Night activists: Staff of the department A5 for heart and vascular diseases, Andreas Liebmann
A night at St. Catherine Hospital. Entrance in the hallway: live piano music. Two people playing on a grand piano pop songs. My mother was a pianist. I feel at home. With the lift I go up to the station 5A: heart and circulatory disease. The senior nurse is experienced and relaxed. Patient reports are completed, notes, and documents completed „You don´t want to do this at four clock in the morning. No one knows what will happen in the night. Normally the chaos starts when you’re alone.“ We are – including me – four people who spend the night on 5A, more than enough for a appropriate presence. The night passes quietly. No heart alarm. No new patients. At the beginning of the night shift all patients are visited. Who needs pain killers, sleeping pills, a new nappy, a cup of tea? Here lie about 34 patients. The key in the moment: 38 patients for 2 nurses. Previously, there were more nurses per patient. The budget is always cut on the backs of the staff. Decision-makers rarely ask about the realities in the stations. Top-down system. How nice when there are bosses who have gone through all the steps of a nurses life. „Then they know how a nurses daily life looks like. They know how it is when you work for example in the emergency department and accidentally there are there two raped women at the same time, which unfortunately occurs. In this case, two nurses have to take care full time about the women and cannot have other patients.“
I am put in white workwear. A doctor takes me with her. She hopes to show me a couple of interesting pictures and explaines to me what she does. Ultrasound. „This colour shows an important artery at the probes. This can be used as entrance for heart surgery. As a new heart valve artificial flaps can be used, or human valves, or heart valves from pigs.“ I am recognized as a nurse who stands silently by the patients. Four men lie there. Bare legs. It’s hot. A fresh heart attack needs about 1-2 weeks of stay. A heart inflammation 6 weeks. Who gathers water in the legs: 5-6 days. Then they go to rehab.
The hottest room of the station: The controlling room, dayroom of the nurses. Monitors and ventilators. I’m still infested with „Homeland“ images. The ECG – screens that transmit the heart rate of patients directly into the center of the station seem to me like surveillance cameras of the CIA. The difference: the wiretapped people know that they are listened to, and it really is for their own good. The tiniest irregularity is immediately audible and the nurses can react. A machine -generated rhythmic tone accompanies us the whole night. Demented patients tear every now and then the electrodes away. A supervisor who believed in the power of her authority took a pledge from a demented patient, no longer to nodd and to leave the electrodes in peace. She told him seriously and with a deep look that this was very important. He promised it high and holy. Two minutes later, the electrodes were again demolished. In such a case, the surveillance by the computer is interruped as it would constantly give a signal.
Not much happens. Because no one is allowed to sleep, stories are told. The boring time must be killed. Nurse B searches in the internet for fashion. Nurse C plays a game on the mobile phone about farmung. In this computer game, tomatoes are planted and eggs are searched for, chickens chickens, and the accounting about the sale of cucumbers is been made. Who farmt good grows, who farmt bad, loses the digital yard. Mobile Surfing cannot been controled here. Though internet research on the hospital computers can. It is been talked about training, procedural tricks, interviews. Duplo chocolate is been eatened. I’ll get me a hot calzone sandwich in the gas station across. A nurse from the neighbor department comes rolling on her scooter. „Hi, do you have Lyrica 125 or 150“. „Lyrica“ – what a name. A drug that makes the patient probably think the latest poetry by Durs Grünbein while strumming bedtime stories on a Neuronenlyra.
The experienced nurse unwraps some stories about death of family members. Death in bathrooms. Missed examinations. Death by ignorance. Medical checks of the whole family, because a family member had a heart attack. What threatens the other? Suspicions are investigated, evidence evaluated. Back to the the spy stories. The hospital CIA wants to find out „what really happened“ and wants to prevent deaths. Diseases are hunted and fought. You come out differently than you went in. Flights to Middle East on a rumble seat, to be on time at funerals. Bus rides, hotel stays, armed travel companion. Funeral rituals of the in-laws family. The women wash the deceased grandmother, the men bury her. A woman screams at her husband because he no longer knows the rituals – he lives in the west and forgot about the traditions. The dead mother must not be touched by the sons. Caressing is taboo now. Men have their role, women have their role. There is screaming and crying. The family is sleeping several nights in the same room as the deceased grandmother. She should not be alone. Ablutions take place. In hot climate you must be buried very quickly. Concrete is poured on the cuffin. Otherwise it stinks. Children flying alone on a plane. Children being left behind and hugged again. In the moment the husband is near his dying mother, he is being grabbed by his neoliberal work mania and gets nervous: This and that needs to be done immediately. He picks up the phone and wants to work. A bus, a bus! The wife tells him: You now forget your work and spend the last days of your mother with her. “
The patient in Room XX has changed. Previously he shouted and wailed in Italian. He is now cooperative and nice, can be washed and plugged on and off. He had nightmares. Actually, a psychologist should visit him, or the psychosomatic department has to be involved. But there’s no time and no money. Another patient has recently been permanently aggressive. In the files it is always indicated if a patient behaves cooperatively or uncooperative. A nurse has to smile, smile, smile, be calm, no matter what the patient says or does. The behavior of the patient has also often to do with how you treat them.
A lifetime according to form X: Conception – infant – toddler – adolescent – adulthood – young old – middle-aged – advanced old age – longtime old ones. There are four terms for old people and three terms for childhood development. Soon there will be a fifth for the even more old ones needed, when the lifetime continues to expand. The conception is appreciated in the list, not the death. The word „conception“ describes the perspective of the mother, not the person who is being starting his/her life.
If anybody is „prefinal“ he is under special observation. „My grandmother had wished that when she would die, her husband should be looking for a new wife. This is something I could never ask for. My husband should not have any new woman when I’m dead.“ „My parents have announced a surprise to me surprise when I will be going to read her will. Maybe they give away all their money to a foundation for animal rights. “
Heart alarm means: If the heart rhythm, for example, has been all night on 120, and then hurtles down within minutes, in increments of ten. Then all the machines flash and sound. If you have no will where you express clearly that in the case of a heart stroke you don´t want treatment, you will be reanimated. The defibrillator is tested once at night. All steps are being documented. What is not documented does not exist. We have one foot in prison. If serious errors happen charges may follow. Who does not want to live anymore, lets himself go. My profession I would choose it again.
At four thirty clock all patients are monitored. Coffee is made: The morning begins. Birds. Light. I’m leaving.
12/06/2014 – 6.22 clock, Andreas Liebmann