Oh, Nurse!

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?

Deb Segelitz
Deb Segelitz was born and raised in Pennsylvania, and is astounded to find herself living in the Scottish Highlands, sharing life with her husband, a Highlander she stumbled across purely by chance on a blog site. They own a small business restoring and selling vintage fountain pens, which allows Deb to set her own schedule and have time for photography, writing and spontaneous car rides in the countryside. She is grateful to the readers of ANC for accepting her into the North State fold.
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37 Responses

  1. Avatar Eleanor Townsend says:

    Hello Deb
    It is so good to hear from you this morning (6:50am here, sun just came up on what will be a hot day), though I read this article with tears in my eyes. Your description of the kindness and strength of the nurses tells such a powerful story, and the underlying ongoing thread of what Sem endured/endures – and your part in his wellbeing – is very moving.
    And the beautiful photos, of course……….oh my!!
    I think of you often, but sometimes don’t respond to your articles just because I don’t think my words can do them justice.
    Thank you for your beautiful writing. You bring a different world to us.

    • Deb Segelitz Deb Segelitz says:

      I’m so glad you enjoyed the article, Eleanor! We have soooo many nurse stories, fortunately most of them are good ones. We’re definitely indebted to them for Sem’s care, and more than once, for his life.

      Please never feel shy about responding. It’s always so lovely to make these connections in the comment section, however brief! I always appreciate it, and love the feedback I get here.

  2. Avatar Jacquelin Breedlove says:

    Deb, thank you for putting into words the thanks that we owe nurses. I share this this morning with my sister in law who has been a nurse for 35 years. She is a gem and someone that I for one is thankful to have in my life. You are the best!

    • Deb Segelitz Deb Segelitz says:

      You’re welcome, Jacquelin, I’m so glad you enjoyed it. Your sister in law is a star… and I don’t even have to know her, to know this is true.

  3. Oh, Deb. What a beautiful, personal piece you’ve shared with us today that so aptly describes both sides of the coin; of patients and their lay caretakers, and the nurses in the trenches who chose this vocation. Thankfully, most of your experiences with nurses have been good ones.

    I am so glad you’re here on ANC in this community where it’s safe and loving for you to tell your stories. Thank you!

    And three cheers for the awesome nurses out there.

    I hope this is a good day for you and your sweet Sem, Deb. xod

    • Deb Segelitz Deb Segelitz says:

      I’m so glad you liked it, Doni! I’ve got a few not-so-great stories as well but I can honestly say the good far outshine the bad.

      It’s wonderful to be here on ANC, sharing stories of life in the north of Scotland! I’m so glad that people enjoy them.

      It’s a ‘hot’ day for us (mid 70s which, I know, I know, is probably something you guys would love – but here it’s definitely considered scorchio haha), and a bit of a quiet day after a rough night. But I think we’ll drag our overheated carcasses out to the store. I just cut up a melon and Sem said, “You know, Parma ham would go really well with that melon…” Hint taken haha.

      xoxo

  4. Avatar Beverly Stafford says:

    Your article should appear in Nurse Magazine – if there is such a title – so that these overworked, mostly underpaid angels know how much they are appreciated. And it might inspire the few who should be in other vocations to be more caring and compassionate. You and Sem have certainly had some rough times, and as dreadful as dialysis can be, you are no doubt grateful that it is available. Thanks for sharing.

    • Deb Segelitz Deb Segelitz says:

      I have a handful of nurse-friends on Facebook who will see this for sure, and hopefully they’ll share it onward. His dialysis nurses are gems, truly.

  5. Avatar Matthew Grigsby says:

    What a fantastic tribute to the Nurses who have given Sem and you something you can never buy: time. Keeping him safe and laughing, fighting for him when he can’t and investing in his well-being are all heroic acts!

    I love how you see and appreciate them, and I hope you’re able to show them this article, so it can say all those things you’d never be able to express in just a conversation. It’s pure poetry, this.

    • Deb Segelitz Deb Segelitz says:

      You are so right about giving us time. Without nurses (and, grudgingly, some of the doctors though goodness knows many of them have let us down) and dialysis, I would have lost Sem two years after moving here. I have many reasons to be thankful.

