The Appendix

Mary Freer asked this generic question in the lead-up to the 'Gathering of Kindness':

"What are you pondering?"

I have to admit that I am currently pondering appendixes.

Haz, my son, at the age of twenty, had his appendix out on Sunday afternoon.

Sadly he missed out on the world record by 19 cm.

The longest recorded human appendix is about 27 cm.

However, despite his demonstrated lack of appendix-growing prowess, he gifted me the privilege to transition from care giver to care consumer.

Funnily enough, being a fly on the wall in a ward is an honoured experience.

I got to see nurses so busy it seemed like they were perpetual motion machines.

When a nurse apologised to Haz for taking a little while to get back to him, she framed her apology around the fact that she had done 'ten other things" whilst she was gone.

Little did she know that no apology was needed.

She had our sincere thanks for merely being there.

At one point during his hospitalisation, Harry post surgery had a young nurse assigned to his care.

She was, I think, a new grad.

And the moment of most significance during his stay belonged to her.

She was young and fit as only the young are.

And frantic. Too busy to even remotely connect with her patients.

She had no time to walk. She dashed.

The sentinal moment for me was the one time she paused long enough to examine Haz's face.

Her pleading glance said it all:

"Please be OK. I don't have time for you NOT to be."

Then she was gone, off to care for her other myriad patients.

The next day I saw her again: a late-early!

I remember thinking.....

"How can we engineer kindness into nursing when we so unthinkingly obliterate the time and space necessary for people to be kind?

How can we nurture kindness when we fail to nurture our young with kindness?

How can we be so ignorant of so poorly designed systems of work, replete with interlocking overburden and work intensification, and yet expect perfection in each and every care activity, 24/7 at the risk of impending doom for both the patient and the nurse?

Part of the fascination was that she reminded me of myself in my training.

I remember being at the peak of my physical fitness.

I could run ten kilometers without blinking a eye.

I could play a full game of rugby league at an unremitting level of intensity.

I could work on the farm all day and not be tired, and had since I was five.

I had been a farmer, a timber mill worker, a plumber's assistant, a bank customer service officer....

And at no time during these diverse careers did I ever arrive home from work,

collapse exhausted on the bed.....

and wake with a start to stare, astonished, at the clock to see it was seven o'clock!

I was supposed to start work at 6:45!

Why hadn't they rung?

I scrambled into my crushed uniform with no time to get ready, and went racing out the door....

into darkness.

It was 7 o'clock at night, not seven in the morning.

At my strongest, most athletic, nursing was the biggest endurance challenge I had ever encountered.

Many years later, I put the puzzle together.

I realised the difference between my other jobs and this one is that nursing contains a triple whammy.

It is physical, as Harry's young nurse demonstrated in her rapid perpetual motion over a full 8 hours.

It is cognitive, because the high level executive functioning keeps the brain working hard all that time.

It is emotional, empathic work with no time nor opportunity to debrief.

It is tiring. Recovery from physical work commences as soon as you stop the activity.

Emotional recovery, however, commences 2 hours after you are removed from the compassionate environment.

So on a late-early, we tend to sleep for about 5 hours instead of our usual 8, incurring a significant sleep debt.

Some would say it is also spiritual.

Irrespective of theology or philosophy, there is a lot of soulful need eminating from people at their most vulnerable.

And nurses deal with it all.

Prior to nursing I could never imagine being that consumed, which is why non-nurses possibly find it impossible to quantify, let alone empathise with such a progressive personal perspectival phenomenological insult.

They can never imagine the triple whammy.

They can never imagine the sheer exhaustion and the endurance required to merely survive.

I really wanted to say to her:

"I'm sorry. I have let you down, and I don't know how to make it right."

Because the 'system' is something that has taken me so long to work out, and having worked it out, I am still powerless to change it.

The only answer we currently and consistently offer is that we must learn to cope better:

learn to cast off the worries, shrug off the turmoil and see, instead of the storm, the clear sky beyond the rainbow.

And I say...."That's great! We can slice coping into ever-finer slices, and being able to do so, we can teach the world;

However, the kinder and more sustainable answer is at the same time to correct a corrupted system of work, a work that expects too much of too few, and crucifies them when they get it wrong.

Instead of putting imperfect people into imperfect systems of work and expecting them to be perfect, maybe we should put good people, as they always are, into GREAT systems of work, and nurture them to perform well.

My vision is that Harry's nurse will be able to enjoy her work, enjoy her patients, engineer the random acts of kindness that are so desperately needed in a 'Castle held together by Hope'.....

And she may be able to walk away at the end of the day with some energy left in the tank

so that she may look after herself (good food, good sleep, good exercise, less stress)

and provide to those she really cares about

the same love she is able to provide so enduringly to us,

those patients who must remain to her eternal strangers.


PS: Why the Koala?

Koalas have an appendix that is 30 cm long.

It is vital to their gum-leaf chewing sleepy existence.





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