Meet Sophie:
Day three into locum life as a vet nurse, after being out of work due to travelling for one and a half years, a female cat strikes!
She sinks both her canines into the palmar aspect of my left index finger as I attempt to position her legs forward and tilt her chin up for a jugular blood sample.
Safe to say I release my grip to grab my hand as I scream out shit whilst fighting back tears. My finger starts to swell as I run cold tap water over it. I quickly discover two small puncture wounds are oozing blood. I give it a good wash with hibiscrub as I think this looks bad.
I confess later on to my surgeon that I squirted strilium on the wounds to which he replied I wouldn’t recommend doing that. I don’t know if he heard me mumble that some people use surgical spirit.
I leave work a little early to surprise my mum and dad with my injury. My mum is a nurse practitioner for Alder Hey Children’s Hospital in the plastic surgery department. I knew I was in good hands.
She puts on her glasses for a closer inspection and presses down on several areas around the wounds. It bloody hurts so I pull my finger back in protest. A typical mum not stopping when you scream out ow.
According to the NICE guidelines, a human or animal bite that has broken the skin and drawn blood requires antibiotics. As this is the case with me, mum recommends I seek immediate medical attention.
Due to COVID-19, I have a telephone consultation with a nurse at a local walk-in clinic. After some history taking, the nurse is happy to prescribe a course of antibiotics without having to see me. Thankfully I am up to date with my tetanus injection.
I head into work the next day, albeit a little nervous about the prospect of my finger being accidentally knocked by a staff member or a bouncy dog. Cats were not handled by me during this shift.
For the whole day, I keep my finger extended and hardly move it. It appears to be getting fatter and a little sorer. Whenever I remember or get a minute to stand still, I position my hand to rest on my right shoulder to keep it elevated; mum’s orders.
The following day during lunch at work, my mum messages requesting I send a picture of my finger for her to show to a couple of consultant doctors at work.
Fantastic! I had plans this weekend.
It’s decided that I will head over to Whiston hospital tonight to be admitted to the orthopaedic ward in time for the ward round in the morning.
Mum and dad kindly drop me off outside the A&E department just after midnight. The weekend has just started and the place is rammed. A whiteboard displays the waiting time: eight hours. I give my name in at the counter and take a seat, COVID style.
Half an hour later my name is shouted by the on-call junior doctor who was aware of my pending arrival. She has a brief exam of my finger and then marks the point where the redness stops on my hand with a pen. This is to indicate whether the redness is spreading.
She sets about preparing the endless paperwork and finishes off by popping an IV catheter into my left arm and attaching a fancy extension port.
As we make our way along the corridor to the ward, I ask her how her shift is going. She tells me she’s not long started the shift and that she is on a run of nights.
All is dark and quiet when we arrive on the ward. A friendly nurse greets us at the nurses’ station, and after a quick handover with the doctor, I am led to my room.
The room has six beds. The bed opposite mine is occupied by a person gently snoring. I hope the level does not crank up. I set about sorting my things.
A short while later a student nurse wheels in an observation trolley to take my obs – blood pressure, temperature and sp02 readings. This takes me back to being a student mental health nurse on the elderly ward. However, this time they record the results on iPads.
Another student nurse enters and takes a COVID and an MRSA swab. They both listen engrossed as to why I have been admitted.
Once I’m comfortable in bed, the nurse in charge asks me whether I’m in pain and require any pain relief. I reply that I’m comfortable. He makes a sling out of a pillowcase for me to rest my arm in to help keep it elevated while I’m asleep.
I’m awake just before six as the nurse hooks me up to IV fluids and antibiotics. The dial on the giving set is pretty much left open and it feels cold as the fluid trickles quickly up my arm.
My neighbour is also awake and we greet each other. Her name is Theresa and she has also been bitten by an animal. Unfortunately for her though, it was by her own dog, Reggie. She tells me she tried to take back the sandwich he had snatched from the table.
She didn’t seek medical attention, and within a day or so, her thumb doubled in size and the redness began tracking up her arm. She was shocked at how this injury ended up having her admitted to hospital.
With the change over of staff, the ward slowly comes to life and the ward-round commences. Somebody switches a radio on close by and out blasts 80s tunes. Happy days!
Theresa has her TV on and tells me that it’s free. This is due to not allowing visitors in because of COVID. I’m far too nosey to watch TV and turn my attention to the window.
Our room looks out onto a park entrance. It’s a lovely sunny day and many people are out for a Saturday morning stroll. I was slightly jealous.
Two male doctors walk into the room at around 8ish and draw the curtains around my bed. They introduce themselves; one is the consultant, the other a junior.
