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00:00Our job is hardcore.
00:10It is life and it's death.
00:13Everything we do relies on there's bond between us all.
00:18I've got secrets I can't tell.
00:23Just stay down. No, no, no.
00:25You're okay, you're okay.
00:26You have to be comfortable in high stress situations.
00:29In this brand new series.
00:34You're in the hospital.
00:36How much? Do you want to tell me what drugs you want to win?
00:39We take you into the theatres and wards of Sydney's busiest hospitals.
00:44And into the world of nurses.
00:47Nurses are the backbone of the hospital.
00:49Through their eyes, you'll see life.
00:52Big deep breath in. Push, push, push.
00:54Good girl!
00:56Death.
00:58Unfortunately, we can't save her.
01:05And everything in between.
01:07Coughs, colds and sore holes.
01:13Welcome to the front line.
01:15Two, three.
01:16Of one of the world's toughest.
01:17It's alright darling, we're looking after you, okay?
01:20And most trusted professions.
01:24It was scary, hey?
01:26Nurses are superheroes.
01:27Without capes.
01:28Just in scrubs.
01:30The calm.
01:31How was that one?
01:32Before the storm.
01:33What?
01:34Our heart rate is super fast.
01:35Have you got everything ready?
01:36Yep.
01:37Yep.
01:38If this goes wrong, our heart will stop.
01:40The nurse at the front line.
01:41Seems schizophrenic.
01:42Yep.
01:43With police.
01:44What's been happening?
01:45I've had a cheekbone in me.
01:46Okay.
01:47And has Chris's brain tumour returned?
01:49That looks and feels different.
01:50Yeah.
01:52Yeah.
01:53The St Vincent's Hospital emergency department is closed off.
01:55It's the officers who are in the house and bankers,
01:58the police who want to stop.
02:00To stop.
02:01The nurse at the front line.
02:02Seems schizophrenic.
02:03Yep.
02:04With police.
02:05What's been happening?
02:06Oh, I had a cheekbone in me.
02:07Okay.
02:08And has Chris's brain tumour returned?
02:09That looks and feels different.
02:11Yeah.
02:12The St Vincent's Hospital emergency department is closed off.
02:14The St Vincent's Hospital emergency department is close to capacity once again.
02:25Just keep your head still. Just don't move.
02:29Today, there are 16 doctors and 18 nurses on the shift.
02:34We're nearly done. We're doing really well.
02:36In the emergency department, every day you've got to be prepared for the unprotectable.
02:40You literally just don't know what kind of you're going to walk into.
02:43At times, you know, the department is a bit of a war zone.
02:56My name's Darren and I grew up in Scotland.
02:59I've been a nurse for like 12 years.
03:01So I think out in the red zone is maybe if Hannah goes out there...
03:05I'm one of the nurse managers in the emergency department.
03:08I guess I'm quite young to be in a management position,
03:12but I've worked really hard to get to this stage.
03:20Nurse Ewan is the first to the bat phone.
03:23There's an incoming emergency.
03:25St Vincent's emergency.
03:27We have a direct communication system between the ambulance service and the hospital.
03:33It tends to be patients that are going to need a lot of resources.
03:41So that is your traumas, your heart attacks, your strokes.
03:44There you go.
03:46The ambulance have just sent through an ECG for a 74-year-old female who currently heart rate is dangerously high.
03:54We'll move this lady out into recess forward.
03:57So the guys will set up as worst case scenario.
04:01So the team will assemble as if it's a cardiac arrest.
04:06Every second counts when a patient's life is in danger.
04:10The woman suffers from tachycardia, where abnormal electrical impulses cause the heart to race dangerously high.
04:18At 200 beats per minute, this is life-threatening.
04:22I've got the Lucas in here.
04:25David pads.
04:33She was at the theatre and she felt these palpitations in her chest.
04:36But she felt really dizzy, she felt really nauseated.
04:39So Hillary, I'll introduce myself. My name's Darren. I'm the nursing charge. Have you been feeling unwell?
04:48It's a little bit scary.
04:50Yeah.
04:53So who's your family? Do you want me to give them a call?
04:58Empathy comes hand in hand with nursing, I think, just wanting to help people.
05:03Cause this is quite a, you know, it's something we don't see all the time.
05:07Hillary's heart rate is about 200 beats per minute.
05:11A normal heart rate would be set between 70 to 90.
05:16So her heart rate is super fast.
05:19I'm just going to put you onto another monitor.
05:22So I think the next step is to get medication.
05:24It's really high risk medication.
05:25So we've had to put her on the defibrillator in case it goes wrong.
05:30With such an elevated heart rate, blood is unable to pump efficiently around Hillary's body.
05:36So reducing it is critical.
05:41The entire resuscitation team is there in case this goes wrong.
