- Feb 3, 2024
- LitCoin
- 0
New blog post by Rachel McCarron
Everything Is Going to Be Alright
It’s been a pretty bad week for me. It started last Monday when I took my mum for an appointment with the gynaecologist. She’s currently on chemo for breast cancer, but they found a large mass on her ovary at her last CT scan. There had been no hurry for the gynae appointment, so we were hoping they would say it was only a cyst. But they couldn’t tell us anything without further investigation, so she goes for an MRI this afternoon.
Tuesday at work, I did an uneventful visit for a patient with swollen legs in a care home, only to be confronted as I sat in my car outside, logging on to my laptop for the details of the next visit. Two cars came speeding down the road, one pulling up in front of me, the other driver abandoning theirs in the middle of the road and blocking me in. The two drivers then got out of their cars and began an aggressive exchange before my eyes. It looked as if it would come to blows but stopped just short. There was a bit of manhandling as one driver got into the other driver’s car and refused to move. I had my windows up and couldn’t hear exactly what was being said, but they both utilised the furthest vocabulary of proper swearing. Normally I would fully approve of this. I’m quite a fan of the C-word which can be effective in the right context. But here it was just vicious. One driver started filming everything on their phone, including me, the innocent bysitter. Then the other driver got back in their car and sped away. The one who’d been filming, came and knocked on my window demanding my contact details as their witness. When I refused, they said in a menacing tone, ‘If anything happens to me, it’s on you.’
I advised them to call the police, but they just stalked off, got back into their car and fled, I imagined, in pursuit of the other driver.
I called 101 myself and gave a report. Just in case.
Wednesday, as I am just about to leave for work, my husband tells me he feels unwell. Why couldn’t he have told me this at 7am instead of half nine when I have a clinic starting at ten? I told him to phone the GP and get an appointment. ‘I don’t have time to sort you out. I’ve got my own patients waiting.’
At half nine, they have no appointments left and he needs to phone 111. I wonder how our doctors’ surgery can basically close to new patients at half nine, when the one I work for triages right up until 4pm and still sees urgent cases including home visits until 7pm.
I call him at lunchtime. ‘What did 111 say?’
‘Someone’s going to call me back.’
‘Okay, let me know what they say.’
I phone him again near the end of my shift.
‘Nobody called back.’
‘Do you still feel unwell?’
‘Yeah, I feel terrible.’
‘Ring them back then.’
‘Okay.’
I arrive home at 7.30pm. ‘What did they say?’
‘I’ve to be at urgent care for 8pm.’
‘But that’s a thirty minute drive away.’
‘Yeah, we need to go now.’
So, I get back into the car and off we go.
When I take my husband or mum for appointments, I don’t usually announce that I’m an advanced practitioner. I don’t want to exploit insider privilege or affect anyone’s clinical decision making, but I do speak up if I think a poor decision is being made.
I looked at the prescription as she handed it over. ‘This isn’t generally first line treatment for men,’ I tell her.
‘Yes, it is,’ she says.
‘I’m an independent prescriber in primary care. We give trimethoprim as first line for males. The guidance changed about five years ago.’
‘No, we still give nitrofurantoin.’
‘Okay. It might work.’
‘Any other problems, see your own GP.’
‘Okay, thanks.’
It’s hard to be assertive against a brick wall, and I went away cursing myself for not being an arsehole about it and kicking off until we got what I thought he needed.
Husband spiked a temp overnight. Started vomiting. Not keeping anything down. Early signs of sepsis. Let’s get you to A&E.
We are rerouted at A&E back to urgent care. ‘We’re trying to keep people out of hospital,’ said a different nurse practitioner, sending us away with a prescription for trimethoprim and an antiemetic.
I’m able to switch to telephone triage and work from home, but I have been docked two hours pay for the time it took in urgent care.
Even with the antiemetic, he is still vomiting. Not even keeping water down now. Temperature is a whopping 40.1 C.
I phone a trusted colleague for advice and moral support. ‘I can’t take him back up there, we’ve already been, and they sent us away.’
‘What would you do if he was your patient?’
‘I’d send him to A&E.’
‘There’s your answer then.’
Back at A&E, we are sent to urgent care again. After waiting only an hour, the same nurse practitioner tells my husband that his temperature is coming down and suggests he goes home again.
‘Shouldn’t you do bloods to check his CRP and make sure he doesn’t have an AKI?’ I ask. (AKI = acute kidney injury. Not an actual injury despite the name, but rather a sudden drop in renal function.)
‘We can’t do bloods here. He’d have to go through A&E and it’s a forty hour wait. We’re trying to keep people out of hospital.’
‘He needs bloods doing.’
‘So, you actually want to wait in A&E?’
‘Yes, or he might die.’
‘Okay, if you think so.’
So, we begin the long wait.
