A Fly in the Ointment

A note to my readers

During my fifty-plus years in Mental Health Nursing, I worked with many nurses, many distraught people, in many situations. What I write about comes from those experiences. Most of my stories come from my memory of an event rather than from remembering the people involved and...most are fictional. When I have written about an actual event or person I have changed the names to protect them.

I write with lessons built in; I am more of a teacher than an author. The nursing position I refer to in this book, Mental Health Nurse Consultant for a Regional General Hospital, is a position I was never fortunate enough to secure. I promoted the idea many times, but in my time of nursing, this position did not exist.

Enjoy the read.

Acknowledgments

Thanks to my son, Laurie Legault, for his drawings on the cover, for his poetry, and for his helpful discussions around my writing.

To my editor - many thanks for your time and patience in working with me to make my stories come to life.

Title and cover design: Jea Larche

This book is dedicated to my husband, Jerry,

who is always supportive.

1

Come on, Spike, let’s go for a walk and get the mail. It was a beautiful day. The temperature was cool, but the sun was shining which made the day bright.

Tracy Shaw lived in a well-favoured neighbourhood. Most of the houses were spacious ranch styles on one-half acre lots, well cared for, with many flowering trees and plants. Tracy enjoyed walking her little Dalmatian through the area to get the mail. There no longer was house delivery in her neighbourhood. In 2014, Canada Post had decided that, to cut costs, it would have residents pick up their mail at the community mailbox, which contained twenty-four separate keyed boxes.

Tracy was a petite woman with short, blonde hair that had a cute messy style to it. Her tanned looking skin showed off her bright blue, expressive eyes. She had just had her thirty-fifth birthday and was very conscious of keeping herself healthy and in good shape. She ran a mile on a daily basis and belonged to a gym, which she tried to visit at least twice a week. She walked with an air of confidence, even though today, she was not feeling it.

Tracy had applied for the newly posted position of Mental Health Nurse Consultant at the local Harbourside Regional General Hospital. It was a large, fairly new hospital. Tracy couldn’t remember the exact year it was built, but she thought maybe ten or twelve years ago.

As of today, she still had not received a response to her application, so each day she was anxious to get the mail. The interview had been three weeks ago, and Tracy could not figure out why she had not heard something. With each day passing, her hopes faltered, and getting the job seemed less likely.

As she walked, Tracy reviewed in her mind her resume and the interview. She had her Registered Nurse Diploma, and her Bachelor of Science in Nursing Degree. Early in her career, when she realized she liked the mental health field, she had taken time off work to get her Master’s Degree in Psychiatric Nursing. Since then she had worked with the mentally ill, in one role or another, so she had a solid twenty years of experience. Tracy sighed. She knew her cover letter and resume told all this information in detail, but she couldn’t help feeling that maybe she should have done more.

She felt she had handled the interview well but it was hard to say, as there were five different professionals on the panel - a psychiatrist, a physician, a social worker, the Director of Care, and the Nurse Educator - and each may have been looking for different skills. She continued to question herself. Then she thought, as she let her tiny Dalmatian smell and lift his leg on every blade of grass they passed, that it was like writing an exam, and every day you don’t get the results, the more you are sure you failed.

The local mailboxes were about one-quarter mile away from Tracy’s home. As she walked, she became more anxious. She wanted to hurry but was afraid it might be another day of no news. But, whatever the news was, even rejection, she knew she would have to face it.

Finally, the mailbox was right in front of her. She hesitated to put the key in to open it, because she imagined another fruitless day. To her surprise, there was something there. She examined the brown envelope, and sure enough the return address read Harbourside Regional General Hospital. Tracy stood for a long time, hesitant to open the envelope. Now that she’d gotten the letter she imagined the worst. Her little dog enjoyed her hesitation, as it gave him more time to smell out the territory around the boxes.

Tracy opened the envelope and slowly read the contents. Then, although no one was listening, she yelled, Yippee! She looked around, feeling embarrassed, and then said to Spike, Come on, baby, enough smelling, we have to get home and share my good news with David!

