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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.
01:51Yeah.
01:52The St Vincent's Hospital emergency department is close to six...
01:54If you are what you are what you are doing.
01:55The nurse at the front line...
01:56...with police.
01:58What's been happening?
01:59I've had a cheekbone in me and...
02:00Okay.
02:01And has Chris's brain tumour returned?
02:02That looks and feels different.
02:04Yeah.
02:05the St. Vincent's Hospital emergency department is close to capacity once again
02:22today there are 16 doctors and 18 nurses on the shift
02:33in the emergency department every day you've got to be prepared for the
02:39unpredictable you literally just don't know what kind of you're going to walk into
02:43at times you know the department is better by war zone
02:48my name is Darren and I grew up in Scotland I've been a nurse for like 12 years so I think out
03:03in the red zone is maybe if Hannah goes out there I'm one of the nurse managers in the
03:07emergency department I guess I'm quite young to be in a management position but I've worked
03:13really hard to get to this stage nurse you and is the first to the bat phone there's an incoming
03:24emergency St Vincent's emergency we have a direct communication system between the ambulance service
03:31and the hospital five four six it tends to be patients that are going to need a lot of resources
03:38thank you so that is your traumas your heart attacks your strokes the ambulance have just sent through an
03:48ECG for a 74 year old female who currently heart rate is dangerously high and we'll move this lady out into recess forward so the guys will set up as worst case scenario so the team will assemble as if it's a cardiac arrest every second counts when a patient's life is in danger
04:09the woman suffers from tachycardia where abnormal electrical impulses cause the heart to race dangerously high at 200 beats per minute this is life-threatening
04:21she was at the theater and she felt these palpitations on her chest but she felt really dizzy she felt really nauseated
04:39so Hillary I'll introduce myself my name is Darren I'm the nurse in charge have you been feeling unwell it's all a bit scary
04:49so who's your family do you want me to give them a call
04:56empathy comes hand in hand with nursing I think just wanting to help people
05:02because this is quite a you know it's something we don't see all the time
05:06Hillary's heart rate is about 200 beats per minute a normal heart rate would be set between 70 to 90
05:14so her heart rate is super fast I'm just going to put you on to another monitor
05:21so I think the next step is to get medication it's really high risk medication so we've had to put her on the defibrillator in case it goes wrong
05:29with such an elevated heart rate blood is unable to pump efficiently around Hillary's body so reducing it is critical
05:38the entire resuscitation team is there in case this goes wrong heart specialist Dr. Jezzieri takes the lead
05:45heart specialist Dr. Jezzieri takes the lead
06:00we're going to have to give a drug called adenosine which is anti-arrhythmic drug
06:04it'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 and we would have to revive it
06:17a few floors up from emergency ten high-tech operating theatres are also busy
06:35they can run 24 hours a day it's a high pressure environment for the dozens of nurses
06:41who are at the front line of the surgery a bad day in the operating room can be extremely bad
06:48and we do take it quite personally because we've always been trained to fix the problem
06:55and if we haven't been able to fix the problem it takes a very emotional toll on everyone
07:02my name is Nikita and I am a perioperative nurse so I am the nurse that will actually
07:14be helping the surgeon throughout the whole entire surgery
07:21today 50 patients will go through these operating theatres Nikita's first is Chris
07:29he's been here before the 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 Lukens
07:44can you please tell me the backstory
07:47so a 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
07:53and given he's had three craniotomies in the last 18 months
07:58he pretty quickly realised what was going on
08:01the tumour looks like it has recurred
08:03and 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 and he can get on with his life
08:10because unfortunately the prognosis is not excellent
08:14this is not a tumour we can cure
08:15so 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
08:24oh
08:28so I'm here to get a
08:30what they call a resection of my brain
08:34to remove a brain tumour
08:37it's like little tentacle of cancer
08:40they
08:41if it forms a tumour they can
08:45they can cut it out
08:47but there's really
08:50unfortunately a cure
08:52so I've been to
08:54it's just wonderful that they can do something rather than
08:57say well there's nothing we can do
09:00so I'm very pleased with him
09:03my wife and I only have three children
09:06we've got
09:07a 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 theatre
09:25before you know it
09:27you'll be back in recovery
09:29asking for a sandwich
09:32to have someone's life in your hands
09:34it's such an honour
09:36you know your patients are coming in for surgery
09:39and they are trusting you with their life
09:42you almost feel a little bit like their guardian angel in the operating room
09:45how are you feeling Chris?
