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>> Friday, February 25, 2011





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.


23 comments:

Jyothi February 25, 2011 at 12:29 PM  

Wow Doc! That was a wonderful expression of gratitude! It is indeed a calling.

I can fully understand Ahmed's situation. I lost two cousins to Muscular Dystrophy. One at 19 and other at 21 years of age. Up until grade 9 they were perfectly fine, then they started to fall down in school for no reason. They were brothers.

Harman February 25, 2011 at 2:31 PM  

I sincerely think...the nurses are great people with lot of skill with strong personality who can see and treat the patient and go though the pain they suffer..its very difficult to see a dying person or clean a patient who is soiled up...its hats off to them!
As far Ahmed..I would.. say ..God help him to take off his pain and suffering!

anilkurup February 25, 2011 at 5:39 PM  

doc, I hope you are back into active blogging.

The post is quite affecting.
And also one has to admit that the profession and the people in it are perhaps one of the most abused and denied . Don't you think so? Your life in the medical world would certainly have provide you with front row view of the tribulations of a nurse.

NRIGirl February 25, 2011 at 6:13 PM  

Welcome back @Doc! Missed your posts.

Thank you for this story. Wish I could have seen Ahmed's smile too.

I have high regard for first teachers and next doctors and nurses. I believe without a calling they couldn't do it...

Insignia February 25, 2011 at 8:14 PM  

Glad to see you. Hope you have recovered. That was a much needed insightful post. As you said, nursing profession is for those who are strong. Its a thankless job; they have to cope.

raji February 26, 2011 at 12:04 AM  

Hello Doc,Ahmed's story was very sad .I remember ,when I saw this sort of a situation in a movie 'Guzarish' I felt and realized the hardships they face.I know certain things in the medical field has only diagnosis ,no treatment .Another such condition which I feel is Autism ,PDD,Mental retardation.Certain God given' gifts 'only have diagnosis!
I also liked the way you described the lives of a nurse.Yes they are such an inseperable predominant part in our lives.

Hold my hand: a social worker's blog February 26, 2011 at 5:39 AM  

What a beautiful tribute to the nurses. Well deserved as I observe their hard work in the nursing home. I know how challenging their jobs are.

I loved learning about Ahmed's birthday party. As sad as his life may seem, every minute that can bring him a smile or happiness is priceless.

Great post! And thanks for stopping by my blog, and commenting on my story. I appreciate it :-)

Doris

Keats The Sunshine Girl February 26, 2011 at 6:20 AM  

A lovely tribute to the nurses.It is an admirable job they hold. When we are sick, as they nurse us, their smiles bring great comfort and help heal us too.

Libby February 26, 2011 at 10:19 PM  

hi doc, i just wandered by from doris' blog of wonderful stories, & i get here and read what you wrote about nurses, & i'm humbled! you both write so well, & i'm glad to read a doctor recognizing the worth of a good nurse!

Rachna February 27, 2011 at 7:16 AM  

Really, some nurses are so amazing. I remember my experience with them at childbirth. They were so amazingly helpful, sympathetic, and patient. Really wonderful!

meerasrajan February 27, 2011 at 7:41 AM  

Nursing is indeed a noble profession!No wonder we revere Florence Nighingale. But in a country like India I often find that nursing is not done the way it is to be! During the days when my mother in law was bedridden, we had a series of home nurses and their ethics were something really questionable. Hospital nurses were no better..! I guess the best of nurses are leaving the country and what we are left with are people who are forced into nursing for want of getting into any other profession.. Sorry but my experience with this lot has not been good.

