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A
Bitter Pill to Swallow
Thankfully yesterday has been and gone. God got me through the ugliness of many mistakes as I sat on the dangerous ride of my life. We are talking about basic nursing care — what goes into the body should come out of the body according to the Fluid Balance Charts (FBCs) tallied up on night duty shifts around midnight, but is it as simple as that? It should be with attentive care but it can mean severe dehydration, several projectile vomits through nose and mouth with force in uncontrolled measure, and kidney malfunction all due to an intravenous (I.V.) line not working over the course of 12 hours. Despite speaking up politely several times when awake enough through the haze of drug induced altered consciousness to advise that the vital fluids required for healing were not getting through (meant to be delivered at 125 ml/hr) surprisingly, nothing changed. It then became more serious as time went by with my request for the IV line to please be resited as that would easily fix the problem and prevent what soon transpired. Half a day in hospital can mean the difference between life and death. If you think this sounds dramatic, it is. Hoping nobody else ever goes through what I did because it is so easy to prevent, but sadly there most likely will be much worse. Where to start?
Going to the private hospital as a public patient was perhaps the first mistake. My surgeon made this choice for me as there is only one DaVinci Robotic machine and this was where it was stationed in the hospital with the best reputation in Adelaide. Many years ago I experienced surgery there but not with any metallic robot present and all went well, therefore was more than pleased to return again as expectations were high. The robotic device did its thing with precision so DaVinci behaved as expected with great and impeccable accuracy along with the skilled surgeon operating this relatively new and expensive piece of equipment. As I took a quick perfunctory glance at the operating theatre's new "toy", my mind decided that it stood rather majestically in its designated corner towering over all else, almost demanding attention (the sort that says "look at me, look at me") while safely ensconced in its sterile home. Indeed it was a very large and solid metal structure, shiny and gleaming silver, boasting not so much as a speck of dust on its sparkling clean apparatus. The operation was a success while I was completely "out of it" once I climbed aboard the fixed form they had in place of where the operating table stands. It was like sitting tilted in a warm jelly saddle supporting the upper torso with full accessibility underneath in order to capture the expelled uterus along with all its associated contents. The surgeon himself advised on his post-op rounds the following morning that it will be about a week before results come back from the testing laboratory in order to know whether the cancer has spread to the Lymphatic System as Lymph nodes were also taken at the same time just to be sure.
Waking up in Recovery was a relief. Back on the ward was when things with the IV went wrong. As a diabetic patient who diligently wants to get well and as soon as possible I began drinking "like a fish" because the thirst was debilitatingly uncomfortable. No matter how many 1 Litre jugs of fluid I guzzled down, nothing satiated my thirst, nor did it even take the edge off. Meanwhile each time they checked my catheter drainage bag, only a very dark trickle of urine could be seen. Nurses looked puzzled as they scratched their heads in dismay. Meanwhile my standard response was "the IV is not working". It seemed as though there was a disconnect. I guess I thought if I repeated this stock standard phrase often enough, somebody would eventually understand. Drifting in and out of the lasting effects of anaethesia coupled with strong opioid medications, it was all I could do to fight through the twists and turns in confusing tunnels of mazes that took me here, there, and everywhere, never quite able to arrive at the destination of where I wanted and needed to be. My head and neck hurt like whiplash and all I craved was clarity. Dehydration at this level is deadly serious — 24 hours prior to the surgery a strict protocol of bowel preparation in addition to fasting was followed, which therefore placed one in an already dehydrated and compromised state. This regime was carefully and rigidly adhered to exactly and thoroughly as stipulated, thereby doing my part to ensure a positive outcome. At this stage a frightening thought threatened to take over, but as quickly as it surfaced I shut it down immediately — no way am I staying more than the projected one night in hospital and there will be no lasting side effects of permanent kidney damage requiring dialysis. This is just not going to happen!!!