09:46fantastic
09:47yes
09:48good
09:49very excited
09:50good
09:51see
09:52mate you've been through it now
09:53so many times
09:54no
09:55it's just
09:56just another one
09:57just another walk in the park
09:59yeah
10:00getting back home
10:01playing another game of golf
10:02this surgery might buy Chris more time
10:03but it's a high risk operation as stroke, paralysis or even brain damage might occur
10:17do you want them all open?
10:18yes
10:19the role of Nikita and the five other nurses in this marathon operation is crucial
10:25this type of surgery it's very delicate work obviously you're operating on a patient's brain
10:31there is a lot at stake today you've always got to remember that at the end of the day you got a patient on the table
10:38anything goes wrong is going to impact on that patient and their life
10:43we just hope that he gets the best result and you know the best quality of life
10:48lot at stake today. You've always got to remember that at the end of the day you've got a patient
10:51on the table. Anything 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.
11:04Any brain surgery is precarious. This one is particularly difficult.
11:09Probably the biggest challenge is its location. It'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,
11:20which is weakness of the entire left side of his body. And across on three, nice and slowly, one,
11:25two, three. So while the tumour is quite small, it's in such an eloquent position that it makes
11:31the surgery quite challenging.
11:37All right, are we right to start? Thank you.
11:45Downstairs in emergency, they're about to administer a drug to bring Hilary's racing heart rate down.
11:53If any BTBF, you go 360, first induction, three in a row. If it's going to be an AC study,
12:03then you start chest compression. Yeah.
12:08You're all right. Very, very safe.
12:10You're all good.
12:10Hey, just as a precaution. It's not to scare you.
12:14Okay, everyone ready?
12:16Yes.
12:17All right, Hilary.
12:17Nurse manager Darren and his resuscitation team are literally ready for anything.
12:25We're just administering the drug. If this goes wrong, then our heart would stop.
12:43This is quite something we don't see all the time.
12:45For an Olympic athlete, a heart rate of 200 beats per minute is dangerously high.
12:52For 74-year-old Hilary, it's life-threatening.
12:56Everyone ready?
12:57Yes.
12:58All right, Hilary.
12:59The medication is supposed to slow her heart rate down, but it could also stop her heart altogether.
13:06We're just administering the drug.
13:07There we go.
13:20So 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.
13:27But it's not over yet.
13:31Suddenly, Hilary's heart rate spikes again.
13:34It's the heart rate's way back up again.
13:38The first dose of her medication had little effect.
13:42Nah, she's flipped back up.
13:44But it's a catch-22.
13:46Give her too much and her heart could stop.
13:49It's quite unstable.
13:50So they might end up going and giving another dose, a stronger dose, the next time.
13:54Just as the higher dose is being prepared, Hilary feels a change.
14:04Is it a burden?
14:06Yep.
14:08Her heart rate has finally stabilised.
14:12Very good.
14:16Hold on.
14:19It worked.
14:21It's now 130.
14:22Still a fast heart rate, but regular.
14:27But it's probably going to take a little bit of time to come down.
14:29The small dose worked.
14:31It was good.
14:34Oh, you're tiny.
14:36Yeah, it's on a shift.
14:37You've got a whirlwind of emotions most of the time.
14:40So more to the point.
14:41What fear are you sure with you?
14:43Appropriate.
14:44Would you sound worthy?
14:45I'm not heard of it.
14:46You're constantly buzzing off some say adrenaline, but I don't know, you just feel this, I don't
14:52know, it's an urge to just make everything work.
14:57The green and the squiggly little lines, 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 someone 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, instrument-wise, we're going to go on.
15:28Perioperative nurse Nikita has a key role in the brain surgery of cancer patient Chris.
