Saturday, 2 February 2013

More Than a Job Part 2 - Beginnings

Working as a physio at Prince Charles Hospital in Merthyr was only meant to be a temporary thing. What I hadn't banked on was that I enjoyed it, and what was even more surprising was that I was good at it. At physio school I'd been so constantly told that I was failing at this, that and the other, and was myself so unmotivated, that I'd thought it was a foregone conclusion that it wasn't the career for me. This was different.

I've always been hardworking (haha, stop laughing, Maddocks clinic lot - filing is not work, it is TORTURE!), and I'm quick to pick things up, so that while I still wasn't the most technically proficient physio, I soon was able to look after my own wards and work on ITU. I'd been lucky in my training in that I'd done two ITU stints, so I knew what to do, and my senior was disproportionately impressed by this. But most impressive of all, I did an on-call within two weeks of starting.

On-call is where you can go home from the hospital and do whatever you want, but you must be available at the end of a phone for the hospital to call you back if anyone needs emergency physio - chest physiotherapy, not emergency ankle strapping or something! In those days there wasn't even an air-call, so it really meant you were quite restricted unless you were within bleep distance of the hospital.

In my second week, the physio who was due to be on-call that night was ill, and with it being such a small department, everyone else happened to have plans. 'That's ok, I'll do it, ' I said.

'But you haven't done the on-call induction day yet.' said the Boss (who had said she would do it if no-one else could - bosses don't usually do on-call).

'But I work on the ITU, I know the patients, and it is most likely to be one of them who will need me. I can do suction, and if I get worried, I'll call you'

Done deal. I wasn't called in - but the fact of me even doing it had impressed people, and it was soon common knowledge that out of the three new starts, I was 'the good one'. It was one of those self-fulfilling prophesy thingies - I became more confident and so I took on harder things, and so people thought I was good etc etc.

I still was naughty though. Not in a way that would hurt anyone, but in a 'doing silly things' way. It was common knowledge that if you were caught being naughty, you would be sent to Aberdare or Mountain Ash or Merthyr General on your next three month rotation. Out of the 18 months I worked in Wales, I spent 6 of them at Aberdare and three at Merthyr General!

What sort of things did I do? Well, a classic one was Dr E_, one of the medical consultants. He was kind and approachable, and he really impressed me by diagnosing a case of Weil's disease on ITU when everyone else was stumped. Here, surely, was my future husband. So I decided to go on his ward rounds. This was an entirely proper thing to do on my own wards but no way should I be doing it on any other physio's wards, but his 'big' ward round was on a day my senior was away doing a degree top-up. I knew the other medical wards pretty well anyway from covering them two afternoons a week and because me and my senior did 'doubles' (patients who need two) together, and she would use her patients for teaching me. Plus most of the ward round was just writing down the odd thing to be done, answering a few questions about progress etc. Thus all went well for a good couple of months. No doubt it could have gone on for the whole of my medical rotation, if ONLY I hadn't been off sick on Dr E_'s 'big' ward round day. Cos he only went and phoned the Boss, didn't he? Asking where 'his' physio was and was she sending anyone else? Shit, meet fan. Karen, meet Aberdare Out-Patients.

It was also on Wales that I did my longest ever working stint. I'd agreed to cover two nights on-call in a row, again due to lack of availability of someone a day before I was on-call anyway. This normally wouldn't be a problem, but we had a child on ITU with cystic fibrosis who needed two-hourly physio, which basically meant you were in the hospital overnight. This meant one of two options - you could sleep on the chairs in the physio staff room (not as uncomfortable as it sounds, more like sleeping on a sofa), or you could sleep in an ITU side-room bed  that was rarely used by patients.

Initially I was going to go for the physio-chair option, but have you ever been in a physio department in the middle of the dark, silent night? SCARY! So instead I 'slept' in the ITU bed. How patients sleep in hospital beds I have no idea. They are sweaty, they make a noise when you move, of plastic creaking, and just as you drop off, someone will come and bang a door or shout an instruction. Plus, you can bet that as soon as I was sleeping, the nurse would come in and say, 'time for C_'s treatment.'

The second night, a couple of the other physios offered to do the on-call for me, cos C_ was still needing two-hourly, but I wanted to see what it was like. So many doctors did these sorts of hours, I wanted to see how far I could go, how much I could do. So I did it. I'm glad I did, it was one of those nights that changes you.

C_ was deteriorating the whole time. Her consultant, Dr M_ was in overnight too. Just before midnight her family were recalled to her bedside, but she struggled on until just after 6, it was a battle against dropping oxygen saturations and horrendous blood gas results, played out against a backdrop of family who knew she was dying but who desperately needed to cling on to hope, to feel something was being done. I wasn't in the room when she died, I was at the nurse's station, but I knew what was happening, and I vividly remember Dr M_ coming out of the room in tears and being led away to the staff room. He was one of your 'typical' consultants - seemingly arrogant and convinced of his own superiority. To see him like that - well, it was one of those times that taught me to be less judgmental about people.

This is something I found at hospitals - it's comforting to be around other staff when it's going tits up. You don't have to talk about it because they get it, they are going through it too, or have been through it another time. Death shakes you, even if you didn't know the person. For it to happen to this little girl, that you've known through various admissions, who's been charming and enchanting, playful, demanding and infuriating in roughly equal measure - for it to happen to someone REAL to you.... That's what happened that night to everyone, to a greater or lesser extent.

By that third day on, I had gone beyond tired. At the end of that day of constantly seeing insects out of the corner of my eye, and missing door handles when I went to open doors, I had been on duty for 56 hours. No-one expected me to go to the work night out that evening, but of course, I so did. At the time doctors worked for way longer - 72 hour stints were common. I have no idea how mistakes weren't more common.

That night, we hadn't got the outcome we wanted, but there would be other nights, other chances.Thing is, after feeling so much a part of something, after feeling like what I did mattered so much, I knew this was what I wanted to do: and I knew where I wanted to do it.

Now I just had to get there.

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