God came to my rescue with the blessed relief of how He has amazingly and wonderfully made our bodies when He created us to cope with emergency situations such as shock, overload, conditions involving hyper and hypostasis, among many altered levels other than the idyllic plateau of homeostasis — the state which our bodies are always trying to achieve through delicate balance. It is at this point King David's words from Psalm 139:13-16 echo in my ears. Three long and wonderful expulsions of full force vomiting suddenly relieved the mounting pressure in my already swollen abdominal area (gas is blown in to hyperinflate for clarity before surgical intervention). Unwanted pressure putting stress on multiple stitches in five sites over the abdominal wall is not something to ignore for obvious reasons. Out through the nose and mouth gushing wildly in a warm liquid torrent, thankfully fully captured and contained into one of those elongated and expandable white plastic sick bags that stretch out long like an elephant's trunk. It was with some transient pleasure that the bag was handed to my nurse in order to measure, record and document as I verbally estimated between 1-1.2 Litres of liquid contents. The Registered Nurse confirmed it was indeed 1.2 L. The joy and satisfaction of over 30+ years of nursing experience not forgotten, and the comforting knowledge that I "still had it" despite not being well enough to work anymore (even though Job Seeker has other ideas) then calmingly washed over me.
Sometime in the early hours of the eventful night (preceded by an unusually wet day replete with sheet lightning) the nurse in charge exclaimed with loud joy that my kidneys were finally starting to work and there was over one litre in the bag. She admitted that she had been very worried about me. My thoughts said "me too" but kept this to myself. Suddenly I noticed that I felt much better and was advised to call her for help when needing to void (use my bladder naturally) as the catheter was out. Much to her surprise I wanted to go almost straight away and another 600 ml+ (not counting what had already flushed out with gravity as I gratefully and tentatively stood up for the first time since coming "under the knife") was there for accounting. We know our bodies and how we feel especially after six decades! Nurses gain a wealth of experience but we do well to listen to our patients as there is always more learning to be done, and just when we think we have seen it all, or think we may know it all, along comes something different, unusual, unexpected or rare, so best to be humble and teachable. It was at this particular point that my memory strongly reminded me of a certain phrase spoken each time I faced extraordinary situations and various medical emergencies — "Now I think I've seen everything" — but instead realistically knew that tomorrow may well bring something else along not seen beforehand. Again, more correlations to meditate upon with God teaching us His Way. So many reminders, lessons, even new and interesting analogies never thought of up till now filling my sore head which craved peace and relief from pain. My mind overwhelmingly said this was not meant to happen to me despite knowing otherwise of the current reality!
At the start of the admission into hospital process the admitting nurse handed me a slip of paper indicating that they would like feedback on my experience as a public patient. All my life until the last year or so it was private health benefits all the way, but not any more. Was there really a difference? All through those decades we were told the only difference was no choice of medical officer, but sadly one nurse curtly pointed out that because I was a public patient there was only one shower and toilet for me to be shared in the corridor with the other patient in the same room. Even though the shower did not work the same nurse said there would be no shower for me in a tone of voice not associated with a professional outlook or delivery (suck it up and take it on the chin thereby turning the other cheek as in Matthew 5:39). So I had to wait a few hours until arriving back at the hotel to wash the bloody mess off. For the first time in all my adult life that I can remember, there was no basic self care about how my appearance looked (washed, dressed, combed hair, known as clean, neat and tidy forming the very basic modicum of socially acceptable decency according to the nursing care plan). As I attended to all the discharge requirements at the ground floor pharmacy and administration counter in front of the tree flashing its twinkling lights, the many people present waiting their turn, and the normalcy of a Friday morning in a primped city hospital flush with donations from wealthy benefactors, hence DaVinci, I felt anything but normal. People did look to the point of almost staring but my care factor had diminished down to nothing in my long nighty — yes, as long as I was appropriately covered, sandals on the correct feet — that was good enough in my state of medicated haze.