After the first couple of hours, you enter another zone where time doesn’t matter, and this just becomes your life now. The A&E staff are truly amazing. Compassionate and hard at the same time. The fellow patients can be entertaining, and there’s something of the blitz spirit alive and well amongst the people crammed in on the rows of chairs fixed to the floor, or wandering in and out for fags and vapes.
An announcement intermittently tells us that, ‘The waiting time in A&E is a currently at least seven hours.’
Husband has stopped vomiting. It crosses my mind to take him home, but the thought of having to come back and start the wait all over again is enough to make us stay put. Those of us hard-core waiters, well beyond six hours of now, consider the people who give up and go home as failures and light-weights. If they really needed to be here, they will undoubtedly deteriorate and need to come back.
‘The waiting time in A&E is currently at least eight hours,’ says the announcement.
There are a couple of police officers waiting quite cheerfully with their charge, perhaps because they know two others will come to relieve them at the end of their shift and they can go home tonight. A drunken teenager in a bright green onesie lies down on the floor kicking his legs and refusing to get up, like an overgrown baby. I’m sure we held our booze so much better when we were kids.
‘The waiting time in A&E is currently at least seven and a half hours.’ Everybody cheers.
At 2 a.m., after ten hours of waiting, husband gets his blood results. CRP is 360 – if that means nothing to you, consider that the upper normal limit is 10, and you will know that something is wrong. I want to tell the nurse practitioner ‘in your face!’ but he will be fast asleep at home and will never give my husband or his own sub-par decision-making skills another thought. And husband’s renal function is way off. I’m not surprised. He’s not kept any fluids down for over 24hrs.
He will get his IV fluids and antibiotics in the next few hours. The right management plan. I go home to get a couple of hours sleep before phoning in sick for work. It’s now Friday. He is still in A&E, albeit having graduated to a tiny room with four recliner chairs and three other patients. The reward for waiting. He still hasn’t slept, but at least he’s got a drip now. I head back to wait with him. He needs to be admitted, but as expected, there’s no beds. He gets on chatting with the chap in the next chair, who tells him all about his narrowboat. It’s quite sociable. I leave them to it at around 10pm and go home to sleep.
I’m on annual leave now. We hadn’t booked a holiday, because mum’s got chemo and an oncology appointment as well as her MRI this week, but we were going to go to York for the weekend. A cheap, non-refundable hotel room didn’t feel like much of a risk at the time of booking. I tell myself we’ll actually save money by not spending as much as we would have if we had gone.
He gets onto a ward at 1 a.m. Saturday. Only a thirty-six hour wait rather than forty as promised. It’s a nice ward. Lovely staff. And a bed he can actually sleep in. I settle into the familiar half hour drive there and back for afternoon and evening visiting.
He asks me to take his laptop in so he can get some writing done. Must be feeling better then. ‘And by the way, when are you coming home?’
‘Not yet. They want to put stents in.’
‘Stents?’
‘And if that doesn’t work, I’ll have to go on dialysis.’
‘What the…?’
I thought it was an AKI that would resolve. I’m an elderly care specialist. I know a lot about palliative care, chronic disease and falls prevention, but I’m clueless about surgical procedures.
‘You should be getting on with your writing,’ he tells me.
‘Yeah, but I’m halfway through cleaning out the kitchen cupboards.’
I’m not a procrastocleaner. It really isn’t me. I’m not prone to cleaning nor procrastination. When it comes to writing, I don’t lack motivation ordinarily. But somehow, tackling the kitchen has been taking my mind off things.
Especially when I get a call from the police wanting to interview me with follow-up questions about the incident the other day. I had forgotten all about it. They’re going to be in touch.
So today, husband is waiting for his surgery, and mum is going for her MRI. I have cleared out some kitchen cupboards and am writing this while I wait for the police to call.
Not my best week.
Oh, and by the way, I just got my first two rejections from agents. I’m a proper writer now. It didn’t upset me as much as it might have done.
Keeping me sane through all this is my main character, Neil Harper, my imaginary friend and voice of reason. I can’t concentrate on his story at the moment, even though it would be the ideal time to get on with my WIP when all I have to do during my week’s holiday is endure hours of waiting. But Neil tells me it doesn’t matter. His exploits can wait and will still be there when I am ready to return to them. He tells me I will survive all this because my husband is my best friend, and we work through everything together. He tells me everything is going to be alright.
‘Is your glass always half full?’ asked Hannah.
‘No,’ said Neil. ‘But when yours is half empty, I top mine up a bit.’
Of course, I’m only talking to myself here. Neil is part of me, and I am part of him. Apart from his innate neat-and-tidiness – which I in no way share – he is probably the character who is most like me. And perhaps I am becoming more like him, what with the procrastocleaning and all.
Have any of you had a terrible week too? It’s human nature to feel better about your own life if someone else has it worse. So, tell me your troubles, and I’ll be happy if you can top mine.