15:34While Dr Lukens tries to find and remove as much tuna tissue as he can, Nikita oversees the team of nurses here.
15:42All right, we're right to start.
15:44He has had a tumour that keeps coming back.
15:49Unfortunately, they've realised that there's not a lot that we can do as curing-wise.
15:55However, we're going to try and give him the best quality of life that we can for the time that he has.
16:02It's a bit of a sad story.
16:04Dr 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.
16:16So he's had previous surgeries where we obviously remove the bone so that we can actually get into the brain.
16:22And then there were three spikes.
16:24They actually like the screws.
16:25So we're actually able to screw the bone flap back down onto the skull.
16:29So bone flaps are really important.
16:30You don't want to ever lose it.
16:31You don't ever want to drop it.
16:33Oh my gosh.
16:33Worst thing in the world.
16:36The layers removed, surgeons can now see the brain.
16:44Definitely the posterior margin of it.
16:47Yep.
16:47The microscope is positioned for the delicate work on the brain.
16:52Yeah, that should be fine there.
16:56Because of the microscope, you can actually see what they're seeing.
17:00So it's really good for people who are in the theatre who are able to actually visualise the brain and the tumour and see what's being operated on.
17:08With the brain exposed, Dr Lukens' full concentration is through the microscope.
17:14The nurse's role is to pre-empt any equipment he'll need.
17:17The microsurgical instruments are quite fine and delicate.
17:23So this way, he'll just keep looking through the microscope while he's working.
17:26And the nurse will actually just place all the instruments in his hands.
17:29Two forceps to myself and to Jolly as well, please.
17:33So it's a wonderful surgery to watch.
17:36That vessel's really fragile.
17:38Yeah.
17:41Isn't that amazing, though, to see the pulse of the brain?
17:44That'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, which controls the opposite side of his body.
17:56So that's why we're just being super, super cautious.
18:00Because an injury at this location is significant on there.
18:07Millimetre by millimetre, the surgeons carefully navigate their way through Chris's brain
18:13until Dr. Lukens finds something that appears abnormal.
18:18That there looks and feels different.
18:22Yeah.
18:29Side, side, to the side, to the other side, and around, and down.
18:38How was that one?
18:43I 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.
18:55Oh, my God.
18:56Come 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?
19:02I work better when things are chaotic and loud and busy.
19:06So much better than routine.
19:07I don't like routine.
19:08My 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.
19:28A lot of our job out the front especially is just letting people know that they're going to be okay,
19:31and we're going to treat them, we're going to help them, we're going to get them feeling better,
19:34and it's, you know, they're just in the right place.
19:35Carly's shift in triage is off to a slow start today.
19:41But an incoming patient is about to change that.
19:45Ah, there's a gentleman coming in with chest pain.
19:47I'm going to bring him in and do an ECG and some stuff.
19:51All right, 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.
20:03Head up this end for me.
20:04So, I'm going to do an ECG.
20:07Right.
20:08If they need ECGs, if they need blood tests, if they need pain relief, x-rays,
20:12I 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,
20:17all those sort of things are taken care of.
20:19Now, I might just have to clip a little bit of hair, is that all right?
20:21Sorry.
20:22I'll do just two little patches, or else the stickers won't stick.
20:25It's a bit blunt, isn't it?
20:31I don't know if it's blunt or your hair's too thick.
20:34Oh, my God.
20:35It's never a good sign.
20:37No, I'll blame you.
20:38I thought for a minute they were nipple clamps.
20:45I thought, oh, no, we've come to the wrong place.
20:47Oh, no, this is the right place.
20:49Here in Darlinghurst.
20:51Anything goes around here.
20:57Beautiful.
20:58Well, it looks like it's doing the right thing.
21:00That's one positive so far.
21:02I'm going to pop a cannula in your arm and get some blood, OK?
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.
21:25What do you want to know?
21:26Well, 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.
21:35Oh, it's such a bonus when you get a patient who has a profession
21:38that can help you out with some free tips.
21:40I think because we're giving them a service,
21:42they're more than happy to give us a service at the same time,
21:45so I always ask for advice.
