What I'd Learnt From The Nursing Class

Let me get straight to the point.

I was taking a class on anti-epileptic agents for the nursing students in my college. I made sure I used simpler parlance to communicate medical terms so that everyone would understand the concept behind whatever I said. I tried my best to make it an interesting discussion. I used some "Nursing points" to highlight the role of nurses in the healthcare.

Halfway through the class, I felt the initial enthusiasm slowly die. So I took a little break from the boring Pharmacology content and spoke a little about the importance of nurses in the healthcare system, hoping that it would make them feel more important and would motivate them. But what I could fell is that most of them didn't realize that nursing was an important part of the health care system. Well, I have seen grumpy & arrogant nurses, sweet & pleasant ones too... Whatever, I have always had this opinion: Nursing is at the heart of the health care. Nurses and even doctors are supposed to provide this nursing care to patients.

And then, I asked an offbeat question. I asked how many of them had taken up nursing willingly and how many had come just because of their parents' coercion. I was quite shocked when a good majority of the class, like a mummy come up to life from the dead, raised their voices to admit parental coercion as the cause for their career choice. Their voices resounded of pent up anger, frustration and resentment. That was quite awkward. I shifted back and continued Pharmacology till the end and bid good-bye.

What I've learnt:

• Most nurses may not know or may not feel the importance of nursing. We NEED TO MAKE THEM FEEL IMPORTANT.

• Parental coercion (I am sorry if it sounds arrogant) still seems to be a major factor that decides career choice. 

Some Quotes:

(Image source: http://blog.chamberlain.edu)

Hypertrophied Mouths & Atrophied Brains

Disclaimer: The following is based on true life experience. Though it would seem like a rant, it isn't.  It is just a capture of how workplace stress can influence people and how people responding to it might in turn affect the workplace. I am too young to be writing this. Constructive criticism is always welcome.

**

A lady, of dark complexion and in her late forties, was afoot with arms folded on her protruding abdomen. She wore a white gown and a plastic white cap to her crown. While she spoke, her voice was loud and discordant and the cacophony she created seemed to fit her figure. It was my first day and as I entered ward G, her shrill piercing voice perturbed the peaceful room filled with pregnant women. My first impression on seeing her was to try my best to avoid any kind of conversation with her. But as I entered the ward, the screams stopped momentarily and then it started again. This time it was at me that she was screaming, only a bit louder.

“Who are you, doctor?” she almost yelled.

“Intern. OG – 2, Sister” I replied and managed to pull a smile.

There was discernibly no pause after I’d finished my humble introduction. She went on to tell me what the junior residents of OG – 2 had left incomplete, urging me to finish them or remind them about it. She didn't notice my gesture of reassurance. Her attention shifted to the orderlies who were on their morning routine of cleaning the wards. Relieved (temporarily), I slipped into the ward and found jobs already waiting for me.

I was in that particular ward for around 8 weeks. I tried my best not to be mindful of the people around me but went on with my business. But I couldn't help but notice the conspicuous difference when she was not on her shift. I learned that the other interns working in the ward were also pissed off with her. They even had their own version of abusive names for her. No wonder she was the most disliked person in the entire floor. I did not bother to carry any hatred or grudge against her, until one fine evening.

I was finishing my shift and was about to leave home. I was tired. I had to do an ECG for a patient. There was no ECG machine in ward so I rolled the ECG machine from the nearby ward, just some 20 meters away. As I was finished with the ECG, the ward attendant, a lady clad in pink, offered to roll the ECG machine back to ward. I had not demanded her but probably out of some compassion to a tiring soul or perhaps remembering my previous gestures of good will to her, she offered me help. Though I politely refused, she was already rolling the ECG machine back. Only to be stopped by the stout, arrogant creature sitting on a cracking old chair. “You don’t have to do what this intern orders. You are here to do this ward work and you’ll do what I say”, she yelled. I could say she was flushing with rage, but her coal dark countenance was too incompetent to reveal any signs of it.  The ward attendant was trying her best to explain. But I wasted no time. I rolled the ECG machine to the adjoining ward on my own and I left home. I was too pissed off. I did not talk back because I knew that behind her big mouth there were no brains backing her up. Any argument would be pointless. I was cursing her on my way back. But soon it slipped off my mind and I was back to my peaceful routine.

I would not say all nursing sisters were of this kind. No. While I was in the nearby OR (operating room), after the surgeries of the day were over, I came out and sat in distress in the nursing station. I was having an attack of migraine. The nurse there took out a kettle and some milk she had brought for herself. She prepared a strong cup of coffee and offered me. More than the caffeine, her care and compassion had a considerable soothing effect on my nerves.