05:45Heart specialist, Dr. Jezzieri takes the lead.
05:48It could be very fast.
05:49It could be very fast.
05:50It could be very fast.
05:51It could be very fast.
05:52It could be very fast.
05:53It could be very fast.
05:54It could be very fast.
05:55It could be very fast.
05:56Yeah.
05:57Hillary, can we just go from your mouth and put this one on?
05:58Yeah.
05:5922.
06:00Adenizine 6 and 2.
06:01We're going to have to give a drug called adenosine, which is an anti-arrhythmic drug.
06:05It's always a scary drug to give because you're playing around with the electrical currents in the heart.
06:11If it goes wrong, we could send it into cardiac arrest.
06:15We would have to revive it.
06:17You got everything ready?
06:18Everyone ready?
06:19Good.
06:20Yep.
06:30A few floors up from emergency, 10 high-tech operating theatres are also busy.
06:36They can run 24 hours a day.
06:38It's a high-pressure environment for the dozens of nurses who are at the front line of the surgery.
06:45A bad day in the operating room can be extremely bad.
06:49And we do take it quite personally because we've always been trained to fix the problem.
06:56And if we haven't been able to fix the problem, it takes a very emotional toll on everyone.
07:08My name is Nikita and I am a perioperative nurse.
07:12So I am the nurse that will actually be helping the surgeon throughout the whole entire surgery.
07:21Today, 50 patients will go through these operating theatres.
07:28Nikita's first is Chris.
07:30He's been here before.
07:32The father of three has a recurring brain tumour.
07:35He's facing his fourth brain surgery in a year.
07:39His operation will be performed by neurosurgeon Dr. Tim Lukas.
07:44Can you please tell me the backstory?
07:47A couple of weeks ago, he was playing golf with his son.
07:50And then he noticed he couldn't hold the handle of the golf club.
07:54And given he's had three craniotomies in the last 18 months,
07:58he pretty quickly realised what was going on.
08:01The tumor looks like it has recurred.
08:03Oh, wow.
08:04And so we got him up here and we're trying to get it done as quickly as we can
08:07so that we can get him home.
08:08And he can get on with his life because, unfortunately, the prognosis is not excellent.
08:14This is not a tumor we can cure.
08:17So everything that we're doing is to give him as long as we can.
08:20That's quality.
08:21With his family and his kids.
08:22And that's all he wants.
08:23Oh.
08:24So I'm here to get what they call a resection of my brain to remove a brain tumor.
08:36It's like a little tentacle of cancer.
08:41If it forms a tumor, they can cut it out.
08:47But there's really, unfortunately, a cure.
08:52It's just wonderful that they can do something rather than say,
08:57well, there's nothing we can do.
09:00So I'm very thankful to him.
09:03My wife and I own our three children.
09:06We've got a chance to be with each other for as long as we can.
09:11Hey, Chris, how are you?
09:13Good.
09:14My name's Nikita.
09:15I'm one of the nurses.
09:16I'm actually going to be in there with Nicola.
09:18So she'll be scrubbed in and I'll just be running around like a headless chicken for you.
09:22So we're just going to reset the theater.
09:25Before you know it, you'll be back in recovery asking for a sandwich.
09:32To have someone's life in your hands, it's such an honor.
09:36You know, your patients are coming in for surgery and they are trusting you with their life.
09:42You almost feel a little bit like their guardian angel in the operating room.
09:54How are you feeling, Chris?
09:55Fantastic.
09:56Good.
09:57Very excited.
09:58Good to see you.
10:00Mate, you've been through it now.
10:01I know.
10:02How many times?
10:03No.
10:04Just another one?
10:05No.
10:06Just another walk in the park.
10:07Walk in the park.
10:08Yeah.
10:09Hopefully.
10:10Getting back home, playing another game of golf.
10:11Yes.
10:12Get forwarded.
10:13Yeah.
10:18Okay, a little bit of a funny smell in that gas now.
10:22This surgery might buy Chris more time, but it's a high risk operation as stroke, paralysis
10:29or even brain damage might occur.
10:32Do you want them all open?
10:33Yes.
10:34The role of Nikita and the five other nurses in this marathon operation is crucial.
10:40This type of surgery, it's very delicate work.
10:42Obviously, you're operating on a patient's brain.
10:45There is a lot at stake today.
10:47You've always got to remember that at the end of the day, you've got a patient on the table.
10:52Anything goes wrong is going to impact on that patient and their life.
10:58We just hope that he gets the best result and the best quality of life with his family.
11:02Any brain surgery is precarious.
11:07This one is particularly difficult.
11:10Probably the biggest challenge is its location.
11:13It's right up against the motor strip of his brain.
11:16And so the consequences of damage to that part of the brain are significant,
11:20which is weakness of the entire left side of his body.