The consultant takes hold of my hand and presses down around the proximal phalanx; I wince.
Their main concern is that the infection may have spread to my tendon sheath. So they both agree to take me to theatre to investigate under local anaesthetic.
The consent form is interesting: all the potential complications, ranging from loss of movement to death. I think veterinary consent forms should include more information like this. To highlight to the clients the potential risks and complications that may happen. This will help manage expectations.
They mark my finger with a pen, but this time to indicate the one needing surgery. Good idea, lads.
I am scheduled for theatre this afternoon so they instruct me to take it easy, rest up and enjoy brekkie.
Before they leave, I sheepishly ask if I can take some pictures for the blog whilst in theatre. Luckily, they both say why not.
When the breakfast trolley arrives, I take a bowl of cereal, fruit and juice. It’s too early for toast.
A health care assistant (HCA) comes in to take more obs. As she takes off the blood pressure cuff, she asks me to give a urine sample to check if I’m pregnant. I think oh God, have my obs indicated to her that I may be pregnant? I keep silent as I don’t want to know the answer and abandon my cereal to run quickly to the loo.
I’m on edge as I wait for the results… Which seems like a lifetime! Finally, she comes back with a serious look on her face and tells me the test has come back invalid!
To cut a long and painful story short, I give a second sample and the result is negative. I, therefore, return to my soggy cereal now that my stomach is no longer in my throat.
Early afternoon the junior doctor walks into the room and asks how we are. He explains that they are slightly behind schedule as their first patient is still in theatre. I reply that I fully understand and will wait until whenever.
In practice, I would often explain to clients upset about their pet not being in theatre yet; theatre, like in humans, does not always go to plan. And that we are just as frustrated as they are because we want to treat their pets just as quickly as they do.
Two hours later I’m called for. So I dress in the gown they have provided me, and ten minutes later, I am walking with a HCA down to theatre.
On our way, we have a good chat about my job. We talk about working for the PDSA and all the lovely animals I see every day. She seems very interested in it all.
In theatre, I’m greeted by the junior doctor from this morning and five other healthcare practitioners. Once I have confirmed my name and the procedure, I lay down on the operating bed and have a good look around.
My head is on a swivel. There is a mountain of swagged-on suture material in one corner and the preparation area in the other. I love it. If I hadn’t become a vet nurse, this would have definitely been a career possibility.
The HCA asks whether I’m nervous as my heart rate has increased as I eye up the doctor preparing the local anaesthetic. I reply “only for this injection” as I’ve had it before in my finger and it stung like hell.
They recommend I look away as the needle pierces my skin. I retort that I can’t; I weirdly need to watch. I would be the one watching out of the window if ever my plane was going down.
I see the area around my finger start to swell. It’s a weird sensation. It feels cold and heavy. Luckily, it’s not as bad as I remember it to be, so I lower my shoulders away from my ears and remind myself to breathe.
As the surgeon prepares to scrub up, the rest of the team gets busy with their own duties. A nurse gently scrubs my hand with iodine, whilst another prepares the surgical equipment.
Once prepped and draped, they can see that I’m interested in it all so they lower the sterile drape to allow me to peep over.
The surgeon asks if I can feel certain areas he is touching and I say no. Thankfully the local anaesthetic has worked and I don’t need a top-up.
Here begins the surgery…
Shortly after the incision, the doctor shouts pus and asks for a sterile swab to take a sample for testing.
He tells me that the tendon sheath is fine but left untreated another day or so, it would have been a mess in there. Copious amounts of sterile water are used to flush out the wound.
The solution to pollution is dilution
An unknown medical poet
Listening to the team talk certainly put me at ease. There was decent banter between them all which I enjoyed.
How must our furry patients feel when they are hospitalised? At least I knew where I was. A gentle touch or tone certainly must go a long way for our patients.
The surgery is complete within twenty minutes. He places two non-dissolving sutures in my skin, bandages up my hand, and sends me back onto the ward. I can’t thank them enough.
Theresa asks how it went as I’m wheeled back into the room. I tell her all good as I show her my bandaged hand. She can’t help but laugh at the size of my bandage; it’s rather huge.
About half an hour later the pain starts to slowly creep up until it starts throbbing. I don’t know why but I didn’t expect it to be this painful.
With pain relief eventually onboard, it takes a good two hours for the pain to subside. I spend that time walking the room and rocking on the bed, toes curling as I’m holding my hand. I hope I will sleep tonight.
