This morning the UK Secretary of state for health Jeremy Hunt has stated that the Chancellor will not grant a pay rise for nursing staff unless the NHS becomes more productive. It is unclear to me how the productivity of the NHS is linked to pay of nursing staff. As a response I am posting my short story, Late, which covers a few hours in the life of a newly qualified nurse on a coronary care unit. Late was previously published in Bare Fiction magazine and highly commended in their 2015 Fiction prize.
I love you even though I have a blood bag in one hand and a drip stand in the other and I should be concentrating on explaining the need for a transfusion to my patient who tells me he didn’t understand a word the doctor said. I’ve got to check the details on the bag against his notes and the request form and his wristband and fill in a couple of forms, but I can’t check it until Mel comes out from behind the curtain where the whole bay can hear someone on a commode who is retching and puking. We’re going to have to move him because of infection control.
If I don’t get this blood checked soon I’ll have to discard it, which would be terrible because it costs about three hundred quid, and someone took the time to donate it, but I can’t give it until it’s been checked because if I give the wrong patient the wrong bag it could kill him and he’s only the same age as me.
I love you even though I haven’t seen you since you came to my graduation last month. After that we went out to celebrate with Mum and Dad, but since then I’ve only had one complete weekend off and that was after nights so I went to bed because I had a cold and I felt like shit.
I love you even as Mrs Jenkins’ son comes over and spays spittle in my face. I can smell his breath as he berates me for the fact his mum hasn’t eaten her tea even though she refused three times when I tried to persuade her. I sent Sue out to get some yoghurt which Mrs Jenkins said she’d like but didn’t eat. I listen, and nod to show I’m listening even though I don’t have time as I’m running behind with my six o’clock drugs. I’m thinking of you as I say that I understand and have made a referral to the dietician who will be up in the morning.
The buzzer in side-room three is going off and the man starts yelling ‘nurse’, but I’m in the middle of my drugs round so I’m hoping Sue will get it. Tracy said she would draw up my IVs for me because I haven’t done the course yet, but she’s been tied up with a hypo in bay two so she hasn’t done them and they’re running late which means the next batch will be late too.
I love you and think of you smiling and telling me to chillax and that everything’s ok and I stop worrying about the blood that is warming in its little plastic bag, the blood that needs to be given urgently because the lad has dangerously low HB.
The arrest buzzer goes off and I run and Mel and Tracy get there first and Sue is pulling the curtains round and I’m pushing the table out of the way and dropping the bed flat and Mel’s on the man’s chest doing compressions and telling me to look after his airway. Tracy’s off to get the arrest trolley and put the call out. Mel stops while Tracy sticks the gel pads to his chest and says clear and we all stand back as the machine wines as it charges to 200 volts. She shocks him and gets back for another cycle of compressions. We stop and check his rhythm and there’s nothing, so it’s my turn and I’m chanting ‘Nelly the elephant packed her trunk’ under my breath to get the rhythm right, which I prefer to ‘Stayin’ Alive’ by the Bee Gees. The S.H.O. arrives with bed hair and a tufty beard and a frown. He’s wearing pointy shoes. Then the Registrar who looks like a Bollywood actor and is calm and wearing scrubs.
Mel gives him the story and some junior doctors arrive, but the Reg. sends them away because we’ve got this and we carry on for a few more cycles but the guy is obviously dead. When the Reg. asks if everyone agrees that we stop, no-one says anything but Mel nods and so he says thanks team and she smiles at him and says thanks and she glances at Tracy when he turns his back with a look that says ‘he’s hot’. The Reg. writes in the notes at the desk and leaves.
Tracy goes to phone the family and I peel the pads off and wipe gel from his grey chest hair and take the central line out of his neck. Sue gets the water and towels and sheets and we wash him and comb his hair and get him tidied up and Sue talks to him while we’re doing it.
By the time I’ve checked and restocked the arrest trolley I’m well behind and the next shift is about to arrive. I haven’t written up my notes yet, and when I look up the old boy with a urine infection is over the side of the bed and off down the ward with his catheter bag dragging along behind and his pyjamas slipping down to reveal his saggy white bum.
