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Student editor blog

'Learning to treat patients with dignity is so important'

Last year, I spent two weeks in an induced coma abroad. And the most surprising thing that will change the way I nurse patients for the rest of my life, is that I can remember conversations that were had at my bedside.

Some conversations were so vivid I can even remember the names that were used in them. This will change the way I nurse patients because it has shown me that even if someone is in a coma, in a particularly deeply unconscious state, they may still be able to hear what is being said around them.

I can’t tell you how many times while working that members of staff started inappropriate conversations with me, while washing a patient who had dementia or who had sustained a severe stroke. Part of this problem might be because we, as nurses, still hold stigma towards certain illnesses such as dementia.

However, there have been times where it was just “assumed” that patients who have sustained certain injuries (particularly head injuries, such as stroke) were unaware of what was being said around them. Sometimes this is the case, but often I would wager that patients such as these are aware of what’s going on more than we give them credit for.

It is especially tough to do the right thing if it means speaking out against qualified staff.

In my first year of nursing as a HCA I was looking after an older patient in the final stages of her life. I held her hand while I watched her life slowly slipping away from her. It was a serene and quiet moment, it was very sacred in it’s nature and I was finding it quite difficult to deal with, but I was determined to get it right. Then all of a sudden, a young nurse burst in through the curtains and enquired quite loudly, “Is she dead yet?”

Through my experience, I believe that might have been the very last thing she heard.

 

 

Readers' comments (9)

  • Adam Roxby

    Hi Mikey.

    such a powerful article and your anecdote at the end is so depressing.

    We often reminded that we should not conduct personal conversations around patients regardless of what state they appear to be in. We're also told that you're hearing is often one last senses to go so, as you said, one patient may appear unable to comprehend what's going on the very opposite may be true.

    I hope this article helps other students improve their practice.

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  • Michael Whitehead

    Thanks Adam. You are right in what they say, hearing is often the last thing to go.

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  • michael stone

    This will change the way I nurse patients because it has shown me that even if someone is in a coma, in a particularly deeply unconscious state, they may still be able to hear what is being said around them.

    _______________________

    I was reading a book about some WW2 nurses. One said that an entire ward full of apaprently injured and 'comatose/unresponsive' soldiers, all joined in with a sing-song when one soldier started to sing it.

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  • Michael Whitehead

    I would not have been able to sing as I was in a critical state, but even in this state I was able to overhear what was being said around me by members of staff and family. Scary to think that many patients probably can hear when we think they can't

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  • Thank you for the above.My wife recently died in Lewisham hospital aged 39.she had been diagnosed weeks before with an aggressive form of cancer.She appeared to be
    asleep most of the time due to the pain killers but because I was by her bedside all the time I managed to catch those precious moments when she was awake and in less pain.She had been fully aware of conversations that had gone on around her when she had been "sleeping" and some of those caused her great distress.I mentioned this to a couple of nurses but as the husband I was largely ignored because I am not a "medic".They did not seem to understand that I was the greatest expert on my wife and that I was with her ALL the time.
    I love my wife very very much (I cannot say loved because there is no past tense about it).and thats the difference

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  • Thank you for the above.My wife recently died in Lewisham hospital aged 39.she had been diagnosed weeks before with an aggressive form of cancer.She appeared to be
    asleep most of the time due to the pain killers but because I was by her bedside all the time I managed to catch those precious moments when she was awake and in less pain.She had been fully aware of conversations that had gone on around her when she had been "sleeping" and some of those caused her great distress.I mentioned this to a couple of nurses but as the husband I was largely ignored because I am not a "medic".They did not seem to understand that I was the greatest expert on my wife and that I was with her ALL the time.
    I love my wife very very much (I cannot say loved because there is no past tense about it).and thats the difference

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  • Michael Whitehead

    Hi Steve

    I am sorry for what you have had to go through through the loss of your wife, my deepest and heartfelt condolences go out to you at this time.

    It is worth remembering, Steve, that the purpose of this article is to highlight that some bad practice can be picked up when we do not expect it to be.
    However, it is written for people in the same scenario as you. Each time that you had a quiet moment with your wife and you told her you loved her, as I am sure you did many times, she would have heard and understood. Each time you whispered something or spoke about something to try and ease each others pain, she would have been aware of it.
    I am living proof that, even in a coma, words and even actions, can be picked up on. It is fact.
    I believe your wife would have heard you tell her how much you loved her, or whatever you said to her.

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  • I am a student nurse, just back to uni after my first placement. Your article reminded me of so many occasions in the last two months where I witnessed this, done by pretty much everyone who came into contact with end of life patients.

    Your article really brought it home to me and I would like to print it and put it in my portfolio as a constant reminder.

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  • Michael Whitehead

    @Anonymous

    Thank you for your complement. I am afraid you're right. I can't remember the last time I did not hear an insensitive comment made in the presence of a patient at the end of their life.

    Should there be training available on this?

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