Just before tea, a new nurse comes around and gives us the option of having an IM injection to prevent blood clots. This injection went to the lower abdomen, and boy did it hurt! I start laughing as I pull my top down and Theresa agrees that it wasn’t a pleasant prick.
I wake up early after a decent night’s sleep. I feel no pain, just a very slight discomfort about the tight dressing.
Before the ward round, a nurse removes my dressing. It feels good to have my hand free and to see the result. My finger certainly feels less tight than twenty-four hours ago.
Two new doctors see me. One of them is the consultant doctor who requested I send a picture to my mum during that Friday lunch hour. Again I can’t thank her enough.
She is happy to discharge me this morning as my finger looks good and I am in no pain.
To my dismay, she advises a week off work at the very least and gives me a doctor’s note. Because I am currently a self-employed locum I want to get back to work as soon as possible.
She instructs the nurse to apply a light, support dressing.
Discharge pending, I get my bag ready. Theresa is also to be discharged this morning and sets about collecting her stuff.
Once my IV catheter is removed, the nurse explains my medication. I refuse co-codamol as it makes me very nauseous.
Theresa and I are now both free to go…
The pair of us are laughing as we walk out of the room. We both agree it looks like we have come for a mum-and-daughter outing.
We say our goodbyes and wish each other a speedy recovery. It feels good to be outside in the fresh air as I wait for my mum and dad to pick me up.
Work is completely understanding of the situation. They tell me to feel better soon and check in with them later on in the week to say how I’m doing.
However, I feel like a fraud walking around Cheshire Oaks shopping outlet completely able-bodied. A shop assistant asks what I have done to my finger. She is shocked that cats have the potential to cause this much damage.
Every now and then I stretch my finger, not meaning to, and my stitches pull. Sometimes the pain makes me jolt.
I cancel my follow-up appointments at the hospital as my mum is competent at dealing with my wound.
I’m back at work after one week off. I’m in no mood to restrain cats for the rest of my locum time here. A pat on the head whilst under GA suffices.
My mum notices that I am hardly using my finger. She tells me to start applying light pressure when holding cups etc to help build up my confidence. The hard work will soon begin when I go to physio.
Fourteen days later my mum removes the two sutures. It doesn’t hurt, I just feel a slight tug at the skin.
To desensitise the wound, mum advises I gently brush a soft cloth over it. I wasn’t aware I may be sensitive to my scar being touched but surprisingly, I was.
Now it’s time for physio.
Moisturising and massaging my finger was again to help desensitise the wound and reduce swelling.
I start with simple exercises such as stretching and flexing my finger for 10 seconds and then releasing. But over time I soon forget to do them.
Maybe I would have faired better injuring my right finger. As a rightie, I would have just had to get on with it. Whereas with my left, I could afford to be slightly lazy.
My sister kindly gives me a physio toy to help build up my strength. She admits she never used it when she broke her wrist. I like it and take it with me during my travels. I especially use it when my fingers are cold.
Whilst travelling, I come across two physiotherapists; one in Turkey, the other in Iraqi Kurdistan. The latter gives me a free session in his clinic.
He moisturises my finger and presses to flex it all the way down.
Oh, the pain. But I feel in no position to pull away. This is necessary as I have not been doing these types of movements. I have been concentrating on strength more than flexibility.
It looks plausible that my finger will return to full ability over the next six months. But I must keep up to date with my physio!
My confidence with cats, however, may take a while to come back. This is a shame. Before my injury, I felt very comfortable handling cats in practice.
All I have to do now is stroke them and the fear inside me starts bubbling. I feel they may turn around and bite me. Even when I see them all smoochie smooch, I cringe at the thought of them playfully biting me.
It’s important that not only veterinary staff follow certain guidelines in treating an animal bite, but also clients.
Don’t chance it. If in doubt, get it checked out. Remember poor Theresa?
Further posts…
A Blushing Vet Nurse
Blushing is the most peculiar and most human of all expressions Charles Darwin Meet Sophie: This will be by far the most stripped-back story I will personally publish on this blog. And to be fair, the most in-depth account…
A Vet Nurse Working at Pet Blood Bank as a Regional Phlebotomist
Pet Blood Bank is a UK charity that provides vets with a blood service for their patients. Meet Lydia: Let me start by saying how amazing this position is! Not only do you get to cuddle, fuss over and…
Designing Bandage Art for Health Care Professionals
Jack is currently a human nursing student. He is a qualified firefighter and paramedic and has worked for five years in a trauma and pediatric emergency department in America. Meet Jack: I am the director of Bandage Art. We…
Veterinary Blog 
Nice one Sophie
Sent from my iPhone
>
LikeLiked by 1 person