Thursday 7 July 2016

A day in the life

My alarm goes off. Bleary eyed and disorientated, I fumble around til I find it. 0540. Thursday. Light is flooding the room. I literally just went to sleep; how can it be that time already? But it is. And the race is on. Shower dress tea run for the bus. Wait for the train. Change onto Victoria Line. Then Northern. It's 7am and I've been on public transport for 40 minutes. Less than half way through the journey. Deep breath. Damn. Forgot my breakfast. And exhale..

Get off near the end of the line after much squishing and sweating and very careful avoidance of making eye contact with ANYONE in case they think I'm a total weirdo, or half human, heaven forbid, only to be welcomed to the outside world by torrential rain for the 30th day in a row followed by the inevitable fight with my eternally reversible umbrella. Arrive at work and catch a glimpse of myself in the mirror. When did those bags get there? No, I know those ones have always been there. I mean those ones. Maybe I should wear make up tomorrow..

The ward is just waking up. Straight into it. Mr. Bond is choking on his tea is he. Yes I'll re-assess him. No it won't be right now. And Mrs. Middleton doesn't like her minced moist diet, right. I don't blame the girl. And yes thank you I know I look tired. I AM tired. And Mr. Pitt has been coughing through the night but has been eating and drinking lying down. Nice. Yes I'll do some education. And document it in the notes. And no i won't forget to update Mr. Smith's daughter on his change in status. And yes I'll reassess Mrs. Brown's language, I did try to see her yesterday but.. Well that's wonderful thank you for that. Can I get through the door now?

A haze of chasing notes and talking to sons and calling daughters and discussing with staff and writing therapy plans and rewriting discharge summaries and sending onward referrals and why haven't I seen an actual patient yet? And how is it 1130 already?

Ahh ha. Mr. Smith. I need to get to him today. Nil by mouth, high risk of aspiration into the lungs. No entry in the notes from the night shift Nurse. Hmm. Okay. Not good. Come to think of it, no sign of a Nurse. Check the charts. No oral cares in over 16 hours. Really not good. Mr. Smith is not good either. After I use 18 swabs to clean the secretions away from his gums and the roof of his mouth, he says he doesn't want to be here anymore. In this hospital? Oh. I see. This world. He's crying. I look at this intelligent, eloquent man, undoubtedly a shadow of his former self, and I feel like crying myself. I feel helpless. What can I say? I wipe his face and hold his hand. I've got to look after him and do my job, I tell him. Is this my job? Maybe it is now.

Mrs. Brown has finally got rid of her entourage of Physios and OTs and Rehab Support Workers and nephews and neighbours and I can get to her. Severe dyspraxia of speech, talking muscles just not playing ball on command, but understanding of language fully intact. Today is particularly bad; she's tired out. Those bloody Physios! One whole session later and despite some minor progress at a phoneme level, the only compete word she can get out, which she does at least two dozen times, is "f*ck". My thoughts exactly, Mrs. Brown ! She collapses in a fit of giggles and I'm not far behind. Persevere, I tell her, we will get there. She nods. I hope I am right.

It's half 2 already and maybe I should eat some lunch now and LOOK there's a Nurse! Hurrah! I'm not sure if you noticed in the notes or on the handover or from the timetable I made for his wall or the huge red sign above his bed but Mr. Smith needs oral cares every 2 hours and I wonder if you could please- I'm sorry? What's oral care? I bang my head repeatedly against the metaphorical brick wall that is already deeply indented with the imprint of my face. Where is the team in this MDT? Is this the NHS I left behind 3 years ago or has something changed? Again? I breath deeply once more and wonder if I'm in some kind of parallel universe to real life. Nope. I'm not.

I catch Mrs. Middleton who is no longer bothered about her swallow and is more interested in telling me that she is a Professor at a top university and an economics magazine Editor on the side. At least, she was before this. To be honest, I'd rather talk about that too. That sounds amazing!! So this swallow then..? A yoghurt, banana, biscuit and glass of water later and Mrs. Middleton has progressed and is back on normal fluids normal diet and I am HER FAVOURITE PERSON EVER. I have a little glow of happiness that I changed someone's life for the better. Food is my all time favourite thing and I can't even imagine what it must be like to be deprived of it. It feels good to remember so acutely why I love this job, despite the challenges it brings. The patients are just amazing.

The receptionist comes over to give me a hug. Why? Just because. Just because. That's a lovely reason. It's Friday tomorrow, she tells me. I know, it's lasted forever but gone in a flash, this week, I tell her. That is hospital life for you, she says. Is it? Intense and fast and furious. A flurry of notes and phone calls and handovers follow before I look up and realise I should have left already. A while ago. But I need to do MORE. That old chestnut. Yes yes, but I can only do what I can do Zzz Zzz.. I slink out the ward, head spinning, mental to-do lists being written frantically. I should really jot this down but OH RAIN. WHAT A SURPRISE.

If people are keen to get to work in London in the morning, they are DESPERATE to get home in the evening.. Much jostling and jabbing and squidging and running and seriously, what's the rush, people? And why can't we talk to each other??! It would make the journey so much nicer and I promise I won't be weird. Kind of promise.. And the heat on this train. How can you be wearing that jacket in this heat ?! Do Londoners ever feel the heat or are they born with a natural ability to store heat and use it at a later date? Someone should look into that. News to keep the fatigue at bay. Something about Boris Johnson, the market plummeting, more on Istanbul and is the world ending?? The long white clouds, black beaches and lush, green hills of New Zealand seem like more than half a hemisphere away right now. A whole world away. Beautiful Aotearoa. I shake off the pangs of something I can't quite recognise, or acknowledge, right here and now, on this crammed, stifling carriage, with rain lashing the windows and travellers crushed together. This city wants Thursday to finish and Friday to start.

I get home 1 hour and 58 minutes after leaving work. I have a 60 second turnaround and head straight to the gym because I know if I sit down there is not a chance in hell I'll get up again. One meal, season finale and brew later, it's time for sleep again. Where did the evening go? I need more evening. More time. As I fade in and out of consciousness, I think about Mr. Smith. I think about his daughters and his wife. I think about Mrs. Middleton and her previous life, and wonder if she'll ever return to her editorial post. Or the teaching post. I smile at the small successes, happy to have helped, and mull over the rest. My brain swirling in the darkness. Where is the off switch?

My alarm goes off. Bleary eyed and disorientated, I fumbled around til I find it. 0540. But, to borrow the simple word of Mrs. Brown, THANKF*CKITSFRIDAY.