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For one Toronto nurse, her work day starts at night and lasts until dawn. Writer Elizabeth Nelson gives us a glimpse of tending to young patients as the rest of the world sleeps.
Text and fotos by:Elizabeth Nelson
Country:Canada

he alarm goes off at 4 p.m. and 27-year-old Brigid Nelson is awake and rubbing the sleep from her eyes. It’s not laziness that keeps her in bed so late – in fact she’s only had three hours sleep – but that’s normal when she’s working double night shifts. She works at Toronto’s world famous children’s Hospital, which is known simply as “SickKids”. The hospital focuses on pediatric care and is a center for research and teaching in affiliation with the University of Toronto.

It’s 4:15 p.m., and to wake herself up, Brigid goes for her daily run then comes home for a shower, a banana smoothie and breakfast. Breakfast is a funny thing in the late afternoon; sometimes it’s traditional English fare of eggs and toast, and sometimes it’s more of an Italian theme with spaghetti bolognese. It’s whatever will get her going for a night on her feet.

Brigid lives in downtown Toronto, within easy walking distance from the subway, bus stops and streetcars. On a nice day, she’ll generally walk to work. There are many coffee stores positioned close to the hospital where thousands of tired workers are able to get their caffeine kicks. Brigid opts for a large Starbucks coffee and tells me, somewhat bashfully, that she’s a gold card member. I didn’t even know such a thing existed. Fueling her caffeine habit at 6:55pm, she pops across the street early for her 7:15pm start.

SickKids Hospital was opened in 1875 by Elizabeth McMaster and was a small operation consisting of only six beds. These days SickKids holds close to four hundred beds and takes up an entire block; including the main hospital site, a research center, the Atrium (a specially designed nine- storey glass roofed building that allows as much healthy natural light in as possible), a critical care unit, and an emergency department. Each year approximately 15, 000 children are admitted to SickKids; almost 300,000 visits are made to its clinics, emergency staff treat about 50,000 children; and 13,000 operations are performed.

Brigid works in the orthopedics and otolaryngology unit, where patients are treated for skeletal problems and ears, nose and throat problems. Her charges are newborns to 18 year olds, and they need constant care. There’s a high turnover of patients. If she’s working a couple of nights in a row, she might see familiar faces, but generally everyone is new.

She clocks in and begins the nightly ritual handover, where the nurses on the day shift give the night nurses a breakdown of the day, including helpful tips and necessary information to ensure the patients have a good night’s sleep. There are seven other nurses on the unit, and each cares for two to four patients, but it can change during the night when patients are admitted late.

The duties

Brigid described her role on the unit as “care in all its capacity”. In her unit, all the kids have IVs through which they are administered medications and fluids to keep them hydrated. All the kids are recovering from a surgery and have had some kind of complication either before, during or after the surgery so the nurses, according to Brigid, “keep a very close watch on all the kids”, by assessing how their heart is functioning, how well they are breathing and whether they have a fever.

The other focus of care is comfort and emotional support. The parents can stay over if they like, and the hospital provides them with beds in the patient’s rooms. The nurses teach the parents how to look after their child while they are recovering, and teach the children how to tell if something feels wrong or how and when to tell the nurse if they don’t feel good. She said, “We comfort crying kids and parents alike (I give a lot of hugs during my shifts!), I spend hours with anxious kids talking about their surgeries and reassuring them that it will get better. I manage pain, teach many of them how to walk again and occasionally spend all night carrying around a baby because his parents need to sleep.”

Tonight, Brigid is assigned two patients recovering from operations: one hip, one spine. She has one patient admitted late, a little girl with appendicitis. The nurses get two breaks at night: a 30-minute break, usually between 10 p.m. and midnight, and another that is a much-needed sleep that happens between midnight and 4 a.m.

When I asked her what happens on a quiet night, she jokes, “We party!” She continues: “No, we don’t, but we really value our quiet time. We sit around and chat and have a break because we know that in 10 minutes someone will beep, and we’ll be running. Whenever one person is having a quiet night, there’s always someone else that needs help.”

After a long night, the day staff arrives at 7:15 a.m. She is now on the giving side of the handover, passing on information about the nightly events and then she’s ready to clock out!

As it’s Brigid’s day off, she’s ready to unwind. She texts her “nursey friends” who are leaving work about the same time in that funny place between day and night, sleep and wakefulness. They meet up for breakfast.

“Sometimes,” she smiles, we’ll have some “Canadian Caesars“ (vodka and Clamato juice), which is a Canadian recipe of vodka, clam broth and tomato juice, or mimosas (orange juice and champagne), which really make for a civilized breakfast!” When asked how she would spend her day, “Bed is definitely on the cards, for about four or so hours, then I’m off to meet people for lunch and shopping!”

After such an exhausting night, I ask her how she can handle doing this every day, she replies, “It is exhausting, but I became a nurse because I love working with people (especially children). I don’t see myself doing nights forever, I plan on going into research in community nursing, focused on kids with chronic illnesses and SickKids Hospital will help me to do that. Nursing gives me a career that is dynamic, exciting and allows me to make a change in people’s lives everyday. I love the job.”

Fast facts about healthcare in Canada

Canada´s health care system has been publicly funded for 40 years. Nurses must license and register in the territory they will work in.
All nurses have to take the Canadian Registered Nurses Examination except Quebec nurses.
There will be an estimated shortage of 22,000 to 35,000 nurses in Canada in the next 10 years.
Specialized nurses in emergency room, critical care and operating room experience are most in demand.
Small isolated communities are in need for nurses.
It’s necessary to speak French to work on Quebec; English or French to work in Ontario and English to work in Vancouver.
Throughout history SickKids has faced many challenges and met many milestones: from the polio epidemic in 1937, to pioneering research on hip replacements, heart defects and intensive care units, to cloning genes to better understand hereditary diseases, to playing a part in revolution of baby food and understanding child nutrition they way we do today.






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The English full fry-up .

Brigid Nelson is a nurse at ‘’SickKids’, Toronto’s world famous hospital for children. She works night shifts, and that’s why her work day starts at 4 p.m. After getting up she goes for a daily run and then eats breakfast, sometimes she has a smoothie and sometimes spaghetti bolognese. She normally walks to work but before she starts working she picks up her extra large coffee in one of the coffee shops around the hospital.

Brigid works in the orthopedic and otolaryngology unit where each nurse cares for two to four patients. Some of her duties include monitoring how her patients are doing: heart function and breathing. She also teaches the children how to tell how they are feeling and the parents how to help them feel better. For her the most important part of the job is providing comfort and emotional support to kids and parents alike.

Her shifts end at 7:15 a.m. and on her days off she would usually meet up for breakfast with her ‘nursey friends’, and do regular things like eating lunch out and shopping, but sleeping is definitely one of the most important activities.

Although working night shifts is exhausting Brigid explains that she became a nurse because she loved working with people (especially children) and because nursing is dynamic and exciting and allows her to make a change in people’s lives every day.


 

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The nightlife of a nurse in Toronto

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