Read Between the Lines.

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Status: Finished  |  Genre: Other  |  House: Booksie Classic
Louise is a nurse - new to the job. She's nervous and unsure and sometimes jumps the wrong conclusions...

Submitted: March 24, 2016

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Submitted: March 24, 2016

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Read Between the Lines.

“We have a blue light, eta 4 minutes, all trained to resus please,” sister’s voice is authoritative through the tannoy system.  I hesitate for a minute, am I supposed to be in resus today?  No, I answer my own question, I’m sure I’m to just stay in Majors. They wouldn’t put me in resus in my first week as a newly qualified, surely?

 

I carry on attaching the ECG leads to Mr Miller’s hairy chest; they’re not sticking, “oh dear Mr Miller, I think I’m going to have to shave you.”

“As long as you’re not waxing me love, you do what you’ve got to do,” Mr Miller replies with a wink. 

The hustle and bustle of the Accident and Emergency department carries on the other side of the curtain as I weald the blue plastic razor; ready to de-fuzz.

 “Nurse Bennet!  What are you doing?”  Sister swings the curtain aside and marches into the cubicle.

My mouth gapes open, but words fail me – that woman scares the living daylights out of me.

“You are supposed to be in resus Nurse, did you not check the rota this morning?”  Before I can answer, she strides out of the cubicle in the direction of the resuscitation room.  Giving Mr Miller an apologetic shrug, I scurry along beside her.

“I, um, I didn’t think I would be assigned to resus yet,” I manage to stutter out.

“Well there’s no better time to learn,” she holds open the door of the resus room and stands aside to let me enter.

 

The stark overhead strip lighting makes me squint slightly as I absorb the scene before me.  A gaggle of people; medics, nurses, porters, all swiftly but calmly, moving around the patient.  Everyone seems to be able to second guess what is needed, a porter takes the samples from a doctor and knows where he needs to ferry them to.  A nurse is on the phone calling for a CT scan – predicting its need.  Another nurse is attaching leads to the patient, without being instructed.  How am I supposed to know what to do?

Feeling the colour drain from my face and my mouth too dry to speak, I turn to Sister.  I must have looked terrified because she says simply, in a tone much gentler than I’ve ever heard, “you can do this.”

Taking a deep breath, and vowing to be professional I yank an apron from the wall container, but the slippery plastic just will not co-operate.  After much rustling and flapping – and some weird looks – I finally get the dammed thing on.  Gloves next – oh for God’s sake!  Clammy hands and gloves that are two sizes too big, render my hands useless and look ridiculous.

“Nurse!”  Dr Munroe calls out, I look behind me, before realising he’s talking to me.  “I need IV access in the patients left arm please.”

For a moment I forget what IV means, then adrenaline kicks in and I’m on it.  Thankfully, this is something I’ve done before.  Grabbing an IV trolley, I head over to the patient.

 

“Oh my word!”  I can’t hide my shock when I see her.  The poor woman’s face is black and blue, one eye is so swollen it cannot be opened, whilst the other has a cut above it.  Her nose looks broken and her bottom lip is split.  I feel like crying. 

“Do your job nurse,” the anaesthetist says sternly, “save your opinions for the staff room.”

 What has happened to this patient?  I’m about to ask, when we are ushered out of the way for the X-ray unit to come through.

“Have you got that access yet?”  Dr Munroe asks impatiently.

“No sorry, I’m right on it,” I say embarrassed.  Unable to ask any questions about how the patient came to be in this state, I press on with my task.

 

Cannula in and fluids successfully attached, I move away to clean my trolley.

“I feel so sorry for her,” I overhear Karen, one of the senior nurses’ whisper to another nurse, Melanie. 

“Well I can’t believe someone would put themselves in that position in the first place,” Melanie replies with a little disdain.

What are they talking about; how the patient got so battered?  What are they suggesting?  Willing my ears to stretch like a gramophone, I lean in a little.