I often wondered what made the arrogant sister of ward G so arrogant. Was it because of the increasing work place stress? Of-course, ward G was one of the busiest and hectic wards in the whole of the hospital. But there were other wards more hectic than this and not all nurses breed such air of arrogance. Maybe she was more susceptible to such stress? Maybe she had other problems which contributed to this? Whatever, she required professional help. And there’s nothing in that to be ashamed of. I sincerely feel that in such places where the work load tends to be more and work flow become hectic, the institution should provide some sort of help/assessment for their staff to keep increasing stress levels at bay. Workplace stress can bring out varied untoward behaviour of people and this only tends to affect the workplace even more adversely for the others. Though the title of this post resonates the residual amount of anger I have on her, I do feel bad at the same time. Trying to act a little more maturely, I keep thinking of changes that can be brought to the system processes at work that will help make the workplace more conducive to the health care force as well as for the patients.

**

Dengue did not kill, despair almost did !

It was during the later half of my study holidays before the pre-final MBBS university exams, the time when a sense of fear and helplessness finally motivated me to start reading. On that evening, just 3 days before the first theory exam, I found myself lying on the bed with the book, casually reading. Suddenly, I felt the room get colder. I got up and turned off the fan and lay again. I felt a little fatigued too. I didn't bother much. I kept reading. But an uncomfortable feeling soon overcame me. I thought I might be running a fever. So I touched my forehead and felt it a little warmer than usual. I didn't understand why nor did I bother to take a pill. I kept on reading and checking my mobile phone for texts, as usual. But, in a matter of few minutes, I could feel my hot breath hit my chest. I was getting heated up and my skin was now feeling like a hot pot. I was a little disturbed. I took a paracetamol tablet, kept my book aside, put off the lights and closed my eyes. I hoped that everything would be OK when I woke up. I didn't speak about it to anybody in the house. It was around 8.30 pm when I fell asleep. It probably might have been very strange for others if they'd noticed that I'd slept so early with my exams right around the corner.

Angel of Grief  by William Wetmore

I woke up at around 2-3 am. I was running a very high temperature. I put a thermometer to my mouth and it read 104 F. I knew something was wrong. It was not the usual fever that comes and leaves without much trouble. The next day, I was fully on fever medications and had intermittent spikes of fever. I had every symptom of dengue fever. Saddle back fever, extreme bone pain, retro-orbital pains and all just like it was written in the book. However, I did not want to get lab tests done or get admitted in a hospital. I knew that would be even more unbearable. However, I was also aware of the danger signs and the management of dengue fever. So I kept a check on myself for them and kept myself well hydrated. I did not take NSAIDs that might interfere with my platelet function. I treated myself the way I thought was the best !

The problem started when people close to me started accusing me of not reading for my exams, not taking responsibilities for my own health, not seeking medical attention etc. The fever also started getting worse. It made me severely myalgic and tired. I could not even stand. I even fell once when I tried to. Nausea and episodes of vomiting made the situation even worse. I ate very little. It was the most torturous period of my life. I had to read for my exam which I couldn't. Not even a bit ! I simply lay alone on my bed and slept most of the time.

As the day of the exam neared, I became more and more nervous. The fever was still the same. Death from dengue was even OK for me but flunking univs ! I couldn't even imagine what would happen if I flunked! No one was there to support me emotionally. No one who would tell me that I could get through, was close. Friends did text and sent Get well messages. But they seemed too superficial. I don't blame them. After all, they had their exams to study for !

On the day of the exam, I felt a little stronger. I was surprised cos I couldn't even stand by myself till then. I rode my bike by myself, drove up to the exam hall. I spoke with no one. (I know, speaking with people would discourage me, cos they'd be discussing the subject and I might not know). I wrote the test. But I did feel sleepy and tired most of the time. I didn't care much of what happened around me. Somehow I survived through the test. The fever and the terrible myalgia stayed with me for about 10 days in all.

The results. I did pass my exam with distinction.

But the moments of loneliness and the despair I had to go through were the most painful of all. That wasn't the direct effect of the dengue virus. Of course, the dengue viruses (the different serotypes) can attack together and can even kill. But this time though, the virus decided to run a benign course on me. But the pathological mechanisms of loneliness and despair were induced by the environment and the people around, and also by some of my own decisions. Anyway, after that painful period, when I had to play the role of a suffering patient, dengue left me a bit wiser !

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Dr. Abialbon Paul
Though my literary skill are almost non existent, I love blogging and photography.
My photopage: www.facebook.com/abialbonpaul.photos
This is my blog and is about a year old. Do feel free to roam around and communicate. Thank you.

My overconfidence got busted ! - Doc confesses - 2

Not even 2 weeks into my internship, I was bubbling with confidence.
Overconfidence, actually.
I was posted in the dept. of Medicine and the residents were cool and they let me do many procedures. And I did them quite well for a first timer. I was already so much interested in medicine since my pre-final year and my confidence levels were sky-rocketing ! To help it all, I was free from migraine attacks.