      If I showed this article to his nurses they would be mortified – often Sem thanks them for taking such good care of him and they all deflect, saying, “Och it’s our job,” and not wanting to take praise for it. They’re good people.

  6. Avatar Mark Roman says:

    Great article, Nurses definitely are the glue that holds the medical machine together.

  7. Avatar Ginny Hibbard says:

    Thank you for your beautiful words about the nurses. The great nurses are always remembered, but I know I tend to forget the ones that are not great.

    Also you have given a little insight into what National Health is all about. Ours may not be absolutely wonderful, but sure better than N.H.

    May you and Sem have wonderful days still to come to you, now and through tomorrow.

    Blessings………

    • Deb Segelitz Deb Segelitz says:

      Oh I definitely remember the ones who are not great 🙂 but I don’t dwell on them.

      The NHS is truly a great thing. It is steadily being chipped-away-at, and now that we have a new Prime Minister who is rather fond of the American president, I fear even more for the NHS because the UK government seems to want to sell it off / privatize it (to US companies) a la what happens in the US. This spells disaster…

      When I moved here my husband and I went over to the local doctor’s office (at the time, literally across the road from our house), introduced me, said I would be living here, and just like that, I was registered with the NHS. Began getting my prescriptions a week or two later, no fuss, no referrals, just good solid medical coverage. Coming from the US system, I was astounded, in a good way.

      • Avatar Ginny Hibbard says:

        Wonderful your experience has been good. Maybe some of the reason for change is not because of our American President, but the cost is so high that the system has to change somehow to keep up.

        • Deb Segelitz Deb Segelitz says:

          No, the change is because the UK government wants to spin it into a money-maker. They would be doing this no matter who the president is, but it will help their cause that our PM thinks the president is the bee’s knees and the feeling seems mutual.

          • Avatar Ginny Hibbard says:

            We can agree to disagree. ;o)

          • Barbara Rice Barbara Rice says:

            I’m going to jump in here for a moment.

            Deb has told me how much she HATES it when someone pulls one tiny aspect of her story out and twists it to make some political/religious point. It might seem minor to many people but it’s crazy-making for her.

            Deb has more than enough on her plate without having to tear her hair out over hijacking of her innocuous stories.

          • Deb Segelitz Deb Segelitz says:

            Ginny, I’m not sure what you think we are disagreeing about. Over here in the UK it is known that they want to sell parts of the NHS off to American companies. The powers that be in the UK government have been wanting to do this for the past few years, by which I mean, pre-the-current-president.

            It is also a known fact that our new PM and the current president seem to admire each other, and likely have similar agendas, so this idea will definitely get a big nod from the US side. So what are you disagreeing with? That the UK wants to turn the NHS into a for-profit scheme rather than what it is right now, and wants to sell it off to the highest American bidder? Because that is what’s in danger of happening. That is fact.

            Or are you arguing about which country has “better” health care? Because if you are, that’s just silly. I have had great health care in BOTH countries… in the US I had great health care because I was fortunate enough to have good health insurance. Here in the UK I have had good health care as well, without needing health insurance. Like most other countries I imagine it’s variable. Not one word of my column was about saying one system is ‘better’ than the other. If that’s what you took out of it, you are mistaken.

            Barbara, thank you. This is now giving me a headache, and I think I need to give up on replying to people who do things like this, because there’s no joy in it.

  8. Avatar Beverly Stafford says:

    I have a little story that might explain what a truly horrible man I worked for for a few months. My husband was a hospital pharmacist for most of his career. The horrible boss was admitted after having a heart attack. Husband told me that the horrible boss was so awful to the staff that the wonderful nurses finally refused to treat him. And to think I put up with his behavior for nine dreadful months. Bless those nurses.

    • Deb Segelitz Deb Segelitz says:

      Oh my goodness, how awful that man must have been! How ever did you manage to cope for so long?

      There was a man in our former village who was so terrible to all the hospital staff that the northern hospital actually refused to admit him. They gave him every good chance but in the end they said, “no more.”