David was her husband of ten years. Both had come away from bad marriages. Neither had children. They were now happy and enjoying this relationship.

She had met David at a local corner store, when he insisted on carrying her groceries out to the car. She liked him right away. He was tall with dark features, ebony eyes framed with crow’s feet. Dark brown hair, very short cut, almost a buzz cut. His face and neck were darkly tanned, as were his arms. He wore a blue denim shirt rolled up to the elbows, denim jeans with flecks of sawdust all over them, and unlaced brown leather work boots. She quickly found out he wasn’t shy, because he asked her for a date after putting her groceries in the car. She accepted. They were married one year later.

Tracy almost ran home, the poor little dog trying his best to keep up. She opened the door and hollered, David, guess what? She didn’t wait for an answer. I got the job, I got the job!

David came out of the kitchen smiling, and hugged her and congratulated her, but Tracy could not hear any of it as she was still too excited. Her excitement prevented her from thinking about what she had gotten herself into.

Her start date was one month away. She now had time to put in a resignation from her present job, as a Nurse in Charge of a Psychiatric Unit, in a smaller hospital. It also gave her time to get ready for her new job as a Mental Health Nurse Consultant, for all units in the much larger Regional Hospital.

2

Finally the day was here. The new job required she spend four days in orientation, and today was the first day. Tracy was feeling anxious about starting, but tried to put it aside by talking to herself, saying, I can do it, I can do the job, I am well qualified, so quit worrying. She took extra time to dress as she had a hard time deciding what to wear. Hair was shiny and clean and make-up was meticulously put on. She examined herself in the floor length mirror and thought, Yep, I’m okay.

She arrived at the hospital in good time, and was shown to a meeting room. The orientation was all about the rules, regulations and procedures of the hospital. There were twenty-five people in the room, and Tracy wondered, Are they all nurses, or what? At coffee break and lunch, she was able to meet a few of the people from the group. Some were from maintenance or sanitation, others were lab technicians or X-ray techs, and three were Registered Nurses.

They had a lecture on fire procedures, and practised using a fire extinguisher. They then had a lecture on human rights, where the presenter spoke in a monotone voice which was hard to listen to. Tracy occupied her thoughts by watching a man with a shiny bald head sitting four rows ahead of her. He kept dozing off and leaning onto the lady beside him. Then he would startle awake and apologize. Soon he was asleep again, leaning the other way.

They learned the color codes that would be announced over the PA system to alert staff to a problem in the hospital, like a red alert for fire. The color codes also kept patients from knowing what the emergency was so they wouldn’t feel unnecessarily anxious or upset. This was all boring to Tracy as she had kept up the yearly obligation in her previous hospital of renewing procedures. But she knew it was part of the orientation, so she participated fully.

On the second day there was a lecture on cardiopulmonary resuscitation, then practice and re-certification. During the lecture, Tracy’s mind travelled back to the first time she had done CPR without the aid of a crash cart, and all the special equipment and life-saving medicines it carries to sudden emergencies within the hospital.

One of Tracy’s patients had been found hanging. He had tied a strip of the bed sheet around his neck and attached it to the upper window bar and jumped off. He’d been quickly cut down and was lying on the floor. Emergency services had been called, and a nurse had been ordered to get the ambu-bag to assist in providing ventilation to his lungs, but in the meantime, Tracy knelt down and started CPR. After four rotations of fifteen chest compressions and two breaths, the man had started to gasp for air, just as the emergency cart arrived and took over caring for him.

Tracy had hurried to her locker and taken out her toothbrush, paste and mouthwash. She spit and gagged and brushed and brushed and gargled over and over, but could not get rid of the taste of the patient. She’d been happy that he lived, but had not realized the trauma of doing CPR, and it had taken a few visits to the hospital counsellor to work through her feelings.

Tracy thought about how CPR had changed in the time since then - it was now taught that mouth breathing would only be done if help had not arrived after 30 compressions. Ever since her early experience, Tracy had been carrying a small plastic airway with her at all times, so she would never have to experience the taste of mouth-to-mouth again.

