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Almost a century ago, when I was quite young in fact – I had just finished my nursing training and was booked in to do Midwifery at the Women’s Hospital in Carlton. I had a six month wait so sought work close by in a small acute hospital in Bayside.
I was looking forward to delivering babies as I fancied myself in a far flung place doing amazing work with travailing women pitted against frontier landscapes. Think “Call the midwife” meets “Lawrence of Arabia” – well Lorraine of Arabia but these days what the heck, you can be intersex in a minute and not even feel a thing.
We “Nursing Sisters” wore beautiful white veils in those days, so the Lawrence imagery was not too inaccurate. But it was the seventies then (I lied about a century) and society was only just coming to grips with Don Dunstan’s Safari suit let alone the fluidity of gender which is today’s norm (and rightly so too – the latter I mean, Don Dunstan’s outfit caught on big time emulated by thousands of blokes, one friend of mine were a pale grey one on his wedding day he was very tubby and looked more like Don Dustbin actually).
I settled into Night Duty at this salubrious institution and met some fantastic nurses who became as they say – lifelong friends. We had enormous fun on night duty and cared for some amazing cases. It was a true mixed bag of nursing challenges; Post-operative, Cardiac, Neurological and Psychiatric (including post-natal depression cases who came with baby). Medical curiosities I remember were a young man treated for syphilis who had a Jarisch Herxheimer reaction and a woman with Mallory Weiss syndrome which had me running to the textbooks, a case of Ludwig’s angina (nothing to do with the heart!) and a woman who was kept sedated in the vein of the Chelmsford (NSW) deep sleep therapy for depression. It was later discredited as a number of people in a Sydney Clinic died from this treatment. The Psychiatrist who advocated it, Dr Henry Bailey committed suicide in 1985.
Our particular lady was only sleeping for a week, her G.P must have read of the treatment well before it was banned. (It went on for 16 years in Sydney in the 60’s and 70’s and led to 24 deaths). Folk were given sedation for 2 weeks or more so it was a “mini” version we did at Bayside, I never heard how the lady faired, better than Dr Bailey one would hope.
It was well before a proper state of due diligence and regulatory control existed in the medical profession and GP’s could admit unwell patients and care for them quite independently it seemed.
One night a depressed woman with marriage issues escaped (unknown to us), walked to her home a few streets away and knifed the paintings on the walls, particularly a portrait of her husband. She told us this in the morning as we did the 7am medication round! Door security was tightened up after this.
We looked after local luminaries and every day folk. It was a small and intimate place; A well-heeled but alcoholic (very elderly) couple came in after a fire flambéed their flat. A bottle of Courvoisier was up ended near an ash tray with a lit cigar far too close, and whoosh, up it all went. They were fine but shaken, lucky not to be incinerated.
Night duty has its own rewards but also its tribulations. I loved it as always sought to work far away from those at the top. I hated hospital hierarchies and enjoyed the comparative anonymity. The one thing I found challenging was dementia I had not experienced this to any extent. Forty years ago the number of cases was far, far less than today. One night we had an elderly confused woman yelling out continuously “Doctor Doctor” nothing we did would pacify her. She shared a room with another woman who was utterly exhausted. This very agitated lady could not be calmed, the more we offered help the worse it got, she became aggressive kicking out at us. In a moment of (rare) brilliance I decided that if she wanted a Dr at 3am she would get one.
A trusty mascara provided a painted on moustache and a hospital gown and a surgical cap left me looking like … yes – a Doctor. As the light was dimmed in the room my disguise actually worked. With a few “medical” interchanges the woman relaxed. I was able to coax her to the loo after a gentle abdo exam. (This was a large part of the problem as her bladder was beyond full but she was only reacting to the pain – too confused to let us nurses help her up.)
As I left the room after settling Mrs X down and wishing her goodnight (in a doctorly fashion) the women next door muttered “This place is a bloody mad house.” Did she mean her neighbour or my pathetic disguise – probably both, but from then on the ladies slept soundly, we did not even wake them for the early cuppa at 7am and day staff promised to ensure their breakfast was as late as possible.
When you are on night duty a certain kind of exhaustion can overtake you. Your body clock is all over the place. Our pineal gland – which is the size of a pea and sits at the base of the brain – is highly sensitive to the normal day/night rhythms and a lot of complex biochemical reactions are controlled by this gland. Many have heard of melatonin released by the pineal gland, it helps the body adapt to day/night and is used pharmaceutically as a non tranquillizing “sleeping pill” and also to reduce jet lag (circadian rhythm disruption is the proper term).
Some folk adapt to Night Duty well and can seem to have their time off as a “day” person and revert to night quite readily. Others constantly struggle – especially in the early hours. I have huge compassion for night staff as I so well remember my body screaming to lie down whilst writing up night reports and the sick feeling around 5am when one had to collect oneself for the most intense part of the shift, when one’s body is at the lowest level of biorhythms; this is totally different to other shifts where the intensity is in the earlier parts of the shift tapering off towards the end.
