The dread.
Legs of lead
palms of sweat
in the car I get.
Autopilot.
Muscle memory
of the journey
allows the mind to drift
anticipating
the awaiting shift.
Thoughts wander
to crashing the car.
Hope for broken legs,
6 weeks on crutches
worth it
to ensure a rest
and avoid these night shifts.
Find a parking space
and take a breath
dont want to release myself from the comforting cwtch of my seat belt
and emerge from the safety
of my Seat Altea.
Foreboding darkness
unnatural lights flicker
Is it morse code I wonder?
S-O-S
Like insects
drawn to the glare
we file in.
The brightness
too harsh
for the reality.
Before I reach the doors
I see them.
Lined against walls
snaked round corners
a tube map of humans.
We weave our way through them.
Eyes searching ours
Hopeful
I recognise the ambo crew
they give me that look,
that look that says
you’re in for a rough one –
turn around and run.
But you can’t,
so you walk on
Before taking off my coat
I’m told to go straight to resus
Blue light en route – eta 2 minutes.
Cardiac arrest.
Lob my bag in a locker
push through trollies
stacked in corridors
get to resus - it’s already full.
Three patients in there,
should only be two.
Time to make a decision
Who is it safest to move?
A game of human Tetris ensues
Shuffling beds between spaces.
We decide moving the patient with raging sepsis
is likely the least dangerous
in comparison
to the guy overdosed
unable to breathe on his own
and the haemorrhaging stroke
next to him with intermittent seizures.
So sepsis patient is demoted
to the main department.
As I wipe down the equipment
in rolls the ambo
Compressions on the go
2 shocks and adrenaline on route
but still no heartbeat.
Task in gloved hand
We descend
Armed with an algorithm
we try to reverse death.
It’s not his time yet.
A young dad
A silly argument
A suicide attempt
Another shock – stand back….
A heartbeat
FUCKING YES!!!!
A millisecond to celebrate
Then straight into post arrest treatment:
oxygen, bloods, ECG, get ITU to accept.
You go with him upstairs
Speak to his wife and kids
try to handover to the team
but the phone rings.
“You need to get back down to resus,
one more coming in”
I could really do with a wee
but remember I’m the only one ILS trained
Just time to record obs
and administer drugs
to your other two patients
when the door swings open.
An old dear
exacerbation of COPD
purple, lips pursed,
sat up tripoding
oxygen probe not recording.
You suddenly realise
the doc hasn’t answered his bleep.
You’re on your own kid.
Ambo couldn’t get access,
woman fighting for breath
split second decisions - life or death
Fuck it, pull the emergency bell.
Whack in a cannula,
back to back nebs,
steroids drawn up
ABG syringe prepped.
Bleep outreach
tell them CPAP likely needed.
The locum doc strolls in
asks what all the fuss is
as you wave a vial of hydrocortisone
whilst screaming “can I give this??”
And so it continues
for twelve and a half hours
relentlessly
with no break
until it’s finally over.
You creep guiltily
past the trolleys with eyes pleading
Heart sinking for colleagues
another understaffed shift.
Walk out to a steady stream of ambulances,
the natural light blinding
too bright for the memory
of the night you leave behind.
Join morning traffic and wonder
do they know where I’ve been?
Can they see as they pass on their daily routine?
Can they feel my anguish?
I shake it away.
Get in, quick cuddle
Crawl to bed
and try to quell
the anxiety rising.
It’s like that feeling
when you go on holiday
and there’s a nagging
in your head and stomach
telling you there’s something important you’ve forgotten.
Imagine that times 1000.
An impossible workload is dangerous
Not just for patients but also the workforce.
The weight of feeling inadequate
no matter what.
Promised to do no harm
but it’s now eventual.
I pull the blinds, shut my eyes
cross my fingers and pray.
Which is ridiculous as i’m not religious
but it’s all I have left.
First class honours
Batchelor of Science
but I’m asking God, Grandma, Nan, Jesus –
basically anyone up there who might listen
to keep my patients safe from our mistakes. Pray I won’t lose my registration or get arrested.
Then I remember
I saved a life last night
And drift to sleep.
I wake, I dread
I get out of bed
for another night shift from hell .
I make a plan
to ring and ask
how cardiac arrest man
is getting on.
At least it’s a reason to go to work
I trudge in.
Meet a pal in the staff room
“Well done – heard you got a guy back last night”
I nod, shrug and say
“Haven’t heard how he’s getting on yet.
I’m just going to ring upstairs before handover”
She said
“No worries, you go ahead”
I pick up the phone
“Hi its, the nurse from resus last night - how’s cardiac arrest guy?”
“Ahh yeah sorry, you did well
but….. I’m afraid
he’s brain dead…
organs due to be harvested…
Family are with him now
before he goes to theatre.”
“Ok, thanks for letting me know”
And off I go to handover.