“Oh that’s a bit harsh Mel, we’ve all done things we regret.  It’s just a matter of finding a way out of that situation,” says Karen, showing empathy to the woman.

“Yeah, well, I would never have put myself in that ‘situation’ in the first place,” she finishes laying out a suture pack, and turns around.  Realising too late that I’m standing right in her way, I stumble backwards slightly and busy myself by reading the insert of a Morphine packet.

“Nurse Bennet,” she eyes me suspiciously, considering whether to chastise me for earwigging.  But then realises she’s better off giving me a job to do.  “You need to carry out 15 minute observations,” and she hands me the patients chart.

 

I press the button on the BP machine and it starts to inflate.  It looks like the patient is coming round as the squeezing of the cuff is making her fidget.  “Hi there…” I falter, realising I still don’t know her name.  I surreptitiously glance at her chart, “Abi - my name is Louise, I’m one of the nurses looking after you today,” I introduce myself, I still feel a rush of pride when I call myself a nurse.

“Trev, where’s Trevor?”  Abi asks in a slightly panicked husky voice.

“Trevor – your partner?  He’s outside, do you want someone to get him for you?”  Melanie asks mid suture.

Abi winces, and I don’t think it’s just from the pain, “no, I don’t want to see him right now.”

“Let’s get you some more analgesia,” Melanie decides, interpreting Abi’s wincing as pain.  “Karen,” she calls across the room, “can you check the patients chart to see what she’s written up for please.”

 

Once Abi condition is stabilised, the team move off to continue with the ever growing list of jobs they all have, whilst Karen and I stay in resus.  I’m about to locate Abi’s notes so I can find out what her ‘situation’ is, but Sister calls me to take a break.  “Take 10 minutes while you can Nurse Bennet,” she advises. 

Stirring my tea idly, I continue to think about my patient, and I keep coming back to the same conclusion – she must be the victim of domestic violence.  It all adds up; badly beaten, not wanting to see her partner and the snippets of conversation I overheard – ‘regrets’, ‘feeling sorry for her’, ‘the situation’.  I recall covering domestic abuse in one of our modules as a student, how the victim blames themselves and how they go to great lengths to protect and cover for the perpetrator.  I vow there and then to help Abi.

 

Returning to resus, Karen is sat at the work station, filling in Abi’s paperwork, “you can go for your break now Nurse Mackenzie,” I say. 

“Ok, thank you; so the patient is stable, next obs due in 5 minutes, GCS is now 14 out of 15 – she’s fully orientated, but still drowsy, “ she relays Abi’s condition, “Oh and just so you know,” she adds, “her partner is waiting outside, asking to see her.  I’ve put him off for now, but he’s not going to be fobbed off for much longer.”

I swallow nervously, the room is silent except for the rhythmic beep of the heart monitor.  I need to talk to Abi alone, before her animal of a boyfriend finds his way in.  How do I start, what do I say?It’s such a delicate subject, especially if she’s not ready to admit what she’s going through, I could really upset her and make her clam up even more.  Sensing my presence, Abi opens her good eye, I go to her side.

“Is Trevor still outside?” she croaks.

“Yes he is,” I answer cautiously.

“I suppose you should let him in, he’ll be really worried – he always is after something like this.”

I gasp, “this has happened before?”

“Once or twice,” she smiles, but looks embarrassed.

“Abi…”  I start, but then we hear a commotion outside.

“I’ve had enough, I want to see her,” I hear a man’s voice getting agitated outside the door.  Then I hear sister’s stern tone, “You’ll do no such thing and if you continue to cause a disturbance I’ll have no choice but to call security.”

Sister is clearly frightening to everyone and not just me as it goes silent outside the door.  I turn to Abi, “Do you want Sister to get him removed from the hospital?”  I ask.

She surprises me with a laugh, “no of course not, he’s not that bad.  He’s just not the most patient of people.”

I’m confused, “so why are you making him wait?

“Because I can,” she says simply.