11:24And across on three, nice and slowly.
11:25One, two, three.
11:27So while the tumour is quite small, it's in such an eloquent position
11:30that it makes the surgery quite challenging.
11:37All right, are we right to start?
11:47Downstairs in emergency, they're about to administer a drug
11:51to bring Hillary's racing heart rate down.
11:55If any VTVF, we go 360.
11:58First induction.
12:00Three in a row.
12:01If it's going to be a C study, then you start chest compression.
12:04Yeah.
12:08You're all right.
12:09Very, very safe.
12:10You're all good.
12:11Just as a precaution.
12:13It's not to scare you.
12:15Okay, everyone ready?
12:16Yes.
12:17All right, Hillary.
12:19Nurse manager Darren and his resuscitation team are literally ready for anything.
12:25We're just administering the drug.
12:27If this goes wrong, then our heart would stop.
12:29This is quite something we don't see all the time.
12:30For an Olympic athlete, a heart rate of 200 beats per minute is dangerously high.
12:39For 74-year-old Hillary, it's life-threatening.
12:40For 74-year-old Hillary, it's life-threatening.
12:41Everyone ready?
12:42Yes.
12:43All right, Hillary.
12:44The medication is supposed to slow her heart rate down, but it could also stop her heart
12:46altogether.
12:47We're just administering the drug.
12:49We're just administering the drug.
12:50We're not just administering the drug.
12:52Kick the drug, okay.
12:53It's so cellular.
12:54We're not just administering the drug.
12:56And we're just administering the drug.
13:00For an Olympic athlete, a heart rate of 200 beats per minute is dangerously high.
13:05For 74-year-old Hilary, it's life-threatening.
13:07Everybody ready?
13:08Yes.
13:09All right, Hillary.
13:10The medication is supposed to slow her heart rate down, but it could also stop her heart
13:15there we go so after the first dose of the medication already the heart rate is starting
13:24to really go down so that's what we want to see but it's not over yet
13:29suddenly hillary's heart rate spikes again this heart rate's way back up again
13:36the first dose of her medication had little effect now she's flipped back
13:45but it's a catch-22 give her too much and her heart could stop it's quite
13:49unstable so they might end up going and giving another dose a stronger dose the
13:54next time just as the higher dose is being prepared
13:58hillary feels a change
14:08her heart rate has finally stabilized
14:12very good
14:15hold on
14:17it worked
14:21still a fast heart rate but regular but it's probably going to take a little bit of time to come down
14:29the the small dose worked that's good
14:32oh you're tiny
14:35yeah it's on a shift you've got a whirlwind of emotions most of the time so more to the point what fear of
14:41you're not sure we uh appropriate would you sound worthy
14:44you're not heard of it you're constantly buzzing off some say adrenaline but i don't know you just like feel
14:51this i don't know it's a urge to you know just make everything work
14:56the green and the squeaky little lanes that's a heart rate so it is still quite fast
15:01the most rewarding part is definitely knowing like your heart that you've given the best care and you've got something better
15:08so now i need to go and make sure the whole department's fine so i'm just gonna go and round up and catch up with the other nurses and see what's going on
15:15i think instrument wise
15:26instrument wise
15:27perioperative nurse nikita has a key role in the brain surgery of cancer patient chris
15:33while dr lucans tries to find and remove as much tuna tissue as he can
15:38nikita oversees the team of nurses here
15:41all right we're right to start thank you he has had a tumor that keeps coming back
15:48unfortunately they've realized that there's not a lot that we can do as cure curing wise
15:54however we're going to try and give him the best quality of life that we can for the time that he has
16:01it's a bit of a sad story
16:04dr lucans carefully removes the same portion of chris's skull from previous surgeries
16:10it's now in nikita's care
16:13that is the patient's skull flap so he's had previous surgeries where we obviously remove the bone so that we can actually get into the brain
16:21and then there was three spikes they actually like the screws so we're actually able to screw the bone flap back down onto the skull
16:27so bone flaps are really important you don't want to ever lose it you don't ever want to drop it oh my gosh worst thing in the world
16:33the layers removed surgeons can now see the brain
16:44definitely the posterior margin of it
16:46yep the microscope is positioned for the delicate work on the brain
16:51yeah that should that should be fine there thank you
16:54because of the microscope you can actually see what they're seeing so it's really good for people who are in the theatre who are able to actually visualize the brain and the tumor and see what's being operated on
17:06with the brain exposed dr lucan's full concentration is through the microscope the nurses role is to pre-empt any equipment he'll need the microsurgical instruments are quite fine and delicate so this way he'll just keep looking through the microscope while he's working and the nurse will actually just place all the instruments in his hands
17:28uh two forceps to myself and care to jolly as well please thank you so it's a wonderful surgery to watch
17:35that vessel's really fragile
17:41isn't that amazing though to see the pulse of the brain that's pretty cool
17:45Tim so what part of the brain are you operating on at the moment
17:48so we're right behind the part that's called the motor strip
17:51which controls the opposite side of his body
17:55so that's why we're just being super super cautious
17:58because an injury at this location is significant on there
18:05millimeter by millimeter the surgeons carefully navigate their way through Chris's brain until Dr. Lucans finds something that appears abnormal
18:16that there looks and feels different
18:21yeah
18:29side
18:30side
18:31side
18:32side
18:33side
18:34to the other side
18:35and around
18:36and up
18:37and down
18:38how was that one?
