by Clark Nidaserialised here by permission of the author.

all in all it’s been a good day

after orange juice which sister gave us mrs wirral came to my bed with the new face hallo jackie this is mr hall she said and he said hallo too

i thought at first he was a doctor but they wear long white coats and have pens in their top pockets and walk round looking shit bored all the time

jackie is one of the three patients here as can talk said she and mr hall nodded he seemed a bit tossed by it all 

just then mr rochdale brought lee hazlewood back to bed from the toilet 

lee was running along shouting golden daffodils golden daffodils and smacking his forehead fit to bust he jumped into bed and sat there jabbing his thumbs in his lip like he usually does

lee is one of the boys who can talk but there’s never any sense in it 

what’s the matter with him said mr hall talking to no one in particular 

he’s nuts said billy snickering away and mr hall looked round in amazement 

what did you say he said and billy repeated it for his benefit 

that’s billy wetherby said mrs wirral he can talk too hallo billy my love everything all right

mr hall looked wanked he said i thought you couldn’t use straitjackets these days 

it isn’t a straitjacket it’s a restrainer it stops the patient falling out of bed 

but he can’t move his arms said mr hall

he inflicts injuries on hisself said mrs wirral he gets unhappy if an arm gets loose and you have to tighten him up again he’ll hurt himself bad one of these days is it tight enough dearie

billy said it was and everything was hunky dory anyway he gets me to call out for a nurse if an arm gets loose because i can shout louder than him

we’d send him to leybourne grange said mrs wirral they don’t use restrainers there they’d dope him so he’d just lie there in a daze all the time but here he can see what’s going on and have a giggle with everyone so what’s for the best like

mr hall looked at billy then at me then at billy again and then at mrs wirral and i wondered if that was the last we were going to see of him 

but no it wasn’t for after lunch he was back on the ward in a proper apron white jacket and black trousers and oh joy he did the big change with mr maskell…

“Your first big change, Alan. So watch what I do carefully. There will be many more.” 

Maskell had piled up the trolley with all the things it needed. A basin with sponge, warm water and a splash of Dettol. A pile of draw-sheets. Another pile of nightshirts and another of nappies. A white linen bag for wet linen, which hung by its drawstrings on the front corner of the trolley. A green silk bag for foul linen, which hung on the other corner. And the largest tub of zinc ointment Alan had ever seen. 

They pushed the trolley out of the passageway into the Boy’s Ward and brought it to rest at the foot of the first bed. 

“Now Roger,” said Maskell with brisk cheeriness, “what have you got for us today?” 

The boy, lying on his side with his hand in his mouth up to the knuckles, ignored him completely. A backward baby – a 15 year-old backward baby. 

Maskell drew back the bedclothes. A sweetish smell arose of fresh warm urine. Alan flinched.

“Rule One. Don’t bugger your back up.”

“I’m not an old man,” replied Alan. “I don’t get backaches.”

“You will if you don’t watch what you’re doing,” said Maskell. “Backache is the number one enemy of a nurse. We can’t afford you taking the days-off sick. Now watch what I do. There – did you see?”

Maskell had hauled the patient over towards him onto his other side. Alan failed to see what he was driving at. 

“Don’t lever from the back. Bend your knees slightly and get them as far as possible under the load. I know it’s difficult with the bed in the way. Get your back in a comfortable position and stiffen it – don’t bend it. Throw your weight backwards slightly and let your legs do the lifting.” 

“I think I see now.”

“I’ll let you do the next patient. Now, when the patient is in this position, never, never go away and leave him. Roger here will stay exactly where you put him – but you mustn’t risk even the slightest danger of the patient falling off the bed. If the alarm bell goes…” Maskell straightened up and looked over either shoulder, as if foul fiends were creeping up behind, “then the safest thing is to put the patient on the floor. Yes really! Then he’s got nowhere to fall. But that’s only in an emergency.”

He turned back to the task in hand. “Now Alan, I want you to pull out the draw-sheet your side and push it under the patient. No, not like that – like this.” 

The bed was made in a curious way – certainly nothing like the way Alan made his own. The pillow was imprisoned under the bottom sheet. Maskell explained that a loose pillow might tangle up with the patient and stifle him. It also saved a pillow case. The pillows themselves were in thick green plastic bags, as was the mattress.

The patient lay on a draw-sheet – a piece of absorbent linen which covered the area under the patient’s body and was tucked in at either side – but didn’t extend as far up as the pillow or down as far as the end of the bed. Under the draw-sheet was what Maskell called a rubber mackintosh – a big red piece of sheet-rubber slightly wider than the draw-sheet. The bottom sheet lay beneath that. 

“Why don’t you put nappies on them?”

“Because these are big boys! They pass a pint of urine each time. A nappy won’t catch that and you’d only have one more thing to wash. It wouldn’t be comfortable for them either. Occasionally we put a patient in a draw-sheet for a nappy when he has diarrhoea. Otherwise you’re changing the whole bed – top sheet, under sheet, pillow, rubber mac – everything.”

…to be continued.


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