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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.
01:52The St Vincent's Hospital emergency department is close to the window.
01:54I don't know if it's a little bit too.
01:55I don't know if it's a little bit too.
01:56I don't know if it's a little bit too.
01:57I'm sorry.
01:58Any questions?
01:59I can't.
02:00I can't stop.
02:01The nurse at the front line.
02:02Seems schizophrenic.
02:03Yep.
02:04With police.
02:05What's been happening?
02:06I've had a cheekbone in me.
02:07Okay.
02:08And has Chris's brain tumour returned?
02:10That looks and feels different.
02:11Yeah.
02:12The St Vincent's Hospital emergency department is close to a room.
02:17A little bit.
02:18The St Vincent's Hospital emergency department is close to a room.
02:20is close to capacity once again today there are 16 doctors and 18 nurses on
02:33the shift in the emergency department every day you've got to be prepared for
02:39the unpredictable you literally just don't know what kind of you're gonna
02:42walk into at times you know the department is a bit of a warzone my name is Darren and I grew up in
02:59Scotland I've been a nurse for like 12 years so I think out in the red zone is maybe if Hannah goes
03:05out there I'm one of the nurse managers in the emergency department I guess I'm quite young
03:10to be in a management position but I've worked really hard to get to this stage nurse you and
03:21is the first to the bat phone there's an incoming emergency simply since emergency we have a direct
03:28communication system between the ambulance service and the hospital five four six it tends to be
03:36patients that are going to need a lot of resources thank you so that is your traumas your heart attacks
03:43your strokes the ambulance have just sent through an ECG for a 74 year old female who currently heart rate
03:51is dangerously high we'll move this lady out into recess forward so the guys will set up as worst case
04:00scenario so the team will assemble as if it's a cardiac arrest every second counts when a patient's life is in
04:08danger the woman suffers from tachycardia where abnormal electrical impulses cause the heart to race
04:16dangerously high at 200 beats per minute this is life-threatening she was at the theater and she felt
04:35these palpitations on her chest but she felt really dizzy she felt really nauseated so Hillary I'll introduce
04:44just myself my name is Darren I'm the nurse in charge have you been feeling unwell it's a little a bit scary
04:53so who's your family do you want me to give them a call empathy comes hand in hand with
05:00nursing and I think just wanting to help people because this is quite you know it's something we
05:06don't see all the time Hillary's heart rate is about 200 beats per minute a normal heart rate would
05:12be set between 70 to 90 so our heart rate is super fast I'm just going to put you on to another
05:21monitor so I think the next step is to get medication it's really high risk medication so we've had to put
05:26her on the defibrillator in case it goes wrong with such an elevated heart rate blood is unable to pump
05:34efficiently around Hillary's body so reducing it is critical the entire resuscitation team is there in
05:43case this goes wrong heart specialist dr. Jezzayeri takes the lead we could be very fast at this
05:50fibrillation Hillary can we just go from your mask and put this one on is that okay we need two adenosine
05:59six and two we're gonna have to give a drug called adenosine which is anti-arrhythmic drug it's always a
06:06scary drug to give because you're playing around with the electrical currents in the heart if it goes wrong
06:12we could send it into cardiac arrest and we would have to revive it
06:17we've got everything ready everyone ready good
06:29a few floors up from emergency ten high-tech operating theatres are also busy they can run 24 hours a day
06:37it's a high-pressure environment for the dozens of nurses who are at the front line of the surgery a
06:44bad day in the operating room can be extremely bad and we do take it quite personally because we've
06:53always been trained to fix the problem and if we haven't been able to fix the problem it takes a very
06:59emotional toll on everyone my name is Nikita and I am a perioperative nurse so I am the nurse that will
07:13actually be helping the surgeon throughout the whole entire surgery today 50 patients will go through these
07:24operating theatres Nikita's first is Chris he's been here before the father of three has a recurring brain tumor
07:34he's facing his fourth brain surgery in a year his operation will be performed by neurosurgeon Dr. Tim Lukens
07:43can you please tell me the back story
07:46so a couple of weeks ago he was playing golf with his son and then he noticed he couldn't hold the handle of the golf club
07:52and given he's had three craniotomies in the last 18 months he pretty quickly realized what was going on
08:00the tumor looks like it has recurred and so we got him up here and we're trying to get it done as quickly as we can
