A Day in The Life of a Nurse. No Two Days are Ever Alike

The corner of my eye catches a giant roach crawling in the kitchen. I cry aloud, “Look, What a large cockroach!” My colleague who is having her morning coffee and watching the AM news on Channel 9 does not even blink. “How strange,” I said to myself, again. I know Maxine to be a city girl from Edinburgh but her lack or reaction surprised me. I walk up to the cockroach in the hope of spraying it with an insecticide. I assume that it saw me. It crawls all over the place. It does not go into hiding. It must have been testing my determination to destroy it. “Just wait a moment, I’ll have you stone dead.” I said to myself.

I hurriedly open an endless line of cupboards filled with roach droppings, old crockery and unwanted scraps of food, There was everything there – frying pans, mice droppings and boxes of tissues. To my disgust and lots of internal anger I did not find any insecticide. The roach does not go into hiding. It was testing my patience. This was a highly unusual behaviour on the part of this, rather large roach, so I concluded that the corners must have been sprayed with an insecticide. Honestly, I did not know the truth. Would any pest control person do that? Only the roach could suss that out.

Deadly silence can be frightening when you are in a strange place. Image via Wikipedia

Feeling a little angry and frustrated at the sub-standard living conditions I walked out of the kitchen. To my relief the roach had disappeared. At least my colleague would not say anything about letting the roach get away. Maxine is still watching TV. She seemed to have no interest in the roach, dead or alive. “How disgusting” I mumbled to myself.

It is approximately 08.00 am. It is the time when we were expected to open our ear assessment clinic. We are all charged up, with a list of patients to be rounded up. We walk up to the school and our other colleagues pull up in the Toyota Ute (This is an Aussie word for a sports utility vehicle) just as we stroll to the front of the isolated looking school. We are all ready to run through the list but the patients and their parents have to be found and brought to this make shift clinic in a remote community in the Northern Territory of Australia.

It is important for nurses, doctors and other professional to know that when the patient is a minor i.e. less than eighteen years old he/she must be seen in the presence of a responsible adult. In the NT (Australia) the term used is carer. Amongst Indigenous Australians the carer is usually an aunt or a closely connected family friend. Our job is made more difficult because many Indigenous Australian homes are without a telephone. Hence, when looking for a child we must be accompanied by a local health care worker who knows the community well. Another compounding problem – Many Indigenous Australians have a White Name and a local name. The White name may appear on the data that is provided to us for screening purpose however very few persons will know the White Name of most patients. So, usually the principal identifier is the Hospital Registration Number. Some clients have multiple birth dates too. Until, I got used to this “checking system” I felt like I was walking a system of mines waiting to explode, I was very uncomfortable with it but got used to it. However, I will never use this system of checking anywhere else.   

At about 09.00 hrs the first lot of patients is brought to us by Lawrence, he is one of the school carers. When the children enter their school library they find us waiting for them. They do not know what is happening and hang on to Lawrence. He is a familiar face to them. Maxine then explains to Lawrence the legal requirements for us to be able to see the kids. We need consent from their parents. Lawrence is now off to hunt for the parents in his Toyota Ute supplied by the Government. He gently walks to the Ute and disappears in a cloud of red dust. I am reminded of the Red Sandstorm they had in Sydney yesterday, the worst in seventy years.

Children in a community. Image via Wikipedia

Keeping five children engaged was not a problem. I made friends with them by offering them stickers. The stickers were brightly coloured. An ear was painted in the middle with the words, “School is Cool” inscribed in black. I wondered what the children thought of what was written. Upon conversing with the children it was clear that the children did not like school with the exception of one. The children, really out patients put the stickers on their faces; one of them put it on the back of his leg. I wondered why but did not ask. Let him do what he wants I said to myself. The other children continued looking into the fairly large collection of books for a remote community.

There, in one corner sat an Indigenous Child. He was barely visible or audible to the team. He sat in the corner, on a computer, playing computer games. A gentleman came looking for him. Was he really looking for him? I wondered because the gentleman looked in the corner where the boy was sitting. He did not say a thing. He did not say anything to us. I ventured to greet him but by then he was gone. The invisible and inaudible boy/patient continued to play computer games in the corner. When I was bored after talking with the children I noted that Dr. Kerry had gone on his morning tea break, and Lindane was gone to the ladies. My sheep mentality led me to go the gents and to the staff room for a cup of Blend 45 which was supplied free. I added a heaped spoonful of powered milk and a spoonful of sugar. If I were ordering this in Canada I would have said, “One small single single.”

A non-Indigenous teacher walks into the library. She is of Indian background and we exchange notes. I remarked that I am trained teacher too. She asks me if I would be interested in a teaching job at the local school. I politely decline but she manages to say that the kids would like me. Despite having rejected the offer I am feeling I should do my little bit more to help the community. However, I do not feel that I have what the community needs – empowerment. I have always had a soft spot for people living in remote communities and try to help within the limits of my resources and abilities. It is my personal view that Indigenous Australian Communities live in third world country conditions. Remote communities remind me of my childhood days in India – poor, limited resources, isolation and limited education. Against that backdrop I feel that more could be done to help empower Indigenous Australians. I do feel that the Government is doing a lot but there seems to be a mismatch between the goals of the communities and the goals of the government.