There was a positive in all of this…I was now out alive in the sweet fresh air given to us by God, and the nurses were very good at offering and giving pain relief, even though more than one hand touched my pills after they handled them from the disposable pill pot rather than giving me the container as they should. Why? Why do they do this strange and unsanitary habit? The focus was not on primary best practice and it was extremely sad to see the state of nursing in a private hospital known for "serving others rather than self" as part of their insignia brand. Almost laughable if it wasn't so serious, for health is a serious matter. Here is their Mission Statement claim "The purpose of [said venue] arises out of the stated purpose of Jesus Christ 'to have life in all its fullness' (John 10:10). As part of [the church mentioned], the mission of [the designated not for profit organisation] is to improve the health and wellbeing of individuals, families and communities as we: Reach out to people in need. Speak out for fairness and justice. Care with compassion, innovation and wisdom. Our Mission Practices are our DNA, informing our practice so our culture and strategy is aligned with our social impact of life in all its fullness for the people we serve". One more golden nugget…as part of their Holistic Care Practice: "We participate in God’s healing power to the whole person". All the right words that sounded good but only paid lip service, form over function, reminding me of Christ's choice words in Matthew 23:3.
For the sake of brevity other fundamental mistakes have been omitted except to say not one staff member — nursing, kitchen, cleaning, or allied health ever knocked on our door before entering. The blue coloured concertina style curtains at each bedside were there to be used but on a rare occasion were actually utilised as an afterthought. They had their tags filled out neatly and clearly of when they needed changing which amused my sensibilities somewhat. Dignity and privacy were out the window despite their glossy brochures indicating otherwise, highlighting cheerily and helpfully what one could reasonably expect on one's important hospital stay. This all brought me to the very sad conclusion that the system is indeed broken to the point of no return. Based on my experience, the desensitisation was widespread and permeated every single staff member working on the surgical ward that came into our shared room. Times they have changed with the efficiently run historical 4 bed bay now with only 2 beds in use making things seem manageable, but remember not to judge with your eyes as everything is not as it seems. Meanwhile, down behind the administration desks there was a semblance of control and calm while things operated in a polite, civilised way as one would expect, not ever suspecting the pandemonium upstairs. The only person that was full of energy was the male student nurse at the beginning of his career. He had lots of questions and despite the way staff ignored him (usually students are seen as just an extra pair of hands rather than giving them the time to meet their learning needs), it was very important to me to fill the gap to provide effective, helpful and meaningful encouragement while learning more about his career choices and aspirations. This was a lovely and unexpected part of my brief stay.
There was one other moment in time that stood out very clearly which gave me all the joy needed to get through this operation. Not planning to leave this till last but now I know why it has been inserted here…God always knows best. He heard your prayers, He answered your prayers and He saw everything done to me, not done to me, said to me, even others' thoughts rightfully or wrongfully, and gave me the most beautiful and stunningly breathtaking moment that could have occurred at my darkest moment. It was so specific and touching; it was one of those times that are truly unforgettable despite, and especially, how we may be treated in this life. More on this later. You see my operation was delayed unnecessarily for approximately 20-30 minutes due to the female Anaesthesiologist becoming upset and irate as she could not find the piece of paper signed by my own hand completely absolving the hospital of any wrongdoing if the worst case scenario happened — death. Once she did, it was not what she expected to see. Furthermore, she went back and forth, over and over again trying to change my mind via various angles of coercion (illegal) in order for me to agree to take blood products for infusion in case of bleeding out, which is life threatening and also rare. What ever happened to respecting one's wishes? As an agency nurse working in literally hundreds of places, we always honoured documentation signed and dated from all clients whether we agreed with their choices, or not. This is standard procedure and forms part of our professional code of ethics. One stipulation is that the person concerned is an adult without any type of Dementia and in their "right mind". By mentioning the word "God" things can rapidly change, and in this current climate of anti-God, not to one's advantage, but again, there was no denial of God when it counted, when everything was supposedly signed, sealed, and delivered, and in spite of not anticipating the need to rehash all these issues already dealt with.