18:41I don't mind a bit of a dance and a sing from time to time
18:45a lot of my day is joking and being loud and trying to be a bit funny
18:50so yeah that's the kind of things I'll do and it's quiet
18:53come and dance with me
18:54oh my god
18:55come on
18:56I think just a bit of life and a bit of noise and a bit of fun can make a whole difference to a shift you know
19:01I work better when things are chaotic and loud and busy
19:04it's so much better than routine I don't like routine
19:15does anyone out there need anything?
19:17my name is Carly and I'm a registered nurse in the ED department
19:21my main role is triage or being the SIN nurse so clinical initiatives nurse
19:26a lot of our job out the front especially is just letting people know that they're gonna be okay
19:30and we're gonna treat them we're gonna help them we're gonna get them feeling better
19:33and it's you know they're just in the right place
19:36Carly's shift in triage is off to a slow start today
19:40but an incoming patient is about to change that
19:44ah there's a gentleman coming in with chest pain
19:46I'm gonna bring him in and do an ECG and some stuff
19:49alright come on in
19:50Carly's first patient is Howard who's been experiencing chest pains
19:55as the SIN nurse it's Carly's responsibility to assess how serious a problem this might be
20:02head up this end for me
20:04so I'm gonna do an ECG
20:06right
20:07if they need ECGs if they need blood tests if they need pain relief x-rays
20:11I can just get that done and sort it out the front
20:13so that by the time that the doctor comes around to seeing them
20:16all those sort of things are taken care of
20:18now I might just have to clip a little bit of hair is that alright?
20:20sorry
20:21I'll do just two little patches or else the stickers won't stick
20:30it's a bit blunt isn't it?
20:31I don't know if it's blunt or your hair is too thick
20:33oh my god
20:34it's never a good sign
20:36nah I'll blame you
20:38I thought for a minute they were nipple clamps I thought oh no we've come to the wrong place
20:47oh no this is the right place here in Darlinghurst
20:50anything goes around here
20:56beautiful
20:57well looks like it's doing the right thing
20:59that's one positive so far
21:01okay great
21:05I'm gonna pop a cannula in your arm and get some blood okay
21:08on arrival Howard wrote down Gardner as his occupation
21:13so while Carly's trying to help with his problem
21:16she's also taking the opportunity to get some help with a problem of her own
21:20do you know anything about crepe myrtles?
21:23yeah what do you want to know?
21:25well we've got one in the backyard that keeps dropping its flowers and its leaves
21:30as soon as it gets them they fall off the next day all of them
21:34oh it's such a bonus when you get a patient who has a profession that can help you out with some free tips
21:39I think because we're giving them a service they're more than happy to give us a service at the same time
21:44so I always ask for advice
21:46um I'll tell you what's good
21:48who flung dung
21:49okay who flung dung?
21:50it is technically a mulch
21:52um but it breaks down into the soil
21:54okay
21:55who flung dung?
21:57all I can think of is someone
21:59flinging cow dung
22:01I'll try that
22:02who flung dung?
22:03it's good stuff
22:04okay
22:05there is no such thing as a typical day in ED
22:07I love that aspect to it
22:08you see a mixture of everything
22:10you know you see people with headaches
22:11you see people with injuries
22:13you see people that have been in car crashes
22:15you see people that just need a band-aid
22:17so you know you could get anything
22:19anything comes in the door
22:21send these off
22:23grab the doctor to come in
22:25I will be back
22:27you're welcome
22:33they've just come down on a region there that feels slightly more firm
22:38upstairs in theatre
22:39neurosurgeon Tim has discovered unusual tissue
22:42in cancer patient Chris's brain
22:46because I'm reasonably confident
22:48that that's tumour just there
22:50like just under that?
22:52just under that vessel
22:53yeah
22:54that looks necrotic
22:56yeah
22:57so the brain's actually quite soft
22:59he can actually feel an area that's quite firm
23:01and so he's suspecting that underneath that blood vessel
23:05that's where the lesion or the tumour is actually lying
23:07so we're just taking some biopsies of this abnormal looking tissue now
23:13that we'll send to the laboratory
23:15and they'll be able to tell us whether there are viable tumour cells
23:19the results from the lab will reveal if this is the return of the cancerous tumour or something else
23:27are you just looking to see if that tissue is tumour tissue or?
