Kembali ke asal....

Friday evening, 5.15pm, I said farewell to fellow nurses and doctors whom I have worked with over the last 4 weeks.

"Good bye Brearley 4. See you next time"

For 12 days and 3 nights I worked this time.
Brearley 4 is a stroke/rehabilitation ward.

Stroke in layman language is also called a 'brain attack' just like a 'heart attack', the end-organ damage is different. There are 2 types of stroke, haemorrhagic (perdarahan) stroke and ischaemic (area dalam brain tak dapat cukup O2 disebabkan salur darah tersumbat) stroke. Effects of both are similar. Causes of stroke are high blood pressure, high cholesterol, smoking, abnormal blood vessels, age and others ( that I can't think of at the moment).

Most of my patients were 70 and above. I can say less than 5 were below 60s. Stroke can be devastating, that it paralysed half of the body but it can also cause subtle changes eg poor memory, change of personality, speech problem. There were 3-4 patients in the ward who were really unwell. Unable to move, unable to speak and unable to eat, that they have to be fed via the nasogastric tube (tube inserted tru the nostril into the stomach) or in long term, they have to be fed via PEG tube (percutaneous (dimasukkan dari skin di perut) enteric-gastrotomy). One or two patients were able to move but couldn't speak and were very confused.

When I spoke to one lady who paralysed her left side, and has aspirated very time we tried to feed her via the NG tube, I could see she was depressed. She was thirsty but I couldn't give her even a sip of water, as she'll aspirate. It must be hard for her,she was once totally independent, suddenly, she depends on others to do every thing for her. And another lady, mid 90's, massive stroke, very drowsy. For she has outlived most her friends, and has made it clear to her family that she didn't want her life to be prolonged when this happened to her, I totally respect her wishes. We were just keeping her comfortable, making sure she was not dehydrated by giving subcutenous fluid. She was basically waiting for her 'time' to come.

All and all, the acute stroke side of the ward could be quite depressing, but the rehabilitation side was slightly cheerful. 8 of them were just waiting for go home once the therapist are happy with their performance. 1 was mobilising around, confused. 3 are in bed, confused and waiting for their 'time' to arrive.

Yes, I do deal with the families, explaining what the current situation was and reassured them.
And yes, I have to deal with dying patients, certifying them upon their decease.
It's part of life. How do I deal with it? Maintain my professionalism, when there're no emotion attached, departing could be a sorrow with no tears; ' ...when the time comes, not a second sooner nor later...'

I did feel sorry for them, especially those who're incapable of doing anything for themselves. Compared to a palliative care ward,where patients are dying of terminal illness, but they're still corpus mentus. They're still able to tend to themselves like toileting and cleaning themselves.

"O All Mighty One Allah have mercy upon me and my fellow muslim and muslimah,please forgive us for all the sins and our ignorance, give us strength to be better servants to you O The Most Merciful"