08:06so that we can get him home and he can get on with his life because unfortunately the prognosis is not excellent
08:13this is not a tumor we can cure so everything that we're doing is to give him as long as we can
08:19with his family and his kids and that's all he wants
08:23so I'm here to get a what they call a resection of my brain to remove a brain tumor
08:36it's like a little tentacle of cancer they if it forms a tumor they can they can cut it out but there's really
08:48unfortunately a cure so I think it's just wonderful that they can do something rather than say well there's nothing we can do
09:00so I'm very pleased with him my wife and I own our three children we've got a chance to be with each other for as long as we can
09:10but hey Chris how are you good my name's Nikita I'm one of the nurses I'm actually gonna be in there with Nicola
09:17so she'll be scrubbed in and I'll just be running around like headless chicken for you no
09:22so we're just gonna reset the theater before you know it you'll be back in recovery asking for a sandwich
09:31to have someone's life in your hands it's such an honor you know your patients are coming in for surgery
09:38and they are trusting you with their life almost feel a little bit like their guardian angel in the operating room
09:45how are you feeling Chris
09:54fantastic
09:55good
09:56very excited
09:57good to see
09:58it's like we walk in the park
09:59mate you've been through it now
10:00I know
10:01so many times
10:02no
10:03it's just
10:04just another one
10:05just another walk in the park
10:06walk in the park
10:07yeah
10:08hopefully
10:09getting back home
10:10playing another game of golf
10:11yes
10:12this surgery might buy Chris more time but it's a high risk operation as stroke paralysis or even brain damage might occur
10:31do you want them all open
10:33the role of Nikita and the five other nurses in this marathon operation is crucial
10:39this type of surgery it's very delicate work obviously you're operating on a patient's brain
10:47there is a lot at stake today you 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
10:57we just hope that he gets the best result and you know the best quality of life with his family
11:02any brain surgery is precarious
11:06this one is particularly difficult
11:09probably the biggest challenge is its location
11:12it's right up against the motor strip of his brain
11:15and so the consequences of damage to that part of the brain are significant
11:19which is weakness of the entire left side of his body
11:23and across on three nice and slowly one two three
11:26so while the tumor is quite small it's in such an eloquent position that it makes the surgery quite challenging
11:33all right we're right to start thank you
11:47downstairs in emergency they're about to administer a drug to bring Hillary's racing heart rate down
11:54if any btbf you go 360 first induction three in a row
12:01if it's going to be ac study then you start chest compression
12:04yeah
12:08you're all right very very safe
12:10you're all good
12:11hey just as a precaution
12:12it's not to scare you
12:14okay everyone ready
12:15yes
12:16all right
12:19nurse manager darren and his resuscitation team
12:22are literally ready for anything
12:25we're just administer the drug
12:27if this goes wrong then our heart would stop
12:43this is quite a something we don't see all the time
12:46for an Olympic athlete a heart rate of 200 beats per minute is dangerously high
12:52for 74 year old Hillary it's life-threatening
12:55everyone ready
12:57yes
12:59the medication is supposed to slow her heart rate down
13:02but it could also stop her heart altogether
13:05we're just administered the drug
13:07there we go so after the first dose of the medication already the heart rate is starting to really go down
13:25so that's what we want to see
13:26we want to see
13:28but it's not over yet
13:31suddenly Hillary's heart rate spikes again
13:34this heart rate is way back up again
13:36the first dose of her medication had little effect
13:42nah she's flipped back out
13:44but it's a catch-22 give her too much and her heart could stop
13:48it's quite unstable
13:49so they might end up going and given another dose a stronger dose
13:53the next time
13:55just as the higher dose is being prepared
13:58Hillary feels a change
13:59her heart rate has finally stabilised
14:12very good
14:16hold on
14:20it worked
14:22it's now 130
14:24still a fast heart rate but regular
14:27but it's probably going to take a little bit of time to come down
14:30the small dose worked
14:32that's good
14:34oh you're tiny
14:36yeah it's on a shift you've got a whirlwind of emotions most of the time
14:40so more to the point what fear are you sure we are
14:43appropriate
14:45I've not heard of it
14:47you're constantly buzzing off
14:48some say adrenaline but I don't know you just like feel this
14:51I don't know it's an urge to you know just make everything work
14:56the green and the squiggy little lines that's at Harbury so it is still quite fast
15:02the most rewarding part is definitely knowing like your heart that you've given the best care and you've got something better
