In Muttacadu, I found someone who I admire greatly. Her name is nurse Dinu. At first when we loaded up the vans for the day, I was disappointed because since there was not a doctor with us, I did not know what the day would hold. This turned out to be the silliest thought I could have had. Nurse Dinu is poised, confident, compassionate, and competent. There is no need for a doctor to be on this visit today. Dinu communicates with us, asks us our opinions, and teaches us. She makes the day the experience it was. She knows her patients and their needs. She may be small but her presence is large and she is greeted warmly by the patients we visit.
The first woman is in a dimly lit home. She needs a catheter change. Dinu asks the husband for a lantern and begins to prep for her catheter change. I watched her so intensely. There were mosquitoes flying in the home, the cement walls were damp from the humidity. The bedsheet’s discoloration makes it unclear when they were last clean, and an old bench is the only acceptable place to set up sterile field. I’m having flashbacks to my first semester of nursing school. Hand’s drop below the waist? Fail. Turn your back on the patient? Fail. Sterile drape moves? Fail. Incredibly enough, I think my lab instructor would have passed Dinu. Somehow in this unclean home, Dinu does this procedure by the book. I still break a sweat in the hospital trying to maintain sterile field on a mobile patient with plenty of space and light, Dinu makes it look like she could do this in her sleep. I am amazed by her.
Thy notices that the urine is cloudy and the patient is able to verbalize pain in the lower abdomen and back. A UTI is suspected. Dinu respects us as we respect her and she asks Thy what she would do. Thy says that an antibiotic should be started and Dinu agrees. It was such a pleasant feeling to be included on patient care. This was a change from the day before where I felt like more of an observer. Dinu made me feel like we were a team. I think that is what I admire most about her. I love that even though she is intelligent and has a lot of experience, she recognizes intelligence in others and takes their opinions seriously.
I ride in the van with Dinu on the way to the next visit. It is a psychiatric patient. Dinu thoroughly and patiently answers all of my questions I ask about the care of psychiatric patients in India. After completing a psychiatric rotation at UIHC, it is upsetting to me there there is not a specific diagnosis for this patient. She is just labeled as “psych.” I know America still has a long way to go to change how we treat patients with mental illness, but it gives me more respect for the progress we have made.
The next patient we visit has an NG tube and needs a catheter change. When I walked into the room, I looked at the bed and didn’t even realize there was a person laying there. She was so frail and had contractures of her arms and legs. She is near the end of life. The daughter of the patient wanted the NG tube out. Dinu is great at communication and you can tell her care is centered around the wants and needs of the family. She listens to the daughter about why she wants the NG tube out and what she thinks her mother’s abilities are. Dinu turns to Stephanie. Again, Dinu’s mutual respect is displayed. She asks Stephanie’s opinion and together they decide that the NG cannot come out until it is seen how something like porridge is swallowed.
The last home Dinu takes us to is an experience I’ll never forget. The woman who was a patient had had a brain bleed after being abused by her husband. My whole group was not emotionally ready for this experience. But Dinu stands tall. The best palliative care she gave this family was a listening ear and a shoulder to cry on. This woman, in her 30s, is cared for by her parents. Dinu steps out of the room and listen’s to the father’s concerns while the rest of us sit with the woman and her mother. The mother tells us that her daughter was a successful accountant before her brain injury and shows us pictures of how beautiful and graceful her daughter used to be. I am sad for her. My heart hurts that this happened to this woman, but my feeling of anger is much stronger. I am outraged that the husband is not in jail and that he has their children. I am outraged that he is not facing the repercussions of his actions. But the woman is safe now. The hands of loved ones no longer harm her, but help her to get stronger. Dinu tells us we were “just checking” on this visit, but this is where we spend the most time. From what I can gather the visits to this home are a great source of emotional support. And Dinu is strong for this patient and the family.
I watched Dinu do a lot of nursing procedures today, but that is not what I learned from her. She showed how important it is to therapeutically communicate with patients and how necessary a soft touch is on the road to recovery and comfort in patients. When I think of a good nurse and the kind of nurse I want to be, an image of Dinu comes to my mind.
Editor note: drawings and blog are by Allie Weis.