The community, in general, perceives nurses to be a chosen few engendered with more than the average degree of compassion. The media, too, take a similar view - and rightly so. Doctors aren’t far behind the nurses in the compassion stakes although one doesn’t see the media often portrait them in that light. Compassion is certainly desirable in all those who attempt to tend to the ill and injured but it is not the sole preserve of nurses and doctors.
We received the call from the ambulance people near dusk. A five year old girl had been hit by a car on the highway not far from the hospital. She was unconscious, had suffered a seizure and they would arrive in a few minutes. Her father and ten year old brother had witnessed the event, were both distraught and were coming in another ambulance.
The emergency medicine physician, the bright young emergency medicine trainee and several senior nurses immediately dropped whatever it was they were doing and moved into the resuscitation area. Quickly and efficiently they all got into plastic aprons and gloves and started preparing the area. We could hear the distant ambulance siren. The ECG machine was switched on, drip stands and giving sets prepared, syringes and needles laid out, endo-tracheal tubes prepared, laryngoscopes checked to ensure they worked and so on. They were still at it when the ambulance entrance doors swung open and the ambos wheeled the trolley briskly into the resuscitation area at the nurse supervisor’s direction.
There was no real place for me in the resusc team and it was better I kept out of the way. There was plenty to do because the two doctors now working on the little girl had been attending to other patients and no other doctors were rostered on. Also, there were several patients in the waiting room. My job, along with the few remaining nurses, was to keep things running as best we could. I went to the waiting room, apologised to those waiting and explained they would probably have to wait an hour or so because we had an emergency to deal with. No one complained. One young bloke in work clothes said, “She’ll be right doc. We’ll just wait our turns.”
I then went around speaking to each of the patients in the ward cubicles explaining that their doctor had to attend to an emergency. I reviewed their notes to determine the stage of assessment and treatment each patient was at and told them I would attempt to keep the processes moving.
By this time the ambulance officers had finished transferring their patient and were collecting fresh linen for their stretcher. The senior officer seemed a bit stressed and I started a conversation with him. It turned out he was very upset that, while he was treating the girl in the middle of the two southbound lanes of the dual carriageway, only a couple of vehicles stopped. He had to get a needle into a tiny vein in the little girl’s arm, while she was having a seizure, start a drip running then give intravenous medication to stop the seizures. This would be difficult enough in the emergency ward with the child on a bed let alone on the roadway. Traffic poured around him, his assistant, the child and the driver of the vehicle that had hit her. It was more than ten minutes before the police arrived and took charge of the very dangerous situation. We talked about it for five minutes or so and he seemed much better. I suggested he might want to avail himself of the ambulance service counselors. He said he thought he would be OK.
A commotion at the ward entrance led me to the child’s mother, confused and distraught and demanding to see her daughter. She worked at the hospital and the orderly and nursing assistants knew her. We decided to take her into a small consulting room while we explained the situation as we knew it. Within a few minutes the father and brother arrived and the scene became one of tumultuous emotional chaos. We let it run until the initial outpourings of shock and grief had run out. While that was happening I quickly went to the resusc area and asked for a condition report to give to the parents.
Returning to the family I found Jimmy, the orderly, preparing tea for the parents and he had obtained a soft drink for the brother. I suspect he had bought it from the dispensing machine with his own money. Claire, another orderly, was on her knees in front of the seated father holding both hands in hers and quietly speaking words of guarded reassurance. He sobbed and cried wretchedly. Helen, the Patient Care Assistant stood alongside the mother holding her head against her waist while she, too, sobbed and cried with her arms around Helen’s body. The boy sat quietly with tears streaming down his face and the soft drink can clutched in both hands. They stared at me without comprehension as I explained their daughter had serious head injuries and once stabilized would be flown by helicopter to the children’s hospital in the city.
I did another round of the ward then checked with the triage nurse to ensure there was no new patient requiring urgent attention. The resusc team had the situation well and truly under control. Their patient had a tube in her trachea and was breathing with the help of a machine. She was unconscious and paralysed in order to control the fits and her breathing. The ECG monitor clicked away rapidly but steadily and the oxygen saturation indicated showed an acceptable level of oxygenation. They were now preparing to take her to x-ray to have an urgent CT scan of the brain. The younger doctor was on the phone to RFDS organising the helicopter.
The family were rational now. The initial shock and disbelief waning - being replaced by stark reality as the situation became clearer. Helen, Claire and Jimmy were still with them; still speaking to them, listening to them and reassuring them. They had their situation wonderfully controlled. Jimmy’s pager buzzed and he excused himself – it was his job to wheel the patient to x-ray.
In due course, after Jimmy brought the patient back from x-ray, she was taken off to the helicopter landing pad and whisked away to the city. Everyone returned to their previous tasks and got about their business, including Helen, Claire and Jimmy. I thanked them for a job extremely well done. They were the unsung heroes of that little drama – doing what is not expected of them and not in their position descriptions but doing it extremely well and much, much better than I could have done.
Compassion is not the sole preserve of nurses and doctors.