15:09so now I need to go and make sure the whole department's fine
15:12so I'm just going to go and round up and catch up with the other nurses and see what's going on
15:15I think instrument wise
15:26perioperative nurse Nikita has a key role in the brain surgery of cancer patient Chris
15:33while Dr Lukens tries to find and remove as much tuna tissue as he can Nikita oversees the team of nurses here
15:37all right we're right to start thank you he has had a tumor that keeps coming back unfortunately they've realized that there's not a lot that we can do as curing wise however we're going to try and give him the best quality of life that we can for the time that he has it's a bit of a sad story
16:03Dr Lukens carefully removes the same portion of Chris's skull from previous surgeries
16:11it's now in Nikita's care
16:14that is the patient's skull flap
16:17so he's had previous surgeries where we obviously remove the bone so that we can actually get into the brain
16:22and 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
16:28so bone parts 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
16:35the layers removed surgeons can now see the brain
16:44definitely the posterior margin of it
16:47yep
16:49the microscope is positioned for the delicate work on the brain
16:51yeah that should that should be fine there thank you
16:55because 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
17:08with the brain exposed Dr Lukens full concentration is through the microscope the nurse's role is to pre-empt any equipment he'll need
17:18the 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 Charlie as well please thank you so it's a wonderful surgery to watch
17:35that vessel's really fragile
17:38yeah
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
17:49so we're right behind the part that's called the motor strip
17:51which controls the opposite side of his body
17:54so that's why we're just being super super cautious
17:59because an injury at this location is significant
18:04on there
18:06millimetre by millimetre
18:09the surgeons carefully navigate their way through Chris's brain
18:13until Dr Lukens finds something that appears abnormal
18:17that there
18:20looks and feels different
18:22yeah
18:30side
18:32side
18:34side
18:36to the other side
18:38and around
18:40and down
18:42how was that one?
18:44I don't mind a bit of a dance and a sing from time to time
18:47a lot of my day is joking and being loud and trying to be a bit funny
18:52so yeah that's the kind of things I'll do and it's quiet
18:54come and dance with me
18:56come on
18:58I 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
19:03I work better when things are chaotic and loud and busy
19:06so much better than routine I don't like routine
19:07does anyone out there need anything?
19:17my name is Carly and I'm a registered nurse in the ED department
19:22my 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 going to be okay and we're going to treat them we're going to help them and we're going to get them feeling better and it's you know they're just in the right place
19:36Carly's shift in triage is off to a slow start today
19:41but an incoming patient is about to change that
19:45there's a gentleman coming in with chest pain
19:47I'm going to bring him in and do an ECG and some stuff
19:50alright come on in
19:52Carly's first patient is Howard who's been experiencing chest pains
19:56as the SIN nurse it's Carly's responsibility to assess how serious a problem this might be
20:02head up this end for me
20:05so I'm going to do an ECG
20:08if they need ECGs if they need blood tests if they need pain relief x-rays I can just get that done and sort it out the front
20:14so that by the time that the doctor comes around to seeing them all those sort of things are taken care of
20:18now I might just have to clip a little bit of hair is that alright
20:21sorry I'll do just two little patches
20:24or else the stickers won't stick
20:25it's a bit blunt isn't it?
20:32I don't know if it's blunt or your hair is too thick oh my god
20:35it's never a good sign
20:37nah I'll blame you
20:43I thought for a minute they were nipple clamps I thought oh no we've come to the wrong place
20:48oh no this is the right place here in Darlinghurst
20:51if anything goes around here
20:57beautiful
20:59well it looks like it's doing the right thing
21:01that's one positive so far
21:03okay great
21:05so I'm going to pop a cannula in your arm and get some blood okay
21:09on arrival Howard wrote down gardener as his occupation
21:14so while Carly's trying to help with his problem
21:17she's also taking the opportunity to get some help with a problem of her own
21:22do you know anything about crepe myrtles?
21:24yeah what do you want to know?
21:26well we've got one in the backyard that keeps dropping its flowers and its leaves
21:31as 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
21:40I think because we're giving them a service they're more than happy to give us a service at the same time
21:45so I always ask for advice
21:46I'll tell you what's good
21:48who flung dung?
