I won't lie - this is tough!

 I thought that when I took this job on a busy hospital ward I would turn into Miss Efficiency – someone who would go about her duties in an effective and productive manner, someone who gives the impression of being in total control.

Haha!! How wrong was I? I’ve clearly been watching too many episodes of Casualty if I thought that I wasn’t going to be affected by the people I am caring for –I know in my heart that that’s what makes me a good nurse but I’m not sure that all of my new colleagues ‘get me’ yet or whether they will try to change that? 

 It all started at the beginning of the week when a new patient was admitted. He reminded me of my late Grandad, only he looked frightened and confused. His slippers looked as though they’d seen better days and he had food debris in his not-so-designer stubble. We’re quite used to patients looking not quite their best when they come to us, but what struck me about this man was the raw fear in his eyes.

He wouldn’t let any of us near him. The full ‘fight or flight’ thing was going on and we were all kind of on standby for something happening. At lunchtime when his meal was placed in front of him, he smashed his fist straight into the middle of it and launched his plate like a discus player taking an Olympic shot. Even the other patients seemed to feel his fear and the expected shouts of ‘pack it in you dirty bugger’ never came. We all looked on in silence, trying to figure out what to do next.

Everyone gave him a wide berth, and the doctors and charge nurse seemed to be in a permanent huddle trying to work out the next move. Our new gent hadn’t said a word since he arrived and it was really quite unnerving. We needed to do his baseline observations but we just couldn’t get near. To be honest, we were all a bit frightened of what he might do to us – if he could manage to smash the hospital mash without breaking a bone then this man was hardcore.

Call me stupid or naïve but I couldn’t just stand by while we all skirted around him. I remembered a similar situation in one of the homes I worked in last year where a resident was displaying signs of distress. It turned out that he was in a lot of pain but the staff team hadn’t considered that at all and had been medicating his behaviour rather than the cause of it. We’d given him pain relief and the change was unbelievable. I learnt a lot from that resident and I figured it was time I put my learning into practice.

 I tried to think about how he might be feeling.

Lost, surrounded by strangers and in a place that he’d never seen before. His admission notes said that he had been found shouting outside a shopping precinct and had almost stepped in front of a bus before being pulled out of the way by a passer-by. He had a big purple bruise forming down one of his arms and I couldn’t help but think he might be feeling in pain.

We didn’t even know his name.

 I tentatively approached him, making sure I didn’t invade his personal space. To be fair, that was self-preservation kicking in on my part, as well as trying not to frighten him any further. I cleared my throat, smiled and said ‘Hello- my name’s Florence. I’m one of the nurses here – we just want to help you'

I can’t repeat what he shouted back – just in case any of you readers are tuning in before the watershed, but suffice it to say the second word was ‘off’. So I did. I backed off right rapid.

A couple of my colleagues gave me sympathetic looks and a pat on the arm but I’m sure I heard one of them laughing under her breath, muttering something like ‘Our very own Florence Nightingale. The lady who almost got lamped’. I tried to glare at her but I think I must have looked more like I was constipated because she openly laughed in my face.

 It wasn’t long after that when I was asked to go and attend to another of the patients, and when I got back to the lounge, our new patient had disappeared. I asked one of the nice girls what had happened and she was a bit vague telling me that the doctors had sorted it and he was having a little rest in one of the side rooms. I couldn’t leave it at that so I went to have a sneak-peak at his notes. It turned out that shortly after I’d left, the doctors had made a decision to sedate him so that they could start a proper assessment on him. It had taken a number of people to restrain him and he hadn’t gone down without a fight. 

I was gutted. That poor, frightened man had just been given a whole new bag of crap to deal with and would wake up feeling even more terrified that he was before.

 The Charge Nurse must have seen my face and took me to one side. I couldn’t help myself and I spilled my guts; told him that I didn’t become a nurse to hurt people who were already hurting and that I wasn’t sure that I could do it anymore.

He took me to one side and said he knew exactly how I was feeling. That came as a bit of a shock – I was half expecting to be disciplined for my outburst, or chucked out on my ear given I wasn’t even a month into my probation period.  

He explained that we needed to get our man stable so that we could do a true assessment. After I’d left, two more nurses and the Consultant had approached him and got pretty much the same reaction as me, so it was decided that he would be sedated due to the risks that he posed to both staff and other patients. He’d been placed under a Section of the Mental Health Act so that medication could be given without his express consent. His medication would be reduced gradually over the next few days, but in the meantime, the decision had been made for him to have the medication to stop him feeling so tormented. 

 I got it, but I didn’t like it. A massive part of me would like to think that, with a little more time we would have got through to him. And that’s the big difference between a hospital ward and a care home. We’re not there to befriend people – we’re there to assess the problem and find a solution so that they can move on with their lives.

 So… I’m trying to look at my half-full cup, thinking about what I can learn from this situation. I think the best I can come up with is that I’ve still got so much to learn – about myself as much as anything. Sometimes in this game, you have to be brave and make a decision. It might not seem to be the most empathetic decision at the time but you have to look at the bigger picture.

I’m not there yet with this big picture stuff – I’m kind of still stuck in the detail. One day though I will be just like my Charge Nurse; full of knowledge topped off with a healthy helping of wisdom.

 Until then, I’ll just be me - Florence Writingale – the lady who nearly got lamped!!