Karuna is our senior nurse. She starts a conversation with me:.
“When the world enjoys the weekend , our week starts.”
“There is nothing which says that pain has to be off on Sunday . Does any suffering reduce on Sunday?”
Sanjana, a caller, requested for service on Monday at 0700h. The operation Manager finds it tough.
“ Can it be 0800h?” The caller says no.
Karuna is detailed . she has to reach in time . she starts in morning .Calls up the patient : No response . Re tries the call . same result. She calls up the operations manager. He tries . No response. Finally she starts off deciding to call en route. Finally reaches. Pushes the bell. Sanjana opens the door : why did you not call me up before coming? The answer is met with a cold stare of disbelief. As she enters , she is stalled by a question , “you have been travelling by bus. What if you bring germs with you? “
“Yes madam, but I am carrying dressing material as well as instruments in sterile packet”
“No , Leave the bag outside .” this time Sanjana’s voice has a tinge of irritation in her voice.
All through the dressing, the chatter continues, sometimes getting into the decibels of shouting.
“ So , were you upset , Karuna”
“ I am a human being, after all” was all she would mumble.
Karuna continued “ but Ajit (Patient) is good. He gave me a kind grateful look , that said it all. It was one of the most vociferous thanks I ever received.”
“What is his diagnosis?” I wished I had asked this question earlier.
“ He is a case of carcinoma Colon(optd.). Sanjana is his daughter.
“ What should I do if next visit also his daughter keeps on shouting at me ?”Karuna asked.
“ Please understand , when does a person shout or scream? It is only when someone is in pain, that he/she screams.” You need not react with any anger or irritation. How do you react to someone who is in pain?
“With Compassion and kindness.” was Karuna’s spontaneous answer.
“Thank you . Sir”
I was left wondering. It was easy to explain to a nurse. She was dealing with a case of terminal cancer, and she could understand the pain of a daughter who would not leave any stone unturned to improve quality of life of her father.
And here, the world is full of anger and violence over seemingly minor reasons.
II
Karuna has another story to narrate.
This is not about disease. perhaps not even about nursing.
Yet it is about pain. about relieving pain. sharing the painful realities of life
Perhaps the most touching aspect- She could convert the pain into joy by a very simple step.
Manjunath is a Diabetic. Like most of the Diabetics , who are vulnerable to Foot ulcers , but are unable to prevent it because no one spared time to explain to him the risk he is exposed to, he landed up with a foot ulcer.
also like most diabetics since his immunity is compromised, his ulcer progressed to infection. He was advised dressings . Unfortunately, his only child -a daughter working with a multinational company, could not afford to take leave to take him to hospital for daily dressings.
So , Nikita , the daughter, called up Anand, our operations manager to get some help regarding dressings
That is how , Karuna was detailed . She went for dressings.The mood in the household was sullen. Manjunath was informed that if the wound does not improve, he may require amputation. His wife Rukmini , had desperation writ large on her face. Few dressings and a week later, Karuna realised that the initial despondency had made way for a little cheer as well. The wound was healing, infection has reduced and so was the dose of insulin the patient was on. Nikita would greet her whenever she would enter the house. Manjunath would smile and look forward to her visit.
However, one day Karuna was in for a surprise. As she entered the house for dressing, she could notice tinge of sadness in Rukmini's eyes. Even Manjunath was looking sad.
Nikita was looking composed but the strain of effort was plainly visible. There was no attempt by any one to arrange for getting the dressings done. Karuna was unable to grasp the situation. She looked at Rukmini. Rukmini , made a futile attempt to look in another direction. She looked at Manjunath. His faint smile failed to camouflage the despair in his eyes. Finally , Karuna had to ask Nikita.
" you do not have to come from tomorrow for dressings. " was all Nikita could say.
" But I am doing a good job. See how his wound has improved "Karuna was proud of her professional training. "
"No Sister, it has nothing to do with your skills . We are grateful that you have saved him from amputation."
Nikita made a vain attempt at clearing her eyes which were becoming wet. "Actually, I was under the impression that the charges for home dressings would be reimbursed by company. However, I have been informed, that they are not covered for reimbursement, and we cannot afford the charges.Hence, we will have to stop the dressings that you do. I am actually worried that if the wound is not completely healed, he may have to go for amputation."
The import of situation now dawned on Karuna.
She was quick to dissipate the gloom. She told Nikita"You do not have to despair. I will show you how to dress the wound. Come and assist me today and do it from tomorrow. "
Nikita did. It was a greatly relieved and grateful Nikita who escorted her to door." Do not hesitate to call me on this number, if you encounter any problems with dressings. "Karuna parted with her on this note. Nikita remained in touch with Karuna.
"We have lost business-one case." Karuna informed Anand.
After a month, Karuna got a call from Nikita asking her to come. " How is your Father", Karuna asked. " He is better,he wants to meet you."
Karuna asked Anand " can I go" "Okay , by me"Anand said.
Next day , Karuna reached the house. Nikita was at the door. A beaming Rukmini escorted her inside. Manjunath received her with a smile. Nikita wanted her to see the wound. as she removed the dressings it was a pink granulating healing wound .
" we wish to thank you , Sister" was all Rukmini would say."Papa wants you to have lunch with us", Nikita requested, " we have been able to save his leg only because of your dressings and guidance."
" Thank you, but it is against my company policy" Karuna said.
"Please talk to your manager" . Nikita persisted. Karuna asked Anand. " Company policy is to bring smile to faces grimacing in pain, bring them joy in their moments of despair" Anand told her.
The most touching moment, Karuna says was after Lunch . After Lunch, as she started to leave, Rukmini asked her to wait. She came out with a plate having 'Kumkum' & Rice .
