Once upon a time, during a gripping nursing lecture, we learnt about cheese. More specifically, swiss cheese. My memory of the precise details is a little hazy – I was pretty busy at the time, bitching about our lecturer with my posse. In a mixed bag of lecturing delight, she was grim. Equipped with a lapel-microphone, a constant supply of Fisherman’s Friends and some kind of sinus complaint, her lecturing was from the inspirational school of ‘You Will Kill Your Patients. It’s Just A Matter Of Time’. Anyway, in keeping with this theme, she was talking about some academic’s theory of clinical risk prediction. The gist of it was that people are swiss cheese. Everyone has weaknesses, or holes. Some times, some days, people are more holey than other days. If all the holes in all the people in a clinical scenario line up, the patient falls through all this holiness into a big, dark hole. So as my Argentinian hula coach would say – One sample:
Woman is having her fourth caesarean. Small hole.
Woman drinks 2 litres of Coke a day, in lieu of water. Average-size hole.
Woman is also heavy smoker. Large hole.
Midwives/Obstetricians providing antenatal care don’t discuss with woman(well, they might have, but as They say, If It’s Not Documented, It Didn’t Happen) the impact of Coke and smoke regime on potential wound-healing. Average-size hole.
Surgeon writes vague post-operative orders re wound dressing. Everyday-size hole.
Midwife sending woman home doesn’t check caesarean wound. Big hole.
Caesarean wound morphs into enormous, pustulent hole. Bigger hole.
Obstetrician readmitting woman thinks conservative management is wise. Bloody big hole.
Theatre staff bump woman’s wound-clean-up surgery for three days. Bottomless pit.
Kerching! Kerching! Kerching!
Or any other sounds approximating pokie fruit machine rows lining up and flashing wildly.
A long way down this bottomless, pustulent, grim pit of wound dressing hell is me, with my best ‘I’m so fine with this seeping, odorous situation’ face and the biggest bottle of hospital-grade hand sanitiser I can find.
I love realising that not every nursing lecture was crap. I hate nursing.