Despite saying all the right things to entice healthy admissions on their printed pamphlets, this was a major stumbling block for my particular medical officer. Furthermore, this is exactly why the pre-operative process deals with legal and binding documents such as what we allow as the patient, and refuse to allow, for it is our body and some of us have preferences and choices made through faith, culture, and traditions. It takes many hours whereby repeating one's name, spelling each name in full, date of birth, and every single pertinent thing on every form or piece of documentation is accounted for and is taken care of ad nauseum. It is exhausting and not once did I ever complain, but rather the multi-disciplinary staff would often apologise over the repetitiveness of what they perceived as boring and perhaps over-the-top needless waste of time. However I, for one, am truly grateful for ensuring accuracy as it could mean the difference between living with an unfixable mistake such as removing the wrong body part. Mistakes happen, and I have seen more than my fair share throughout my long nursing career as people rush, cut corners or take short cuts, for the world is getting faster, and it is not a good thing. We know the world's systems are under the sway of our enemy, our Adversary, the devil. It would not be an understatement by any stretch of the imagination to say that entering a hospital for surgery can be "hit or miss" and somewhat akin to a minefield.
What was the joy delivered? The nurse assisting the anaesthesiologist, known as Anaesthetic Nurse (of which I also have some experience in) took my hand, and as she kindly walked me into the Operating Theatre she quietly said "I wish I had such strong faith like you". These were the words that instantly cut through the nasty attack experienced just prior. There were another three nurses present who apologised to me before they entered the theatre, but were silent during the verbal onslaught as they wanted to keep their jobs and most likely had seen nothing like this before. Even though the doctor putting me to sleep expectedly and mistakenly labelled me a Jehovah Witness, from which I replied with a simple "No" as in Matthew 5:37, my response was God will look after me and I have strong faith that He will. In hindsight it must have been like waving a red flag in front of a bull even though God gave me incredible supernatural peace for it did not deter me in the slightest. Despite her cruel words delivered with venom, as she tried to send me on a guilt trip, "Oh, so you are happy to die on the table today" and "Imagine how I would feel seeing you bleeding out and dying…it is not a nice thing" were anything but professional and should never have been said. My memory is of being quiet, calm, and at complete peace despite knowing what goes on in operating theatres and what can go wrong, and horribly wrong. God always gives us exactly what we need.
This is what God did for me — never expecting anything except that He will never leave me because He said so in Deuteronomy 31:6. He will never leave you either as long as we remain steadfast despite what is in front of us; despite angry, bitter, frustrated people in the world who are suffering and barely coping. Another thing God did was comfort me with the best sermon possible at exactly the right time as I recovered from all the madness left behind in that hospital, for I truly felt like I had a huge taste of what the world is like away from my peaceful "fortress" with my High Tower (Psalm 18:2) in the rolling hills of the countryside. Here it is, this inspired masterpiece of wisdom in all its glorious 74 minutes: https://www.ucg.org/sermons/gods-mercy-and-the-kingdom-yet-to-come Thanking God for His love and mercy is where we start even though this feels incredibly inadequate. Yet, by hearing God speak to me so clearly and profoundly via the above message, this is my obedient choice, to willingly show mercy to those who are suffering even though it may seem counterintuitive. Even when the strong German side of me just wants to correct others and put things right (in wisdom with tact and diplomacy), the Nurse-in-Charge who supervised, directed and taught best practice nursing care for three decades, just wanted to help the nursing staff who know better but have succumbed to the god of opportunistic ease and "me first" attitude, forgetting the mantra of the very hospital they work in. God will always see us through, even and especially in our darkest moments when all looks hopeless (Isaiah 41:10). There is great power in self-control while extending mercy to others who know right from wrong and this reminds me to be always humble and teachable, for we can all learn from each other.