21:47I'll tell you what's good.
21:48Who flung dung?
21:49OK, who flung dung?
21:51It's technically a mulch, but it breaks down into the soil.
21:55OK.
21:56Who flung dung?
21:57All I can think of is someone flinging cow dung.
22:02I'll try that.
22:02Who flung dung?
22:03It's good stuff.
22:05OK.
22:05There 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, you see people with injuries,
22:14you 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.
22:19Anything comes in the door.
22:20I'm going to send these off.
22:24I'll have the doctor to come in.
22:25I've forgotten that.
22:26I will be back.
22:28You're welcome.
22:34They've just come down on a region there that feels slightly more firm.
22:38Upstairs in theatre, neurosurgeon Tim has discovered unusual tissue
22:43in cancer patient Chris's brain.
22:46Because I'm reasonably confident that that tumour is just there.
22:51Like just under that?
22:52Just under that vessel.
22:54Yeah.
22:55That looks necrotic.
22:57Yeah.
22:58So the brain's actually quite soft.
23:00He 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.
23:08So we're just taking some biopsies of this abnormal-looking tissue now
23:14that we'll send to the laboratory,
23:17and they'll be able to tell us whether there are viable tumour cells.
23:21The results from the lab will reveal
23:24if this is the return of the cancerous tumour or something else.
23:28Are you just looking to see if that tissue is tumour tissue or...?
23:32Yeah, and just trying to identify any viable tumour,
23:35because it will dictate whether he has further female and radiotherapy.
23:42I'm going to give you one more piece,
23:44and then we'll send that off as a frozen section.
23:45So 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.
23:58They 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,
24:07so we need to write the extension number up here.
24:09Excellent. Let's take an urgent.
24:11Beautiful.
24:12Porter, frozen.
24:13Must go to pathology immediately, please.
24:16Chris's life rests with these lab results.
24:19A negative means that Chris can avoid more chemo and radiation therapy.
24:24But if the sample tests positive, the cancer is back.
24:28This is the way that the surgeons are actually able to get a clear black and white.
24:32This is what it is.
24:32One in five Australians suffers mental illness.
24:50Do you want to save it?
24:52When someone is in crisis,
24:54it's often the police who are called in before an ambulance.
24:58We are headed into the city for a 28-year-old male
25:02who has a history of mental illness.
25:05St Vincent's is trialling a bold new programme...
25:08Hey, guys. How are you?
25:09..that takes nursing to the streets.
25:12How do you think your mental health is overall?
25:14It's good. It's happy.
25:15OK, good.
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.
25:28This is our tune of the day.
25:36Glasses on.
25:37I can see clearly now.
25:39My name is Kate,
25:41and I am a clinical nurse consultant.
25:44Bye, guys.
25:45And I work for the mental health side of St Vincent's Hospital,
25:49and I'm a PACER nurse.
25:51Basically, what PACER stands for
25:52is Police, Ambulance, Clinical Early Response.
25:55The PACER role is a new role
25:59which has been rolled out in New South Wales.
26:01Us clinicians are based in police stations,
26:03and we respond to emergency calls for mental health.
26:07Oh!
26:11I'm from Ireland.
26:12I'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.
26:23Ha, ha, ha.
26:28So, we are on the way to King's 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.
26:40A woman's walked in making wild claims about being bugged.
26:44She's come in and said that the police officer
26:46put the cameras in her house and seems schizophrenic.
26:50Yeah.
26:50We checked her up on cops,
26:52and it comes up that she's done this before.
26:54Yeah.
26:55Yeah.
26:57Okay, so tell me, what's been happening?
27:00I had a chick put in there.
27:01Yeah.
27:022002.
27:03Yeah, okay.
27:04The guy was an adult.
27:05Okay.
27:06He was a police officer.
27:07Okay.
27:07He said he'd give me a local anaesthetic.
27:10He gave me a general anaesthetic instead.
27:13He knocked me out, put the chip in.
27:14Yeah.
27:15So, I didn't know exactly where it was.
27:17Right.
