I told them to wait and see. ‘It’s too early to tell, but you’re still walking, so it’ll probably be fine.’ And it usually is. A bit of reassurance is all most people need.
Then, a few days later, Claire hobbled into my office.
‘I fell off my bike,’ she said by way of a greeting, and began to take down her jeans.
‘Hold on … slow down a bit,’ I stammered. ‘Why don’t you tell me what’s wrong first?’
‘I’m sure you’ve seen it all before,’ she declared, immune to my protests. ‘It’s pretty badly bruised. I just want to know if there is anything you can do.’ What I could do is get Michaela to have a look, but she told me not to bother. ‘Just look at my hip, that’s all.’
Her skin was a ripe black and blue, extending from the crest of the right hip, all the way down the side of her leg, ending midway down her thigh. ‘What the hell were you doing? That’s some fall you’ve had.’ It would take weeks to heal completely, but she said it wasn’t a particularly big fall. ‘I wasn’t jumping … just landed awkwardly.’ I recommended she get an x-ray, but she was reluctant to go. ‘Can’t you just give me some cream or something?’ I explained I was worried that she might have a small chip broken off her hip, or something more. ‘I want you to check your urine, to make sure there’s no blood in it.’
Despite my advice, she was still reluctant to see Dr Fritz. In the end, I took her to see him myself.
An x-ray showed Claire had chipped her hip bone, although her urine was clear. Treatment involved regular ibuprofen and gel to apply topically (which means, on the surface).
‘Thanks for everything – I didn’t think it was so bad. I owe you one.’
But, Claire never did pay me back. Especially not after ‘the incident’ …
Two months later
Claire had just returned from the Christmas break. Nearly everyone heads away for the break, the British to Britain, the Americans to somewhere warmer, with a beach and palm trees, and the Kiwis to wherever their hearts desire. I spent Christmas at school with family.
The night before school was about to start up again, I received a message on my phone.
‘Can I see you soon? Urgent. Claire.’
I called her straight back and she said she was in terrible pain, and I agreed to see her in the health centre.
Claire couldn’t sit still. ‘It hurts so much, I don’t know what to do.’ I asked her what was wrong, and she became shy, reluctant to share. ‘It’s so embarrassing, but it’s so sore, you have to help me.’
I promised I wouldn’t tell a soul, and suggested that she didn’t have to tell me; that I could take her to hospital, but she knew what was wrong.
‘I can’t poo.’
A chuckle escaped.
‘It’s not funny,’ she snapped. ‘It’s so sore.’
I asked how long since she last had one.
‘Two weeks, I haven’t had a poo in two weeks.’
‘Shit.’
‘Yes, shit,’ she echoed.
I asked her what she’d tried so far to fix the problem. She said she’d tried liquids, tablets, and even suppositories. ‘And they didn’t help, even a little?’
She shook her head. ‘It’s just there, like concrete. I feel like I’m trying to pass a brick.’
‘You really need to go to hospital, I’ll drive you there.’
But she refused to go. ‘Can’t you do something, like, you know …’ I did know something that would work, but it didn’t feel right, so I asked Claire if she would mind if I called Michaela for some backup.
‘I don’t care who you get, as long as they can help.’
I have no problem with getting down and dirty, but Claire was a colleague, a friend, and, most importantly, a woman.
We did have an enema in stock, but I handed the problem over to Michaela.
I don’t think you need much more detail. Suffice to say, the enema Claire received was not quite enough, and Michaela said she had to give a little, er, encouragement, but the problem was fixed, and Claire was eternally grateful. But there has been no offer to pay me back because she ‘owed’ me one. In fact, she has avoided Michaela and me ever since.
Foodies
It’s not just the teachers that require some medical advice. It’s the maintenance, domestic and kitchen staff too. And you can forget about office hours; they approach me anytime, about anything … a lot.
I first met Raj during breakfast.
‘Can you please be giving me something for my stomach?’ Raj asked as he charged into my office, hopping from one foot to the next, as if barely able to contain himself.
I’d only ever seen glimpses of Raj in the kitchen or serving up meals in the cafeteria. I’d never spoken with him before, but he looked in pain.
‘What’s wrong?’ I replied. ‘Perhaps you should be at home.’
‘No, no, no. I’ll be fine, I just need something to stop the diarrhoea.’ I normally don’t give anything for diarrhoea, at least in the first 24 hours of a bug, as it’s a normal part of the illness. Instead, I encouraged him to drink and told him that the diarrhoea should settle down on its own in a day or two.
‘But it’s been three days already.’
I paused, and kept the forkful of scrambled egg I was about to ingest, in mid-air.
‘But you’re at work?’
Raj started at me blankly; he seemed to be trying to figure out what I was trying to say.
‘It’s OK,’ he finally said. ‘I’m not asking for any time off, I’ll be fine.’ I placed my fork and egg back down on the plate.
If someone has diarrhoea for three days, I’d normally refer him or her to the doctor, at least if it was serious and frequent, which Raj explained his was.
‘It’s exploding very much,’ he said, almost cheerfully, when I asked how bad it was. That would explain the hopping on his feet. He really was trying to hold it in.
