Unfortunate Deaths In Our Hospitals; A Nurse's Perspective

I have read quite a handful of stories about unfortunate and preventable deaths in our hospitals, both private and public. Some have touched me personally, especially when it involves a pregnant woman, or a young promising life like the uniport student. For anyone who has been a victim, no amount consolation would be enough to pacify the pain of losing a loved one. As a nurse, i have seen this scenario play out time and again, to the point that i have grown thick skin, but i still feel deeply for anyone who has lost a loved one in death. Death is usually more painful when it could have been avoid. But in Nigerian hospitals, avoidable deaths tend to be more common. Believe me, only a few actually come to public knowledge. And when it does, one set of healthcare professionals are often at the receiving end of the vituperation and opprobrium it generates ; The NURSES!. They are the easiest to vilify, and push around. Often times, we only hear one side of these stories, that is the deseased's side, or in rare cases we hear the side of the hospital management. This article is not meant to exonerate nurses from all blame, (sometimes they are directly responsible) it is meant to tell one of such stories from the nurse's angle.

If we look at these stories carefully with an open mind you would discover one major problem in our hospitals, and that is lack of equipments. Like in the case of the upth student, the problem was lack of bed space. We only heard the story from one side, and we vilified the nurses and doctors, and berated them for not finding an alternative. Well i wasn't at upth, so i have no idea what really happened. But i have lost a patient in similar fashion before, and i was almost beaten up by the patient's relatives, so i can relate. In my own case, we were only two nurses on duty, myself and another nurse who was pregnant at the time. We were covering the emergency and labour ward together.

The patient in question arrived with his family members, he was in obvious distress, but his condition did not seem life threatening at the time. Myself and my colleague were both in the labour room, trying to deliver a baby with breech presentation, an extremely risky procedure. When i heard their shout for attention, i left my colleague alone to handle the delivery (which was risky) in order to attend to the new patient. There was no bed space, so i simply spread a blanket on the ground for him to lie on. The family members protested, but i had neither the time nor the patience to explain and negotiate with them. I explained our admission procedure to them, told them to pay for a card, and purchase the A&E kit. Once again, they protested that they had no money. I explained to them that given the fact that he had been vomiting and stooling, he would need i.v infusion immediately. I put a call across to the doctor on call, who was equally busy, and headed back to the labour room.

After about 30 minutes, the doctor arrived. The family had not purchased the A&E kit, neither had they paid for a card. So he referred them to a teaching hospital and left for the theater. They called me out a few minutes later, this time one of them had an i.v infusion with him, which he had gone to buy from a local chemist that night. They begged me to give him the infusion. I explained to them that the hospital policy does not permit me to insert a canula into a patient's vein, hence they have to wait for the doctor. I left them again, and called the doctor to inform him. The doctor came back, and insisted that they should go to the teaching hospital.

About thirty minutes later, i heard a loud shout, and rushed out to see what was happening. Behold, our patient was unconscious, and almost not breathing. I advised the family to quickly take him to the teaching hospital, because we do not have equipments to resuscitate him. They requested for an ambulance and someone to accompany them. There was a problem, we only had one ambulance driver, and he doesn't work night shifts, and more so we had no personnel to spare for the trip. All hell broke loose, the family members began to shout and make threats. I had to hide my head. I left them and went back to the labour room. I did not hear from them again that night, until the morning after when hoodlums invaded the hospital, bearing matchets and sticks. I scaled the hospital fence and got away. The doctor and the morning nurses weren't so fortunate, they vandalised cars and beat them up.

The boy died, but the story that was circulated was that " because they had no money, the wicked nurse refused to attend to them, and left them to go and sleep elsewhere. When they even bought drip from a chemist, the wicked nurse refused to give their son the drip, insisting that they must buy from the hospital." No one considered the fact that the overworked nurse was busy handling another delicate situation, and could not focus attention on a patient who has not been admitted. Now you must be wondering, since it was an emergency, why did we not just attend to the patient and worry about the money later? My answer; HOSPITAL POLICY. If i admit the patient, and use the hospital's consumables without the patient paying for it, the bill would be subtracted from my salary, after i am issued a query. If the bills of 3 or 4 patients are subtracted from my salary, how much would be left?. The best i could do was to refer them to the teaching hospital, where they ll receiving free emergency treatment for 24 hours before payment.

Now, let us examine the most recent case. When the man arrived with his wife, the nurses told him straight away to go to igando general hospital, because there was no doctor. But he refused, insisting that the hospital was too big not to have a doctor on call. But it is very possible that the hospital may have only one doctor, who cannot work for 24 hours. I have seen such scenarios alot. There are unreasonable restrictions placed on nurses in nigeria today, our scope of practice is unjustly limited. Hence, when a nurse refuses to touch a patient, she is probably afraid of crossing a line and indicting herself. So when there is no doctor, and the hospital policy prevents the nurse from doing what he/she knows, what do you expect the nurse to do?. That was probably why the nurses insisted that he take his wife to igando. But the man stubbornly carried his wife into the hospital himself. When he insisted, the nurses probably out of pity cautiously did the little they could do without crossing a line, which was obviously inadequate.

When he agreed to go, the nurses did not have the key to the ambulance, maybe the ambulance driver was not on duty! Again, the nurses did not want to accompany him, probably because they were already understaffed and overbooked, and had no one to spare. Do we know how many nurses where on duty? What about the doctor who arrived late? It is also possible that he is the only doctor in the hospital, and works 8 to 4pm like everyone else. If he leaves his house at all that night, he is only doing you a favour, he is not paid to work at that time. It sounds cruel, but that is the truth.

When he got to igando, there was no bed space! Are the health workers to blame for that? Peharps, while he waited for what seemed like an eternity, the nurses were frantically making efforts to secure a bed space for the patient. And then the money issue came, which i have already dealt with.

I can assure you of one small truth. The issue will be swept under the carpet, because if it is investigated constructively, the blame will fall largely on the government. Our health sector is in shambles, it needs massive investment, in terms of man power and infrastructure. Until this happen, we cannot continue to heap all the blame on our hardworking doctors and nurses. They are just like the soldiers sent to confront boko haram without weapons. They deserve our sympathy, not insults. When next a nurse in a public hospital seem not to perform to your expectation, it may be because her hands are tied!

Source:Nairaland