There are often times, as nurses, when our duty of care falls upon people who we may feel do not deserve it, or, at least, do not deserve to engage any significant slice of those precious resources we are constantly having to ration around.
These feelings can be a natural response to scenarios ranging from the well dressed businessman who presents to the emergency department at 8PM on a frantic Saturday night requesting to have his in-grown toenail sorted out, to the demanding man with abdominal pain who we suspect of seeking narcotics, to the disheveled girl in police custody who seriously assaulted an elderly man and now is requiring decontamination after being capsicum sprayed.
These sort of events occur every day. When they do, most nurses are more than capable of distilling their own reactions, opinions and prejudices from those intrinsic values of non-judgmental quality care our profession demands.
When you are engaged as a nurse, it is not about you.
But what about situations that are so horrible, they threaten to overwhelm our ability to put our self in neutral and engage our nurse in overdrive?
One such situation that springs quickly to mind are service nurses.
Nurses who work in the military have, on many occasions throughout history, found themselves caring for enemy combatants who may well be responsible for injuries inflicted on soldiers in the beds around them.
Nurses who work in the prison system are another group who might face challenging moral dilemmas.
Perhaps even more difficult than this, are those times when unprepared civilian nurses face an unexpected and unfathomable collision with someone very very bad.
A friend of mine was nursing in an intensive care unit in Hobart, Tasmania when in 1996, a man named Martin Bryant went on a shooting rampage in Port Arthur, murdering 35 people and injuring 21 others.
He callously walked about and shot his victims, often chasing them down before shooting them.
During his eventual capture, Bryant suffered burns to his back and buttocks which required hospitalization.
It fell upon some of the staff at the hospital to look after both the multiple victims of the massacre and the person responsible for their injuries.
In a paper titled The Port Arthur shootings Royal Hobart Hospital staff response, Rosie Crumpton-Crook reflected on the subsequent reactions of staff:
The hospital’s response ran very smoothly, but for staff, the difficulty was witnessing the distress of the injured and their relatives, hearing their horrific accounts of what they had witnessed, and feeling helpless in response. Staff spoke of being overwhelmed by what they were seeing and hearing.
In the initial stages the worst thing was the waiting. People were fearful of what was to come and fearful of someone familiar being among the injured. There was also a great fear of stuffing up, of not being up to the task.
All of the staff I spoke to who were to be involved in his treatment just accepted that it was part of their duty to care for him. None were too impressed with the idea, but contrary to some media reports no one refused to work, all in all the staffs reaction was ‘well we just have to get on with it’.
One Senior Nurse Manager who had a major involvement told me that she was
devastated when she learnt that due to the requirements of forensic evidence she was not allowed to do anything to the bodies. Not being allowed to wash the bodies, to make them look their best went against the whole grain of her nursing philosophy.
In an effort to make some small amends she dressed in her smartest clothes every day, she said it was her way of showing respect for the deceased and their relatives. It soon became evident that it wasn’t only those people closely involved with the identifications who were upset, other staff told of being distressed at seeing groups of grieving, weeping relatives, of trying to avoid them in corridors and of feeling entirely overwhelmed.
During Bryants stay in Hobart Hospital the frenzied media coverage resulted in a highly charged community feeling.
Even though staff reported that the overwhelming public response to the staff working in the hospital at this time was positive. However, some staff did receive threatening calls, and at one point the words “an eye for an eye” were scrawled across one of the hospital walls in large black letters.
In a newspaper report at the time anaesthetist Paul Luckin spoke of the despair and anger that had consumed many of Royal Hobart’s medical staff:
“There is no doubt staff at the hospital have very human feelings about this,” Dr Luckin said. “I cannot say everyone is happy about it and we’re all aware there’s a huge well of anger in the community.
“But those medical and academic staff who do have contact with him (Bryant) are treating him absolutely professionally.”
::The West Australian ::
One of those medical staff was a friend of mine, who was to care for Bryant for most of his hospital stay.
She told me that by far the most disturbing thing to deal with was the perception that he seemed like such a normal, (even likable) person.
This was a very difficult time for her and her colleagues, and it took considerable support and introspection to sort it all through.
Sadly, you only have to turn on the news each night to realize that there are many other instances where people who are responsible for heinous crimes or unspeakable acts are injured in their capture or simply become unwell, requiring the sustained emotional stretch of non-judgemental, professional care by doctors, nurses and other hospital staff.
Martin Bryant is currently serving 35 life sentences plus 1,035 years without parole in the psychiatric wing of Risdon Prison in Hobart