Some time ago an article in our local paper described the anguish of a family of a patient who alleged they were left in a urine soaked bed for several hours.
I make no comment on this particular incident as I do not know the details around it.
There is no doubt that leaving a patient in such a state is deeply demeaning for the person involved as well as multiplying the risk of pressure injury and skin breakdown.
But the judgement inferred by the report picks uncomfortably at something from my own past. So let me tell you a story I am not proud of.
On a very busy evening, not that long ago, I left an elderly lady laying in a urine soaked bed.
I cannot recall how long exactly, for time tends to compress when it is busy in the emergency department. But it could easily have been two hours.
I knew she was wet.
She had asked for a pan and I had gotten it for her straight away. A minute to the pan room and back.
Which was too late. She told me so with a deep flush of embarrassment. Her dignity breaking with her voice.
“Im so sorry Carol, I’ll get a fresh change of sheets and help you wash. A couple of minutes and you will feel much better.”
This was the moment my next patient arrived. By ambulance. A middle-aged man with cancer of the lung. He was suspected to be neutropenic. Hot and breathing hard.
He came with a suck of urgency, a clutch of problems that required immediate attention in order to increase his chances of survival. Time critical we call it.
Staff were busy everywhere, but another nurse slid over to help.
Oxygen, observations, IV access, bloods, IV antibiotics. One sentence that takes seconds to write on a standing order, but easily 30 minutes to complete in task. Maybe more, ’cause when you are dealing with a human being at the other end of your list, nothing is linear.
Half way through all this my third patient arrived. Chest pain.
As soon as we connected him to the monitor you could see he was infarcting.
Another queue of time critical priorities as we controlled his pain and prepped him for cardiac catheterisation.
I escorted him to the coronary care unit, and returned.
A new patient had already taken his place. Another chest pain to be quickly assessed. History taken and ECG attended until it became evident that there was no real urgency here.
Finally, I returned to Carroll.
The bed had drawn damp through. Sticky with the amonia smell of stale urine.
But even then there would be further delay as I searched for someone who was free to to help out. To turn, and wash and spread new sheets beneath.
Carrol’s apologies for being so helpless and such a nuisance collided uncomfortably with my own.
I do not think I am a bad nurse, and think most of the time I deliver a very high standard of care. But not always.
Sometimes the complex entanglement of things happening within a hospital mean that I must make difficult decisions. In reality the frequency with which things like this occur means they are not really difficult decisions at all.
It is just what must be done.
Nursing requires the knowledge and skills to deliver high quality, evidence based care to our patients. Doing so without abandoning attention to essential, basic nursing care and compassion.
Sometimes this is not possible. Sometimes nursing just sucks.
Featured image via: zoe J