Category: Nursing

A Shift On Women’s Surgical Ward

                   When bodies falter, nurses have a ringside seat, give care to all, to strangers. Who will the strangers be? Someone’s mum, auntie, brother, cousin, sister, uncle, granny, grandpa. They never know.

This shift begins with bedside handover.

First patient, large ovarian cancer removed the day before. Eye contact, smile, ID check, note her skin colour, facial expression, position in the bed, moving, scared to move?

Large wound, clear waterproof dressing. Intact, bleeding, ooze, gape? Check.

Plastic drain stitched in, tubing unclamped, chamber vacuumed, volume acceptable? Check.

Drip stand, multiple pumps, 1st, opiate painkiller. Labelled correctly, programmed accurately, drug matches order, IV dressing secure, kink in the line? Check.

2nd, 3rd pumps, subcut anaesthetic. Dressings secure, no leak. Check.

4th, saline plus antibiotics. Check.

Catheter, fixed securely to thigh, no pulling urethra (god forbid,) volume, colour of urine. Check.

Obs machine, charged, ready to go? Buzzer, pain button, drink, within reach?

Check. Check. Check.

Untangling, unwinding, simplifying. Sickest = tidiest. No tripping over shit on floor, uncool, unsafe.

Thinking ahead (always,) the move out of bed, unhooking drains, catheter bags, unplugging pumps.

Handover’s done, 7 patients, 1 empty bed, 2 registered nurses, no healthcare assistants. This is QLD Australia, “Ratios Save Lives.” They really do.

(UK nurse/midwife shortage dire, unconscionable, untenable.)

Aim by shift end? Each woman, clinically stable, pain-free, clean, cocooned, fresh sheets, feeling cared for.**

Into the fray to a chorus of alarms, to call bells, pain relief needed, to retching, a bag full of vomit and a new admission wheeling up the corridor.

Immediate fires tended, they start proper, no sitting, treading a constant path. Bed, treatment room, nurses station, linen trolley, pan room, back.

First observations. Blood pumping effectively, oxygenating tissues? Heart racing or too slow? Breaths a minute? Too warm, too cold? Pain out of 10?

Next medications, hone in, focused concentration amidst chaos, scrutinising poly-pharmacy multiple charts, no short cuts, ever, no accidental deaths, please. Can you imagine?

Then showering, multiple drips, drains, catheters in tow, major physical manoeuvre for both patient and nurse. Quick is key.

Cannulas/wounds waterproofed, (plastic bags, reams of tape) sweat, blood, antiseptic, gently hosed off.

Drying backs, lower legs, feet, scanning naked flesh, skin detectives looking for problem, rash, bruise, sore.

Adorn in clean hospital gown, final push back across floor to freshly made bed, to opioid pain control, to sleep. Scan again, quick recce, everything in place? Move on.

One patient, one episode of care. Things can and do go wrong.

Constant interruptions. Insensible losses of time. Drugs not available. Equipment malfunctions. Doctors uncontactable. BP’s Crash. Temps soar. Blood pours in rivers. Bodies collapse to the floor.

And human factors? Extra time needed, pain crisis, crying, hyperventilating, relatives spewing anger, nurse in the firing line. Emotional energy needed huge, boundaries a must, we’re not repositories for peoples pain, won’t tolerate disrespect.

End of shift, notes done, we huddle, check in, satisfied, patients as planned ** or commiserate, stretched too thin, patients stable, safe. At whose cost?

We learn not to blame ourselves, work in a 24/7 team, so handover, go home, rest, re-energise, ready for the next .

Lindsey Crossan Registered Nurse/Midwife

Learning To Be A Nurse Glasgow 1983

I’m from a family of nurses going way back.

Great auntie Evelyn nursed in London during WW2.

Great Auntie Jean was a “Call The Midwife” helping women birth at home, day and night in 1950’s Greenock, Scotland.

Three of dads’ sisters were nurses and my own mum a community district nurse. Watching her leave home of a morning in standard navy dress, hat and coat, huge nylon bag over her shoulder full of mysterious dressings and paraphernalia, I knew I wanted to keep up the family tradition.

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The Night Shift

1988. Glasgow Royal Infirmary, drunk lad pinned down by police and porters, “get tae fk, get aff me ya bastards!” face slashed (bottle/knife?) skin flapping, blood spraying up the curtains, on the docs white coat. “Keep still!!”