I referred him to the doctor, and told him he couldn’t work in the kitchen.
‘No doctor. It’s OK.’ He waved his arms, brushing off my suggestions, before leaving me to eat my breakfast in peace.
I forgot about Raj, until later that day …
Raj seemed a bit better – he was no longer hopping.
He served up lunch, a curry, a brown curry, to me as well as every student who walked into the cafeteria.
For some reason, I couldn’t eat the curry; it looked too loose, and besides, I don’t eat enough fruit anyway. I made do with an apple and banana.
The next morning twenty cases of gastroenteritis were reported.
I was suddenly very grateful I’d taken the healthy option the previous lunch. Something had to be done. As soon as all twenty cases had been dealt with, I entered the bowels of the kitchen.
There were a dozen kitchen staff in total, including Raj, all curious, all unaware.
‘I just want to find out what your policy is in the case of illness,’ I asked delicately, fearing a backlash. Instead, they stared at each other for answers, before shrugging their shoulders and grinning.
‘What happens if you have diarrhoea?’ Again, I drew a blank.
‘You do know you need to be diarrhoea free for at least 48 hours before working in a kitchen.’ I finally got a response. They all began laughing.
‘What’s so funny?’ I asked, and Raj spoke up.
‘If we did that, no one would ever be at work.’ The conversation was over as they dispersed to their various stations to prepare the next meal.
I don’t eat at school anymore. And neither do half the students.
I wrote a letter to the headmaster outlining my concerns, and I was told that they’d looked into it. But I never heard from anyone about it again.
Since the scene in the kitchen, Raj stopped coming to me when he was sick. In fact, I’ve not seen anyone from the food crew in the health centre in many years.
We still do get regular outbreaks of diarrhoea and vomiting, it just never goes away. And from the discussions I�
��ve had with other school nurses at various conferences, the matter of food quality and food hygiene at schools can be hit or miss; some schools have great food, some mediocre, some disturbing. We seem to be somewhere in the middle. While the occasional mass-event stomach upset is wrong – especially if you know the root cause – I have learned that the best school nurses have to choose their battles wisely. Especially when you’re dealing with the boss …
Priorities
Dear Mr Driscoll,
After our recent boarding school conference, we discovered we were the only school out of 60 that does not have defibrillators. Can we please remedy this?’
Sincerely,
The health centre
Attendees at a conference I had recently been to were shocked – not literally, thank goodness – that we didn’t have any defibrillators on campus, and horrified when I explained how isolated we were.
I don’t usually like being the centre of a confrontation, but after my letter, Mr Driscoll called a meeting with the nurses.
‘In all your years here, have we ever needed one?’ Mr Driscoll asked. I reminded him that Dr Fritz had used one during a cross-country running event, but as Dr Fritz was actually in attendance during the event, we hadn’t needed one of our own.
‘But kids don’t have heart attacks.’
He was right, they don’t really have heart attacks in the traditional sense, where a clot blocks an artery, the patient just suddenly collapses and their heart goes into life threatening rhythms.
‘But it’s not just the kids, there’s over 100 staff here.’ I kept my cool, because surely he’d see that the one-off cost of 5000 euros for three defibrillators spread throughout campus was worth every penny. ‘And have you seen how many of your workers smoke and drink, and how old they are?’
Mr Driscoll was unfazed, so I pulled out the big guns.
‘Take Mr Rodgers, for example.’ I was referring to our beloved art teacher, due to retire at the end of the year. ‘He’s just had a heart attack.’ It’s helpful that the weekend the medical staff were away at the conference that inspired my plea, learning about our deficiencies, Mr Rodgers had a heart attack.
Mr Driscoll didn’t answer straight away, perhaps because there was no answer to this, but he came up with something.
‘He’s OK, he’s going to be fine. He wasn’t shocked. The emergency services were fantastic.’
Mr Rodgers was down the mountain in the city when he’d turned grey and clutched his chest in pain. His wife had taken him to the emergency room where they treated him with clot busting drugs, and saved his heart from being damaged. He hadn’t needed a defibrillator, but that was because of his rapid treatment. Any longer, and he probably would have.
‘Listen, this conference you went to was run by Americans, right?’ I could read his mind, but I nodded my head and kept silent.
‘We all know they overdo things.’
‘Do you not care about your staff?’ I dared, and Mr Driscoll took the bait.
‘You’re walking a fine line.’
It seems I’m always walking a fine line, but why is doing the right thing such a risky business? Whether it’s working in a hospital or a school, the battle is the same. Management want to save money, staff just want to do what’s right.
‘So, we’re not going to get any?’ Mr Driscoll was fuming. Instead of answering he shook his head and stormed out.
‘Can I get that in writing?’ I said to his retreating back, but he didn’t pause, and I never got an official written reply.
I had to get creative.
I asked the people in charge of raising donations for the school to ask families if they could donate money to the good cause, but they said no.
‘It doesn’t look good asking money for something we should already have.’
‘It would look a lot worse if someone keels over and dies when we could have saved them,’ I retaliated.
