Some of you will know that I often rage against the sheer screw-uppery of NHS Highland (NHS = National Health Service), and with good reason. On the whole I think the NHS is brilliant and for an overloaded system, it struggles on valiantly, especially here in Scotland. We are in real danger of losing it if the UK government has its way, which gives me the shakes. But it has to be said that up here in the north, NHS Highland is too often a cluster…uh…bomb of incompetence and bad decisions. Every time we have to deal with them – unfortunately all too frequently – it is an exercise in head-slamming frustration because they get it so wrong in so many ways, nearly all the time.
And then there are the nurses.
Caveat: I know that there are great, good, mediocre and awful people in every profession, everywhere. For the most part, though, the nurses we have dealt with across most departments in the hospitals and doctors’ offices here have been… wonderful. (Gotcha! You thought I was going to have a big ol’ rant about nurses, didn’t you?)
“Shelter from the storm,” in the local dialect.
Here in the Highlands, and perhaps everywhere, nurses are in short supply. They are understaffed and overworked at every level, yet they try their hardest to do right by their patients in very difficult circumstances. Especially up here in the far north at our local hospital, patients and nurses soon get to know each other, usually discovering that they have people in common. It is a very close community, in that sense. I should say that my husband has had decent care in the main hospital in Inverness but if he’s got to be in a hospital at all he would always prefer to be in our local, northern one.
When Sem started peritoneal dialysis (“PD”) in 2011 there was a small group of specialist nurses at the hospital in Inverness who were in charge of his care and also his dialysis training. All of the “regular” nurses on the ward knew with certainty that if they touched Sem’s dressings a PD nurse would come swooping down on them like a furious angel, sternly letting them know that Sem was firmly Off Limits. Even the doctors on the ward knew not to mess with the PD nurses or their patients. They all laughed ruefully about it but they did not overstep; I think they were genuinely a little afraid of the consequences if they did.
During one of Sem’s hospital stays he had not been given pain meds directly after surgery and for the entire night and much of the next morning. He was in agony. The ward nurse in charge had no interest in what I had to say about it (note: there was no medical reason to deny him painkillers) and when one of the PD nurses arrived to check on Sem in the morning she found me near tears in the dayroom. I explained the situation and this warm, gentle, soft-spoken woman changed before my eyes into a hard, angry, protector-of-Sem. “Leave it with me,” she said through clenched teeth, eyes flashing. My Hero stalked off in quiet fury, and Sem had strong pain meds within minutes, dispensed by the formerly obstructive ward nurse who was by now looking very chagrined. I believe his pain meds were administered on time, after that!
One of the other PD nurses won our adoration for life when she said upon meeting Sem for the first time, “Let me just pull the blinds down over the window [to the hallway] in case someone walking by starts pervin’ on your wounds when I change your dressing.” Ha! Dark humor just like ours! We’d found a kindred spirit, and she remained our favorite PD nurse throughout those years.
There are, of course, the nurses you wish you’d never met even though they are well-intentioned, like the one who spoke to all her patients loudly and somewhat overly-cheerfully; perhaps she’d spent so much time caring for elderly patients that foghorn-and-jollying was her default. But when Sem finally had an appetite after weeks of near-starvation and had just dug in to a meal he had actually been looking forward to, the last thing he needed was to hear the nurse say from behind the curtained bed next to his, “I don’t know, Ian, I think we’ll have to put some dynamite up ye to shift that lot!” The resulting bedpan-sounds (and smells) did nothing for Sem’s hard-won appetite and we fled for the dayroom, echoes of the nurse’s high-volume encouragement following us down the hall. Every time she walked in thereafter, the rest of the patients in the room tensed up a little. What would she holler next about some very personal matter or other? Still, her heart was in the right place and it gave us another hospital anecdote – much later when we could see the funny side, that is!
I’ve had a lot of time to observe nurses over the past ten years and most of them have my sincere admiration. There’s our local practice nurse specializing in asthma, who is always filled with concern for Sem’s lung issues and who tries her best to minimize his struggles. There was one nurse years ago in the hospital who answered the same questions over and over again, asked by a somewhat confused patient in a neighboring bed. She replied to him without a hint of exasperation, each time answering like it was the first time he’d asked. I don’t have nearly enough patience for something like that, and I will never forget her.