21:50okay who flung dung?
21:52it's technically a mulch
21:54but it breaks down into the soil
21:56okay who flung dung?
21:58all I can think of is someone
22:00flinging cow dung
22:02I'll try that, who flung dung?
22:04okay
22:06there is no such thing as a typical day in ED
22:08I love that aspect to it
22:09you see a mixture of everything
22:11you know you see people with headaches
22:12you see people with injuries
22:13you see people that have been in car crashes
22:16you see people that just need a band-aid
22:18so you know you could get anything
22:20anything comes in the door
22:22send these off
22:24grab the doctor to come in
22:26I will be back
22:28you're welcome
22:34they've just come down on a region there that feels slightly more firm
22:39upstairs in theatre
22:41neurosurgeon Tim has discovered unusual tissue in cancer patient Chris's brain
22:46because I'm reasonably confident that that's tumour just there
22:51like just under that?
22:53just under that vessel
22:55yeah
22:57that looks necrotic
22:59so the brain is actually quite soft
23:01he can actually feel an area that's quite firm
23:03and so he's suspecting that underneath that blood vessel
23:05that's where the lesion or the tumour is actually lying
23:09so we're just taking some
23:11biopsies of this abnormal looking tissue now
23:15that we'll send to the laboratory
23:17and they'll be able to tell us whether there are viable tumour cells
23:22the results from the lab will reveal if this is the return of the cancerous tumour
23:27or something else
23:29are you just looking to see if that tissue is tumour tissue or?
23:31yeah and just trying to identify any viable tumour
23:36because it will dictate whether he has further female and radiotherapy
23:40I'm going to give you one more piece and then we'll send that off as a frozen section
23:46so we've just taken a part of the lesion
23:50and we're going to send it off for what we call a frozen specimen
23:53so frozen means that it's got a sense of urgency behind it
23:56so it'll go straight up to pathology
23:57they will be able to get back to us in about 20 to 30 minutes
24:01and actually give us more information about the tumour itself
24:05now they're going to need to call the theatre to give us the results
24:08so we need to write the extension number up here
24:10excellent let's take an urgent, beautiful
24:12quarter, frozen, must go to pathology immediately please
24:15Chris's life rests with these lab results
24:18a negative means that Chris can avoid more chemo and radiation therapy
24:24but if the sample tests positive
24:27the cancer is back
24:29this is the way that the surgeons are actually able to get a clear black and white
24:32this is what it is
24:33one in five Australians suffers mental illness
24:51come on, save it
24:53when someone is in crisis
24:55it's often the police who are called in before an ambulance
24:57we are headed into the city for a 28 year old male who has a history of mental illness
25:05St Vincent's is trialing a bold new program
25:08hey guys, how are you?
25:10that takes nursing to the streets
25:12how do you think your mental health is overall?
25:14it's good, it's happy
25:16I approach it as I approach everyone else
25:18which is just basically trying to understand what's going on for them
25:20trying to meet them at their level
25:22trying to understand their distress
25:23because in that moment that's what they need
25:25is someone who's able to listen and able to validate them
25:34this is our tune of the day
25:36glasses on, I can see clearly now
25:39my name is Kate
25:41and I am a clinical nurse consultant
25:44bye guys
25:46and I work for the mental health side of St Vincent's Hospital
25:49and I'm a PACER nurse
25:50basically what PACER stands for is Police Ambulance Clinical Early Response
25:56the PACER role is a new role which has been rolled out in New South Wales
26:01us clinicians are based in police stations
26:04and we respond to emergency calls for mental health
26:11I'm from Ireland, I'm from County Cork
26:14I came out here because I wanted to travel
26:16and the plan was to come out for a year
26:18my family didn't think that I would last a week
26:21and four years later I'm still here
26:25so we are on the way to Kings Cross Police Station
26:32which is where I work for my entire shift really
26:36Kate'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 the police officer put the cameras in her house
26:48okay
26:49she seems schizophrenic
26:50yeah
26:51checks her up on cops and it comes up that she's done this before
26:53yeah
26:55yeah
26:57okay so tell me what's been happening
27:00I had a chick put in there
27:02yeah
27:03yeah okay
27:04the guy wasn't a doctor
27:05okay
27:06he was a police officer
27:07okay
27:08he said he'd give me a local anaesthetic
27:11he gave me a general anaesthetic instead
27:13he knocked me out, put the chip in
27:15yeah
27:16so I didn't know exactly where it was
27:18right
27:19there was no mark on your skin
27:20so you couldn't see
27:21no
27:22no
27:23no
27:24okay
27:25and I've been trying to find it
27:26yeah
27:27find the chip
27:28yeah
27:29MRIs
27:30MRIs
27:31I think sometimes people think that people with mental health problems
27:34can control their behaviours or control their emotions
27:38and they really can't
27:40people need to understand it's an illness
27:42and there's no shame in having an illness
27:43but they can't control it
27:44there's nothing they can do
27:46anyway I started hearing Sue and hostile voices
27:50yeah
27:54I could hear this
27:55and every single time I turn around there's no one there
27:59and when somebody yells out
28:01in the middle of the street
28:04I mean everybody looks
28:06you know what I mean?