I began a campaign of annoyance, and regularly bombarded management with written requests for defibrillators, which generally went like this:
‘I hope you don’t mind me putting it in writing, but I can’t accept responsibility if one of the students or staff dies because we don’t have a defibrillator. The decision and responsibility is yours.’
I knew that when you put requests like this in writing, they have to reply. I learnt that from my time working in hospitals. In fact, in hospitals, if you didn’t put it in writing, you didn’t do it. It’s one of the reasons so many nurses are compelled to spend more time in the office than with their patients.
Shockingly, management didn’t reply; yet another reminder I was no longer an A&E nurse.
It took four years, but finally we got them. Our sheer tenacity paid off. All the nurses brought up the issue of defibrillators every chance we got, either at a staff meeting, or further written requests. We even sourced out the best deals and managed to include a training course for the whole faculty as part of the package. Financially, it was now more attractive as it wasn’t just 5000 euros for the health centre, but 5000 euros to cover compulsory training for all the staff. It’s a shame that it took so long, but, for the sake of the children and the staff, I’m proud that I kept on fighting for them. We haven’t used them yet … but it’s nice to know that they’re there.
Payback
I didn’t really know what to say, and that in itself is saying a lot because I am rarely left tongue tied, but the headmaster was deadly serious. ‘Is there any risk of infection?’ he asked again, while I busily searched for an answer on Google.
Meanwhile, Adam sat on the edge of the examination table unsure how to react. I think he was trying to look upset, worried, angry and disgusted all at the same time. I just hoped my face was not as transparent as his because I was having difficulty keeping it straight.
Adam and Bryce had enrolled halfway through the first term and had found themselves roommates. It takes time to adjust to a new school, particularly in your senior year and especially when joining mid-term as there are questions which are rarely left unasked, such as: why anyone would transfer in their senior year? Did they get kicked out from their last school? Are they troublemakers? Was it drugs? Even if the reason is benign, the speculation is usually not. The school gives these students a chance, an officially clean slate, but we sit, we wait and we wonder.
When two seventeen-year-old boys are thrust together in a new environment they’re never themselves; they’re two egos trying to appear strong, desperate to fit in and become popular. By mid-term the social groups are already well established and newcomers sometimes struggle. To fit in they do silly things, all for a laugh, and what’s better than laughing at someone else’s expense? Sadly not all teenagers know when to say enough is enough.
It began one evening when Bryce was absent and Adam herded half a dozen lads into his room – ‘bring your phones guys, this is going online’ – and proceeded to play his prank.
The following evening Bryce was confused and angered by the behaviour of the other boys in the dorm. No one would sit near him, some started calling him ‘shithead’ or ‘shit for brains’; he had no idea why until a message arrived in his inbox. Bryce clicked on the link and watched a video of Adam as he picked up Bryce’s pillow and farted loudly into it.
How should he react? How would you react? In the old days (time before the internet) it wouldn’t be such a big deal because you might have heard that someone’s buttocks had been intimate with your pillow, but now you not only saw it in high definition, the rest of the school did too, making retaliation compulsory, and it would need to be equally as public.
‘He’s going to fucking pay!’ Bryce shouted. The boys, iPhones at the ready, followed Bryce as he made his way from the study hall in search of Adam. But such a crowd couldn’t pass through the dorm unnoticed and probably saved Adam from a certain brawl, the staff on duty were quick to intervene.
The IT department discovered the video and were eventually able to delete from the schoo
l’s system, although I’m sure it’s still floating somewhere in cyberspace, no doubt forever.
Adam received a full weekend of detention, a small price to pay for the prestige he earned. In the minds of every student on campus justice had not been served.
Thankfully, once the heat of the moment had passed, the boys chose to be men and made an effort to get along. No one said ‘I’m sorry’ or ‘I forgive you’, that’s not how young men talk to each other. Instead, they played at fighting, shared links to some online porn (determined students always find ways around firewalls) and even backed each other when empty beer cans were found in the room.
Then, one morning about two weeks after the pillow incident, or ‘butt-gate’ as it became known, Adam woke and felt something not quite right with his eyes, and when he looked in the mirror he saw that both of his eyes were red and watery.
‘Is it pink-eye?’ he asked and I said that it certainly looked that way. Pink-eye is the expression Americans use for conjunctivitis. If it looks mild, and there is no discharge (crust or pus), then the modern treatment is to wait for a day or two as it often resolves on its own. In this instance, because there had been pus I chose not to wait to see the doctor.
With a simple course of antibiotics his eyes should have got better, but after three days they had become worse and so his treatment was upped.
That same week, another video surfaced amongst the students and this time it featured Bryce pulling down his pants and very liberally ‘smearing’ his bare arse on Adam’s pillow. Butt-gate had escalated to ‘smear-gate’.
I’d never heard of anyone contracting conjunctivitis through a pillow that had been in contact with someone’s buttocks, but apparently it is not unheard of. I’m sure Bryce had no idea such a thing could happen, and hadn’t wanted Adam to get ill. Either way, it didn’t matter if he knew or not because revenge had not only been served, but served in a very public way. For weeks after, Adam was continually asked if he had been ‘poo-faced’.
Confessions of a School Nurse Page 13