This did not stop me from enjoying the job and deferring my foray into the world of childbirth. I soon became In Charge on night shifts and when the D.O.N Position became available the owner, a Doctor asked me to take on the role.
From night work to day work was not the only huge and complete annihilation of what I had assumed would be my life’s trajectory. I never did midwifery, rather than escape the hierarchy I became part of it, and my trepidation about aged and dementia nursing became passions for both areas of practice.
Like many nurses as our profession moved from hospital training to academia I took up university study to better understand the huge phenomenon of human care. But like everything, experience and engagement are the best teachers, one learns something every day and I am often astonished by how much I don’t know. One of the nicest things about being an old hand though is certain little wisdoms you can pass on to the emerging professional nurses who are about to finish their degree. We have had many such staff members who work with us part time for years until the huge challenge comes to leave and they face their 4th graduate year in a hospital! I have had many talks with teary staff who express their fears for the responsibilities of the future and reflect on how much they have learned at fairway. I tell them that the more they fear the better they will be, that life throws up the most amazing twists and turns and to go with all of them with an open heart even though it may be beating with terror! (Mine always was)
Above all I tell them that no matter what technical brilliance or academic excellence ones career may embrace, the essence of Nursing is engaging with the human being in front of you. No matter how complex the case or if their work is curative, palliative or in between; it’s the human spirit they will work with much more than the body, and how wonderful it will be as they go forward to help countless folk in the future.. who knows maybe a “painted on moustache” moment may be theirs to find!
Blessings to all.
To those who may have more than a little curiosity about medical diagnoses, I offer the following:
Jurisch Herxheimer reaction—A collection of symptoms due to the body’s reaction to circulating toxins released by dying spirochetal organisms (such as in syphilis, Lyme disease and relapsing fever). This only occurs when antibiotics have been introduced and the toxins released flood the blood stream.
Mallory—Weiss Syndrome—A longitudinal tear at the base of the oesophagus usually due to severe vomiting.
Ludwig’s Angina—An acute infection underneath the tongue or at the soft tissue of the lower jaw resulting in cellulitis and (often) enormous swelling. Angina comes from Latin/Greek meaning to strangle or choke, usually referring to central chest pain from cardiac origin but in this case the sensation is around the neck.
STAFF MOVES AND GROOVES
Lakshmi Shanmugam completed her locum contract with us at the end of June. We enjoyed her company in finance where she assisted greatly with our accounts and resident and staff queries. We had a very happy morning tea for her and she told us all how much she had enjoyed her stay. Sadly Lakshmis’s mum was very ill in Malaysia and she intended to leave as soon as she could to see her.
At the same morning tea was lovely Emma Stafford who had completed project work for us in updating policy and procedure linkages to provide greater clarity and usefulness. Emma will be starting a Law Degree soon and we enjoyed the few months we had whilst she toiled away at the computer.
Soon to leave us is carer Lee Anne Smith who has been at Fairway for almost 15 years. A night duty person Lee Anne has been an amazing and loyal carer who never let her health challenges get in the way of caring for our residents with huge love and skill. She laughed illness in the face and went on to fall in love and get married 4 years ago. Facing the news that her kidneys were struggling she chose to leap out of a plane in one of her many bucket list challenges. She will re-unite with her ancestral roots in moving back to Tasmania on 21st July. She beamed as she said to me “I’m booked- in for dialysis as soon as I land! Such is her positive outlook that I felt momentarily envious – not of being hooked up to a kidney machine, but to be blessed with such a magic spirit. We wish Lee Anne all the fulfilment she deserves.
The doors also open at Fairway and part of our “Changes” is regeneration in the Finance Office. To this end we welcome Vivi Jia in early June. Vivi is our Senior Accountant with a very healthy pedigree both in her work history and also her personality. Vivi is bright and positive! She needs all of this as she picks up lots of challenges to make us audit-worthy in the very near future. Compiling figures and reports for a new auditing firm Morton Watson and Young, Vivi would have been greatly helped by many more months with us than she has had but “needs must”. Vivi replaced Chris Lyell who retired and Megan Buckingham who left quite suddenly due to Uni pressures and expecting another baby. Vivi is also a young mum with a 12 month old son. Aren’t these working mothers amazing? We welcome you with open arms Vivi.
Vivi is being supported by Kris Kadali our Project Payroll analyst and Finance Support. Kris is helping us with many improvements to the way we process pays and manage employment details. He has an encyclopaedic knowledge of awards and the EBA and is researching an electronic system to help us with streamlining of rostering for care and nursing staff. Kris is also bright and positive as he beds down new processes and handles multiple queries and achieves more cost effective solutions to complex issues. Kris is studying for his C.P.A. – where does he get the time? What a team!
Since last newsletter we have welcomed EEN’s Naomi Bird and Selena Cox to our casual staff, also a new P.C. Hannah Bainsbridge will join us in August . All of these women are skilled as well as bright and caring, such a delight to have them.
Jo Dalianis (daughter of Maria) is proving invaluable also, she is a great learner and has been helping with catering and housekeeping and keeping fellow team members supported and hassle free. Well done Jo!