She was given the customary farewell due to a daughter leaving the house.
I could barely smile "Did you ask the manager on the company policy" I tried to tease her.
" No Sir, I take the Company decisions on such matters. It is a matter of heart and emotions, nothing to do with the company." Karuna was taking turn to tease the COO now.
I love to have my employees follow the company policy in spirit and not merely in words , when it comes to matters of heart, empathy , and understanding the language of pain and despair , and essaying their compassion through their acts.
III
WAKE UP CALL...........................
It was past midnight. I was woken up by the ring on my mobile.
Karuna was on line.
" Sorry to disturb you Sir, but I need to take your advice."
" Go ahead, Sister", I was awake now." what happened? "
" Sir , the patient Sunitha , is not responding, her pupils are dilated, and she is not breathing"
I looked at my watch. It was showing 2.30 AM.I was puzzled. "But what are you doing in patient's home at this time" . As a policy matter, we do not provide service after 8.00PM. Moreover we are not Emergency care provider.
"No , I am at my home. Sunitha's husband called up. I asked him to call 108(Emergency Service), asked him to start CPR, and take her to hospital" She wanted to update me before I could ask any other question.
"She is diabetic, did they check random glucose?"
"Yeah , I told them to. The emergency ambulance with paramedic is there. He has rushed glucose also"
"Yet , Sunitha's husband wants your advice?" I was wide awake now. " He wanted to know whether, anything else needs to be done?"She continued.
" No I suppose, the paramedic needs to continue CPR(Cardiopulmonary Resuscitation) till patient reaches hospital." I was confident of competency of 108 Paramedics (I should know , being head of Medical training of 108 Emergency services ,and having trained more than thousand EMTs(Emergency Medical Technicians) in my past assignment).
Karuna met me in office in the morning. " Sorry Sir, we lost Sunitha" She told me about the patient. "She was a case of diabetic foot , and was getting dressings done through us. Her wound has healed but she required review by Diabetologist.She called up after review and discussed with me. Then at night when she suddenly became unresponsive, her husband called up"
" But Karuna, You are not a Doctor, You are not a Diabetologist. In emergency, I suppose he should have called up some Doctor first. it is a matter of common sense."
"Sir, It is a matter of Faith. I have been managing her for a long time .The couple trusted me like a family member. In Emergency, a person would first call the person he trusts most." She countered me.
Trust , Faith , care , compassion.......How many Medical and Nursing Schools would be teaching it.How many textbooks mention them? I was left wondering.
The experiences that defy common sense and demonstrate kind of bonding hard to see these days.
My present assignment at Plus at Home Lifecare never ceases to amaze me.
Today ,when we keep reading news of medical and nursing personnel being assaulted, and hospitals vandalised after death of some patient, here I stand witness to a Husband calling up the Nurse , before even calling up the Doctor, or emergency, when his wife is dying.
I have a nurse who casually dismisses it as a matter of deep faith and understanding, and moves on to her next assignment.
They are simple Nurses just committed to the cause of nursing
And I do not have Florence Nightingale on my Payroll !
III
WAKE UP CALL...........................
It was past midnight. I was woken up by the ring on my mobile.
Karuna was on line.
" Sorry to disturb you Sir, but I need to take your advice."
" Go ahead, Sister", I was awake now." what happened? "
" Sir , the patient Sunitha , is not responding, her pupils are dilated, and she is not breathing"
I looked at my watch. It was showing 2.30 AM.I was puzzled. "But what are you doing in patient's home at this time" . As a policy matter, we do not provide service after 8.00PM. Moreover we are not Emergency care provider.
"No , I am at my home. Sunitha's husband called up. I asked him to call 108(Emergency Service), asked him to start CPR, and take her to hospital" She wanted to update me before I could ask any other question.
"She is diabetic, did they check random glucose?"
"Yeah , I told them to. The emergency ambulance with paramedic is there. He has rushed glucose also"
"Yet , Sunitha's husband wants your advice?" I was wide awake now. " He wanted to know whether, anything else needs to be done?"She continued.
" No I suppose, the paramedic needs to continue CPR(Cardiopulmonary Resuscitation) till patient reaches hospital." I was confident of competency of 108 Paramedics (I should know , being head of Medical training of 108 Emergency services ,and having trained more than thousand EMTs(Emergency Medical Technicians) in my past assignment).
Karuna met me in office in the morning. " Sorry Sir, we lost Sunitha" She told me about the patient. "She was a case of diabetic foot , and was getting dressings done through us. Her wound has healed but she required review by Diabetologist.She called up after review and discussed with me. Then at night when she suddenly became unresponsive, her husband called up"
" But Karuna, You are not a Doctor, You are not a Diabetologist. In emergency, I suppose he should have called up some Doctor first. it is a matter of common sense."
"Sir, It is a matter of Faith. I have been managing her for a long time .The couple trusted me like a family member. In Emergency, a person would first call the person he trusts most." She countered me.
Trust , Faith , care , compassion.......How many Medical and Nursing Schools would be teaching it.How many textbooks mention them? I was left wondering.
The experiences that defy common sense and demonstrate kind of bonding hard to see these days.
My present assignment at Plus at Home Lifecare never ceases to amaze me.
Today ,when we keep reading news of medical and nursing personnel being assaulted, and hospitals vandalised after death of some patient, here I stand witness to a Husband calling up the Nurse , before even calling up the Doctor, or emergency, when his wife is dying.
I have a nurse who casually dismisses it as a matter of deep faith and understanding, and moves on to her next assignment.
They are simple Nurses just committed to the cause of nursing
And I do not have Florence Nightingale on my Payroll !
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