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Monday, 12 October 2015

For the fiction aficionado... Phobic Wars

The following is an extract from Phobic Wars.
My second book published that is available on kindle Countdown Deal on the 14th  of October

It's a complex and entertaining read guaranteed to meet your needs as a fiction aficionado....

Who is Miss Sally Mack?

 It was a cold November morning, the snow had come early and the ward had seemed to admit half the population of the town. Obviously this was not the fact but it felt like it. The inclement weather and the low temperatures of minus ten degrees with a wind-chill factor of minus fifteen (Why not call it minus fifteen?) made many of the elderly patients quite unwell. On top of the bad weather, there was a particularly difficult strain of influenza hitting the community and the nation as a whole. The admissions ward was full to the brim, and there was a bed crisis in the hospital as always. A bed crisis is the term used when there are more patients needing beds in hospital than there are beds available. The crisis had escalated to Red on the Red, Amber, Green scale of bed management! All non-essential operations were called off, all staff available to cover any shifts were called in and in general, the movement of people, personnel, beds and equipment was planned and executed effectively by a bunch of managers and there teams. Frances was on duty on this day, working as hard and as fast as she could, supported by her team and colleagues. The phone rang for the umpteenth time that afternoon and the ward clerk jotted more details on the board, 3 patients coming up from the admissions unit. All three had “exacerbation of C.O.P.D.”as their diagnosis. With all the workload and the low numbers of staff, as a number of staff members were also suffering with the influenza virus, Frances needed to be dynamic with the management of her team. She asked a senior student and a more junior student to admit two of the patients, two males who were going to be allocated to one part of the ward and she would admit the lady, a Miss Sally Mack. The students would help each other and she could get on with the admission and any other pressing stuff that may be required of her and then she might squeeze in the I.V.’s and write up the reports and maybe cram in a quick cup of strong coffee to keep her going? At half past four in the afternoon, just before the evening meals were about to be served, Miss Mack and the two gents came from the admissions unit. Timing in hospitals is never right…Like a convoy of slow moving vehicles, the beds were wheeled in by burly porters and nursing staff, clad with notes, clothes, drips and oxygen tubing. Frances directed them to the spaces allocated for them and proceeded to delegate some tasks to Linda and Jill who were on duty too. As she was about to greet Miss Mack, the phone call she had heard in the background had been answered by one of the students and she said, ‘sister, it’s the E.R. asking to speak with you urgently’she turned and headed for the phone, gesticulating to the Porter to accompany the lady to the space in bed 5. Following the conversation about a possible other patient with a pneumothorax and chest drain in situ coming up to them, Frances directed her attentions to processing Miss Mack’s admission. She approached Miss Mack who by this point she was sitting comfortably on the bed, with the head-rest out, fluffed pillows and looking quite comfortable, despite the whooshing oxygen being delivered via the nasal specs. Her blue nightdress went quite well with her current complexion but hopefully, they would remedy this in the next few days. Frances approached her and said ‘Hello Miss Mack, welcome to ward 9’. Frances put her hand out to greet Miss Mack and then she noticed she had webbed fingers to both hands. Syndactyly. This was the rare Type 4: Haas-type syndactyly which was complete webbing, or complete syndactyly of all digits. She also had cupped hands. This was not mentioned prior to admission, the only problem she could foresee was that she may not be able to check her oxygen saturations with a finger probe and may need an ear probe. Practicalities of nursing care...! Frances tried not to show any shock on her face but it was too late, Miss Mack had noticed, but she said ‘it’s okay dear; it is not something you probably see every day’. She was right; Frances had seen clubbed fingers, cyanosed fingers, missing fingers, broken fingers, burnt fingers etc. but never webbed fingers. ‘I am sorry if I appeared rude but ...’‘Please dear’, Miss Mack interrupted, ‘don’t worry or apologise, you were not rude at all’‘Please call me Sally’. ‘I am Frances, the ward sister ‘she retorted. Frances proceeded to make her feel welcome and underwent the admission process, efficiently and with speed, not compromising on quality for the sake of getting the paperwork done. There was something atypical about her condition, during the admission questions she had noted that she was diagnosed with COPD yet she had never smoked, she was not an asthmatic or ever been ill before, her records were surprisingly small for someone so ill. What also made her curious was that her chest x-ray had shown she had pulmonary oedema yet her chest was remarkably clear of any crackles, strange! She was allergic to diuretics so none were prescribed and she noted that her blue discolouration, cyanosis, was not much better with her oxygen flowing at 2 litres per minute and her blood gases were quite normal, despite all the respiratory effort and breathlessness. Within 30 minutes, she was clerked in and ready for a bite of something warm to eat and a nice warm cup of tea. Hospital food can be quite off putting at times but hospital tea will help anything flow down the oesophagus. The meals, medicines, I.V. drugs, nebulisers and the plethora of other things that needed to be done had been done. The patients were comfortable, clean, fed and watered. Frances now had some time to herself as the visiting time was underway and she could catch up with the lesser priorities such as taking a quick break and resting. The shift was finally nearly over, ‘what a busy one it had been’Frances thought. She prepared all the information to hand over to the night shift and allowed the students off the ward a little early as they had worked their socks off and this was her way of thanking them, as well as saying ‘thanks for all your hard work today’. They left the ward with beaming smiles, feeling useful and part of the workforce. Frances handed over to the night shift and left for home, but not before she went down the ward and checked all was to her satisfaction. All was in order and as she passed by Sally Mack’s bed, she heard her say, ‘Frances, please go home and have a good rest, you cannot do any more for anyone else today, have a bath, have some food, have a warm drink and let your dreams take you on a nice long swim …’Frances smiled and said good night and walked off. However, as she left the ward, she recalled that last conversation and thought ‘a nice long swim’. What is a strange analogy’but thought nothing else of it. She drove home, in the winter weather; concentrating on the traitorous icy roads beneath the newly settling snow. She looked forward to the bath and rest, this triggered off another recall of that conversation with Sally and her watery comments. She arrived home, and run from the car, despite the snow. It was cold and she was looking forward to that elusive nice warm bubble-bath, putting the kettle and on and making herself a big mug of hot chocolate and the radio in the background chilling out. Once all this was done and she settled to bed, wrapped herself in her duvet and she finally relaxed and rested and seemed to go into a warm slumber.