Skip to main content

Why expect nurses to be superhuman?

Although one cannot imagine a hospital without nurses, their importance in the delivery of care often goes unrecognized.
It is not uncommon to hear of instances when a very critical patient with little hope of survival, has been successfully operated upon by a team of highly specialized doctors, brought back to life as it were by a group of intensivists in the ICU, and then, after several weeks in hospital when hope has mounted, suddenly dies due a wrong injection or infection from a catheter due to nursing lapse. What relatives experience at such times is a deep sense of betrayal and anger, that soon replaces the gratitude and appreciation that the previous few weeks of heroic achievement had earned.
And what compounds matters in busy hospitals is that nurses neither have the time nor the training to provide emotional support to grieving relatives at this stage, ensuring that they go back with permanent bitter memories and impressions of this hospital.
To be fair to nurses, just too much is expected of them and just too little effort goes into looking after them. Most hospitals run woefully short of nursing staff, resulting in overburdening the few.
Consider their case. A regular eveing or night nursing shift comprises 2 nurses who are expected to look afte 30 (in some 60)  sick patients over 6 to 8 hours. At first sight it may look simple, but here is the list of what they are expected to do in this period: take over the stock of medicines and details of patients from their colleagues of the previous shift (30 min), check each patient’s vitals (pulse rate, BP, respiration and temperature 4 to 6 hourly (@ 10 mins x 30 patients = 300 minutes), distribute medicines ( highly individualized) to 30 patients 2-6 hourly (90 mi), give injections (to 20 odd patients), draw blood samples for tests (from around 10 patients), start IV fluids or change IV bottles ( around 15 patients), shift patients for procedures such as surgery, endoscopy or radiology (10 patients), assist doctors in minor procedures such as ascitic or pleural taps (10 patients), supervise diet, complete discharge formalities and expalin instructions to those who are leaving, and the list goes on. On top of all this, every time a patient’s condition deteriorates, they have to assist with resiscitation (30 mins) and respond to SOS calls (quite frequent as 50% of the ward consistes of very sick patients).
If you calculate what they actually achieve during their shift, you will be surprised how they indeed manage. Where then is the time to administer TLC (acronym for tender loving care), talk and establish rapport with patients and relatives, sponge and clean them, and do all that good nursing is all about?
It is unfair to expect nurses to perform as super-humans all through their careers. While the complexity of medical care has increased several fold over the last 5 decades, the ratio of nurses to patients have hardly changed. Strengthening this pillar is essential if hospital care has to improve to the next level. 
As published in HT City (Hindustan Times) dated 22 April, 2012.

Comments

Popular posts from this blog

Food Fads in Liver Disorders

In an attempt at trying to do well to those they love, spouses and parents often enforce diets on patients of liver diseases that often turn out to be detrimental. The commonest food fad is pale insipid boiled cabbage being doled out to nauseous patients suffering from hepatitis that makes them puke even more.  The liver, in a way, is a buzzing manufacturing unit that requires lots of energy to keep its multiple functions going. And it derives all this from the food we eat. During disease, such as during an attack of jaundice, when many of the liver cells get killed, the liver attemptsdamage control by trying to regenerate quickly. For its cells to multiply however, it requires a generous supply of energy that comes from carbohydrates, and protein, the building block for its cells and tissues. Boiled green vegetables unfortunately have neither of these. Hence the situation often progresses to that of a starved liver unable to recuperate due to cut-off food suppl...

How do you like your Tea?

The way we drink our tea may not only reflect our taste and style, but our health as well. Tea drinking is around 4700 years old and had its origin in China. Leaves of the shrub Camellia sinensis (tea plant) were in use at that time as a remedy for wounds and diseases. With the legendary emperor Shenong brewing and drinking its extracts, tea drinking became a popular habit in this part of the world. The British, impressed with the brew and the customs that go with drinking it in China and Japan, tried to emulate and evolve a tea-drinking custom of their own, and soon “tea-time”became a familiar term across the globe. Every home or cafe seems to have its own flavour. The north Indian variety of “chay” is a glass of hot creamy milk (more cream as it gets more “special”) with lots of sugar and a lacing of  “tea liquor” of strong tea that grows on lower heights (Assam, Nilgiri, Sri Lanka etc). In contrast, the Chinese and Japanese prefer light green or jasmine tea without a drop of mi...

Questions from a Doctor’s Life

There is hardly any person in Uttar Pradesh who has not heard of Dr D K Chhabra, a senior neurosurgeon, who died recently. Over the decades his expertise, pragmatic advice and popularity had broken the shackles of his narrow surgical field coming to be known as a “brain-specialist”and a genuine adviser for all health problems. I got to know him in 1987 when I joined the upcoming Sanjay Gandhi PG Institute of Medical Sciences (SGPGI) in Lucknow as a young member of the faculty in Gastroenterology. He had moved from his alma mater the KG Medical College where he is still regarded as a legend. An omnipresent bachelor doctor living in the duty room readily available to help anybody anytime.He was tasked to heading and developing Neurosciences at SGPGI. He had an eye for detail and was tasked additionally by the director to set up not just his department, but the whole hospital, the building, equipment and the campus. DKC was a tall and handsome man who spoke little. But when he did inl...