The parents arrived. They are made to feel welcome. Each of the patients is examined in the library. Other patients are looking on and they all know what the problem (diagnosis) is going to be. “Glue Ears” is the order of the day. Glue Ears simply meant middle ear infection. This was the most common condition here. All the parents signed the usual consent forms so that the information about their children can be shared between the clinic and other stake holders. For reasons of confidentiality I will not identify the other stake holders.

Our communication was adjusted to meet the needs of the patient population. When the patient’s ears were good the patient and the parent were told that the patient had “strong ears.” Locally translated, it meant that the ears were free of infection which did not treatment. Then the child was sent for a hearing test. If the results of the hearing tests were good the patient and parent were told that the patient had “strong hearing” which meant that the hearing was good and did not need treatment. The opposite of strong ears would be “sick ears” and the opposite of strong hearing would be, “hearing not good.”

Towards the end of the day we pack our equipment and head to the clinic. A patient and a parent had shown up there. However, we also needed to compile records of our work so it was in our interest go the Health Clinic. We ended the working day at about 5.00pm.

“Lets go for a drive,” remarked Maxine. Dr. Kerry who was the principal driver for the day agreed. So did I; and the audiologist. We drove for a few miles along a dirt road and come to a large satellite dish. We looked at is a contradiction, “No tech vs High tech”, we took some pictures and moved on.

We came to an open area with small scrubs and bush. Our four wheel drive Toyota UTE gave us the necessary confidence to continue driving. Suddenly, the wheels started turning and the UTE moved no more. We started to consult one another busily. I was frightened and nervous but felt that we were safe. If the worst happened we could always call the local clinic for help but deep inside me I did not want to do this. I felt that the best outcome would be for us to just buckle down, dig ourselves out and get home in one piece. We did exactly that.

Dr. Kerry got out of the vehicle. A team member drove the vehicle and noted that only two wheels were turning. At this point we agreed that for some reason all the four wheels were not pulling. Putting our minds together we figured out that the wheels needed to be “locked”; Honestly, this was Maxine’s idea. With our shoes in the mud we managed to get the wheels locked and drive the Toyota UTE and it’s contents out to safety. We breathed a sigh of relief but knew full well that we still had a lot of work to be done – wash our shoes and the Toyota UTE. Thanks to the dirt roads the tires became naturally cleaned by the time we got home.

Aboriginal Rock Art, Australia. Image via Wikipedia

At 6.15pm it was time to warm up our dinner. It was my responsibility. I started the process. It was a strange microwave oven. It required me to enter the weight of the soup / pasta etc including the size of the pizza pizza. I had none of that. I was trying to defrost and warm up rice and curry. Since there was no equivalent time given to heat rice and curry I did what I knew best. It was time to do the trial and error method. The pain of the trial and error method was that I was stuck in the kitchen while my colleagues watched TV. Maxine kept saying “Can I help you?” I could not be a gentleman if I asked her to help I concluded in my mind. “I am fine I replied.”

When the meal was ready we sat on the dining table and ate to our heart’s content. One of my colleagues felt it too hot and diarrhoea the next day but Maxine remarked, “It is the best meal I have had.”  I did not have any remarks as it is something which I ate frequently. I could not complain because three of my resident chefs had cooked it.

After dinner we watched TV. Then, suddenly we felt the rain come on and off. We wondered, somewhat loudly, “It is the dry, surely it is not raining!” Then the rain stopped. It was dark outside. We were not venturing out for fear of snakes and “cheeky” dogs. Then it started to pour buckets again. This rain is funny. It comes and it goes. Above all, it is the dry season. How strange. To our disgust we learned that there was no rain. Not a drop of it. It was the rotating sprinkler system. How could we be so foolish? How come they turn on the sprinkler system at night?

It is about 10.00 pm and we still need to complete the paperwork for the day. Thank God my computer and the wireless modem are working though it has lost charge. However, I can fix this as I have brought. The cable actually weighs as much as the computer and makes the computer bag look ugly. It is difficult to pack yet the computer manufacturers who sell you the computer never tell you about this painful link and the fact that batteries seldom hold charge for the amount of time that they are supposed to hold charge. This is my personal gripe.

We settled into our bedrooms at our own chosen times. I remembered that we all said good night but do not recall the times. All I know is that “the rain” had stopped. Also, Maxine did not hear my cry about the cockroach because she did not have her hearing aids in place. It was a silent moonlit night in Milingimbi, Northern Territory, Australia.

Map of the Northern Territory, Australia. A backpackers paradise. Image via Wikipedia

Parliament House of the Northern Territory. Image via Wikipedia