Monday, December 19, 2016

Still more nursing episodes - II

The nurses who come here are from Kerala and Tamil Nadu both of which have hot climates. (It is said that Chennai has 3 climates - hot, hotter and hottest.) They start shivering at a dip in temperature  at a time when I will be sweating. This will put me in a dilemma. I will want to continue putting the fan at full speed or consider switching on the A/c but this would make the nurse uncomfortable.

If I keep sweating, the bedsheets on which I am sleeping will get damp and I am afraid that it could eventually lead to my developing bed sores. I have heard that they are quite painful and this thought prevents me from humoring the nurses.


Sometimes, a physiotherapist who is not familiar with the intricacies of communicating with me will ask me something like, 'In which movie is this song?' and wait. Then the nurse will say' 'How can he tell you the answer? You have to tell the names of various movies and he will blink for the correct answer if he knows it.' A few days later  the same nurse will get frustrated trying to understand something that I had indicated. Finally she will exclaim,  'Why don't you say clearly so that I can understand?' She would seem to have forgotten what she had told the physiotherapist.

Some  nurses will tell guests, 'Even if he has some pain, he will say that he has no pain.' This is not strictly true. My response will depend on who is asking me the question. If it is Jaya, then I will specify where exactly the pain is, its intensity, etc. and discuss how to remedy it. With others, I will generally say that there is no pain. This is because I will not be able to tell them anything about the location or intensity of the pain. This might prompt them to investigate a bit which may make  matters worse.

The nurse would also be prompted to make this observation due to my responses during physiotherapy. Some pain is to be expected during some of the exercises because of the stretching of certain muscles. If such pain is not there, it would mean that the exercise is not being effective. When physiotherapists ask me about pain, they would mean whether I was feeling any pain other than the normal stretch pain in which case they have to find out why the new pain has come. The nurses find it strange that I often say that there I don't feel any pain when it would be obvious from my expressions that there is some pain. I would  actually be indicating to the physiotherapist that I am not feeling any abnormal pain.


Sometimes  a nurse will try to do something that I don't want to be done. For example, she may try to adjust the pillow under my head which would be in the correct position. I will keep blinking several times and also keep nodding my head  to indicate that it is fine. But the nurse will continue to adjust the pillow and keep asking me about other things. Finally I will use a pre-set signal to indicate that she should call Jaya.

When Jaya comes, I will explain to her what the problem was. She will tell the nurse that I was indicating to her that the pillow was in correct position and that she need not do anything. The nurse will say, 'That's all? You should have told me. You could have blinked!' But that is what I had been doing! A strained grimace is the best that I will be able to manage in such circumstances.

Wednesday, December 7, 2016

Still more nursing episodes - I

Some nurses had the strange habit of complaining to me about things that I had nothing to do with. For eg., if there was too much or too little spice in some dish or perhaps they wanted a different type of glove , they used to crib to me about it. The first few times, I called Jaya and told her to ask the nurse what the problem was. At these times the nurse would say that she didn't have any issues and everything was perfectly fine.When this happened a few times, I started ignoring their cribs to me.


One nurse was briefed by the agency about the patient she had to look after before she came here, as per their usual practise. She was told that she had to look after a male patient who was bed ridden and couldn't speak. She assumed that her patient was an old man who was on his death-bed. She had looked after many such patients and assumed that she will have a short stay before she moved on. When she came home, my father-in-law opened the door and she was nonplussed - here was the bed-ridden old man she had assumed was her patient welcoming her in!

She didn't know what to say. She came to my room where Jaya introduced her to me. So this was the patient - but he was much younger and didn't look like croaking in a few days! She kept quiet, went to the balcony and then to the kitchen and stood for a few minutes. From her demeanour, it seemed to Jaya and me that she will not stay for long. But as it has turned out, she is still here after 10 months. Her plan of an early exit has not worked out.


In a previous post, I had written about the strangeness of failing to notice the nurse giving me feeding. This sort of thing happens frequently. For instance, I was recently watching a film starring the Malayalam superstar Mohanlal (my favourite actor among the older stars). I was so absorbed in watching the fiery dialogue that I didn't notice the time.I suddenly realized that it was well past the feeding time and reminded the nurse about it. She told me that she had already given it and I didn't have a clue!

Nowadays, I am often reluctant to remind the nurse about feeding if I suddenly remember it. I will not be able to make up my mind about whether the nurse has forgotten the time or whether I failed to notice feeding being given. Knowing that I missed noticing the gorilla, I am prepared to accept the latter explanation.


Some nurses are impatient especially when it comes to my passing urine. A few seconds after keeping the can, they will ask me if I have passed urine. There is some connection between emotions and the bladder muscles because when I feel some psychological pressure from the nurse, I will not be able to pass urine even if I feel pressure in the bladder. This also happens when my attention is diverted  by the nurse when she asks me some question or when I pay attention to something on TV. After the urine flow has started, if the nurse asks me whether I have finished passing urine or if there is slight movement of the can, the flow immediately stops.

This situation is similar to that of a baby. If you disturb a baby even slightly when it is passing urine, the flow immediately stops. This reflex diminishes as the baby grows older and gains more control over the functioning of its bladder. Following my stroke, my bladder control seems to have reverted to the situation of a baby. When an impatient nurse comes, I wait till the last possible moment before calling the nurse. I will hope that this will ensure that the urine flow will begin as soon as she keeps the can but sometimes, even then the urine flow will take some time to start because I will feel the psychological pressure.