By Dr. ELSA LYCIAS JOEL
From time immemorial women have been considered to be better caretakers. Nothing unusual about it. History has provided us with many examples of women as nurses and their contributions to our communities. Be it the lady with the lamp or the angel of the battlefield or sojourner truth or the first black woman general of USA or the first lady of nursing, there is no dearth of inspiration. All of us, at least when pandemics hit us come to know what the word ‘nurse’ stands for. The word is derived from the fifth-century post-Classical Latin nutrice a wet-nurse hired to provide an infant with breast milk when the infant’s mother would not or could not do so. Etymologically it is related to our modern word nourish.
As Britain prepares to celebrate Florence Nightingale’s 200th birthday on May 12, the whole world cling to nurses as their saviours and would not let go of them. In today’s scenario, despite intensive care many die. That doesn’t stop anyone from believing that nurses are a courageous lot under the most adverse conditions. Uncomplaining resilience and calm professionalism displayed by them make known that they should be considered essential elements of all societies, at all times. With a long history, they are everywhere as members of the largest health care profession in diverse settings and fields. Stories of army nurses have reinforced the fact that they do their best withstanding hardships at the front and have been awardees of ‘The Purple Heart’. We all know how vulnerable they are under the present circumstances as a vital link between the patient and the rest of the healthcare system. Raincoats and helmets in lieu of coveralls and masks, claps and clanging pots instead of PPEs and a pay raise, it’s a struggle day in and day out. Being around critically ill patients even when the surge hits is an act of self-denial. A listening ear and a calming touch even as they keep their senses alert for one small subtle change to determine what or who needs to be called reflects their flexibility, innovativeness, patience and adaptability.
Severe shortages of nurses characterizing the current and post pandemic periods is a result of governments’ lethargy and unpreparedness of governments in addition to an uneven battle with the deadly virus in turn threatening the delivery of health services to the public. Though nursing’s image takes on an heroic cast during pandemics and wars, the reality for most nurses is that the work is incredibly demanding with few financial rewards and poor working conditions. Nursing fails to keep up economically with other occupations. For the sake of four words – Humanity, Fortitude, Devotion and Sacrifice which describe this profession the best and for these words to ring true, the cracks in the current edifice of healthcare safety should not continually grow. For those thousands who died on duty leaving their colleagues and families shaken, their contributions are acknowledged as essential to victory against this evil called COVID19. If we think, nurses report for work in the most challenging of circumstances anyway, because that is their job we should rethink. Well, it’s also because they believe that respect for the inherent dignity and of human lives is a fundamental principle of their profession.
While nurses are looked upon as those holding the fort and expected to go on and on their psychosocial well-being is a concern. At these times, even behind a mask the nurses are not wholly successful in altering their outward demeanour and the presentation of what they see as their ‘detached’ face does not serve to mask feelings of exhaustion, demoralisation, anger or sorrow. Recently, with too many failings and deaths to handle, however, nurses find themselves having to perform a different kind of emotion management than that prescribed by their profession. They have to present the detached face of the professional career as fear of losing grips them. Next moment, they also have to handle intense joy on liberating someone from a ventilator, when another one stabilises and could breathe on her/his own again. ‘Smiling happiest faces’ also means they have to work hard on their emotions especially with families of patients whose expectations of a quality service have been raised beyond anything better than the best. An impending doom or an existing gloom, the overall effect is physically and psychologically palpable. Wobble rooms are indeed “rainbow rooms” that offer peace and quiet plus a space to have a safe conversation. Above all, nurses need not go home thinking, ‘I could have been the kindest to so and so’.
If we think nurses’ experience alternate between periods of intense activity, sleep and anxiety, we are wrong. It’s much more than that. Underpaid, under- resourced and overworked, they are barely holding it together. Patients who arrive in severe shock, others very sick demanding a high level of nursing care and many others on the verge of death needing a kind look or words of comfort, surrender themselves with ‘that’ look in their eyes. ‘Stoicism’ is the ruling word in times of profound upheaval, risk, and strain. Is there anything more traumatic than seeing the one you cared for in the previous shift with lot of hopes and prayers, in a body bag hours later? These soldiers who display courage in the face of duty are more than deserving of a ‘Maidstone Medal’ or “The Christiane Reimann Prize”. What’s more, they put the wellness of others before their own, and many accept their fate with incredible dignity. Bold voices clearly articulate ethical positions with an astute understanding of human rights, careful discernment of human rights violations and bold acceptance of professional responsibility. When push comes to shove, many expose racism despite knowing the ordeals ahead with their livelihood at stake, as more than life savers who are willing to advocate for victims and to collaborate with right thinking people in finding solutions to ethical and racial issues. Whatever, deafening sounds of oxygen will accompany them for years to come.
Forget Covid19 for a moment. In normal circumstances, to smooth the often turbulent path of interaction between patient and an overworked health specialist, nurses become able to tolerate differences, willingly keep aside potential perceptions and whole heartedly contribute to shared care plans even when multiple patient handoffs play foul in establishing a trusting and collegial relationship. Nurses must re-define stressful situations, carry on and do their job in any situation with or without resources. There seems to be no recognition anymore of the collective goodwill involved in providing a service, many a time selfless one. A bad job is definitely not excusable, but others involved with nurses ought to understand and appreciate the struggles or shortcomings. At the end of the day, they don’t feel like heroes but rush back home as a daughter, wife, mother, lover or a friend to feel belonged, to care and be cared for.
Still, everybody fights, nobody quits.