With its variety of causes – norovirus and Clostridium difficile to name but a couple – diarrhoea, as you all know, is a very common problem in hospitals.
Diarrhoea causes lots of unpleasant work for nurses. More importantly, it causes loss of dignity and lots of distress for our patients. It also makes people very ill. It can extend the length of stay in hospital, kills people and costs the health service millions.
Every time you go into a room with a patient who has diarrhoea, there is the process of putting on aprons and gloves in addition to the normal handwashing. Once you get in there, no matter how organised you try to be, you find you need something you had not anticipated. Then there is the hassle of finding someone to get it for you by opening the door and hoping there is a nurse nearby. As there is rarely anyone around, you just grit your teeth, take off the apron and gloves, thoroughly wash your hands and go and get whatever you need. Then you start the whole process again.
My patient today, before she developed diarrhoea, was an independent 87-year-old. This unexpected and intense bout of diarrhoea, which developed at home, reduced her to a very feeble lady who could barely stand. It caused her 24 hours of intense confusion. It will take her many weeks to recover if, indeed, she ever fully recovers. She felt the loss of her independence greatly and tried to accept what to her was something of a nightmare – loss of continence.
For many people, not surprisingly, loss of continence equates to loss of dignity.
In situations such as this, how do we, as nurses, make a patient feel they are not a burden on us? The constant changing and cleaning is wearing. The smell can be terrible. In addition, you still have your other patients to care for, with the added worry of the possibility of passing an infection on to them. You spend more time than normal washing your hands.
I feel, of all the situations nurses are expected to cope with, this is the one that most tests our patience, endurance, communication skills, empathetic natures and strength of character. To repeatedly deal with the patient in a dignified manner when you are feeling stretched and frazzled is sheer hard work. Will you survive to the end of the shift and never appear anything but calm and pleasant to your patient? It is quite a task, you must admit, but definitely achievable.
Gail Smith is a staff nurse in Cardiff
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