---
Everything Is Going to Be Alright
It’s been a pretty bad week for me. It started last Monday when I took my mum for an appointment with the gynaecologist. She’s currently on chemo for breast cancer, but they found a large mass on her ovary at her last CT scan. There had been no hurry for the gynae appointment, so we were hoping they would say it was only a cyst. But they couldn’t tell us anything without further investigation, so she goes for an MRI this afternoon.
Tuesday at work, I did an uneventful visit for a patient with swollen legs in a care home, only to be confronted as I sat in my car outside, logging on to my laptop for the details of the next visit. Two cars came speeding down the road, one pulling up in front of me, the other driver abandoning theirs in the middle of the road and blocking me in. The two drivers then got out of their cars and began an aggressive exchange before my eyes. It looked as if it would come to blows but stopped just short. There was a bit of manhandling as one driver got into the other driver’s car and refused to move. I had my windows up and couldn’t hear exactly what was being said, but they both utilised the furthest vocabulary of proper swearing. Normally I would fully approve of this. I’m quite a fan of the C-word which can be effective in the right context. But here it was just vicious. One driver started filming everything on their phone, including me, the innocent bysitter. Then the other driver got back in their car and sped away. The one who’d been filming, came and knocked on my window demanding my contact details as their witness. When I refused, they said in a menacing tone, ‘If anything happens to me, it’s on you.’
I advised them to call the police, but they just stalked off, got back into their car and fled, I imagined, in pursuit of the other driver.
I called 101 myself and gave a report. Just in case.
Wednesday, as I am just about to leave for work, my husband tells me he feels unwell. Why couldn’t he have told me this at 7am instead of half nine when I have a clinic starting at ten? I told him to phone the GP and get an appointment. ‘I don’t have time to sort you out. I’ve got my own patients waiting.’
At half nine, they have no appointments left and he needs to phone 111. I wonder how our doctors’ surgery can basically close to new patients at half nine, when the one I work for triages right up until 4pm and still sees urgent cases including home visits until 7pm.
I call him at lunchtime. ‘What did 111 say?’
‘Someone’s going to call me back.’
‘Okay, let me know what they say.’
I phone him again near the end of my shift.
‘Nobody called back.’
‘Do you still feel unwell?’
‘Yeah, I feel terrible.’
‘Ring them back then.’
‘Okay.’
I arrive home at 7.30pm. ‘What did they say?’
‘I’ve to be at urgent care for 8pm.’
‘But that’s a thirty minute drive away.’
‘Yeah, we need to go now.’
So, I get back into the car and off we go.
When I take my husband or mum for appointments, I don’t usually announce that I’m an advanced practitioner. I don’t want to exploit insider privilege or affect anyone’s clinical decision making, but I do speak up if I think a poor decision is being made.
I looked at the prescription as she handed it over. ‘This isn’t generally first line treatment for men,’ I tell her.
‘Yes, it is,’ she says.
‘I’m an independent prescriber in primary care. We give trimethoprim as first line for males. The guidance changed about five years ago.’
‘No, we still give nitrofurantoin.’
‘Okay. It might work.’
‘Any other problems, see your own GP.’
‘Okay, thanks.’
It’s hard to be assertive against a brick wall, and I went away cursing myself for not being an arsehole about it and kicking off until we got what I thought he needed.
Husband spiked a temp overnight. Started vomiting. Not keeping anything down. Early signs of sepsis. Let’s get you to A&E.
We are rerouted at A&E back to urgent care. ‘We’re trying to keep people out of hospital,’ said a different nurse practitioner, sending us away with a prescription for trimethoprim and an antiemetic.
I’m able to switch to telephone triage and work from home, but I have been docked two hours pay for the time it took in urgent care.
Even with the antiemetic, he is still vomiting. Not even keeping water down now. Temperature is a whopping 40.1 C.
I phone a trusted colleague for advice and moral support. ‘I can’t take him back up there, we’ve already been, and they sent us away.’
‘What would you do if he was your patient?’
‘I’d send him to A&E.’
‘There’s your answer then.’
Back at A&E, we are sent to urgent care again. After waiting only an hour, the same nurse practitioner tells my husband that his temperature is coming down and suggests he goes home again.
‘Shouldn’t you do bloods to check his CRP and make sure he doesn’t have an AKI?’ I ask. (AKI = acute kidney injury. Not an actual injury despite the name, but rather a sudden drop in renal function.)
‘We can’t do bloods here. He’d have to go through A&E and it’s a forty hour wait. We’re trying to keep people out of hospital.’
‘He needs bloods doing.’
‘So, you actually want to wait in A&E?’
‘Yes, or he might die.’
‘Okay, if you think so.’
So, we begin the long wait.