I say “shit” and a relative hears me and gives me a look but I walk quickly down the ward to stop him as he reaches the main corridor. And I love you and think how you would laugh if I told you this and kiss me on the forehead as I lead him back and I call for help and the three of us get him back into bed. As I’m untangling his catheter tube I notice he’s managed to pull it out and pee is welling out, so we wash him down and put a pad under him for the time being.
We’re ten minutes late for handover when I remember the blood bag. I shouldn’t have left it on the locker and Mel’s pissed off with me because she spotted it first and I know she’d tell me off properly if she had time. She looks annoyed as we are going through the checks and she still has my IVs to do. We check the time the blood came up and thank God it’s still alright to give it.
I go into the staffroom and the next shift look unimpressed when I stammer through my handover and I have to tell them about the physio. referral I haven’t made and pass on a couple of other jobs. They know there was an arrest and we had three admissions and I don’t know how we were supposed to keep on top of all this but I can tell from their faces that we’re supposed to.
Because I’m new they’re probably thinking I’m a bit slow and crap and this feeling gets worse when I realise I missed a leg dressing on the smiley white-haired lady in bay three. So I hand that over and Jim asks me what she’s having on it and I tell him I think it’s Mellopore and he asks me if we’ve got any in stock and did I order any from pharmacy because it’s closed now and I want to cry because I have to say I don’t know.
I love you as I go back to see if the blood is going through ok and check the patient’s temp and blood pressure and my pen has leaked in my top pocket and I have a little chat with the boy as I’m doing his obs. because he looks really scared. He laughs about my pen leaking and lends me a biro and I like him even if he has a copy of Nuts and the Sun.
The old chap has peed the bed and Mel asks me for a quick hand because she’s sent Sue home and we can’t leave him like this since the others are still getting handover from Mel and we both know we wouldn’t anyway. I finish writing up my notes, and I have to cross out and rewrite a couple of things and sign each crossing out and it looks quite scrappy and I’m a bit upset because I like to be neat.
The dead man’s family arrive and I want to say something because he was a sweet man and I looked after him yesterday and his wife comes towards me but I’m on the phone to C.T. so I show her I’m sorry by looking sad. He was Mel’s patient today so she says she’s sorry and puts her arm around the woman who looks very pale. One of the two middle aged daughters is crying and the tall blonde grandson is with them and they all go into the dayroom with Mel and when I come off the phone she asks me to page the S.H.O. He comes up the ward quickly, his pointy shoes slapping the floor, looking serious in his wispy beard and goes into the dayroom to talk to the family and then they all come out after ten minutes and Mel takes them behind the curtain.
We should have gone home forty minutes ago and I love you but don’t want you to see me like this because I’m sweaty and red because the heating is too high and my feet hurt and I’ve got stomach cramps and I’m hoping it’s my period because I’m late. You would probably say I looked sexy because you like it when I have my hair up and it starts coming down.
The windows are black and the dust is smeared with rain and I’ve got to walk home because the bus takes a long route. I get my coat and umbrella and go down in the lift and walk through the sliding doors which don’t slide properly. A man in hospital pyjamas with a spider web tattoo on his neck is standing in the doorway smoking with a drip stand and a bandage around his canulated hand which you shouldn’t do, you should use a clear dressing so you can see if it’s tissued.
I walk through his smoke and into the rain, over chewing gum stars and a whitewash of pigeon shit and past the bin overflowing with crisp packets that are blowing away and through the gate and under the Lucozade streetlights. The umbrella gets turned inside out by a gust of wind because it’s a cheap one and a car goes by and soaks my shoes and legs.
I think of you and being in your arms and you stroking my hair and saying its ok, but you stopped answering your phone and texting four days ago. I’m cold and the last time we spoke you didn’t say much, and when I asked you if something was wrong you just went quiet and said you had to go. Some water has got down the back of my neck by the time I get in and pick up the post, which is takeaway flyers and an electric bill and Shaphi has left a note saying we need milk sorry and by the time I have a shower and heat some soup there are six hours before the alarm goes off because I’m on an early.