28:07and could you see everyone looking around and they were looking at you?
28:09no
28:10only one who could hear her was you
28:12okay
28:13there's only two people that I can hear
28:15yeah
28:16and a bunch of men
28:17Sue and Bob
28:18yeah
28:19do you hear them every day?
28:20all day? every day?
28:21yes
28:22they've been playing tag ever since Covid started
28:24right
28:26it's nice to try and make some bit of a difference to 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 I know what's going on
28:34you know sometimes people have bad life stories
28:38but they still have an illness
28:40and they still need to be treated like a human
28:42and like sometimes you need to separate those things
28:44and just you know give them the care that's needed
28:47but the main thing that Bob and Sue wanted
28:51was to denigrate me
28:53so that I would lose all confidence
28:56yeah
28:57and perhaps commit suicide
28:58so that he can get the shit on the road
29:11possibly do need to come a bit further forward
29:13in theatre lead 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 patty again
29:25if it comes back positive
29:27he'll need debilitating chemo or radiation treatment
29:31we'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
30:18now's probably a good time to stop
30:22the 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
30:37we'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
30:47we'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
30:55theatre four and Akita speaking
30:59um Tim I've got pathology
31:01oh great
31:02the results of the frozen sample are in
31:06hello
31:08okay
31:10okay
31:12okay
31:13oh wait and see
31:14thanks Julie
31:15bye
31:16bye
31:17bye
31:18bye
31:20so no viable tumour cells seen
31:22we will have to examine all the remaining specimens that have been sent down
31:28and that will tell us whether or not in fact this is recurrence or whether it's just necrosis
31:33time will tell
31:35time will tell
31:36we'll have to wait a week
31:37a week
31:38hmm
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
31:52bearing in we know that it is going to come back at some point but if it doesn't have to happen right away then I think that's great
31:59that's a positive outcome
32:01good job sister
32:02very good job
32:03you did well
32:05once they've woken him up they're just going to make sure that there's no nerve damage or anything to his left side of his body
32:13slowly across one two three
32:15the right side of the brain controls the left side so not only the arm and the leg but also the face
32:20let's see how he wakes up
32:23chris operations all finished just waking up
32:27open your eyes for me
32:31chris's brain has endured a lot but there's a new concern
32:37chris
32:38open your eyes for me
32:39nurses have been trying to wake him up for the past 20 minutes he's not responding
32:45chris just waking up
32:47we're quite concerned
32:49we're trying to wake chris up from the anaesthetic and he's not coming around
32:54chris operations all finished open your eyes for me
33:08chris operations all finished just waking up
33:10brain cancer patient chris is not responding after enduring four hours of neurosurgery
33:17chris open your eyes for me operations all finished just waking up
33:21it's an anxious wait for all in theatre as nurses and anaesthetists try to rouse chris
33:27chris operations all finished open your eyes for me
33:30chris coming up call me
33:39obviously we were operating around the brain so you're always worried did we cause a bleed
33:40have we caused any damage nerve-wise
33:41there's a lot of nervous energy while we're waiting for him to wake up
33:43chris operations all finished can you open your eyes for us
33:45it's a bit of a tense wait because if you nice to see moving everything
33:48the team moving everything, or doing Mr. Tom Cuffick.
33:52Just open your eyes for me. Operation's all done.
33:56Chris? Chris? Hello? Operation's all finished.
34:00Open your eyes for me. It's all done really well.