27:18And there was no mark on your skin?
27:20No.
27:20So, you couldn't see?
27:21Okay.
27:21No.
27:22No.
27:22Okay.
27:23And I've been trying to find it.
27:25Yeah.
27:26Find the chip?
27:27Yeah.
27:27How have you been trying?
27:28MRIs?
27:29Yeah.
27:30Okay.
27:31I think sometimes people think that people with mental health problems can control their behaviours
27:36or control their emotions, and they really can't.
27:39People need to understand it's an illness, and there's no shame in having an illness, but
27:43they can't control it.
27:44There's nothing they can do.
27:46Anyway, I started hearing Sue and hostile voices.
27:50Yeah.
27:50I could hear this, and every single time I'd turn around, there's no one there.
27:59And when somebody yells out in the middle of the street, I mean, everybody looks.
28:06You know what I mean?
28:06And was every...
28:07Could you see everyone looking around, and they were looking at you?
28:09No.
28:09Only one who could hear was you.
28:12Okay.
28:13There's only two people that I can hear.
28:15Yeah.
28:15And a bunch of men.
28:16Sue and Bob.
28:19Yeah.
28:19Yeah.
28:19Do you hear them every day, all day, every day?
28:21Yes, they've been playing tagging since COVID started.
28:25Right.
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.
28:34I know what's going on.
28:35You know, sometimes people have bad life stories, but they still have an illness, and they still
28:40need to be treated like a human.
28:42And, like, sometimes you need to separate those things and just, you know, give them the care
28:45that's needed.
28:46But the main thing that Bob and Sue wanted was to denigrate me so that I would lose all confidence
28:56and perhaps commit suicide so that you can get the show on the road.
29:00Possibly do need to come a bit further forward.
29:13In theatre, lead nurse Nikita is anxiously awaiting a call from the laboratory.
29:19Dr. Lukens has taken a sample of suspected tumour tissue from patient Chris's brain.
29:24Just a small patty again.
29:26If it comes back positive, he'll need debilitating chemo or radiation treatment.
29:31We'll just start to clean up the cavity.
29:33While they wait, Dr. Lukens continues to remove as much suspected tumour tissue as possible.
29:40The margin for error is zero.
29:43Make sure there's no active bleeding.
29:45It's the last thing he needs as opposed to properly for hematoma.
29:48So you can see that our cavity is actually nice and clean.
29:53So Tim has actually been resecting away all the bits of tissue, all the unusual tissue.
29:59It looks nice and fresh as well.
30:01No bleeding, which is what's important.
30:04I think we've achieved what we wanted to do.
30:07I don't think we've disturbed the motor fibres.
30:10So I think about that.
30:11You can see the brain pulsating away.
30:14There's no active bleeding.
30:15It's definitely a good thing.
30:19Now's probably a good time to stop.
30:23The surgical team has done all they can today.
30:27After four hours, the careful process of closing the skull begins.
30:32So we just secure the bone window that we've removed.
30:35It went really well.
30:36Really happy with the resection.
30:37We're able to get back to the normal brain tissue surrounding that cavity.
30:41So I'm confident we've gotten as close to 100% of that tumour as we can.
30:45So 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.
30:58Theodore 4 and Akita speaking.
31:00Tim, I've got pathology.
31:02Oh, great.
31:02The results of the frozen sample are in.
31:05Hello.
31:07Hello.
31:09Okay.
31:11Okay.
31:12Okay.
31:13I'll wait and see.
31:14Thanks, Julie.
31:16Bye.
31:17Bye.
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.
31:35Time will tell.
31:36Yes.
31:36We'll have to wait a week.
31:38A week.
31:38Mm.
31:38The initial lab results are good.
31:42The sample might have been dead tissue, necrosis, not 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, 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.
32:02Very good job.
32:04You did well.
32:08Once 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.
32:14Slowly across.
32:15One, two, three.
32:16The right side of the brain controls the left side, so not only the arm and the leg, but also the face.
32:21Let's see how he wakes up.
32:23Chris, operation's all finished.
32:24Just waking up.
32:27Open your eyes for me.
