‘Doctor, your patient died peacefully!’

‘Doctor, your patient died peacefully!’

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The nurse sent a text, ‘Doctor, your patient died peacefully’.

This was ostensibly so as not to disturb the sleep of the consultant at 4 am. But, the real story is that this was a patient having emergency care for a heart condition. The doctor had left specific instructions as to the management of the patient: the care parameters and that he should be contacted should there be a problem. He also noted that if the blood pressure was going down or the pulse rising or there were steps to take and that he should be called. The doctor had many more tricks up his sleeves to use in helping the patient get through the night!
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But the nurse on duty had other ideas. In effect, the text clearly indicated that the nurse thought the care unit was a nursing home or the patient was admitted for terminal care. The truth is that the nurse on night duty had no clue the patient was deteriorating and the patient had actually been found dead.

The doctor sent a text, ‘Chief, your patient extubated himself and arrested’.

A doctor called to the scene of a cardiac arrest was told by the nurse that the patient on a ventilator had removed his tube (extubated himself) and subsequently had difficulty in breathing, leading ultimately to his death. This must be a miracle indeed, since the particular patient was completely paralysed and unable to move his arms and legs.

It is difficult to fathom exactly what happened and how. How could a patient paralysed in bed remove the tube helping him to breathe?

The patient called, ‘Doctor, I cannot breathe properly’.

A patient having respiratory difficulty was ignored by the nurse who felt he was making things up. Since he could talk, how could he say he could not breathe!?

The patient had to call the doctor when he could not get the attention of the nurse. This particular patient really couldn’t breathe and died before real help arrived. Apparently, the nurse was writing her nursing notes and did not want to be disturbed. You must wonder what she subsequently wrote about the patient!

Nursing is a calling!

Nursing is a calling and not just a job. People do not go into nursing for the money, because there is not enough money to compensate them for what they do. There is not enough money to compensate for leaving after a 12-hour shift with back feeling like it is broken, like your legs can no longer hold you up and your feet feeling like they have carried the world on them all day. Which they have!

Until you have worked as a nurse: been puked on, peed on, pooped on, bled on and cursed out, you would not realise exactly what nursing is all about. Regardless, good and great nurses bend over backwards to ensure their patients’ wellbeing. They do not ignore patients concerns and ensure they check out every single complaint: just in case.

Bad nurses, however, abound and it is not too difficult to tell the difference between a good and a bad nurse. Some nurses upgrade their worth and abdicate their roles to auxiliary nurses and patients’ relatives.

After complaining about the fact that a patient was developing bed sores, one nurse blamed the relatives for not turning the patient! Many nurses in our hospitals ask relatives to empty urine bags and clean up after their own relatives! Only in Nigeria!

In my humble opinion

The nurses referred to above are bad ones and should be removed from the nursing profession. They should be excluded permanently from patient care. There are no excuses strong enough and no justification in many instances for such an abysmal behaviour. Sadly, many are protected by the profession and attempts to clean out the dead woods seen as witch-hunting.

We are as strong as our weakest link. These nurses destroy the trust and respect the community has for all members of the health care profession. The fact that our patients are trooping out to other countries is a testimony to the damage these people are wrecking on the health care profession as a whole. Same can be said for doctors, pharmacists and physiotherapists who maim and kill patients.

The way forward

We need to improve nursing care in Nigeria. We need to give credit to our good nurses and punish the bad eggs. Nursing must be improved through better training, continuous medical education after qualification and regular on-the-job assessments.

Currently, there is little recognition for CME programmes by the hierarchy and little oversight of hospitals and clinics. Renewal of the yearly registration is not based on strong CME activities, but this should change.

Nurses need further training and specialisation. They need better communication skills and re-education. Team work should be encouraged in nursing education. Too many times, the fight for superiority and the small-mindedness of the older nurses impact negatively.

Nurses and nurse educators need to step up, stand up and be counted. It is the least our patients deserve.

NB: The Nigerian Medical Association, FCT branch, will be carrying out a communication skills workshop at its Annual General Meeting in August. The workshop is to be anchored by Dr. Gbenga Adebayo of Living Health TV.

PUNCH.

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