Story from an aged care nurse: The invisible man

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 Sara Karacsony was runner-up in the NSWNMA Short Story Competition 2017 with this moving story, ‘The invisible man’.

The first time I met Frank, he was lying on his side in his small single bed facing the wall. On the bedside locker next to him was a photo of Frank as a young man with his wife. He looked tall, lean and athletic. Frank shared the room with three other residents. The room had a homely and comfortable feel, although it was an older style facility with four beds to a room. There was an inevitable cluttered look that came with a lack of space, added to by the encumbrance of a privacy curtain that could be drawn around each bed for occasions of personal hygiene.

Three old fellows shared the room with Frank. Noel was a retired engineer who had lost a leg in a work-related accident. On account of this, he was the longest stayer in the facility and had built a reputation for his workplace stories. The other two residents kept to themselves. John sat with the daily crossword in his lap for most of the day. From time to time, he would lift his pen and carefully write down an answer in one of the columns on the page. The other John who was known as Jack liked to be the first up and out of the room. He needed little help and spent much of the morning sitting outside on a bench under one of the large liquid amber trees, exchanging the pleasantries of the day with whoever happened to be out there.

While Frank’s roommates were all able to get up and vacate their shared space, settling outside, in the dining room or elsewhere in the facility, Frank was not. He could not move on his own or speak and seemed to communicate only with his eyes, imploringly sometimes, it seemed to me. I did not know much about his condition at the time, being new to nursing and, while not exactly young at 28, I did not have much experience in caring for people who could not care for themselves. But cared for he was by the nursing home staff who, throughout their various allocations, sat him upright for breakfast, washed and groomed him and spoke to him in all manner of ways: playfully, encouragingly, reproachfully and, at times, soothingly. They had come to know him over the years of his stay and had witnessed his gradual decline into dependency. Frank didn’t appear to suffer and he could not tell us any differently. I never saw him upset or angry. For the most part, he was invisible.

“Come on now Frank; let’s sit you up ready for lunch. Your wife will be here soon”, said Irene, the registered nurse with whom I often worked. I liked working with Irene as her manner, while to the point, conveyed understanding and warmth. She dealt with the complexity of residential life in a non-judgemental and friendly way. She was at her best with residents like Frank who she spoke to like an old friend. I would often talk to him too and, occasionally, he would smile, his mouth ajar and his large blue eyes twinkling. “Give me a hand, Frank”, I would say to him as a cue to dressing or repositioning.

Frank’s wife came in every day at lunchtime and before the trays arrived for those residents who stayed in their room for feeding. She was always smartly dressed for the occasion in an old-fashioned sort of way, wearing a knee-length skirt and blouse, with low court-style shoes. On her jacket was a pretty pearl and gold broach in the shape of a musical tremolo. Her greying hair was groomed into a soft, loose bun framing her open face. She presented a respectable and responsible demeanour. Maybe, she had been a music teacher or head of a small department, I thought, although I never asked.

She would take off her jacket and place it on the back of a chair drawn up near Frank’s bed. From this chair, she carefully fed Frank his lunchtime meal, or as much of it as he would take. If I was in the room, I would watch her briefly feeding him, sitting quietly at his bedside when the others had gone to the dining room. She never rushed him and made the feeding ritual appear a skill that came naturally to her. It was quietly done with a few words spoken softly from her to him. Even without hearing her words, the decades of closeness between them was evident. After wiping his mouth and giving him a small drink, Frank’s wife would place the tray on the chair, put on her jacket, kiss him on the forehead and leave. If she saw me, she would smile and say goodbye.

This daily routine continued for the many months that I worked at the nursing home. When my registration came through, I moved on as a registered nurse to the hospice where I had been waiting to take up a position. I knew I wanted to specialise in palliative care nursing following a student clinical placement in a city-based hospice. For a short while, Frank and his wife were among the many impressions of my time in the nursing home as I met new colleagues, patients and families and undertook new routines.

She came in by ambulance on a stretcher within a few months of my leaving the nursing home. I recognised her straightaway without her jacket and in a nightgown, her hair still captured by the arrangement of her bun, but no longer kempt. She did not recognise me and it is likely that she would not have recognised anyone. I was told her name was Helena, which I had not known before. I was one of the first nurses to care for her as she was now beyond food, beyond sustenance and the life she had been living just a short while ago. I gently washed her face, cleaned her mouth, brushed and arranged her hair. There were no visitors.

She died within days and I was astounded by the seeming rapidity of her illness. Even though I did not really know her, the known persona of wife, carer, teacher and everyday woman of routine and responsibility lay before me. In the short time she was at the hospice, she was cared for by many of the nursing staff but none knew the last part of her life’s story as I did. Her daily commitment to her husband lying bed­ridden in the nursing home was unknown. I could only imagine her hidden burden.

Did she tell Frank? How could she tell him, what would he understand? And now, did he know where his wife had gone, who would tell him that his wife had died? These were the questions I asked myself throughout the day following the night she died, and 1knew I needed to talk to Irene.

It was the first experience that began to build my understanding of our connections to one another. We cannot anticipate who will come through the door in any health care facility and how and where we, as nurses, will encounter them again. We are taught that the remit of the nurse’s role is from birth to death although we are free to choose at what point we deliver our care.

After work that day, I returned to the nursing home. Irene was there. “What a day”, she said, “we’ve had everybody here this afternoon. The whole Hilliard family came in to see Noel. Head office has been here, as has the council inspecting the drain and those tree roots outside.”

“Irene”, I said, “did you know that Frank’s wife has been in the hospice and that she died last night?” “Yes”, she said, looking at me. “Has anyone told Frank yet?” I asked. Irene paused. “We must tell him”, I said. “Yes, we will”, she intoned her voice assertively. Several of the other staff, on their way down the hall to the door, joined us, saying hello to me. I felt we were all strangely saddened by the knowledge of Frank’s loss while he did not yet know it. We fell quietly into briefly discussing the whys and why nots of this difficult task. How would he take such news? Would he comprehend? Each one of the nurses seemed to want to share their opinion before they made their way out of the door and into their own lives.

The curtain around his bed shielded Frank from my view. I stood back near the door and listened to Irene’s low murmuring voice. A moment of quiet seemed to fall on the room which had been vacated by Noel and the others who had left for the dining room. The loud, singular sobs of Frank could be heard from behind the curtain as Irene sat with him. I waited for what seemed like a long time, looking around the familiar room and out the window at the large shady branches covering the sky. I heard the curtain slide across its railing and Irene stepped forward. She smiled sadly as she looked back at Frank. I followed her eyes and saw that he was now lying quietly with his eyes closed. He appeared to be asleep.

The dinner trolleys rattled down the hallway and the voices of the nurses were heard rallying the residents to dinner. Irene pulled up the chair next to Frank’s bed and awaited the dinner trolley.

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