Then there were the angels working in the Intensive Care Unit who saw Sem through some of the darkest times he has ever had. He was in ICU for about a week after an operation which he nearly did not survive, and the nurse on his first evening there – which was her final shift before she went on vacation – sat with him for hours, helping him through a time so terrible that he still doesn’t speak of it. She got him through every minute of that long, dark night; truly his guardian angel. I am deeply indebted to her. The next morning when the day nurse took over – a wonderfully cheerful no-nonsense Western Isles lass – Sem was tended to as if he was the most precious person there. Which he was, to me… and for those handful of days he was to the ICU nurses, too.
There are of course also the auxiliary nurses who, along with their other duties, bring countless cups of tea or coffee and cookies or a bit of cake a few times a day, doling out kindness and cheer in equal measure during those long, dull days on the ward. And then, when Sem’s new dialysis chapter began and he switched from peritoneal dialysis to hemodialysis, there were – and still are – his hemodialysis nurses. They are something extra-special.
Here at the local northern hospital, Sem attends hemodialysis three times a week. There’s a team of nurses who work both with dialysis patients and chemotherapy patients, as well as handling infusions of whatever kind for other patients. There are eight of them plus an auxiliary and they have become Sem’s friends over these last few years. After all, in various combinations depending on their shifts, they spend more than four hours together with their patients, three times a week. While they aren’t with the patients for every minute of those four hours, they are nearby and they check on everyone regularly. The auxiliary is a shining star, taking on every sort of task from keeping things well-stocked to taking patients’ stats and, as Sem has said, “When she has been around the room to see us she leaves all of us smiling, patients and nurses alike.” The dialysis nurses are kind and attentive, and often Sem comes home with tales of their conversations and laughter. But he has also seen them shift instantly into emergency mode when something goes wrong. They swing into well-coordinated action with intense concentration and professionalism until the crisis has been resolved. For years I was basically Sem’s PD nurse at home, and handing over his care to strangers (at the time) was difficult for me. Now that I know them, I have no doubt that he is in very good hands, and I trust them to care for him with as much attention and focus as I would.
View from Sem’s chair at the local dialysis unit.
Much like the PD nurses, Sem’s hemo nurses are protective of their patients. On the first day of one of his local hospital admissions last year, as usual there had been a mixup with his meds on the ward. He had been given a pill in the morning which makes him violently ill unless he takes it last thing at night – which we had both specifically told the ward nurses and doctor when he was admitted. When he was brought down for dialysis that morning he was in pain and terribly sick, to the extent that his dialysis machine kept alarming. We told the dialysis nurse what had happened with the meds, and why Sem was so sick. This nurse is a petite, birdlike, cheerful woman who often twitters away to herself at high speed as she goes about her work (also at high speed). In that moment, though, she transformed into an angry, high-speed missile as she shot upstairs to find the ward doctor to get a prescription for an anti-emetic injection. “They will see my Spanish temper, and they will not like it,” she said darkly as she left. It wasn’t long before she was back with a doctor in tow, but she’d already picked up the syringe on her way. She politely “asked” the doc’s opinion, by which I mean she told him what she was going to do, and why, and he knew better than to argue. Within minutes Sem was much improved and after our wee Spanish warrior-angel made one more trip up to the ward for “a word with the nurses,” Sem was not given that pill in the daytime again. Score one for tiny-but-fierce!
Sometimes Sem comes home from dialysis with a spray of blood over his clothes (and once in his hair) and he’ll say, “One of my needle sites erupted as I was being taken off the machine – we thought the bleeding had stopped, but it hadn’t. I got the nurse pretty good with a big jet of blood – oh how we laughed!!” Laughed!?! Dialysis patients and nurses definitely have their own brand of humor, that’s for sure. They all take the occasional bloodbath in their stride.
I suppose my favorite nurse in all of Scotland would be the now-retired nurse at the GP practice in our former village who said to Sem, a few months after I arrived here, “Your blood pressure has never been this good.” Sem remarked that he had recently married me and she said, “Well that’ll be the reason, then.” Best nurse ever!
Really, the world needs more nurses, of all kinds. Government cutbacks dictate otherwise, as they close down entire wards even though patient numbers don’t go down – in fact they go up, leaving less nurses to deal with more patients, in less space, with fewer resources. I don’t know how nurses continue to cope, but I’m very glad they do. Long shifts, often cranky patients, difficult doctors, and hopeless administration, and still they show up and get the job done, many with compassion and skill and real old-fashioned caring. Where would we be without our nurses?