After the first couple of hours, you enter another zone where time doesn’t matter, and this just becomes your life now. The A&E staff are truly amazing. Compassionate and hard at the same time. The fellow patients can be entertaining, and there’s something of the blitz spirit alive and well amongst the people crammed in on the rows of chairs fixed to the floor, or wandering in and out for fags and vapes.
An announcement intermittently tells us that, ‘The waiting time in A&E is a currently at least seven hours.’
Husband has stopped vomiting. It crosses my mind to take him home, but the thought of having to come back and start the wait all over again is enough to make us stay put. Those of us hard-core waiters, well beyond six hours of now, consider the people who give up and go home as failures and light-weights. If they really needed to be here, they will undoubtedly deteriorate and need to come back.
‘The waiting time in A&E is currently at least eight hours,’ says the announcement.
There are a couple of police officers waiting quite cheerfully with their charge, perhaps because they know two others will come to relieve them at the end of their shift and they can go home tonight. A drunken teenager in a bright green onesie lies down on the floor kicking his legs and refusing to get up, like an overgrown baby. I’m sure we held our booze so much better when we were kids.
‘The waiting time in A&E is currently at least seven and a half hours.’ Everybody cheers.
At 2 a.m., after ten hours of waiting, husband gets his blood results. CRP is 360 – if that means nothing to you, consider that the upper normal limit is 10, and you will know that something is wrong. I want to tell the nurse practitioner ‘in your face!’ but he will be fast asleep at home and will never give my husband or his own sub-par decision-making skills another thought. And husband’s renal function is way off. I’m not surprised. He’s not kept any fluids down for over 24hrs.
He will get his IV fluids and antibiotics in the next few hours. The right management plan. I go home to get a couple of hours sleep before phoning in sick for work. It’s now Friday. He is still in A&E, albeit having graduated to a tiny room with four recliner chairs and three other patients. The reward for waiting. He still hasn’t slept, but at least he’s got a drip now. I head back to wait with him. He needs to be admitted, but as expected, there’s no beds. He gets on chatting with the chap in the next chair, who tells him all about his narrowboat. It’s quite sociable. I leave them to it at around 10pm and go home to sleep.
I’m on annual leave now. We hadn’t booked a holiday, because mum’s got chemo and an oncology appointment as well as her MRI this week, but we were going to go to York for the weekend. A cheap, non-refundable hotel room didn’t feel like much of a risk at the time of booking. I tell myself we’ll actually save money by not spending as much as we would have if we had gone.
He gets onto a ward at 1 a.m. Saturday. Only a thirty-six hour wait rather than forty as promised. It’s a nice ward. Lovely staff. And a bed he can actually sleep in. I settle into the familiar half hour drive there and back for afternoon and evening visiting.
He asks me to take his laptop in so he can get some writing done. Must be feeling better then. ‘And by the way, when are you coming home?’
‘Not yet. They want to put stents in.’
‘Stents?’
‘And if that doesn’t work, I’ll have to go on dialysis.’
‘What the…?’
I thought it was an AKI that would resolve. I’m an elderly care specialist. I know a lot about palliative care, chronic disease and falls prevention, but I’m clueless about surgical procedures.
‘You should be getting on with your writing,’ he tells me.
‘Yeah, but I’m halfway through cleaning out the kitchen cupboards.’
I’m not a procrastocleaner. It really isn’t me. I’m not prone to cleaning nor procrastination. When it comes to writing, I don’t lack motivation ordinarily. But somehow, tackling the kitchen has been taking my mind off things.
Especially when I get a call from the police wanting to interview me with follow-up questions about the incident the other day. I had forgotten all about it. They’re going to be in touch.
So today, husband is waiting for his surgery, and mum is going for her MRI. I have cleared out some kitchen cupboards and am writing this while I wait for the police to call.
Not my best week.
Oh, and by the way, I just got my first two rejections from agents. I’m a proper writer now. It didn’t upset me as much as it might have done.
Keeping me sane through all this is my main character, Neil Harper, my imaginary friend and voice of reason. I can’t concentrate on his story at the moment, even though it would be the ideal time to get on with my WIP when all I have to do during my week’s holiday is endure hours of waiting. But Neil tells me it doesn’t matter. His exploits can wait and will still be there when I am ready to return to them. He tells me I will survive all this because my husband is my best friend, and we work through everything together. He tells me everything is going to be alright.
‘Is your glass always half full?’ asked Hannah.
‘No,’ said Neil. ‘But when yours is half empty, I top mine up a bit.’
Of course, I’m only talking to myself here. Neil is part of me, and I am part of him. Apart from his innate neat-and-tidiness – which I in no way share – he is probably the character who is most like me. And perhaps I am becoming more like him, what with the procrastocleaning and all.
Have any of you had a terrible week too? It’s human nature to feel better about your own life if someone else has it worse. So, tell me your troubles, and I’ll be happy if you can top mine.
---
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