Making lives easier

I was held up at work and missed all of you. It is said, never ruin an apology with an excuse. So no regrets or apologies. But I will sure catch up with you.

When an individual becomes sick, a doctor is who they go to in order to seek treatment or get advice. But nurses play an equally important role in a patient’s care and recovery. When trying to separate the two jobs, a doctor is the one who does the examining and diagnosing, while the nurse has a “more hands-on role with physically treating a patient”. Do the two jobs intertwine? Absolutely, and that is why many nurses feel that on certain occasions they may have more insight into a patient’s case.

I had always seen  the hospital work as a simple routine and failed to recognise or acknowledge the kind of service offered by the nursing staff and the sacrifices they make.Everything was taken for granted.I havent paused for a minute to look at them with thankfullness and gratitude.I am glad that this event prompted me to do that.

Ahmed (Not his real name) has been with us in the medical ward for more than 18 months. He has turned 16 years now.From childhood, he has been suffering from a crippling illness called muscular dystrophy. At school, he started falling down repeatedly during games, and then had difficulty to get up from squatting position .He had been taken to many hospitals in and outside here, and was finally labeled with this diagnosis.There is a diagnosis, but no treatment. And there is nothing which stops its progression to crippling and death. This is the paradox in neurology. There is lot of scope for hair splitting academic discussions, but when it comes to treatment, often there is nothing much to offer. Our nerve cells do not have the capacity to regenerate, or if at all they do, they do it at a snail’s pace. And also we do not have an idea as to how and why many of these diseases develop.

He had been confined to a bed for few years now, and then the worst part of his illness took over. When the muscles to breathe got involved, he became unable to breathe by himself. After many attempts of non invasive ventilator support, finally he had to undergo a tracheotomy and then connected to a ventilator.

He is unable to move. His muscles are wasted. The only parts which move are his fingers and the face muscles. He is fond of soccer matches, and so we have managed to get a television for him and given him a remote control by which he can choose his favorite games .He has no voice, but can move his lips. His face muscles are intact so he can express. He has to be fed, cleaned and given all the daily care by the nursing staff. His world has shrunken to the hospital bed. The ward is his home and he is a part of the family there.

We start our morning rounds in the medical ward by visiting him. I stay for some time and try to entertain him with some silly questions and jokes. He always welcomes me with a smile. Through the middle of his tears, he has learned to smile. He likes to have someone around him, but hardly gets any visitor,except his parents.

I walked in to his room last Sunday as usual, but was in for a surprise. The room looked bright and colorful.  A big banner stretched from one end to the other. Written “Happy Birthday, Ahmed ”. Balloons floated everywhere. Ahmed was dressed in a color shirt which one of the nurses had brought for him. Beside him, on a table was a beautifully decorated cake. Soon after I entered the room, all the nurses and cleaning staff walked in and started singing “happy birthday’. Ahmed was all smile and cheer. While we made him cut the cake, a big bouquet of flowers was brought in, sent in by the Matron (She is very fond of him too).The celebration was short and sweet, and I know it has filled his day with memories he would cherish for the rest of his life.

I felt so happy that those nurses had the goodness in them to remember his birthday and make a day for him. These are acts of kindness that make them truly human and earn them the names  ’ nurses’ ‘sisters’ ‘angels’ and nightingales ’. Their routine is not an easy one and their work so demanding.

Wounds need to be dressed, patients need to be fed, reports for the hospital must be filled out, and medical records must be documented for continuity of care, and prevent the ever present fear of litigation. The doctor is here and wants to see the patient with her and asks how they're doing. He writes some orders that they must document, then carry out and then finally document them again.

Patients need to be walked, tracheotomies need to be cared for, the patient in 19B is complaining of  pain, IVs need to be started and some restarted, and the next shift nurse has called in sick ,so someone has to work 12 hours today. There is going to be a transfer of a patient to Abu Dhabi and another nurse who is off duty has to be called in. The patient in 22 B has passed stools and soiled his bed and had to be cleaned immediately because his son has come to visit him and can’t stand the odor.

It goes on and on with endless telephone calls and constant moving around. It is said that a nurse walks around an average of 8 KMs during her 8 hour shift .At the end, everyone complains, and very few say at least a word of thanks. 

Seldom are they remembered after people walk out of hospitals. No one thinks for a minute that they would seldom do the task of carrying the feces and urine of even the closest of their relatives. How many would dare to clean their own relative who has soiled his bed and is bathed in urine, leave alone putting their fingers in to the rectum to remove the impacted feces.

 Many patients do not feel the need to tell nurses thanks, but telling them that you appreciate them would add a little more meaning to their lives. After hearing curses all day, it is so nice to have somebody come back and show their appreciation. Never mind the last eight hours have been spent without food or water as you run like a chicken with your head cut off,  trying to keep people alive and out of pain. This profession is for stronger minded people, with high coping skills, and definitely a sense that we do not live in a perfect world, and therefore you cannot expect perfection, you can only do your best to try to give good care. It occurs to me that there will eventually be no one who will become nurses except those who have no choice like life term prisoners. The stress is unbelievable, the rewards few, the perks even less. 

It is an unusual profession, it is a calling.