The Side Ward

I thought I was done with anecdotes from my nursing days, but this story sort of dredged itself out of my memory after watching a tv drama about the Withdrawal of treatment from a child patient on intensive care

Over Twenty years ago I was a ward manager.

The ward was a twenty bedded spinal injury ward with over fifty staff to look after 

We incorporated acute spinal injury care, four patients on long term ventilation, and had two high priority beds for sick spinal injury patients.

In short we were busy.

What we seldom had was emergency admissions, for most of the patients had to be assessed carefully in their admitting hospitals before transfer over to us. Sheffield was a regional speciality and took patients from as far as Lincoln, Cambridgeshire, Derby, Suffolk and Norfolk.

I remember one elderly lady being admitted over a bank holiday from Sheffield itself and it stuck in my mind as a student nurse was central to her story.

The patient was elderly. A much loved matriarch of a big Yorkshire family. She had fallen down some steps and had sustained damage to her cervical vertebrae. 

It was a catastrophic injury, with no chance of survival as the resulting paralysis was encroaching on her ability to breathe and long term ventilation was not viable given the lady’s age and premorbidities . 

Usually such patient’s are cared for on intensive care or a suitable ward where they would be made comfortable and where the family could be supported. 

Because we were a spinal Injury ward we were happy to take her. 

The student nurse, who was called Michael, was a third year student with little general experience , but he was keen and wanted to “ take” the patient with support from me, so we worked together as she arrived.

From the get go I could tell he was nervous, especially as the patient arrived with all of the bells and whistles of an acute patient. She was flat on her back, on a scoop stretcher, with neck brace, monitor leads, flashing beeps and high flow oxygen everywhere.

I told the student our job was to “calm things down”, and before the family arrived that’s exactly what we did. We placed the old lady onto a hospital bed, ensured she was pain free and with instructions from the consultant who had interviewed the family at length, to let nature take its course.

Michael went white when he heard the instructions. He had never seen a withdrawl of treatment before, so I remember taking him to one side in the anti room to the side ward to prepare him.

I explained that the patient and her family were aware of what was going to happen. She had already been given an infusion from a syringe driver which was reducing her pain and anxiety and I had already checked with her entire family would be up with as soon as we he’s settled her. 

She was conscious but very weak, and time was of the essence .

Michael said he was ready, and together we removed the patient’s hard plastic neck brace and we washed her face and combed her hair and sat her up a little until she could see around her. 

At every little job the patient gave a tiny mouthed thank you and I could see Michael was near tears at every turn.

I gave him a few more gentle instructions and after a short conversation preparing them , I let the lady’s husband  and sons and daughters into the room.

They moved slowly around the bed, like sleepwalkers and I asked Michael to pass me the noisy oxygen mask from her face so she could see her family and they could see her. The noisy oxygen suddenly hushed the room, which immediately became less clinical and more personal .

“ My Old Girl” the husband said gently and he kissed his wife after asking permission from us two.

we slowly  stepped back into a corner.

and let the family surround her.

And Michael cried quietly to himself, as he watched 

“ Our Job is to make this as easy as we can” I told him. 

It won’t be long. 

And it wasn’t .

Almost two hours later she had peacefully passed away. Free of the bells and whistles of intensive care.

I taught Michael the tricks of giving the family little jobs to do when they watched and waited, to brush her hair, to wet her lips to talk to her when they thought she wasn’t hearing them,  jobs that gave them a little purpose in a nightmare moment and made sure he took in trays of tea with a teapot full, so someone in the room would have a job to do the pouring.

I taught him to assess the patient condition only if she needed medication to ensure her comfort and after it had all concluded , he accompanied the family to the car park in a final show of respect and solidarity.

We laid the patient out together too. And I asked him how he was feeling when the room was empty and almost ready for the next patient .

He looked tired and much older than his twenty five years

“ I’m not sure I want to be a nurse today” he said 

But he came to the Dog And Partridge on a triplet Lane with the ward staff for a drink when we had finished 

And where we all got a little drunk.