Reflections on 4 Weeks in ED
Author: Cristiana Theodoli
Starting a new job is an anxious time for most people. Starting a new job as a newly qualified nurse in one of Glasgow’s busiest emergency departments is frightening. Starting at the tail end of a long winter in which the NHS crisis hit the headlines almost daily is downright terrifying.
On the upside, I say to myself, I just spent 12 weeks on placement in an emergency department before qualifying as a nurse and I am aware of how different it is from ward-based nursing. However, I am also aware the patients likely to come through the doors of my new second home will be somewhat different to those I am used to.
When I first moved to Scotland in 2003, Glasgow had the reputation of stab capital of Western Europe. About 15 years and countless violent crime reduction strategies later, the city I love won’t be sending quite so many stabbings my way. However, thanks to my previous career as a court and crime journalist in Glasgow’s courts I am very familiar with this emergency department’s catchment area and know that its high levels of poverty and health inequality will bring along their own challenges.
My first month goes in a blur. As expected I see higher numbers of conditions related to deprivation than I did as a student nurse. The hospital I trained at, in a nearby city, also covered some very deprived areas. Glasgow however, is a whole different ballgame. Along with the winter-related flu & breathing difficulties, the north of Glasgow and city centre send a constant stream of assaults and overdoses, withdrawals and mental health problems.
When working in court I always felt the majority of accused took a wrong turn and got stuck in a self-destructive cycle. The career criminals and truly evil offenders were very few and far between. The vast majority of court cases I sat in were stories of human tragedies. People stuck in a cycle of poverty and unattainable opportunities. Scotland may have amazing welfare compared to most nations but when people grow up being constantly told they will never amount to anything and surrounded by poverty, alcohol or drug abuse it’s not quite so easy to get out.
The situation is similar in this emergency department. On an average nightshift there are as many police officers as there are nurses walking its corridors. It’s easy to get frustrated as you show into a cubicle the 10th patient of the night who has taken an overdose and is arguing against getting checked over. It’s easy to be irritated when it takes three times as normal to get a patient’s ECG because they keep moving and talking and twitching and you know for a fact the doctor will ask for a repeat if you don’t get them to sit still.
But then you realise the man brought in by two police officers after being found unconscious in the street is a refugee who has recently received asylum after being repeatedly tortured in his country while the woman in alcohol withdrawals in the cubicle next to him lost multiple loved ones to cancer in the space of a year.
Four weeks into being a staff nurse in one of the city’s busiest emergency department and I can see how it is easy to get jaded and demoralised when most conditions coming through the doors could be prevented. However, what I have also witnessed is nurses and porters, healthcare assistants and paramedics, radiographers and doctors working together with humanity and empathy, recognising that each patient has a story and a reason for being where they are; and I am glad this is where I get to work. It is a job that is tough, and stressful, and heart-breaking, but it makes a real difference to some of the most vulnerable patients in the country.