  9. Avatar Candace C says:

    Deb, I always love to read your writing. Although you’re far away I feel like I’m right there with you! I agree with you that the majority of nurses are indeed compassionate, hard working caretakers. I can relate to Seth’s “chair buddies” I’ve been there for a different reason but they do indeed become your friends to help through tough times. Especially if you have a shared sarcastic and silly sense of humor! While I think your emphasis on nurses is important and should be shared what struck me the most while reading was yours and Seth’s obvious love and respect for one another. It definitely sounds like you both found your “person”. It comes through in all you write.

    • Deb Segelitz Deb Segelitz says:

      Thank you, Candace, I’m so glad you enjoy my column!

      I like the term “chair buddies” – it makes all the difference to have good ones, doesn’t it?

      We have definitely both found our “person”… it still astounds me and delights me that we did. 🙂

  10. Avatar Erika Kilborn says:

    I firmly believe that most nurses are just angels in disguise. Yes, I have run into a few of the not so angelic ones, but it is rare. Very rare. I am very glad that Sem has such wonderful professionals caring for him. Lovely piece, as always.

  11. Avatar Gloria Bobak says:

    good read

  12. Avatar Anita Brady says:

    I did an unexpected 5 day stint in the local hospital on the hill earlier this month. The nurses on the Second Floor East were fantastic. I felt that I was not getting enough information from the Hospitalist at the time, and the nurses told me whatever was in my “chart”. While I valued that information, I told the hospital admin that I spoke with that the doctors had become too reliant on the nurses communicating with the patients, and the doctors seemed to not do it anymore. I verbalized that the nurses don’t get the big $$ on their paychecks.

    • Deb Segelitz Deb Segelitz says:

      Doctors here in the hospital seem to hardly want to speak to patients at all – on hospital rounds they talk to the nurses but almost have to be forced to look at and speak to the actual patients. Frustrating!

  13. Avatar Bruce Vojtecky says:

    Nurses get paid a salary that doesn’t reflect how many or how few patients they take care of. Doctors will pop in on as many patients as they can because they get paid the same for each visit whether it is 30 minutes or 30 seconds.

    • Deb Segelitz Deb Segelitz says:

      Not sure it’s that way re: doctors here in the UK, but yes, overloading nurses is definitely a problem.

  14. Avatar Karen Calanchini says:

    Always love reading your articles Deb, your photos are amazing, as well. You write in such a way, that I visualize pictures in my head as I read the story. I feel for you and Sem and what you are going through. It must be grueling at times.
    Although I do not know you, I find myself wondering how it is going for you two and just about that time, I find another article. Thank you for sharing your life with us.

    • Deb Segelitz Deb Segelitz says:

      I’m glad you enjoy my articles Karen, thank you for telling me! I’m glad to be able to connect so well with so many fine ANC folks :-). It’s lovely that you think of us, very kind!

  15. Adrienne Jacoby Adrienne Jacoby says:

    Now that I am moving into a portion of my life that will undoubtedly, involve more and more investment of time and money into medical expertise I realize I will become more and more acquainted with nurses. So far, I’ve had nary a bad one. Overworked and unable to respond to your request immediately (sorry I took so long to bring you a glass of juice, I was helping to resuscitate a patient.). It help to remember the Golden Rule . . . It’s easy to love back someone who loves you. Well, okay, that’ s a little appropriation of the golden rule, but the idea is there.
    Deb, as usual, I do thank you for your contributions. Now, when I come to visit I want to stand on that one corner on Telford St. and gaze up at the moon. Make sure it’s 70 degrees!!!

    • Deb Segelitz Deb Segelitz says:

      I hope all of your nurses will be lovely and helpful, always. We always try to be very patient and polite and it does help.

      Glad you enjoyed the article. That corner on Telford Street is literally minutes from where we live, so I can guarantee the corner, but not necessarily the moon or the 70 degrees! 🙂

  16. Terry Turner Terry Turner says:

    Deb, you have such a gift for making your stories alive. I felt as if I were there with you. I loved your tribute to the good nurses who have helped you both. It is so moving. Thank you!