateful for any small service – even just spending five minutes listening to them – that they want to shake your hand or marry you off to one of their grandchildren. I’ve seen people too afraid to disturb the nurse, as they don’t want to be a burden, even though they are worried about the pain in their chest. I’ve seen others treating nurses like servants. Then there are people who lose all initiative, because they aren’t sure what they are supposed to do; they don’t know how to be a patient and they’re not sure what exactly a nurse’s role is.

When I picture myself sitting for hours in the waiting room, seeing patients who came after me being dealt with first, I wonder whether this would irritate me, or whether I’d be calm and rational, like all nurses want their patients to be. Then when I finally get called through to see the doctor, I imagine expecting the doctor to have all the answers to my problems as, ‘Doctor knows best.’

It must be frightening for patients who are admitted to be put on a drip, to have blood taken every day, or tubes stuck in some surprising places. For some having to share a room with a bunch of sick strangers might seem difficult.

But that’s why I’m here, your average nurse. It isn’t just about giving you your medicines and dressing your wounds. I’m here to explain things, including the foreign language the doctors use. I’m here to help you in and out of bed, to help you help yourself. I’m here to help calm you in the night when you wake up wondering where you are, or worrying about that pain in your chest. I’m here to help make your treatment as bearable as possible.

I (#u99288368-c2dc-581b-8db8-b64de8fcf600)

Slippery beginnings (#u99288368-c2dc-581b-8db8-b64de8fcf600)

Did I always know what I was doing? Of course not, but I couldn’t tell the patients that. A nurse must be confident and assertive, yet caring. The problem was I didn’t feel confident, nor the least bit assertive; I did care, though.

I will never forget my first day at Allswell, a hospital situated in the middle of nowhere – well, maybe more like everywhere. Allswell was a fairly typical example of all that is good, bad, outrageous and hilarious about hospitals across the civilised world. I remember vividly the reaction as I walked into the ward and explained I was the new nurse; mouths dropped open and there were mutterings of ‘there must be some mistake’ and even ‘this is a joke’. The nurse in charge of the ward even made a phone call to the head of personnel to explain the problem. You see, I was not just straight out of college; I was the only male in a gynaecology ward. The most important people I met that first day were Sharon and Cherie. Sharon was the nurse in charge of running the ward, similar to a traditional Matron. Cherie was the nurse whose job it was to familiarise me with the ward. It was a huge responsibility for her, although I didn’t realise it at the time. Over the next two months, Cherie’s task was to transform me from a naïve new graduate to an effective, safe and efficient member of the team. I don’t think either of us knew how difficult that was going to be.

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.