Jay February 27, 2011 at 9:30 AM  

Hy Doc,
glad to see you blog actively and recovered from your setback. very interesting post.
Nurses are such a wonderful persons full of patience and helpful. Have amazed at their smiley face in quite a situations!
Tasty appetite

Anonymous,  February 27, 2011 at 11:37 AM  

When I think about all the patients and their loved ones that I have worked with over the years, I know most of them don't remember me nor I them. But I do know that I gave a little piece of myself to each of them and they to me and those threads make up the beautiful tapestry in my mind that is my career in nursing. ~Donna Wilk Cardillo

lakshmi February 28, 2011 at 1:12 AM  

This act of the nurses is really beautiful.

A very noble profession indeed

....Petty Witter February 28, 2011 at 8:32 AM  

Thanks for mentioning all the wonderful nurses out there. Have you ever considered putting your posts into book form?

Margaret Cloud February 28, 2011 at 12:45 PM  

I for one appreciate the care I receive when hospitalized. I love the nurses dedication and I have never in all my life had a crabby or lazy nurse. Their dedication to the profession is so great, and they do meet the challenge. Thanks for a very well written post, it tells it all. Thank you for taking the time to come by.

Happy Kitten March 1, 2011 at 12:37 AM  

It is an unusual profession, it is a calling..

How true.. nd if only the medical profession was filled with only those who responded to this calling and not to the money. But unfortunately like every other profession, even this has been forced onto many hapless individuals..
As for me, I have always been thankful to the nurses who have crossed my path. Even recently I saw the dedication of some of them in the palliative care centre where my FIL was admitted.

dr.antony March 1, 2011 at 11:50 AM  

@Jyothi
It changes the whole environment of a home when you have someone afflicted with an illness like this.There are some new medicines which slow the progression of the disease.
@Harman
To acknowledge them is the beginning.
@Anil
One of the most misunderstood professions.You know,it is a taboo still in India.There is a changing trend,which is welcome.
The problem is when girls from very poor families are sent to courses which are not recognized.because their chances are poor,they get exploited.
@NRI girl
It is easy to sense your attitudes.I wanted to show that theirs is not an easy job.
@Insignia
I am OK. The problem is the shortage at the hospital.Your travelogue is wonderful.
@Raji
You have a good idea about the problems.Every profession should be given its credit.
@Doris
You are in the field and you know better.I know you are part of this system of gifted people.You are doing an excellent work in your field.And you write so well !
@Keats
There would hardly be anyone,who haven't enjoyed the miraculous touch.
@Rachna
Yes,and that is one occasion when one would need the real soothing touch.

A March 2, 2011 at 6:44 AM  

Dr. Antony,

I read this post the day it appeared. I have a lot of respect for nurses too. They do very hard work, long hours and listening to sick people is not easy job.

dr.antony March 2, 2011 at 11:06 AM  

@Meera
You could be right.There are exceptions in any situation. All of us go through difficult times and sometimes,it might reflect on to the work.It is easy to say' don't mix up work and personal matters',but it is more than difficult to do so.But in general,I would still say,it is a difficult job and they need to be appreciated for what they do.
@Jay
Thanks.I managed to keep my appetite all along !
@Anonymous
I had read that comment." a little piece of myself"..isn't it a touchy comment?
@Lakshmi
Thanks for the mails.
@Petty
Thanks for appreciating.I am just a beginner and had never written anything serious ,other than prescriptions! It is encouraging to hear such comments.But I would say your post stands out among the lot.Who knows..some day we would come out with a best seller!
@Margaret
I have witnessed the difficulties they go through.
@Happy Kitten
There would be only few who wouldn't have received some kind of care from them.We take it as routine,and 'just another job".I believe there is something uniquely different about it.
@A
True.Some kind of appreciation would help as an encouragement.it really is not an easy job.

Haneen El Emarate March 4, 2011 at 8:36 AM  

salam alykum doctor antony :-) i enjoyed the story since i lived a part of it..... i will miss the department... but i will pass to say hello to all of you

dr.antony March 7, 2011 at 12:08 AM  

@sm
thanks for coming in.come as often as u can.
@Hi Dr Haneen
I came home on a short break.Hope you are doing fine.Thanks for the visit.

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