Carolie could not stand by herself. Her muscle wasting was such that she required
an overhead support harness to walk on a treadmill. With support she could stand for a moment to
transfer to a wheelchair or to a toilet. Her immobility left her vulnerable to
falls. She had gone from an active
professional woman to a mostly helpless chair bound invalid in the space of two
months.
Toileting remained a dangerous
activity. She fell off the toilet a
couple more times while nurses left her unsupervised. When someone with brain trauma falls it can be
life threatening. There were many junior nurses on the ward who meant well, but
who lacked the experience necessary to manage brain trauma patients without
close supervision. I had to complain to
senior nurses to ensure supervision protocols were strictly observed during
trips to the bathroom.
The wonderful School of Music friends followed
us to the ward. Their singing efforts
went unremarked initially by management but soon attracted the attention of one
of the senior nurses, who complained they were too loud. She had a patient who suffered from severe
headache, but I question whether the complaint came from her. I doubt her extremely debilitating condition
would have been affected by beautiful singing.
I suspect it was another iteration of the ‘command and control’ approach
that pervaded management of the ward.
After
a minor run in between our friends and this nurse we decided to limit the
singing to the gym. The senior
physiotherapist was welcoming as music was played during gym sessions. The extra stimulus of high quality live
singing was a bonus. The majority of
patients responded positively to the singing, such that it became a regular fixture
in late afternoon sessions in the gym.
After one such singing session on a Sunday
afternoon in the ward room - prior to the singers limiting their sessions to
the gym (and outside on weekends) - our friends left Carolie sitting up in her
wheelchair. She would be uplifted by joining
the singing and occasionally forget her physical limitations. Just as some visiting children from her
school and their parents were taking their leave she suddenly stood up in a
farewell reflex. She fell heavily to one
side, bruising herself badly.
On
receiving a call from the ward I immediately drove anxiously to the hospital. On
arrival a senior nurse proceeded to berate me about the singers leaving her
unattended, despite this not being their concern as the visiting family had
arrived. I defended our friends stoutly and
subsequently discovered it was the visiting family that triggered the
accident. Again, they would have no
reason to assume any risk. The nurse
made it clear ‘the situation’ could not continue and that change would be made. It was unclear what this meant but did not
bode well to my ears – it was a portent of more ‘command and control’. We did not have to wait long.
During a luncheon period I went to fetch
something from Carolie’s room. She
remained in the dining room. I was
surprised to find unknown persons standing by the bed and her personal effects
removed. It quickly became apparent that
Carolie had been moved without notice.
She was now accommodated in a room adjacent to the nurses’ station. Her beautiful view on to flowers was gone;
the room had damaged blinds so sunlight heat could not be managed as easily; it
was noisier as immediately outside the room was an administrative area; and
worst of all, Carolie had not been informed of the change.
Nurse management had decided that Carolie
needed to be closer to the station in case of further falls. It was instructive that nurses continued to
leave her unsupervised on the toilet.
For the second time on our labyrinthine journey I lost my temper.
Arcing with anger I returned to the dining room
and made it very clear that I wanted to transfer Carolie to another
facility. After our treatment to this
juncture by ward management I saw this as a bridge too far. The place seemed mired in a time when
patients were totally disempowered and subject to the whim of fierce nursing
sisters. Many a motion picture has
focussed on the theme. Flashes of One Flew Over the Cuckoo’s Nest kept
'gingering' my sense of this ward culture.
I refused to be bound by the ‘givens’ in this particular time warp. This time I did the
berating, reducing the same senior nurse to tears in the process.
The nurse was fairly tough but maybe unused to
having to deal with someone articulate and determined, who had dealt with much
tougher souls, and who was as angry as I was.
On cue, after a little dust had settled, the ward boss reappeared to
again put me in my place and upbraid me for ‘abusing’ her staff. She agreed the shift manager had done the
wrong thing by not consulting with us but that did not excuse my treatment of her
staff member.
I indicated to her that the
conversation was pointless as she was about ‘command and control’ and nothing I
could say would change that. I defended
the accusation of ‘abuse’, replying that although I was truly angry I had not
used any terms of abuse, which was true.
She tried to twist my evident anger into a ‘personal problem’ - perhaps
I needed counselling. No, what we needed
was to be treated with respect and not disempowered. My ‘Red Queen’ alert was screeching:
‘Speak when you’re
spoken to!’ the Red Queen sharply interrupted her.
‘But if everybody obeyed that rule’,
said Alice, who was always ready for a little argument, ‘and if you only spoke
when you were spoken to, and the other person always waited for you to begin,
you see nobody would ever say anything, so that—‘
‘Ridiculous!’ cried the Queen.*
To be continued....