34:04Chris? Open your eyes for me.
34:08That's it. Just waking up after your operation.
34:12Big breaths, Chris.
34:16Hey Chris, can you give my hand a squeeze?
34:20It went really well. Can you give my hand a squeeze? Fantastic.
34:24A simple hand squeeze confirms for Dr. Lukens
34:28that Chris can hear him. Went well. Can you squeeze this one? And is responsive.
34:32A little bit. More of a squeeze.
34:36That's good.
34:40Certainly raising. Chris will wake up to the news that the cancer
34:44has not returned this time.
34:46There's no telling when another tumour might occur.
34:48But at least he can enjoy quality time with his family
34:52for the foreseeable future.
34:54He was weak preoperatively.
34:56And I expect he's going to be at least that weak postoperatively.
35:00It's just, I guess, how weak and what degree that recovery is too.
35:04Fingers crossed.
35:06Your patients are coming in for surgery and they are trusting you with their life.
35:18And you actually become that patient's hero without them knowing your name.
35:24They might not remember your name. That's fine. They can forget us.
35:28They can forget us. We won't forget them.
35:38That's awful. I'm sorry that you're going through this.
35:40I'm telling you, it's a living nightmare.
35:42I know. And have you ever tried to take your own life before?
35:44Never. Okay. And are you, do you feel suicidal now?
35:48No. No. That's good.
35:52At Kings Cross Police Station, mental health nurse Kate is assessing a delusional patient
35:58to see if she's at risk of self-harm.
36:01When I was 15, a 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.
36:20They can come in any time and put a camera in the smoke alarm.
36:25Yeah. I've wrecked that many of them.
36:27She does have chronic schizophrenia and she's very well known to calling Kings Cross Police Station,
36:32making reports, but, yeah, the poor thing.
36:35Kate is part of the St Vincent's Hospital PACER program
36:39that embeds trained nurses with the police to deal with mental health cases.
36:44She literally left the hospital and then came down here.
36:46Oh, really? Yeah, so she came down because she wanted the police to take on board what she was saying.
36:50Yeah, yeah.
36:51Police aren't trained to be mental health clinicians.
36:54They're not, that's not their speciality.
36:56And they're called out to so many jobs that are mental health related every day.
37:01So many. And I solely studied mental health nursing for four years.
37:05So I'm not a medical nurse. I can't get a job as a medical nurse down in ED.
37:09Like, it's mental health, that's what I'm qualified in.
37:11So I'm just trying to find a discharge summary from last night.
37:14Where are the videos?
37:16Through the hospital, Kate is able to access the patient's medical history
37:20and her treatment plan.
37:22I think she has a history of non-compliance with meds. So...
37:26She obviously just wants... She wants to make someone to listen to her.
37:30Yeah. Yeah.
37:31Listen, did you have her overnight? We did.
37:34Can you just give me a little bit of a rundown about a discharge plan?
37:38Kate checks with other health agencies to help her make a call
37:42on whether to readmit her to hospital or send her home.
37:45OK, perfect. So that was handover was done?
37:48That's absolutely fine. Isn't she lovely?
37:52She's lovely. God love her. Yeah, she is.
37:54I'm actually going to drive her to the bus and get her on the bus home.
37:57OK, I just gave a call to the hospital and I spoke to Zoe.
38:02Do you remember seeing Zoe last night? Yes.
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. OK.
38:11OK, so would you like me to bring you up to Oxford Street to the bus?
38:14Thank you very much. Shall we? Yes.
38:16OK. Nurse Kate is satisfied that her patient is not a danger to herself or others.
38:22If she sticks to her medication, she'll be able to function with freedom,
38:26and without fear.
38:28Will I take one of your bags? I'll just one of you. Yeah.
38:31Thanks, guys.
38:32I think she just needed to be heard
38:34and I think she needed to feel validated about her concerns.
38:37So just listening to her basically, I think, kind of alleviated her distress
38:41and then, you know, making sure that the appropriate team
38:44was following up with her when she went home.
38:45Now, you know you just turned this corner and the bus stop is up there.
38:48I know. Yeah? Good woman. You probably know it 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
39:01if you were in that situation.
39:03You look after yourself, all right? See you later.
39:06Give us a call if there's any issues. Okay.
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
39:18is a better option than sending her to hospital
39:20and, you know, making her sit around, I suppose,
39:23for the same thing to happen again, just to be discharged again.
