By Patricia Mukhim
May 12, observed as International Nurses Day, passed by without much fanfare. On that day nurses worked just as hard to assist and serve Covid patients in all the hospitals of the state – government and private. It is ironic that while we see statistics of the number of doctors that have lost their lives to Covid, no one tells us how many nurses and their family members have become victims of this virus. It’s unfair to treat nurses as less important than doctors. Covid patients I have spoken to have been appreciative of the nursing care they received at hospitals. Nurses are the first contacts with Covid patients. Doctors act on the information given to them by nurses. In a particular private hospital in Shillong, there is a very innovative practice of monitoring patients via a WhatsApp group comprising doctors and nurses. Nurses diligently give feedback to doctors on the condition of every Covid patient. This is important because Covid affects different patients in different ways. While some patients have stronger immunity and therefore fight the virus better, others with compromised immune systems are dealt a heavier blow and it becomes a battle for survival.
In all of this, nurses are the ones that assist the patient, administer injections and medicines prescribed by doctors-in-charge, check the IV fluid, check blood pressure and monitor the oxygen flow to ensure that a patient that shows signs of breathlessness is given oxygen without delay. Nurses communicate with family members of a patient and give them assurance that he/she is being looked after well.
A nurse therefore has to be a good communicator on two counts. First she (I am using ‘she’ here because the majority of nurses are women) has to give constant feedback to doctors about the patients’ condition, hence has to be as conversant with medical vocabulary. Based on that feedback doctors prescribe drugs/injections and other diagnostic tests. Second, the nurse also has to give feedback to the family members and this requires a high degree of social communication skills. To be able to explain in layperson’s language a difficult medical condition requires exceptional skill and patience. It is a very demanding job because nurses are expected to be (a) professional (b) empathetic and caring (c) to show patience when a patient is difficult and throws tantrums. Most patients have confessed that it is nursing care that has been instrumental in their healing from medically challenging ailments. Nursing therefore is not just a career but a vocation and only the best can succeed in this profession dedicated to Florence Nightingale.
However, what many of us forget is that nursing is also very taxing for women. The nurse is also a mother, sister, daughter who has to go back to her family after nursing hours. During this pandemic nurses looking after Covid patients are apprehensive about returning home lest they carry the virus with them and infect their family members, especially the elders who might have co-morbidities. There isn’t enough facility for nurses to quarantine themselves within the hospital premises. Last year nurses, doctors and ward girls/boys that came in contact with Covid patients were quarantined in hotels and Corona Care Centres. This year the facilities are withdrawn, thereby putting nurses and also doctors at high risk. I know of a nurse who is a single parent and had to keep her two children with friends, to protect them from herself. Some weeks ago she tested Covid positive and it was a God-send that her children are safe elsewhere. Of course the emotional wrench is difficult to address but at this time safety is uppermost.
This article by no means seeks to downplay the role of doctors as they too are critical to saving lives. In fact, a collaborative effort between nurses and doctors and a good understanding between the two is important to the healthcare system. A surgery of any kind requires the involvement of doctors and nurses. Post operative care is essentially provided by nurses. While doctors visit their patients once a day while making rounds, nurses constantly check the patient’s vitals. In one sense, nurses are like advocates for patients and a bridge between the patient and doctor and patients and their family members.
A nurse understands that a hospital stay is not exactly pleasant. Most patients resist hospitalization and vent their frustrations on nurses. But I have seen nurses calming patients down and even singing to them. The very fact that a nurse tries to understand the patient’s predicament is itself a healing touch. We need to remember that sickness is both physiological and psychological as well. A compassionate nurse addresses both.
In India there is a huge gap in the nurse to patient ratio, hence a patient needs an attendant (family member) to attend to his/her needs. Nurses provide the training to such attendants and guide them on how exactly to minister to the patient – what to feed and what not to feed the patient. It is the nurse that trains the attendants on what kind of diet the patient requires, the timings for medication and in case of kidney patients to monitor the urine output as well.
During these Covid times, nurses have been in the forefront to administer vaccinations. In every centre, those who have gone to be vaccinated have reported a very congenial atmosphere that drove away any fear they had of receiving the vaccine. Before they knew it the jab had been given and the other nurses are at hand to direct the patient to the waiting room where they are told to wait for 30 minutes in case they have any reactions to the vaccine. The manner in which they explain the whole process is simple and clear. This in itself dissipates any fear people may have of taking the vaccine.
It is a fact though that nurses are not paid as well as they should despite their duty hours being very strenuous. Considering that medicine is an evolving science and that technology is being used to improve treatment outcomes, nurses also deserve training because the more they are trained the better they become at serving patients. I asked a patient who recovered from Covid what it is that he remembers most about his hospital stay. Without hesitation he said, “nursing care.” His contention is that while doctors prescribe medicines based on feedback they receive from nurses, they are hardly in contact with the patients. It’s the nurses that are really front-liners in every sense of the word.
The pandemic has also laid bare the importance of mental health of the patient and his/her relatives. Every Covid patient is fearful of what might happen. Those with more complications wonder if they will come out alive. If nurses are also trained to understand the nuances of mental health and what language and vocabulary to use with patients without being patronizing it would be a boon to healthcare as a whole. For a long time we have compartmentalized mental health and believed that only psychiatrists, psychologists and clinicians can help people with agonizing mental health problems. But most people with mental health issues, particularly those suffering from Covid just need a non-judgmental and soothing presence to listen and understand their plight. Perhaps they know the solution to their problems or the solutions will emerge even as they speak. We cannot undermine the power of empathetic listening and considering we have so few mental health professionals it is time to train nurses to play that critical role of listening with empathy.
A post-Covid patient also said that he realises there is a great need for male nurses as well to better manage male patients. But that’s not the only point. A male nurse might not be overly burdened with domestic work and parenting as a lady nurse is. Also a healthy balance is always good in any profession.
On that note let us salute our nurses for their phenomenal service to suffering humanity!