Running head: BED NUMBER TEN 1

Bed Number Ten

University of Saint Mary

Ashley King
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The novel, Bed Number Ten is a huge wake-up call that shows the real world situation of

members of a health care team neglecting to communicate with an unresponsive patient. This

patient, Sue has been diagnosed with Guillain-Barre syndrome. Guillain-Barre syndrome usually

presents as tingling in lower extremities, as it did for Sue in the very beginning of Bed Number

Ten. As this syndrome progresses the muscles weakness can evolve in paralysis. Forty-eight

hours after the tingling of the toes and burning of the mouth kicked in, Sue ended up in the

intensive care unit (ICU) unable to move anything but her eyelids and unable to breath on her

own. Bed Number Ten opens up the reality of neglect by nurses, physicians, physical therapist,

etc. on the population of ICU patients who are ventilated and unresponsive.

Throughout Bed Number Ten, a good portion of the staff in charge of Sue’s care showed

the opposite of the 5 C’s of caring, which is taught and reiterated all throughout nursing school.

When it came to caring, a lot of the staff may have done the bare minimum of daily cares but did

not show that they were concerned in caring for Sue by being disengaged with her. A lot of the

staff seemed to forget that a human being unable to speak or breath on her own was in the room

and treated her as if she was not even there. For example, on page 50, Sue was trying to express

her need to use the restroom after her enema was given that morning, “When Sandra came in on

Monday morning, I tried to tell her what I needed. She just laughed . “Sue, you couldn’t need a

bed pan.” Then something at the nurses’ station caught her attention. “I’ll be back in just a

minute, Sue.” And off she went.” This shows the disregard in caring for the patient and really

trying to communicate with her. This lead to Sue feeling embarrassed and humiliated in herself

and distrust in her nursing staff. The article, “Communication Skills Intervention: Promoting

Effective Communication Between Nurses and Mechanically Ventilated Patients” states that,

“communication forms the basis of a nurse-patient relationship and is an essential element of

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trust and comfort” (Dithole, Thupayagale-Tshweneagae, Akpor, & Moleki., p. 1). This statement

is contrasting how nurse Sandra reacted in her time of caring for Sue that leads to Sue’s feeling

of shame and humiliation.

Communication is another topic taught again and again in nursing school. The

importance of it, how to therapeutically deliver it, and different techniques. Some of the

communication among the health care staff and Sue is the opposite of therapeutic or

informational. There are a ton of examples of poor communication in Bed Number Ten. Sue was

sent to the ICU with no real explanation as to why. She was given information from nurse Bruce

that she would spend at least 3 months in the ICU. She was at a complete loss for words due to

her confusion and the lack of communication between the health care team. “He reached toward

a cart behind him for some kind of apparatus attached to a plastic tube, told me to lie down, and

then pushed the tube down my throat. I gagged. Immediately he pulled it out again. “Get used to

that because you’re going to have a lot of the while you’re here” (Baier & Schomaker, p. 16).

For starters, Sue was never given her diagnosis from a physician but by her husband, Bill

who did not know much about Guillain-Barre syndrome. When nurse Bruce decided to shove a

tube down Sue’s throat, she was not aware of any diagnosis or why he was doing it. It is not

Bruce’s responsibility to diagnose Sue, but he could of educated Sue on what the equipment was

and warned Sue on what he was going to use it for and talk her through the procedure. According

to the research article, nurses who work in the ICU find it challenging to communicate with very

ill, unconscious, sedated or mechanically ventilated patients. Communication between nurses

and these patients requires specific knowledge, skill and commitment (Dithole, Thupayagale-

Tshweneagae, Akpor, & Moleki, p.1). Nurse Bruce definitely lacked the knowledge, skill, and
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commitment in making Sue feel at ease during her hospital stay. If anything he heightened her

anxiety, fear, and loneliness.

Sue may have had negative experiences within this healthcare team, but she also had a

couple of staff members that eased her loneliness and made an effort to communicate with her.

With Sue being in the ICU for an extended time she got to experience code blues and the sad

facial expressions on all of the staff’s faces when they were not able to bring the patient back.

