by Trisha Jeram
I have always been a carer and helper. As the eldest of 7 children, I frequently helped my mum to babysit my siblings. My mum wanted me to be a nurse when I left college at 16. She was a nursing assistant and wanted me to follow in her footsteps. But I said no. Nursing is not for me. I hated hospitals. I was in and out of them as a child due to frequent episodes of febrile convulsions and malaria. I was queasy about blood and body fluids. I hated injections. I have a strong sense of smell and Maths & Science are not a strong point of mine. SO, NO! Nursing is not for me. Instead I wanted to be a teacher. I am good at explaining things to people, just like my favourite teachers. I have a vivid imagination and love drama. None of these qualities are related to nursing, surely?
For someone who did not want to be a nurse, I spent most of my adult life working in caring roles and environments. During this time, colleagues encouraged me to do nurse training. But I said no. Instead I went to university and studied theology, psychology and counselling. In 2017, a series of life events eventually led me to apply for nursing at Edinburgh Napier University. I was offered masters of pre-registration nursing education because of my previous studies and I accepted the offer. Not only was I doing nursing, I took a harder approach to it.
Student placement was scary. I had to learn to give patients piece-meal care times to ensure that everyone gets cared for in an often busy but short-staffed environment. Some staff were supportive, others just saw me as an extra pair of hands and allocated endless tasks to me. I came home feeling achy, tired and grumpy after the long shifts, unable to hold a conversation. My husband felt isolated. Like most students, I also worked extra hours to earn money. And unlike most sensible students, I took on extra-curricular activities like playwrighting and drama. I laughed and I cried. I came close to giving up but carried on, encouraged by family, friends, and some of the patients I looked after.
These patients often tell me I would make an amazing nurse. They liked my honest human approach to care. I made them laugh with my poor jokes, I held their hands in my cold ones. I made them cups of tea, fed those who couldn’t do so themselves, took their weight on me when they felt wobbly. I personal care while chatting to them about my favourite meal. I made their beds and charted their obs. while listening to their life stories. I gave some a cuddle when they were upset amid criticism from some of my colleagues who thought it was unprofessional. But I was also firm with them when they stopped following their care protocols. And I stood up to them when they try to take me for granted.
I knew when to back off when they become agitated, aggressive or abusive. I have been told to “go back to where I came from” by a few patients. This aspect of nursing saddens me. I am human and no matter what anyone says about it not being personal, I feel that caring for people is deeply personal. Nurses care for people with all their being even when it appears like a mundane task. So it hurts to be abused by people we care for. It is what makes me human, I guess. The following are some highlights from my placements:
In my first year, I cared for a patient in his 30s with type 2 respiratory failure, liver and kidneys failure. His mother requested to sit by his bedside all night. I teased him at the start of my shift and made him laugh. He desperately needed to move his bowels but refused to use the commode even though he was too weak and on high oxygen therapy. By midnight his condition got worse. His mother was worried and in tears. She apologised for “disturbing” us, I assured her that it was not a disturbance and that she was doing what a brilliant mother would do for her child and she should be proud of herself. I alerted my mentor and the patient was reviewed by the on-call registrar who prescribed some diuretics and analgesia to ease pulmonary oedema secondary to poor kidney and liver function. This improved him temporarily as we knew it would. By about 3am, he requested to use the commode. I threw a victorious punch in the air which his mother found quite amusing. It was the first time she had laughed during my shift. The patient smiled and said: “ok you win this time Trish, but it won’t happen again” He was right, it never happened again. He died the next day. But his mother saw him compassionately cared for, saw his pain relieved, saw him smile and watched him listen to his favourite football team playing on the radio. She sent me a card and a scented candle to say, “thank you for looking after my son”. I knew then that I could not give up on my training.
In my second-year placement I looked after a 90year old with end stage ovarian cancer and dementia. At the start of my 5week placement she was fully mobile but soon deteriorated. She was an exceedingly kind and spiritual person. I felt a deep connection with her. Whenever the ward was quiet, I would go and keep her company. She and her husband were church missionaries in their younger days. She used to sing and play the piano in her local church. She frequently asked me if I thought she had done a decent job of bringing her children up and if they would be ok when she was gone. She would take my hand in hers and attempt to warm them up because my hands were always cold. She could not remember why she was in hospital, so I wrote the events down for her to read. She was scared of being alone in that single room but appreciated everything we did for her. She called me “an angel of light” and thanked me for my patience. I held her hand, chatted to her and played church music for her on my phone when she stopped speaking. I held her hand when she took her last breath during a night shift. It was a privilege to look after her because she enriched my life more than I enriched hers. She drew my attention to the things which truly matter in life: Love, kindness, compassion, and laughter.
At the start of my third year I worked in a stroke ward and looked after a gentleman in his 60s. He had a few complex medical conditions which affected his mobility and bowel function. He was a well-mannered gentle giant with a great sense of humour. He found it difficult to let me care for him at first. The first time I gave him a bed bath, I made a show about choosing the right outfit for him. I told him it was important, and he found it funny. He let me choose, but I had to say why I chose an item, from clothes to toiletries. For example, when I chose between 2 bottles of deodorant spray, I told him one smelled like an insect and I did not think he should go about smelling like an insect. Because he had a great sense of humour, he found this funny for several days afterwards and told his partner about it when she visited. It became our joke: “do not go around smelling like an insect!”. When I finished my placement part of his written feedback to me was: “Trish is a person who is warm hearted and caring with a terrific sense of humour…she is rare, I could not fault her”. I felt touched by his inner strength and the ability to see the funny side of his illness. He would say things like: “I am sorry to trouble you but I tried to do some exercise and when I stood up, I realised the floor was flooded for some reason” to which I would reply “Ah it must be a broken pipe from an old building” but we both knew he was standing in his own urine. He was a joy to look after.
I do not know what the future holds for me as a nurse but I know one thing: I am caring, I am passionate, I am outspoken and I am an idiot for not listening to my mum at the age of 16 when she told me to go train to be a nurse.