32:28Chris' brain has endured a lot, but there's a new concern.
32:37Chris, open your eyes for me.
32:39Nurses have been trying to wake him up for the past 20 minutes.
32:43He'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, operation's all finished.
32:56Open your eyes for me.
32:58Chris, operation's all finished.
33:09Just waking up.
33:10Brain cancer patient Chris is not responding after enduring four hours of neurosurgery.
33:17Chris, open your eyes for me.
33:18Operation's all finished.
33:19Just waking up.
33:20It's an anxious wait for all in theatre, as nurses and anaesthetists try to rouse Chris.
33:27Chris, operation's all finished.
33:29Open your eyes for me.
33:31Obviously, we're operating around the brain.
33:33So, you're always worried.
33:34Did we cause a bleed?
33:36Have we caused any damage nerve-wise?
33:38There's a lot of nervous energy while we're waiting for him to wake up.
33:42Chris, operation's all finished.
33:44Can you open your eyes for us?
33:46It's a bit of a tense wait, because if you're nice to see him moving everything, I'm giving
33:50us the thumbs up.
33:52Just open your eyes for me.
33:54Operation's all done.
33:55Chris?
33:56Chris?
33:57Chris?
33:58Hello?
33:59Operation's all finished.
34:00Open your eyes for me.
34:01It's all done really well.
34:02Chris?
34:03Open your eyes for me.
34:04Christopher?
34:05That's it.
34:06Okay, nice.
34:07That's it.
34:08Just waking up after your operation.
34:09Big breaths, Chris.
34:10Hey, Chris.
34:11Can you give my hand a squeeze?
34:12It went really well.
34:13Can you give my hand a squeeze?
34:14Fantastic.
34:15A simple hand squeeze confirms for Dr Lukens that Chris can hear him.
34:29It went well.
34:30Can you squeeze this one?
34:31And is responsive.
34:32A little bit.
34:33More of a squeeze.
34:38It's good.
34:39It's certainly raising.
34:41Chris will wake up to the news that the cancer has not returned.
34:44This time.
34:45There's no telling when another tumour might occur.
34:49But at least he can enjoy quality time with his family for the foreseeable future.
34:55He 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.
35:07Fingers crossed.
35:08Fingers crossed.
35:09Fingers crossed.
35:10Fingers crossed.
35:11Fingers crossed.
35:12Fingers crossed.
35:13Fingers crossed.
35:14Your 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.
35:25They might not remember your name.
35:27That's fine.
35:28They can forget us.
35:29We won't forget them.
35:30That's awful.
35:31I'm sorry that you're going through this.
35:32I'm telling you, it's a living nightmare.
35:33I know.
35:34And have you ever tried to take your own life before?
35:35Never.
35:36Okay.
35:37And are you, do you feel suicidal now?
35:38No.
35:39Okay.
35:40No.
35:41All right.
35:42That's good.
35:43At 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.
36:06I think that's probably the biggest basis of why I decided to become a mental health nurse.
36:11Seeing the impact that had on the family and on, like, even the community, yeah, I think
36:16that's probably, like, what encouraged me most to become a mental health nurse.
36:20They can come in any time and put a camera and a smoke alarm.
36:25Yeah.
36:26I've wrecked that many of them.
36:27She does have chronic schizophrenia and she's very well known to calling Kings Cross Police
36:32Station, making reports.
36:33But, yeah, the poor thing.
36:35Kate is part of the St Vincent's Hospital PACER program that embeds trained nurses with
36:41the police to deal with mental health cases.
36:44She literally left the hospital and then came down here.
36:46Oh, really?
36:47Yeah, 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.
37:02And I solely studied mental health nursing for four years.
37:05So I'm not a medical nurse.
37:07I 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.
37:16Through the hospital, Kate is able to access the patient's medical history and her treatment plan.
37:22I think she has a history of non-compliance with meds.
37:25So...
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?
37:38Kate checks with other health agencies to help her make a call on whether to readmit her to hospital or send her home.
37:45Okay, perfect.
37:46So that was handover was done?
37:48That's absolutely fine.