She also got to experience being there after the patient had died and witnessing the men come up

to claim the body. When this is happening a nurse goes around closing all the patient’s curtain as

a curtesy, not realizing it put Sue in full fledge panic. After this occurring at least once a week,

Sue was never able to shake that fear of feeling isolated. Until one day this happened and James

who was a respiratory therapist, caught the glimpse of pure anxiety on Sue’s face and stepped in

the room just at the foot of the bed once the curtain was drawn shut. “From then on, whenever he

was available to stay with me, I never had to face that horror alone. Immediately James would

appear, usually carrying a stack of charts. He’d sit on a stool near the edge of my cubicle,

scribbling and shuffling. Sometimes he’d smile and thank me for allowing him to use my stool

for his charting. But he was there, soothing me with his presence” (Baier & Schomaker, p. 136).

James was always one of Sue’s favorites throughout this novel. His roommate, Dick was

also one her favorites. Sue was introduced to Dick once physical therapy got involved in her

care. He was in training for his physical therapy program and a part time college student. He was

assigned to sit with Sue while she was up in her chair. He spent that time attempting to help Sue

communicate, especially about their mutual interest Houston Rockets basketball. “I was relieved

to have him nearby” (Baier & Schomaker, p. 159). Their presence and kindness brought her

peace, hope, and a comfort. They did simple gestures just to know they cared. Like making her a
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pie once she was off the respirator and could start eating again. It is simple acts of kindness like

making a patient a pie to show them how much you care about them and their recovery.

The article, “Communication Skills Intervention: Promoting Effective Communication

Between Nurses and Mechanically Ventilated Patients” goes in detail of ways to better the

communication process from nurse to ventilated patients in the ICU. This article studies different

techniques and devices to make this possible. Dick and James stood out when it came to

communicating with Sue and even just making her feel human. They attempted to read her facial

expressions, comfort her when they believe she needed it, spend time with her even if she could

not communicate with them, go out of their way to encourage her recovery. “Nurses are expected

to provide quality care in intensive care as well as to empower their patients” (Dithole,

Thupayagale-Tshweneagae, Akpor, & Moleki, p. 5). Even though Dick and James were not

nurses in Bed Number Ten, these communication skills are needed with every part of the staff.

Most of Sue’s health care team should of taken notes from these two men on how to

communicate.

If any health care persons were to read this novel, Bed Number Ten; implementing new

ways of communication should be their first thought. How can nurses, doctors, respiratory

therapist, physical therapist, etc. make the already frightening stay for these patients in the ICU

better. First off, if a patient is ventilated and cannot communicate, does not mean they are not

conscious or do not understand what is going on around them. Treat them like humans. “Patients

that have been critically ill, usually remember the nurse patient communication very clearly even

if they were unconscious most of the time” (Dithole, Thupayagale-Tshweneagae, Akpor, &

Moleki, p. 2). Nurses should be implementing the therapeutic communication skills they were

taught all through nursing school. In the research article referenced above states,
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“Communication, through verbal and non-verbal means is used to convey messages, share

information and establish, strengthen or influence relationships. Non-verbal communication

includes, but is not limited to touch, facial expression and tone of voice. Communication forms

the basis of a nurse-patient relationship and is an essential element of trust and comfort”(Dithole,

Thupayagale-Tshweneagae, Akpor, & Moleki, p.1). This statement provides realistic ways of

communication with non-verbal patients that should already be implemented in practice but can

always be reeducated throughout intensive care units. Overall, health care as a whole should

learn from this book and put new ways of communicating with ventilated patients into practice.
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References

Dithole, K. S., Thupayagale-Tshweneagae, G., Akpor, O. A., & Moleki, M. M. (2017).

Communication skills intervention: promoting effective communication between nurses

and mechanically ventilated patients. BMC Nursing, 16, 1–6. https://doi-

org.stmary.idm.oclc.org/10.1186/s12912-017-0268-5

Baier, S., & Schomaker, M. (1989). Bed number ten. Boca Raton, FL: CRC Press.

ISBN: 978-0-8493-4270-7