23:31yeah and just trying to identify any viable tumour
23:35because it will dictate whether he has further female and radiotherapy
23:39I'm going to give you one more piece and then we'll send that off as a frozen section
23:45so we've just taken a part of the lesion
23:49and we're going to send it off for what we call a frozen specimen
23:52so frozen means that it's got a sense of urgency behind it
23:55so it'll go straight up to pathology
23:57they will be able to get back to us in about 20 to 30 minutes
24:00and actually give us more information about the tumour itself
24:04now they're going to need to call the theatre to give us the results
24:07so we need to write the extension number up here
24:09excellent let's take an urgent
24:10beautiful
24:11quarter
24:12frozen
24:13must go to pathology immediately please
24:14Chris's life rests with these lab results
24:18a negative means that Chris can avoid more chemo and radiation therapy
24:23but if the sample tests positive the cancer is back
24:27this is the way that the surgeons are actually able to get a clear black and white
24:31this is what it is
24:44one in five australians suffers mental illness
24:47one in five australians suffers mental illness
24:51when someone is in crisis it's often the police who are called in before an ambulance
24:58we are headed into the city for a 28 year old male who has a history of mental illness
25:04St. Vincent's is trialing a bold new program
25:07Hey guys
25:08How are you?
25:09that takes nursing to the streets
25:11How do you think your mental health is overall?
25:13It's good
25:14yeah
25:15okay good
25:16I approach it as I approach everyone else
25:17which is just basically trying to understand what's going on for them
25:20trying to meet them at their level
25:21trying to understand their distress
25:23because in that moment that's what they need
25:24is someone who's able to listen and able to validate them
25:34this is our tune of the day
25:35glasses on
25:36I can see clearly now
25:38my name is Kate
25:40and I am a clinical nurse consultant
25:43Bye guys
25:44and I work for the mental health side of St. Vincent's Hospital
25:48and I'm a PACER nurse
25:50basically what PACER stands for is police ambulance
25:53clinical early response
25:56the PACER role is a new role which has been rolled out in New South Wales
26:00us clinicians are based in police stations
26:03and we respond to emergency calls for mental health
26:10I'm from Ireland
26:12I'm from County Cork
26:13I came out here because I wanted to travel
26:15and the plan was to come out for a year
26:18my family didn't think that I would last a week
26:20and four years later I'm still here
26:22so we are on the way to Kings Cross police station
26:32which is where I work for my entire shift really
26:35Kate's already had a word from the police station
26:39a woman's walked in making wild claims about being bugged
26:43she's come in and said that police officer put the cameras in her house
26:47okay
26:48she seems schizophrenic
26:49yeah
26:50checks her up on cops and it comes up that she's done this before
26:53yeah
26:54yeah
26:55okay
26:56okay
26:57okay
26:58so tell me what's been happening
26:59I had a chip put in there
27:00yeah
27:012002
27:02yeah okay
27:03the guy was an adult
27:04okay
27:05he was a police officer
27:06okay
27:07he said he'd give me a local anesthetic
27:09he gave me a general anesthetic instead
27:12he knocked me out
27:13put the chip in
27:14yeah
27:15so I didn't know exactly where it was
27:16right
27:17and there was no mark on your skin
27:19so you couldn't see
27:20no
27:21no
27:22okay
27:23and I've been trying to find it
27:24yeah
27:25find the chip
27:26yeah
27:27MRIs
27:28yeah
27:29MRIs
27:30okay
27:31I think sometimes people think
27:32that people with mental health problems can control
27:34their behaviours
27:35or control their emotions
27:37and they really can't
27:38people need to understand
27:39it's an illness
27:40and there's no shame in having an illness
27:42but they can't control it
27:43there's nothing they can do
27:45anyway
27:46I started hearing Sue
27:47and hostile voices
27:49yeah
27:50I could hear this
27:54and every single time I'd turn around
27:56there's no one there
27:57and when somebody yells out
27:59in the middle of the street
28:02I mean everybody looks
28:04you know what I mean
28:05and was every
28:06could you see everyone looking around
28:07and they were looking at you
28:08no
28:09only one of you here
28:10was you
28:11okay
28:12there's only two people that I can hear
28:14yeah
28:15and a bunch of men
28:16Sue and Bob
28:18yeah
28:19do you hear them every day
28:20all day every day
28:21yes they've been playing tag
28:22ever since Covid started
28:24right
28:25it's nice to try and make some bit of a difference
28:28to somebody's crisis
28:30you just need to understand what's going on for them
28:32you know tell them okay I'm hearing you
28:33I know what's going on
28:34you know sometimes people have bad life stories
28:37but they still have an illness
28:39and they still need to be treated like a human