I felt that Internal Medicine would be the area of my specialization. I actively involved myself in patient care. I tried to do more that what was required of me.

Now there was a 55 year old guy who had a 1.5 x 2 cm liver abscess. A diagnostic tap was required.
"I will get this one done", I declared. 
"This is not the first time I am doing one"

I took the patient to the procedure room and bored into his liver. I did everything correct. You can believe my word. I did do everything perfectly fine. Except for one little thing! The radiologist had surface-marked the abscess with the patient in the sitting position while I did the procedure in the lying position. I did read the radiologist's report but didn't notice this line ! And we know the liver moves significantly between the two positions and the abscess was small. My bad luck, I got 2 drops of thick pus in the aspirate and after that whatever came was dark red stuff.

Believe me, at the sight of blood, I was about to faint. My heart almost broke my rib cage. My useless double agent brain was frightening me more. "You've given your patient a hemoperitoneum, well done doc!", "I think you tore the IVC, your patient will be dead in minutes". Such thoughts came like a tornedo from nowhere and tossed my mind. 

Strangely, on the outside, I was calm. I abandoned the procedure and let the patient lie down. I kept checking his vitals every 5 minutes. The IV access was ready and fluids were all kept ready. I informed the residents.

Fortunately nothing happened to the patient. He was stable and fine. 
But me! I went through all the stages of shock and survived!

In a way, I was happy that this incident took place very early in my internship. My overconfidence got busted earlier and I maintained sanity.

The patient knew I had made a mistake. Being a terminally ill patient, he was already depressed and he didn't bother to make a big fuss out of this. Everyday I spent some time talking to him. We became friends. I came to know that he wasn't really afraid of dying. He and his wife lived alone after their children had left them long ago. His grief was in leaving his wife alone. 

The Ethics of Love

This post is a part of my "Getting Trained for Marriage" post. I try to learn the principles of a good relationship through whatever I observe. Being a post graduate medico in Pharmacology, I was talking a class on ethics for some students. This post is a result of post-class effect (musings).

How would you react when your doctor performed an appendectomy on you and charged you when there was no actual need?

How would you react when your personal information was shared to others without your knowledge by your doctor?

Unethical aren’t they??

How would a girl react when she finds after her marriage that her husband had been a chronic smoker and has actually cheated her? (If love was true, he should have stopped smoking for his love instead of trying to cheat)

All is fair in love & marriage, they say. Is is so? Are thousand lies acceptable for establishing a lifelong relationship in marriage?

If your answer to the above questions is “yes”, just imagine yourself to be on the wronged side for a moment!!

There are certain ethical principles which every medical professional is supposed to follow. I find that these provide certain principles on how we should treat our most loved one as well. Well, isn’t this relationship more important than the doc-patient relationship!!

The Principle of Autonomy

You love a person. You propose. But you are left with a rejected proposal and a broken heart. What do you do?? Find out the reason behind the rejection. Explain your love more clearly. Show your love in action to him/her without offending the other person. Give time for the emotions of love to take root in the other heart. NEVER FORCE or ATTEMPT TO FORCE. Love never buds by force. It rather would die.

If it still doesn't work out, move away gracefully.

And just because you are united together in marriage, never force decisions or orders on your spouse. Appreciate individuality and foster autonomy.

The Principle of Beneficence/ No Harm

Ask yourself.

“What’s the purpose of this love?”

“Is your love a means by which you serve your own interest?”

Many people get this thing totally wrong. The major reason why young people seek out for relationships while at their college is peer pressure. Their main aim to show others they too have a girl/guy with them.

You are to love someone to make him/her happy. It is to sacrifice everything of yours to benefit the other. As I put in my words, “True love is like a tumour that arises in the heart And permeates your soul until you lose yourself selflessly for the other”
If you love someone for your happiness, to satisfy your ego or lust then you’re merely using them. And it equates to harming them.

But then, do you loose yourself because of love ! No ! I don't think so. But rather, in mutually trying to seek for the best of the other, a richer and fulfilling relationship will form! I hope.

The Principle of Justice & Equality

You come home late but you get angry at your partner when the meeting at her workplace took his/her time.

You rest all Sunday but you expect your partner to cook, to clean, to care the child etc..etc..

So many examples can be given in this regard.

Whatever privileges you’re allowed, your partner has them too.

Whatever law binds your partner, binds you as well.

The Principle of Confidentiality

Major relationship break ups occur because one of the members divulges information about the other to the outer world. And these social networking sites come handy in breaking relationships! Happens mostly by girls, though not exclusively. In their gossip hours, they let out certain personal info of their significant other.  This could start an unhealthy conversation about your significant other and may sow hatred in hearts. Unnecessary doubts and suspicions can be kept at bay if certain levels of confidentiality are maintained.

Have your principles right. Principles are the guiding posts to reach your purpose in life.

I do appreciate your comments as I go on with my "getting trained for my marriage" posts !