Tracy felt even more wearied by the end of the second day, as she had just come from working in a hospital where the rules and regulations were the same, but thought, We do what we must.

On the morning of the third day, Tracy and the three other nurses were called out of the room to meet with the Director of Care. The Director introduced herself as Louise Pratt. She was a tall woman in the 50-60 age range. She walked straight and proud. In Tracy’s mind, she thought, She looks like what a Director should look. She was dressed in a linen suit the colour of her eyes, which were a turquoise green, and wore a soft floral scarf around her neck. Her salt-and-pepper hair was pulled into a French roll at the back of her head, with a small sparkly turquoise comb complementing it. Makeup was put on with care, with a very light eye shadow that worked with the outfit. Her legs were shapely in black pumps.

The Director welcomed them to the hospital and their new jobs. She then had her assistant tour them through the hospital, and introduce them to the Nurse in Charge of each unit. Then they moved on to the pharmacy, where the pharmacist reviewed medication protocols.

The last day was mostly taken up by a meeting with union leaders. Then the nurses were assigned the units they would be working on. For Tracy, the day was completed with a tour of the Psychiatric Unit, and meeting the two psychiatrists.

Then the Director of Care met privately with Tracy, and escorted her to where her office would be on the third floor. The room assigned to Tracy was small, but she thought it would be adequate. Its saving grace was that it had a window, which was not wide, but long, almost from ceiling to floor. Tracy wondered why such a window would have been put in this room, but she liked that she could see the mountains whether she was sitting or standing. There was a large desk set at an angle so that your back was not totally facing the door, and at the same time you could see out the window. There was also a small bookcase, but otherwise, the room was totally bare. Not even a picture on the wall. Tracy felt she could make this office her own.

The Director asked Tracy if she had read the job description. Tracy smiled and said, More than once! Louise returned the smile with a nod of the head that was saying, I figured so.

With that, the Director reviewed once more with Tracy that she would be expected to assist all units in the hospital, with consultation and assistance as needed for any mental health problems. She also explained to Tracy that she would be free to visit other patients who may just need someone to talk to. Lastly, Tracy was reminded to keep clear notes of her activities, as the position would be up for review in six months and again in one year.

3

Orientation ended early on the last day, so Tracy headed for the gym. She had been sitting a lot during the last four days, and it felt good to exercise her body and clear her brain. She was excited at starting the new job, and thought she would be capable of turning her small office into a pleasant area, to engage with others. After a good workout and a hot shower, Tracy headed home. She spent time playing with Spike and then started dinner.

When David arrived home, she was so excited to tell him everything about her office and her plans that he had to say, Slow down, slow down! Give me a chance to get out of these dirty clothes and have a shower, and then I’ll listen to every detail. He kissed Tracy and headed for the shower.

In just a few minutes he was back. Okay, I’m ready. Let’s sit down at the kitchen table, and you can tell me everything.

Thanks David. I love you. First, I’m happy the orientation part of the job is over. I found some of it pretty boring because I have kept my skills up, so it was a lot of repeat. The Director of Care, her name is Louise Pratt, showed me to my office. She’s very attractive. Looks like a leader. Tracy was talking fast, and David realized she was excited and trying to spit it all out in one breath. He knew she had so much on her mind. It’s on the third floor and it’s pretty small but I think I can make it mine. It has a small, narrow window that goes floor to ceiling so there is some light, but I will need pictures that give the room the effect of it being bigger. You game to help me search for the right ones?

He smiled, Of course!

"It will need some colour, and I will need to get my computer set up. I guess I go to Maintenance to check that all out. I’ll take some books from home to fill the bookcase. For the first week there may not be much for me to do as far as working with patients. I thought I might go to some of the units, to introduce myself to the Nurse in Charge, and start meeting some of the nurses and other employees. Then I thought I would go to coffee - oh, that reminds me, I will need a coffee maker - and sit with the different nurses to meet them and let them