28:41and like sometimes you need to separate those things
28:43and just you know give them the care that's needed
28:46but the main thing that Bob and Sue wanted
28:50was to denigrate me
28:52right
28:53so that I would lose all confidence
28:55yeah
28:56and perhaps commit suicide
28:58so that you get the shit on the road
29:00yeah
29:01yeah
29:02yeah
29:03yeah
29:04yeah
29:05yeah
29:06yeah
29:07yeah
29:08yeah
29:09yeah
29:10yeah
29:11possibly do need to come a bit further forward
29:13in theatre
29:14lead nurse Nikita
29:15is anxiously awaiting a call from the laboratory
29:18Dr Lukens has taken a sample of suspected tumour tissue
29:22from patient Chris's brain
29:24just a small padding thing
29:25if it comes back positive he'll need debilitating chemo or radiation treatment
29:30we'll just start to clean up the cavity
29:33while they wait
29:34Dr Lukens continues to remove as much suspected tumour tissue as possible
29:40the margin for error is zero
29:42make sure there's no active bleeding
29:44it's the last thing he needs is a post-operative hematoma
29:47so you can see that our cavity is actually nice and clean
29:52so Tim has actually been resecting away all the bits of tissue
29:56all the unusual tissue
29:58it looks nice and fresh as well
30:00no bleeding which is what's important
30:03I think we've achieved what we wanted to do
30:06I don't think we've disturbed the motor fibres
30:09so happy about that
30:10you can see the brain pulsating away
30:13there's no active bleeding
30:15it's definitely a good thing
30:17now is probably a good time to stop
30:20the surgical team has done all they can today
30:26after four hours the careful process of closing the skull begins
30:31so we just secure the bone window that we've removed
30:34it went really well
30:35really happy with the resection
30:36we're able to get back to the normal brain tissue
30:39surrounding that cavity
30:40so I'm confident we've gotten as close to 100% of that tumour as we can
30:44so we're closing up
30:46we've sent off our specimens to pathology
30:49and hopefully we'll actually be able to get a definite result
30:52and then that way we can actually treat our patient accordingly
30:55the results of the frozen sample are in
31:05hello
31:06okay
31:09okay
31:11okay
31:12okay
31:13I'll wait and see
31:14thanks Julia
31:15bye
31:16bye
31:20so no viable tumour cells seen
31:22we will have to examine all the remaining specimens that have been sent down
31:27and that will tell us whether or not in fact this is recurrence or whether it's just necrosis
31:33time will tell
31:35yes
31:36we'll have to wait a week
31:37a week
31:39the initial lab results are good
31:41the sample might have been dead tissue
31:44necrosis
31:45not the returning tumour
31:47hopefully it would mean that he doesn't need to undergo further rounds of tumour radiotherapy at this stage
31:53bearing in mind we know that it is going to come back at some point
31:57but if it doesn't have to happen right away then I think that's great
32:00that's a positive outcome
32:01good job sister
32:03very good job
32:04you did well
32:07once they've woken him up
32:09they're just going to make sure that there's no nerve damage or anything
32:11to his left side of his body
32:13slowly across
32:14one, two, three
32:15the right side of the brain controls the left side
32:17so not only the arm and the leg but also the face
32:20let's see how he wakes up
32:22Chris, operation's all finished, just waking up
32:26open your eyes for me
32:28Chris's brain has endured a lot
32:32but there's a new concern
32:34Chris, open your eyes for me
32:38nurses have been trying to wake him up for the past 20 minutes
32:42he's not responding
32:44Chris, just waking up
32:46we're quite concerned
32:48we're trying to wake Chris up from the anaesthetic
32:51and he's not coming around
32:53Chris, operation's all finished, open your eyes for me
32:56Chris, operation's all finished, just waking up
33:09brain cancer patient Chris is not responding
33:12after enduring four hours of neurosurgery
33:15Chris, open your eyes for me, operation's all finished, just waking up
33:19it's an anxious wait for all in theatre
33:22as nurses and anaesthetists try to rouse Chris
33:26Chris, operation's all finished, open your eyes for me
33:29obviously we're operating around the brain
33:31so you're always worried, did we cause a bleed
33:35have we caused any damage nerve-wise
33:37there's a lot of nervous energy
33:39while we're waiting for him to wake up
33:41Chris, operation's all finished
33:43can you open your eyes for us
33:45it's a bit of a tense wait
33:46because if you're nice to see him moving everything
33:48we're going to get around
33:49we're going to get around
33:51just open your eyes for me, operation's all done
33:54Chris, Chris
33:57hello, operation's all finished
33:59open your eyes for me
34:01it's all done really well
34:03Chris
34:05open your eyes for me
34:07that's it
34:09just waking up after your operation
34:15big breaths Chris
34:17hey Chris, can you give my hand a squeeze?