My job, apply pressure (try not to get stitched to mental boy in the process) fingers scarily close to needle, thick black silk, no plastic surgeon, no operating theatre. Finally, the doc finished, another ‘Glasgow smile’ done.

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Chapter 12. Womens Theatre

We take modern surgery for granted. Anaesthetists render us unconscious, surgeons make deft incisions, cauterise, snip, scrape, biopsy, repair. We wake without remembering a thing. A miracle of modern medicine.

Not a miracle of course but the result of many highly qualified individuals coming together, an array of pharmaceuticals, specialized equipment and instruments.

I often work in a women’s operating theatre prepping them for surgery, minor, major, life-saving, specific to the female sex.

In this theatre, babies are born by caesarean, haemorrhaging is stopped, prolapsing organs replaced, cancers removed, contraceptive devices placed, pregnancies ended, tiny fragments of tissue gently removed after miscarriage.

In admissions our job is to help women feel safe, respected, cared for. Turning up for surgery is nerve wracking. We get it!

We see women across the spectrum.

Elderly, Girls with mature bodies, Indigenous, Neurodivergent, (aspergers, autism, dyspraxia) Disabled physically or intellectually, With mental illness, With history of sexual abuse and resulting PTSD, With gender dysphoria, Refugees, Non – English Speaking.

All humans, all worthy of dignity, respect and equal healthcare. Negative stereotyping is deadly. Nurses know this. We don’t assume anything.

Quiet hijab wearing woman might be confident, articulate, highly intelligent, questioning everything.

Exquisitely dressed woman with the frosty demeanour and clipped communication style may be on the verge of a panic attack, just holding it all together.

Woman with english as a second language, relaxes in our presence, reveals a significant health issue, till now untold. Surgery is delayed.

Vague , delightful elderly woman may not understand exactly what’s about to happen, surgery can’t go ahead without appropriate consent.

The next elderly woman spirited, spritely, sharp as a tack, gives accurate answers and cheek!

Shouty angry woman might just be terrified, missing her usual self medicating drugs, anger turning to tears.

Woman clasping emotional support teddy, own pillow , headphones, eye mask and fidget spinner is autistic with sensory issues.

We accomodate, we manage, advocate, gate-keep, check lists, mitigate risk, tend fragile mental health, keep everyone safe. Nothing surprises us, humans are complex.

Questions, questions, so many questions

Why are you here? What surgery are you expecting ? When did you last eat? Did you take any drugs today? Do you need any drugs? Any jewellery on your body, any sneaky piercings?

Some women are scared, facing a lengthy surgery for cancer, pre-chemotherapy.

Some having minor surgery, glad of the anaesthetic escape from the relentless parenting of small children.

Some mortified, hating the need for surgery in their most intimate parts.

Some barely conscious, rushed through from emergency, actively bleeding, blood drip, drip, dripping into a vein.

We swoop, urgency, speed, focus, No words needed.

Some physically damaged from assault. So confronting every time. TLC is dispensed.

Some thousands of miles away from family.

Many heartbroken having miscarried a pregnancy, still bleeding, needing a curette

Some having an abortion feel shame, embarrassed, many are not, aware of their right to reproductive autonomy, no matter the opinion of others.

She’s been raped, maybe a child herself, abused by a family member, her life a train wreck, she’s vulnerable, she is septic, she is bleeding, at risk of dying if the pregnancy implanted in her fallopian tube ruptures.

She is beyond heartbroken, devastated, carrying a baby with abnormalities who won’t survive, has made the brave decision to end the pregnancy

Can you even begin to put yourself in her shoes?

No matter your feelings, thoughts, opinions, this decision is never taken lightly, is frankly no one else’s business, should not be up for public debate , certainly not by old white male politicians of the patriarchy. Photos of the Supreme Court judges in the USA abhorrent, make my blood boil

The idea of a woman not being able to have this safe procedure in a hospital is unthinkable, medieval.

In my hospital, in this theatre if you need us, you’ll be in safe hands.

Hope we don’t see you anytime soon

Lindsey Crossan. Registered Nurse/Midwife

Another Day At The Office

Recently had the delightful task in the postnatal ward of weighing the newborn babies going home

Wheeling them to the scales one at a time in fish bowl hospital cots

Quickly, gently, wrangling them out of clothes and nappy

Talking to them , shushing them, apologising for ma cold hands

Placing them atop the scales on the blanket nest, tiny bums in the air, so cute!

Just as quick, dress em up again, straight back to mum’s arms

Next day a shift in emergency, seeing the polar opposite example of human

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