Classic sign of abuse, I think to myself.  She’s grabbing on to any fragment of control she can.  Suddenly, I feel out of my depth – this is real, very real.  My actions could be life changing, I really should ask Sister’s advice but there isn’t time.  Speaking before engaging my brain, I turn to Abi.

“I know what’s going on Abi,” I whisper, “it’s going to be ok, you’re safe here, we can get you the help you need.”

She looks uncomfortable with my outburst, “what are you talking about?”  Then she looks angry, “you know nothing about me or my life, stop interfering and let him in.”

I’m taken aback, oh no I’ve really messed this up, she’s not ready to admit the abuse. Damn! What have I done?  Feeling furious with myself, I reluctantly head to the waiting room, “Trevor,” I call, and immediately a tall, muscular man with blonde hair stands up.

“I’m Trevor, is this about my missus, Abi?  Can I see her now?”

“Yes, you can, this way please.”

“Finally!  I don’t know what you lot are playing at, but I’ve been out her for hours, worried sick I am.”

Hmm, I bet you are. “Abi was very badly injured and the team needed to stabilise her before we could let you in.”  I respond, using my most professional voice. I hold open the door for him and he rushes to her side.

“Hello babe,” he says gently, putting his hand up to stroke her hair.  Abi pulls back ever so slightly, but I see it.

“Hi,” she says in return, “mind where you’re touching Trev, I’m a bit sore.”

“Alright, calm down,” he says defensively, “it’s only a couple of bruises,” he adds under his breath.

Oh my god, the audacity!  I’ve got to get out of here before I say anything else that’ll I’ll regret.  Fortunately Karen comes back from her break.

“I’m sorry, I’ve got to get some air,” I push past her and head out to the ambulance bay.  Breathing in deeply, I spy Sister having a crafty cigarette.

“It’s almost the end of your shift, how has it been?” she asks with genuine interest.  I’m surprised but relieved – I need to tell her what’s been going on.

“Abi, my patient is being abused by her partner, but won’t admit it and there is nothing I can do about it,” the words tumble out.  It’s sister’s turn to stare, mouth open.

“What makes you think she’s being abused?”

“Well her face for starters,” I begin and then continue with all the other evidence I had heard.

Sister’s face is unreadable, then she starts to laugh.

“Oh honestly Nurse, I know you wasn’t there for the ambulance hand over, but have you even read her notes?”

“I haven’t had the chance,”

“She’s a female boxer Louise – she enjoys fighting.  I think you’ve got hold of the wrong end of the stick with all that eavesdropping.” She still smirking when she adds, “now I think you’d better go and give your patient an apology.”

 

Oh my, how could I have got it so wrong, I chastise myself as I walk slowly back to my patient, formulating an apology.

I head over to Abi, keen to get my humble apology over and done with.  Trevor is up close to her talking softly - but Abi still looks uncomfortable.  Probably pain, I think to myself. 

“Trevor, you need to go now, the nurse is coming to check on me,” Abi says quickly, spotting me coming to her bedside.

“No that’s ok, this won’t take long,” I sigh, contemplating the trouble I’m in.  I look at Abi and it looks like she’s trying to communicate something to me.  It takes me a few seconds before I fall in, there is something she wants to tell me.

“Oh yes, that’s right, I er, need to check her um IPPV,” I say in a stage voice, hoping he doesn’t ask me what IPPV is.  Karen looks at me like I’ve gone mad – but fortunately doesn’t say anything.  And Trevor looking suitable confused, slopes away reluctantly.

“Please don’t ask what IPPV is, because I have no idea,” I give a nervous giggle, but the look on Abi’s face tells me this is anything but funny.

“I need your help Louise,” she says firmly, but I can see her holding back the tears, “yes, I am a boxer, but these bruises were not caused by an equal opponent…they were caused by Trevor,” her voice catches and she starts to cry.  My heart breaks for her.

 

It occurs to me later, that Abi’s circumstances could have been overlooked– had I read the notes.  You know what?  I think I’m going to be just fine as a nurse.

End.


© Copyright 2020 Nicola Macbeth. All rights reserved.

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