39:26The PACER program, nurses working alongside police,
39:31has been going for six months.
39:33It has already cut down the time police spend
39:35at non-crime incidents or waiting in hospital.
39:39I think it's really important just to try and create a better understanding
39:44for mental illness, basically, because nobody's exempt.
39:47Like, nobody's exempt from mental illness.
39:49And it could be, like, your mother, brother, sister tomorrow.
39:52So just to try and have a better understanding, I think, is really important.
39:56Now I have to go and write my notes
39:58and I need to pee and all of the above.
40:15Back in emergency, Carly is bringing Dr Nick
40:18to check on her patient's ECG results.
40:21He had a lovely ECG.
40:23Lovely.
40:24Yep.
40:25It's pretty.
40:26It's gorgeous.
40:27And you're seeing such a great looking complex.
40:30Exactly.
40:31That QRS was like, ooh!
40:32That's way too mad.
40:33Ha, ha, ha, ha.
40:35Ha, ha, ha.
40:36Da-da-da-da.
40:37What's that?
40:38Sorry, I'm Nick.
40:39I'm another one of the doctors.
40:40I'm just going to take a quick degree to your ECG.
40:42Do you still have pain?
40:43Nope.
40:44No, go.
40:45Nope.
40:46All right.
40:47All good.
40:48The ECG looks fine.
40:49That's a good thing.
40:50Yeah?
40:51Cool.
40:52I'm just going to order a chest x-ray.
40:53Howard arrived with chest pains.
40:56He will still get a precautionary x-ray.
40:59Good news so far that your ECG is good.
41:02But it looks like a false alarm, and that's a good thing.
41:05It's all about helping people.
41:06A great outcome is that, you know, someone 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.
41:14I just like the rewarding bits about it, just helping people in general.
41:18Paramedics have arrived with a new patient.
41:21While one of them checks in, Carly checks him out.
41:24Pretty sure that's workplace harassment.
41:25This handsome man is my lovely partner, Tim.
41:26We 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.
41:43Much to his dislike.
41:44I met my partner at work.
41:46I noticed him one day.
41:47This gorgeous guy with his beard.
41:49And I asked who he was, and they're like, that's Tim.
41:52Supposedly I'd known him for a year without the beard, and then as soon as he had the beard,
41:55I noticed him.
41:56Nice to see him.
41:59The rest is history.
42:01We had a few smooches at a few parties, and then he asked me out on a date.
42:04And a couple of kids later, and here we are.
42:06Tim, you look so handsome today.
42:09Love you.
42:10Carly.
42:11Sleeping on his laptop.
42:13You can see it.
42:14It's going to kill me.
42:15You dropped something.
42:16You did.
42:17Well, hopefully that's made his day.
42:20Highly doubt it though.
42:39Seven floors up, and just three days after surgery, brain cancer patient Chris is packing his
42:48bags.
42:49Just getting ready to depart from St. Vincent's Hospital after having my fourth brain surgery.
42:56You just don't know with brain surgery what deficits you might come out with after surgery,
43:01and really just went in.
43:02I went to sleep, woke up in ICU, and thought, wow, I can move my arm.
43:12That's great.
43:13That's just amazing.
43:14I'm very excited to go home.
43:15I'm very excited.
43:16I'm very excited.
43:17I don't want to jump up and down, but I really am just so happy.
43:24I know there's no cure, but any time with my family, my children, my wife is a blessing.
43:35I think it's the most exciting thing when you get a good result for your patient who has
43:39come in and is literally clinging on to life.
43:42You look amazing.
43:43You look brilliant.
43:44Yeah.
43:45You're up to drive home?
43:46Of course.
43:47That day when you hear that that patient's being discharged and is able to go back to
43:54their family and be with their loved ones, yeah, it's definitely a great feeling.
44:09Have a lovely night.
44:10See you, team.
44:15There are days that it does get a little bit too much.
44:20Those are the days that you hug your partners, you ring your mum, you tell her you love her.
44:26There are definitely those days that you are very grateful for everything that you have.
44:32So we'll need to give a close eye in you in case that goes back up fast again.
44:36Knowing that we have saved someone's life and they have been able to get home to their
44:39loved ones is 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, you get days where it's like, oh my Lord, I'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.
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