Nursing Covid-19 patients

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On 10 May, the helpline at the Srinagar-based nonprofit Social Reform Organisation Batamaloo (SRO) got an unusual SOS call — it was doctors from the Shri Maharaja Hari Singh hospital, one of the largest tertiary care hospitals in Kashmir.

The caller sought the nonprofit’s help to provide an attendant to an abandoned Covid-19 patient suffering from tuberculosis and bilateral pneumonia. The woman, in her fifties, was abandoned by her family.

The woman, all alone in the grim Covid-19 ward, was admitted to the hospital by the police after they found her on a roadside. The SRO — which provides oxygen concentrators, other medical help, and alms to the needy — immediately dispatched a nurse to care for her.

The task was fraught with the risk of getting infected but that didn’t deter 25-year-old Anju Kour. She wore her protective gear and headed to the hospital from the nonprofits accomodation for nurses.

Kour holds a diploma in General Nursing and Midwifery and is part of a team of twelve nurses associated with SRO. Their task is to go to the houses of Covid-19 patients daily to assist with cleaning, feeding the sick, and administering injections.

It was a rare case that one of the nurses had to go to a hospital to look after the patient who was without any attendant. Kour spent six hours, till 11 pm, caring for the woman, whose family was missing from the picture, in the ward that was crammed with Covid patients.

When Kour arrived, the first thing that the woman asked for her help to get to the washroom. “She even had a catheter connected. Her saturation was abruptly dropping to 45. (So) I couldn’t take her to the washroom with those heavy cylinders. Then I helped her put on a diaper,” Kour said.

The woman had grown weak and struggled to speak, said Kour. Whatever little she spoke, was a horrid tale of abandonment — told amid several deep pauses. “ She told me that she has two children. She kept telling me that her daughter was just like me and even of my age… her son was 11-year-old,” said Kour.

“Initially her husband was also Covid positive,” Kour said. “She said that even after 25 days of recovering he had not come to visit her. He had told her that he would but he hadn’t shown up”.

After her shift at the hospital ended, Kour went home but requested the hospital’s nurse to take care of the patient as her condition was deteriorating with each passing hour. “I even gave her my number and I had asked her to call me immediately if the patient needed anything at all,” said Kour.

But the next day, when Kour called the nurse to know about the patient, she was told that the patient had passed away. “I knew that she was not going to survive and I had only helped her for a few hours but I still felt really bad. More because she was alone,” sighed Kour.

‘I have to do this’

Since the day Kour was hired as a nurse by SRO, she has been attending at least three houses each day to look after the isolated Covid patients, sometimes she makes two visits based on the medicines prescribed by the doctors. “The number can be more also, depending on the calls that we get. Sometimes even ten to twelve calls in a day,” she said.

Usually, Kour said, she attends to calls from families where only one patient is positive and is kept in isolation while another family member has been attending to the patient, she said. “We don’t meet the rest of the family. So we are in contact with just one attendant and the patient.”

Based on how the attendant describes the patient’s condition and after checking the prescription, the nurses decided a course of action, said Kour. “If a patient is in the condition to talk, we try communicating. We give them suggestions,” she added.

If the nurses feel that the condition of the patient isn’t getting better, they immediately inform SRO or ask the families to speak to the concerned doctors and get the patient hospitalized. “Just in case a family cannot afford the medicines, injections or oxygen concentrators, we immediately inform SRO and they provide everything,” said Kour.

Initially, Kour like other nurses of the group was hesitant about going to the house of Covid-19 positive patients but with time she understood the demand of her duty, she said. “There is a possibility that I might get infected someday but that should not stop me from doing my job,” she said.

The role of nurses is more difficult than that of doctors as they work more closely with the patients, believes Kour. “A doctor prescribes but a nurse does the rest of the work. She has to keep giving the medicines on the prescribed timings and she has to be able to fulfill her responsibility and maintain a proper chart,” she said.

Quite often, a bond is formed between a patient and a nurse due to constant reassurances given by the nurse, leading to gain of trust, said Kour. “When we tell them that they will be okay, they actually trust us,” she said. “They don’t take a lot of stress after that.”

Performing her duty for two days and nights during the week, Kour does not feel stressed or anxious as “this is what my job demands”. “If at this point I do not perform my job, then I should not have chosen this profession in the first place,” said Kour. “Now that I have chosen this profession, I have to do this.”

‘Real warriors’

The role of doctors as frontline workers is widely appreciated but in the aftermath of the scale of the pandemic overwhelming Kashmir’s hospitals, the critical shortage of nursing staff has come to the fore.

Last year, in May, SRO created a toll free number to provide support to people who required oxygen, food, and other help during the lockdown. However, the nonprofit kept receiving queries about nurses who could help the families with injections.

“When we kept receiving calls for nurses, we decided to create a nursing department,” said Aafaq Sayeed, project director at SRO Kashmir.

After months of brainstorming, SRO finally collaborated with another organisation, Kashmir Care, which provided the human resource. “We have provided them with our logistical support. We bear the expense of all logistics and they bear the expense of human resources,” said Sayeed.

Currently, SRO has appointed three drivers and has also set up a control room with three people answering the calls and based on the demand and roster, the nurses are deployed to the patients’ homes.

“We receive around a dozen calls throughout the day for patients. Many people don’t know about the initiative till now,” he said.

Sayeed said that the team has been receiving great response from the people and the initiative has turned into a “great service for people”. “Usually people are prescribed antibiotics by the doctors but they are IV drugs. Nobody would agree to come to a house that is full of Covid positive patients,” said Sayeed. “People got a support system through us.”

Currently, SRO’s response time to distress calls is thirty minutes. The team has been working hard to minimise it further. SRO is planning to come up with another facility near Soura to minimise the response time, Sayeed said.

The nurses appointed by SRO have been counselled to help the Covid-19 patients who may be suffering from fear and anxiety, said Sayeed. For him, their small team of twelve nurses are the “real warriors”.

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