If I were her instead, I'd certainly would've out-barked him (not in front of Edi of course). I do know the difference between professionalism and plain stupidity in not caring about how the patient feels. And yeah... he IS paid for being a nurse (who is supposed to CARE for the sick), not some idiotic robot who just do what he is trained to do mechanically..
It reminds me strongly to my own thoughts about medical profession people, doctors especially: never, NEVER get involved with them, because all they give you is pain.. !! I say this with utmost confidence purely from experience.. actually 2 or 3 experiences... anyway, I digress..
Here is the extract from Vivien's email..
"Thur, 03/12/09
5'ish pm visit - Edi was eating (again, he felt hungry) and we all chatted a bit. After Hei Meng's departure for home, the evening was settling down to be restful and without drama but we were wrong.
Just as I was about to leave at 6'ish at Edi's insistence, Nurse Patrick came in and with a loud voice (that's his manner I soon found out) said, Edi because of your heart fibrillation, I'm going to set up a cannula (IV tube to administer drug) to give you potassium for your
heart. By now, the notion of needles fills Edi with dread but of course, he cooperated and pumped his fist as Patrick got ready to insert the needle. Edi didn't hear the nurse asking him to stop pumping and Patrick got annoyed! To me, he said, tell him to stop or I will miss his vein.
Patrick warned that the potassium drip could be painful as it gives a burning feeling. He's got a major vein on his left arm for this purpose and the burning should be reduced as compared with a small vein. However, Edi having such a low threshold for pain by now was in agony. I could only place my hands on his right shoulder and right knee to comfort him. After about 15 mins he drifted into sleep and I was glad. However in the last ½ hour of administering the potassium, he experienced the pain to such an extent that he was moaning and groaning and at times, gasping.
During such a distressing experience, Patrick did a few things:-
(1) Edi, Edi, Edi do you know what this tube of cream is for? It's been prescribed a week ago but not been used. Edi, in agony, said ask the day nurse (Patrick was the day nurse).
(2) Come on mate (Edi), transcend your pain. Fight it (depression) and to Edi's What's there to fight? - he was still in great pain from the drip - Patrick's answer was "that's depression talking".
(3) I'm giving you an injection on your tummy for XXX (medical term for anti-ambolism). Edi, do you hear me? Do you understand what I've just said? Turning to me, he continued, I must make sure he hears and understands me otherwise I think there is something wrong with him, like having a stroke. He must answer me. After the jab, he speculated that Edi has a very low threshold to pain - Edi arched his back at the sting of the needle.
(4) Open your mouth, here's your medication. Swallow it.
(5) This is for your mouth (syringed awful medicine right into Edi's mouth in an expedient manner).
All the above occured when Edi was writhing in pain. Could he not wait until the drip was over (in all it took over an hour and a bit and we were in the last ½ hour of it). The added stress was .... I won't grapple for the words here but the more I talked about this, the angrier I am.
(6) Patrick: You (talking to me now) continue to be compassionate, that's fine but I must do my job (I think he realised his own behaviour was poor and then tried to justify himself). I had tried a few times to give him information so that he would adopt a gentler manner with Edi but my efforts were fruitless. Each time I volunteered some info, he said, I know or something along this line. Perhaps I should have said firmly, stop, this is creating a lot of stress for my brother.
The above showed Patrick's lack of judgement on what/when to say/do it. Initially, I thought it might be a good idea to distract Edi from his pain with Patrick's approach (my poor judgement) but I have come to the conclusion that what he did was inappropriate. I must be fair and give an objective picture here: there were times when he talked in a manner that showed compassion, eg: a heart operation is a big thing and unfortunately he's gone through so much more; you (Edi) are doing good; I am not doing anything yet so there should be no pain, Edi, etc. However, his poor behaviours outweighed these moments. He thought he was encouraging Edi, "be a man" but wasn't taking into account that this was very bad timing. Here was a patient in agony and clearly struggling to cope with the pain. It might be that Edi was "expansive" in his reactions to the drip but the level of pain was his reality. Patrick needed to see Edi's frame of mind in that "moment".
Fri, 04.12.09
I asked to speak with David the Head nurse this morning but left for work without having done that. Will follow up on this as I'm leaving soon for the hospital.
8.30 am visit - Edi has had breakfast. The doctors were there and I seized the opportunity to ask two things (1) result of the throat scan and (2) yesterday's heart fibrillation (AF) and the potassium treatment. Throat is fine, no damage and they are now allowing him normal fluids. Basically he can eat and drink anything now except for chewy food. Must be to condition his stomach again to solids. Dr Markham Phuong doesn't seem too concerned with the AF and I managed to establish that should Edi need potassium again, now that he's drinking, there are tablets to take instead of going on the drip. This is a huge, huge relief.
Took Edi on the walker for a short spell; showed him the kitchen and instead of returning to the chair in his room, at Sandi's (physiotherapist) prompting, he sat on a couch outside his room and near the nurses stations so that he could see what goes on in his immediate surroundings. Good to take his mind off things. Sandi and he bandied around a bit on when to take a longer walk and to sit in the sun room. Edi even tried some humour and smiled (what a beautiful sight): Kenneth Williams has all the time in the world. Context: Edi was saying maybe later (to the longer walk) and Sandi was saying, I have no time (there are other patients to visit). Sandi: who's Kenneth Williams? Edi: he's a comedian. Marvellous that he's actively engaging in the dialogue.
Nurse Brooke asked me, did the doctors order a blood test? I was so tempted to say No to save Edi the ordeal but of course could not and must not. I knew they would want blood after last evening (to check for potassium and magnesium levels and whatever else to tell what is needed for the heart. Edi couldn't get away with "must I have it?" with Brooke. Foregone conclusion.
12.30 pm visit - Bought a dozen of Krispy Kreme doughnuts for the ward staff afternoon tea as a small gesture of our heartfelt thanks to them; this morning Edi has asked me to get something for them. Bearing the box I ventured into Head Nurse David's room and proceeded to express our gratitude again. Following up on that I gave feedback on Nurse Patrick. David put up a defence (but not in a defensive manner) for Patrick but also accepts my comments, acknowledging that Patrick needs to know the patient better. I was very careful to describe Patrick's behaviours and used his words as much as possible so that I reduced the risk of using labels and sounding judgmental. However I was clear on my opinion that Patrick needs to exercise discernment. David says as Patrick is intense and dedicated in his work, he would be devastated if he knew about my complaint of him. I pointed out that it's not a complaint per se but feedback. I acknowledged Patrick's expertise and experience, I pointed out what was good about him. I expressed to David that I would like Patrick to have my feedback and leave it to him to decide how to deliver it. I learned that Patrick in fact is in training (he started in the Ward a few weeks ago) in cardio thoracic patient
care.
Edi considered Patrick as "arrogant" and I can understand how he is perceived in this way when he barks orders at Edi. I have no doubt that clinically, he is a good nurse ("I've done this - setting up the cannula - thousands of times") but is not very experienced as yet in reading patients and handling their mental health.
They are hopeful that when the weekend's over they can remove the feeding tube. When David asked how I think my brother's oral food intake has been these two days, I could not honestly say that it was enough for the tube to be taken out. So, let's wait out the weekend. Where he goes for rehab next week is uncertain, depending on bed availability. It could be St George's hospital on Cotham Road in Kew or St Vincent's another building close by where Edi is. Former is not ideal for our visits especially during work days but all we want now is a place where the rehab people and environment are best for Edi's progress. If Rehab is still at the city fringe (ie St V's) and we can visit as regularly, that would be great."
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