Nurse Ratched and the quality of mercy

2008-06-25 00:00

“The quality of mercy is not strained,” said good Will Shakespeare. “It droppeth as the gentle rain from heaven.” As always, Will got it in one. Mercy, gentleness, kindness are the most important attributes of being human. They are as close to divine as we can get. Unfortunately, these qualities aren’t highly prized in our very materialistic society

Nowhere is the need for mercy more obvious than when you are in hospital. In hospital you are at the mercy, literally, of strangers who hold your life in their hands. Their good will, or the lack of it, can determine whether you live or die.

I had to go to hospital recently for major but fairly routine surgery which I’ve put off for years. The memory of three emergency Caesareans hadn’t quite left me and I wasn’t keen on another abdominal surgery. Eventually, though, the benefits of the surgery began to outweigh the risks, so I submitted to the urgings of my doctor and a trusted specialist. Three weeks ago I lit my candles, said my prayers and went into hospital.

At first it all seemed to go very well. I came out of surgery surprised that the pain seemed less than that of the Caesareans. This may have had something to do with the do-it-yourself morphine I’d been given. But the following evening something felt wrong. My abdomen was very sore and I couldn’t go to the loo. I begged the nurse on duty to re-catheterise me as I thought a blocked bladder was the source of the pain. Unfortunately, the nurse had watched One Flew Over the Cuckoo’s Nest and decided that Nurse Ratched was her role model. She dismissed my writhing on the bed in agony with: “I’m busy doing my rounds.”

When I began to sweat profusely and started to black out, I shouted for someone, even God, to help me. I have a vision etched in my mind of two nurses watching me rolling on the bed, their hands on their hips, their faces completely dispassionate. They walked away.

At one point I even tried to dial out on the phone beside the bed but those phones have no outside lines.

After what felt like weeks a catheter was inserted. I was berated for having so little urine flow out. Finally someone brought a blood pressure machine. The reading was 70 over 40. This, my medical cousin says, was when my heart would start shutting down. Someone must have called the doctor as her anxious face drifted into my view. She urged the nurses to install another drip and to monitor me throughout the night.

To cut to the chase, in the morning my HB (iron levels) had dropped to five out of 14. I was bleeding internally and, for once, had lost the will to fight. Emergency surgery was done to repair an artery which had slowly bled into my abdomen. Blood clots had blocked the exit of urine the night before. It took five units of blood and, a day later, a litre drip of iron to get me close to having a chance to live.

The Nurse Ratched team came on duty the night after I received my iron drip. I was desperate for the now-empty drip to be removed. My veins were sore! I’d had so many drips in ICU that I could have starred in Trainspotting. After having done an HB test my doctor told me and the day staff that the drip must come out at 6 pm. But Nurse Ratched’s team wouldn’t remove the drip.

When Nurse Ratched informed me she was keeping the drip in so the doctor could do an HB test, I exploded. I told her I would phone my doctor myself, as I now had my cellphone with me. If she didn’t remove the drip I’d write a story to blow her incompetence wide open. I also brought up the fact that she’d neglected Mrs P. in the bed next to mine who’d been calling for Imodium for an hour to stop the severe diarrhoea she was suffering from. Suddenly Nurse Ratched thought it was a good idea to remove the drip. She scuttled out to get back-up and from behind the curtain next to me came the throaty voice of Mrs P. “Well done, my Sisi. Well done,” she hissed with feeling. Suffice to say that night Mrs P. and I, bonded deeply and forever, barely had to look at our beepers to have nurses at our side.

The difference between kindness and cruel indifference is never more crucial than when one is reduced to one’s weakest state. In ICU, a nurse called Dudu fluttered at my bedside like an angel, offering me ice if I so much as moved, rubbing my shoulders when I was in pain. She was mercy personified. Many other nurses were exceptionally kind too. Understaffed and overworked, certainly, but always kind, even if they couldn’t help you immediately.

And so I thought of Will Shakespeare that long night after my explosion at Nurse Ratched. Mercy is about offering kindness before someone threatens you. In my case the lack of mercy could have been costly. But at least it was the exception rather than the rule.

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