34:19it went really well
34:21can you give my hand a squeeze?
34:23fantastic
34:24a simple hand squeeze
34:25confirms for Dr Lukens
34:27that Chris can hear him
34:29went well
34:30can you squeeze this one?
34:31and is responsive
34:32little bit
34:33more of a squeeze
34:34that's good
34:38that's good
34:39certainly raising
34:40Chris will wake up to the news
34:42that the cancer has not returned this time
34:45there's no telling when another tumour might occur
34:48but at least he can enjoy quality time with his family
34:51for the foreseeable future
34:53he was weak preoperatively
34:55and I expect he's going to be at least that weak
34:58postoperatively
34:59it's just I guess how weak
35:01and what degree that recovery is too
35:03fingers crossed
35:05your patients are coming in for surgery
35:15and they are trusting you with their life
35:18and you actually become that patient's hero
35:22without them knowing your name
35:25they might not remember your name
35:26that's fine
35:27they can forget us
35:28we won't forget them
35:30that's awful
35:39I'm sorry that you're going through this
35:40I'm telling you it's a living nightmare
35:42I know
35:43and have you ever tried to take your own life before?
35:45never
35:46ok
35:47do you feel suicidal now?
35:48no
35:49ok
35:50no
35:51that's good
35:52at Kings Cross Police Station
35:54mental health nurse Kate
35:55is assessing a delusional patient
35:58to see if she's at risk of self-harm
36:01when I was 15
36:03a family member took their own life
36:05I think that's probably the biggest basis of why I decided to become a mental health nurse
36:10seeing the impact that had on the family and on like even the community
36:15yeah I think that's probably like what encouraged me most to become a mental health nurse
36:19they can come in any time and put a camera in the smoke alarm
36:24yeah
36:25I've wrecked that many of them
36:26she does have chronic schizophrenia
36:28and she's very well known to calling Kings Cross Police Station
36:32making reports
36:33but yeah the poor thing
36:35Kate is part of the St Vincent's Hospital PACER program
36:38that embeds trained nurses with the police to deal with mental health cases
36:43she literally left the hospital and then came down here
36:45oh really?
36:46yeah so she came down because she wanted the police to
36:48take on board what she was saying
36:50yeah yeah
36:51police aren't trained to be mental health clinicians
36:54that's not their speciality
36:55and they're called out to so many jobs
36:58that are mental health related every day
37:00so many
37:01and I solely studied mental health nursing for four years
37:04so I'm not a medical nurse
37:06I can't get a job as a medical nurse down in ED
37:08like it's mental health that's what I'm qualified in
37:10so I'm just trying to find a discharge summary from last night
37:14through the hospital Kate is able to access the patient's medical history
37:20and her treatment plan
37:21I think she has a history of non-compliance with meds
37:24so
37:26she obviously just wants she wants to then get someone to listen to her
37:30yeah
37:31listen did you have her overnight?
37:33we did
37:34can you just give me a little bit of a rundown about a discharge plan?
37:37Kate checks with other health agencies to help her make a call
37:41on whether to read meet her to hospital or send her home
37:45okay perfect
37:46so that handover was done?
37:49that's absolutely fine
37:50isn't she lovely?
37:51she's lovely
37:52god love her
37:53yeah she is
37:54I'm actually going to drive her to the bus
37:56and get her on the bus home
37:58okay
37:59I just gave a call to the hospital
38:01and I spoke to Zoe
38:02do you remember seeing Zoe last night?
38:03yes
38:04she had loads of nice things to say about you
38:06did she?
38:07so she said that she has referred you to the acute care team
38:09so they'll be following up with you
38:10okay
38:11okay
38:12so would you like me to bring you up to Oxford Street to the bus?
38:14thank you very much
38:15shall we?
38:16okay
38:17nurse Kate is satisfied that her patient is not a danger to herself or others
38:22if she sticks to her medication
38:24she'll be able to function with freedom and without fear
38:27will I take one of your bags?
38:29I'll just one of you
38:30yeah
38:31I think she just needed to be heard
38:33and I think she needed to feel validated about her concerns
38:37so just listening to her basically I think kind of alleviated her distress
38:40and then you know making sure that the appropriate team was following up with her
38:43when she went home
38:44now you know you just turned this corner and the bus stop is up there
38:47I know
38:48yeah?
