When Sue McCreadie asked her patient’s GP to visit him urgently, she understood his family’s anger when her request went unfulfilled.
”Another tyre gone, nurse? That must be the third this month!” Terry knew my car well as I seemed to be in his garage every other week with a torn tyre or a hole in the exhaust. My trusty hatchback was a rattling can since I began community nursing in this remote Welsh terrain.
The reason for this week’s flat tyre was the rutted lane to Mr Jones the forester’s house, which was tucked away in the middle of nowhere.
His cottage was nestled in a copse of trees with only a mud track as access. The path to the cottage was full of ruts and stones and my car thumped and crunched its way along the tree lined road, clods of mud hitting the sides. The pot holes were ruining it but Mr Jones was terminally ill and he and his family needed daily support.
”The couple were devoted and private, wanting little fuss”
The cottage was eerie and dark with little natural light. It was nestled into the side of a hill and the way the trees overshadowed it gave it a sense of Hansel and Gretel.
I’d been visiting him for a month, keeping an eye on his pain control as he refused all other care preferring the administrations of his wife. The couple were devoted and private, wanting little fuss.
I’d noticed that his son Gwillam was quiet and sullen and would leave the room when I arrived. Mrs Jones told me that he spent all his time when not in school helping his father in the forest and was finding it difficult to accept that he was dying.
“He won’t have it,” she told me. “He’s blocking it out”.
”Mr Jones’ condition was deteriorating and the dose of morphine he was receiving wasn’t touching his pain”
Mr Jones’ condition was deteriorating and the dose of morphine he was receiving wasn’t touching his pain. I promised that I would get the doctor to visit and put in a syringe driver device for him to have continuous pain relief. I immediately went back to the surgery and left a message for the doctor to deal with this as an emergency.
Morag the receptionist was scathing: ”Dr Thomas won’t go down that lane with his new car, that place is in the back of beyond!”
“Well he better had,” I told her. “The patient needs his pain relief sorting out as soon as possible so please make sure he gets the message as soon as you can”.
I left the surgery frustrated by her attitude and apparent control over the doctors and the information they received.
The next day I was met at the Jones’ door by Gwillam shaking with anger.
“My Dad’s in agony!” he shouted. “I thought you were going to sort out his morphine”.
Mrs Jones called from the living room: “Stop it Gwillam, let the nurse in”.
”I found Mr Jones lying on the sofa with his wife holding his hand, he was clearly in agony”
I found Mr Jones lying on the sofa with his wife holding his hand, he was clearly in agony.
“Where’s the syringe pump that the doctor put up yesterday?” I asked.
”The doctor didn’t come. Look at him,” Mrs Jones started to cry. ”I found him trying to get that off the wall last night”.
I followed her gaze to the fireplace and above it Mr Jones’ shotgun.
“I want to shoot myself,” he muttered. “I can’t go on like this anymore”.
”I drove to the surgery so fast that I could hear my exhaust banging on the stones”
I was angry - angry and ashamed. Ashamed that my colleagues hadn’t responded to my requests and left this man and his family in such distress for the last 24 hours. I promised to deal with it straight away and drove to the surgery so fast that I could hear my exhaust banging on the stones.
Morag was in her usual place behind the reception desk ready to stop me proceeding further. I opened the door to the reception area and pushed past her, I didn’t have the time and patience for her today.
“Where do you think you’re going?” She put out her hand to stop me but recoiled back when she saw the look on my face.
“Where’s the doctor? I need to see him now”.
Dr Thomas was sitting in his consulting room reading notes and stood when he saw me.
“Whatever’s the matter nurse?” he asked.
I tried to control my temper but my words came out in a spurt of emotion.
”Why didn’t you put up the syringe driver on Mr Jones yesterday? Morag seems to think it has something to do with you not wanting to ruin your tyres.”
He reddened and sat back at his desk. “I got tied up with some paperwork, I was going to go today.”
”Well that’s not good enough! He tried to shoot himself last night, but for the fact that he was too weak to reach his gun, you would have a suicide on your conscience.”
He stood and picked up his bag. “I’ll go there now.” He left the room leaving, with no apology and avoiding eye contact.
Morag was waiting for me when I went back to reception. “How dare you go back there!” She faced me, her hands on her hips,defiant. “You’re not supposed to disturb the doctors”.
”I will speak to the doctors whenever I need to. We’re here for the patients.”
”I will speak to the doctors whenever I need to. We’re here for the patients. Please get out of my way.”
Let them sack me, I thought, I can’t work like this. I got in my car and followed the doctor to the forest. I didn’t care if he didn’t like me checking up on him it was my responsibility and I had a niggling worry about Gwillam. He was only 15 but a strapping six foot like his dad and very upset.
Dr Thomas’ car was parked outside the cottage and the front door was open. As I got closer I could see that something was on the ground in the doorway. It was Dr Thomas. I got out of my car and ran to the door.
“What’s happened?” I asked Mrs Jones as she appeared in the doorway with tears streaming down her face.
“It’s Gwillam,” she said. “He just lashed out when he saw the doctor”.
Dr Thomas groaned at my feet and grabbed the wall to pull himself up, the shadow of a bruise already forming on his cheek.
”Let’s get this syringe pump up, shall we?” he uttered, walking unsteadily into the cottage.
Gwillam was nowhere to be seen. ”He’s gone into the forest,” his mother told me.
Soon Mr Jones was sleeping with a continuous dose of morphine keeping him comfortable. The doctor left without saying a word to me. Climbing into his car he drove slowly down the lane.
”I’m so sorry about Gwillam, I don’t know what I’m going to do with him”. Mrs Jones made me a cup of tea and we sat next to the wood burning stove watching her husband asleep on the sofa.
”I’ll try and talk to him if you like?” I offered.
“That would be great, thanks”.
I was getting ready to leave when Gwillam came in through the back door. He went straight to his dad and checked on him.
His mother put her hand on his arm. “Tea?”
As his mother left the room, Gwilliam sat down opposite his dad, never taking his eyes off him.
”Sorry I lamped the doc but he should have come yesterday,” he muttered. ”Will he tell the police on me?”
”I doubt it, he knows he did wrong. Your dad will be ok now.”
“But he won’t, will he? He’s never going to get better.” A tear ran slowly down his cheek.
”No I’m afraid he won’t, but your Mum needs you now more than ever and your Dad will feel better knowing that you’re here for her.”
”I know, I’m keeping the trees in order like he did, that’ll please him won’t it?”
Mrs Jones came back in from the kitchen. “He’s very proud of you and I need you here to help me with him in the next few days.”
They stood mother and son arms around each other looking at the quiet man sleeping by the fire. I left quietly. My car clattering along the lane, a loud noise coming from my exhaust.
Another trip to see Terry tomorrow, I thought.
Sue McCready is retired from the NHS and now works as a CQC inspector
*Please note: Names have been changed to protect confidentiality
More from Sue
- When providing care becomes a battle of wills
- ‘I understood her loneliness but couldn’t provide the full time company she needed
- Stories from nursing: dealing with death