Thursday, January 9, 2014

Nursing changes - I

The nurse who had been looking after me for about 12 years left  because of some domestic issues. Looking after me is a pain in the neck and during her unexpectedly long tenure, all the regular routines which I am used to now were established. She had done a great job and I was under no illusions about the difficulty of finding  a replacement for her.This was especially because we had experienced a succession of nurses before her who stayed for a few days to a couple of months. They were used to looking after mobile patients who could speak and mine is a very different case.

We tried a couple of male nurses but Jaya was not comfortable with them since she has to spend a lot of time with them explaining my quirks and communication signals. They also seemed weaker than the female nurses. One male nurse turned out to be diabetic and his hands shook  so much of the feeding used to fall on the bed. Getting a female nurse was not easy because in many places a female nurse will come only for a male patient who is above 60.

We had encountered similar issues at the time of my stroke also and the problem seems to have increased. The reputation of males seems to have taken a turn for the worse during the period. Since it is a bit difficult for me to undergo a sex-change operation or to increase my age by a couple of decades, we decided to be patient and wait for the right nurse to come along. Thus we  played host to a series of nurses who stayed for a few days to a month.

All nurses have one or even two of an instrument that I have come  to hate - the mobile phone. The phone is always engaged and the conversations often last for an hour about such vital issues like the latest movie release. Meanwhile I would have finished the page I was reading and waiting for somebody to turn the damn page. I will use part of that time trying to improve my cursing abilities and part of time thinking of the next PJ to inflict on my hapless readers (those who still survive the assault).

Slate had an article about some annoying technologies. I would have added my pet hate to the list - the mobile phone. I hope the person who invented the mobile phone goes (or has already gone) straight to hell where he (or she)  is having a gala time in the vats of boiling oil or whatever else people in the know say the place is stocked with.Your queue is my mobile phone.

Most nurses suffer from The Dunning-Kruger syndrome - the exasperating ability of many human beings to be confidently wrong about something. If I have to nominate one human weakness that I have found most difficult to deal with after my stroke, it is this syndrome. There is nothing much that can be done by blinking when you are face to face with someone who seems to suggest like Yul Brynner in The Ten Commandments: "So let it be written. So let it be done." Mine not to question why, mine but to do and sigh.

Jaya has learned through trial and error for 14 years and through discussions with various doctors and physiotherapists what would be the best way to handle me in various situations. The nurses will never have seen a brain stem stoke patient. They will try the same thing  that they had done with other patients and fail but they will keep doing the same thing even after being repeatedly told the correct procedure.

For example, one characteristic of this stroke is clonus accompanied by spasticity. One physiotherapist described this as 'velocity dependant stiffness'. Thus if try to bend my leg fast, it will become stiff as a log and you will not be able to bend it. But if you bend it slowly, it will be as limp as a rag and it will bend easily. So, to bend my leg quickly and easily, you should do it slowly. This counter-intuitive idea never seems to occur to the nurses in spite of it being demonstrated several times. They will try to bend the leg fast but will be unable to do so. They will get exasperated and will keep telling me to loosen my leg. They are unable to grasp the idea that this is not in my voluntary control.

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