38:49good woman
38:50you probably know better than me
38:51my motto always has been since day one when I started
38:55is treat others how you would want your family member to be treated
38:59treat them how you would want to be treated yourself if you were in that situation
39:02you look after yourself all right
39:05see you later
39:06give us a call if there's any issues
39:08okay
39:09we always try and ensure that we practice least restrictive care
39:13so I think sending her home and involving the supports that she's got involved is a better option than sending her to hospital
39:20and you know making her sit around I suppose for the same thing to happen again just to be discharged again
39:25the PACER program nurses working alongside police has been going for six months
39:32it has already cut down the time police spend at non-crime incidents or waiting in hospital
39:38I think it's really important just to try and create a better understanding for mental illness basically
39:44because nobody's exempt like nobody's exempt from mental illness and it could be like your mother, brother, sister, tomorrow
39:51so just to try and have a better understanding I think is really important
39:55now I have to go and write my notes and I need to pee and all of the above
39:59what do you want to do?
40:14ah, syndrome
40:15back in emergency, Carly is bringing Dr Nick to check on her patient's ECG results
40:21he had a lovely ECG
40:23lovely
40:24yep
40:25it's gorgeous
40:26you're seeing such a great looking complex
40:29exactly that QRS was like
40:31ooh
40:32that's way too mad
40:33ha ha ha ha
40:35da da da da
40:37alright sir, sorry I'm Nick, I'm another one of the doctors
40:39I'm just going to take a quick degree here
40:41do you still have pain?
40:42no
40:43no
40:44nope
40:45alright, all good
40:47it looks fine
40:49yeah
40:50cool
40:51I'm just going to order a chest x-ray
40:53Howard arrived with chest pains
40:55he will still get a precautionary x-ray
40:58good news so far that your ECG is good
41:01but it looks like a false alarm
41:03and that's a good thing
41:05it's all about helping people
41:06a great outcome is that you know
41:08someone will come in with an issue and it's not life threatening
41:11and we can treat them and get them back home again you know
41:13I just like the rewarding bits about it just helping people in general
41:16paramedics have arrived with a new patient
41:20while one of them checks in
41:22Carly checks him out
41:24well I think they're mine
41:25pretty sure that's workplace harassment
41:30this handsome man is my lovely partner Tim
41:35we don't get to work many days together but today is a special day
41:39both the kids are being looked after
41:41so we're going to work together today much to his dislike
41:44I met my partner at work
41:46I noticed him one day
41:47this gorgeous guy with his beard
41:48and I asked who he was
41:50and they're like that's Tim
41:51supposedly I'd known him for a year without the beard
41:53and then as soon as he had the beard
41:55I noticed him
41:56nice to see him
41:57the rest is history
42:00we had a few smooches at a few parties
42:02and then he asked me out on a date
42:03and a couple of kids later
42:04and here we are
42:05Tim you look so handsome today
42:08love you
42:09Carly
42:10sleeping on his laptop
42:13you can see it
42:15it's going to kill me
42:24you dropped something
42:25you did
42:32hopefully that's made his day
42:36highly doubt it though
42:40seven floors up
42:41and just three days after surgery
42:44brain cancer patient Chris is packing his bags
42:48just getting ready to depart from St Vincent's Hospital
42:51after having my fourth brain surgery
42:53brain surgery
42:55you just don't know
42:56with brain surgery
42:57what deficits you might come out with
42:59after surgery
43:00and really just
43:02I went in
43:03I went to sleep
43:04I woke up in ICU
43:06and thought
43:08wow
43:09I can move my arm
43:11that's great
43:12that's just amazing
43:13I'm very excited to go home
43:16I'm very excited to go home
43:17very excited
43:18I don't want to jump up and down
43:20but I really am just so happy
43:24I know there's no cure
43:26but any time with my family
43:29and our children
43:30my wife
43:31is a blessing
43:32it is the most exciting thing
43:36when you get a good result for your patient
43:38who has come in
43:39and is literally clinging on to life
43:41you look amazing
43:42you look really
43:43yeah
43:44you're up to drive home
43:46of course
43:47that day when you hear that that patient's being discharged
43:51and is able to go back to their family
43:54and be with their loved ones
43:56yeah
43:57it's definitely a great feeling
44:08have a lovely night
44:09see you team
44:17there are days that it does get a little bit too much
44:20those are the days that you hug your partners
44:22you ring your mum
44:24you tell her you love her
44:25there are definitely those days
44:27that you are very grateful for everything that you have
44:31so we'll need to give a close eye in you
44:33in case that goes back up fast again
44:35knowing that we have saved someone's life
44:37and they've been able to get home to their loved ones
44:39is one of the best rewards in nursing
44:43listen tell me what's been going on
44:45have you used any substances today?
44:47after being a nurse for nine years
44:49you get days where it's like
44:51oh my lord
44:53I'm tired
44:56but it's never too much
44:58I love doing what I do
45:00I don't know what I would do if I wasn't a nurse
45:02I really don't
45:03leave in your dreams
45:04leave in your dreams and it's all you need
45:05all you need
45:06all you need
45:08all you need
45:09to be on
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