37:51Isn't she lovely?
37:52She's lovely.
37:53God love her.
37:54Yeah, she is.
37:55I'm actually going to drive her to the bus and get her on the bus home.
37:58Okay, I just gave a call to the hospital and I spoke to Zoe.
38:02Do you remember seeing Zoe last night?
38:04Yes.
38:05She 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 so they'll be following up with you.
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?
38:16Yes.
38:17Nurse 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 and without fear.
38:28Will I take one of your bags?
38:30Yeah.
38:31I think she just needed to be heard and I think she needed to feel validated about her concerns.
38:37So just listening to her basically I think kind of alleviated her distress and then, you know, making sure that the appropriate team was 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.
38:49Yeah?
38:50Good woman.
38:51You probably know better than me.
38:52My motto always has been since day one when I started is treat others how you would want your family member to be treated.
39:00Treat them how you would want to be treated yourself if you were in that situation.
39:03You look after yourself alright.
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.
39:14So I think sending her home and involving the supports that she's got involved is a better option than sending her to hospital and, you know, making her sit around, I suppose, for the same thing to happen again, just to be discharged again.
39:27The PACER program, nurses working alongside police, has been going for six months.
39:33It has already cut down the time police spend at non-crime incidents or waiting in hospital.
39:40I think it's really important just to try and create a better understanding for mental illness basically.
39:46Because nobody's exempt, like 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 and I need to pee and all of the above.
40:00What are you going to do?
40:15Ah, syndrome.
40:16Back in emergency, Carly is bringing Dr Nick to check on her patient's ECG results.
40:22He had a lovely ECG.
40:23Lovely.
40:24Yep.
40:25It's pretty.
40:26It's gorgeous.
40:27I'm going to see such a great looking complex.
40:30Exactly.
40:31That QRS was like, ooh.
40:32It's way too many.
40:33Oh.
40:34Ha ha ha.
40:35Ha ha.
40:36Ha ha.
40:37Ha ha.
40:38Ha ha.
40:39Sorry, I'm Nick.
40:40I'm another one of the doctors.
40:41I'm just going to take a quick degree to your age here.
40:42Do you still have pain?
40:43Nope.
40:44No, no.
40:45Nope.
40:46All right.
40:47All good.
40:48Pain.
40:49It looks fine.
40:50That's a good thing.
40:51Yeah.
40:52Cool.
40:53I'm just going to order a chest x-ray.
40:54While it arrived with chest pains, he 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.
41:07A great outcome is that, you know, someone will come in with an issue and it's not life-threatening
41:12and 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.
41:17Paramedics have arrived with a new patient.
41:21While one of them checks in, Carly checks him out.
41:25I think they're mine.
41:29Pretty sure that's workplace, Rasmid.
41:31Ha ha ha ha.
41:32This 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.
41:41Yeah.
41:42So we're going to work together today, much to his dislike.
41:45I met my partner at work.
41:46I noticed him one day, this gorgeous guy with his beard, and I asked who he was and they're
41:51like, 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.
41:57Yeah.
41:58Nice to see him.
41:59Nice to see you.
42:00The 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.
42:12Sleeping on his laptop.
42:14You can see it.
42:17It's going to kill me.
42:19You dropped something.
42:20You did.
42:21Well, hopefully that's made his day.
42:36Highly doubt it though.
42:40Seven 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.
42:55You just don't know with brain surgery what deficits you might come out with after surgery
43:01and really just went in, 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, very excited.
43:19I 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, you know, children, my wife is a blessing.
43:31It is the most exciting thing when you get a good result for your patient who has come
43:38in 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 is being discharged and is able to go back to
43:54their family and be with their loved ones.
43:57Yeah.
43:58It's definitely a great feeling.
44:00Yeah.
44:01Have a lovely night.
44:02See you, team.
44:03There 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.
44:31So we'll need to give a close eye in you in case that goes back up fast again.
44:35Knowing that we have saved someone's life and they have been able to get home to their loved ones
44:39is one of the best rewards in nursing.
44:42Listen, 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.
44:54Anything is possible.
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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