Nurse – Like a Family Member for a Patient, a Helping Hand for Doctors and a Team’s Inspiration
We meet Vilma, a general practice nurse working at the nursing centre “Gemma”, in the spacious room, where patients gather for lunch, a cup of tea or a quiet rest. Our conversation starts by discussing working in a nursing institution, patients, the challenges of quarantine and what makes her happy and gives strength in this kind of a stressful job. Vilma has been working at the nursing centre “Gemma” for nine years during which she has gained invaluable experience and knowledge, but as Vilma says: “Each day brings new challenges as new patients arrive and each of them have their own unique story.”
How does your work day start? What are your first tasks? What thoughts do you have when crossing the threshold of the nursing institution?
My day starts energetically with a truly good morning! Sometimes there is also the feeling of concern, anxiety while thinking how my patients spent the night, whether their condition did not get worse. Or maybe new patients have arrived, with whom it will be a pleasure to meet as every patient at our institution must feel safe and cared for from the first minutes. There are meetings not only with patients, but also with doctors and colleagues. What is most important during these meetings? What do you get from such discussions?
It is important for me to get all the information from the night shift staff: the health of the patients, their mood, what has changed as I and my colleagues will continue the work, so every detail about the well-being of the patients is important. Doctors help us to decide how the work should be organized: distribution of medicines according to the prescriptions, instructions regarding the changes of the diet, coordinating which patient can be taken outside if the weather is good and which patients must spend the day in bed. Then we start measuring temperature and blood pressure of the patients. Together with nurse assistants we distribute breakfast. Those patients who can eat themselves gather in the common room, but there are also patients who can only be fed through a tube. At the nursing centre, we take care of patients who suffer from complex multiple illnesses as well as geriatric problems. Even eating is a challenge for many, so a nurse or nurse assistant has to always be by the side of the patient.
A nurse is a helping hand for doctors. What is your role during the morning visits?
Morning visits are very important for treatment and proper care. I measure blood pressure, temperature of the patient, record data, communicate with the patient, listen to complaints and just have a calm, pleasant conversation. Later in the doctor’s office we discuss what medicines are prescribed and my work is to follow the exact instructions of the doctor. In these situations I have to work like a Swiss watch: precisely and always on time. Then we perform all other procedures: blood or other tests, drips, medication administration, catheterization, drops, other medicines as well as monitoring how the patients feel, whether their condition has worsened, in what mood they are and what their general condition is. We are always around, our duties include not only performing the procedures, but also sitting down, hugging, talking or just listening about their memories, children and grandchildren. Sometimes I think that attention heals better than any medication. We are always near the patients, while relatives, especially during the quarantine, are worrying at home, not being able to visit. That is why it is very important to maintain close contact with the family, to talk, tell stories, even when there is no news. Then we just simply tell the relatives how the patients slept, what they ate for breakfast, what mood they are in. Technology also helps as we can arrange video calls with relatives.
What makes nursing patients special? What are their needs? What problems do they have? What challenges you have to face?
Our patients are those who can no longer take care of themselves at all, even reaching out for water may be a difficult task for them, sometimes they cannot even utter a single word. The role of the nurse is very important: to observe, to always be there and provide continuous care. We cannot just leave our patients in their rooms and wait for them to call us. We often compare our patients to helpless babies: they need constant attention and special care. Some of our patients are energetic and strong for their age, but they hardly understand where they are or what is happening to them. In such cases the challenge is to ensure their safety so that their excess energy does not cause problems. Another group – those only lying in bed, sometimes they are unconscious, breathing, their heart beating and they have to be fed through a tube. We constantly check up on them, measure their blood pressure, pulse. There are patients who always feel unhappy, sometimes moody and they have difficulty understanding that it is time to eat, take medicine. We have to understand them and be patient with them. Sometimes you have to use your imagination, physiotherapists, massage therapists and occupational therapists help us a lot by channelling the patients’ energy through physical activities.
Patients in a nursing institution certainly feel different, as they are not home, not in their usual environment, they are surrounded by strangers. How do you deal with the emotions of patients? Where do you get your strength and motivation from?
When I was choosing my profession, I already knew that I would have to be close to patients, I really don’t think that it is difficult for me or that I have chosen wrongly. My mission is to help patients feel better, live longer, my motivation and positivity comes from understanding that my job is very important in another person’s life, that I can change or somehow improve it. All medical workers have the same desire and ability to help others. When I think this way it is easier to deal with my emotions and feelings and I become much stronger at work. Being emotionally healthy allows me to build good relationships with patients. We all bring to work what we value most in our families: relationships, trust, friendliness, the desire to help not only patients, but also colleagues. I think that patients and their relatives can sense it too. We call all patients by their names, we know their stories as we take the time not only to look after them, but also to listen and understand. We also talk to their relatives and tell them how their loved ones are doing. During the quarantine some interesting things happened: on the birthday of one of the patients, the whole family lined up outside and sang. They were singing on the street while we were singing in the room of the patient. When a person is being treated here, we are like his family. It is a huge responsibility, but also a great joy, especially when we see an improvement, a smile on their face, when the patient feel less pain, if they get out of bed – sometimes we have really wonderful days here! Such moments inspire. The understanding and a simple “thank you” from the relatives also help a lot. The ones who have nursed their loved ones at home and then brought them to our nursing centre know best how much strength and effort this kind of job requires. Such families appreciate any improvement, even the smallest one, which can only be achieved through a continuous hard work.
As you mentioned, you have to work not only with the patients, but also with the relatives. Maybe you can compare which part of the job is harder?
My first priority is always the patient. Our working day begins and ends with our patients. Sometimes we bring the thoughts about the patients home. The entire medical team (doctors, nurse, physiotherapists) has to communicate with the relatives. If all relatives were understanding and compassionate towards doctors, it would really become easier for us. During my entire career, I have not met a single doctor or nurse who did not care about their patients. After all, we work for the sake of our patients, their health and well-being if it is impossible to cure the disease. It’s sad, but that is life and no matter how hard we try, no matter how much the medicine improves, sometimes we are unable to help a seriously ill person.
What has changed in your work during the quarantine? Did all safety measures replace your normal work routine?
The changes were big: from reorganizing processes to training to work while using all personal safety measures. I work only in my own department in order to maintain distance, it is difficult to do our job with the special clothing, it is difficult to breathe with a mask, but it is necessary in order to protect patients and myself as well as my colleagues; you have to change clothes every time you go to other rooms or come back to the department: specials overalls, gloves and boot swabs. You can get used to this, all medical workers work like this, but I will never get used to the situation when you find out that a patient is infected with COVID-19. I hope that the vaccination process accelerates, our employees are among the first ones to be vaccinated, we also vaccinate our patients if they haven’t had the vaccine before.
It seems like a really amazing and interesting job as it contains the moments of joy, care and sadness. What personal qualities do nurses need? What advice would you give to those who are planning on taking a career as a nurse?
To start with developing determination to serve to those suffering, to save and help them recover. You also need to have courage, because you have to make decisions, react to changes and look for solutions. I would also advise developing the habit of protecting yourself, your physical and emotional well-being, as only a healthy and positive person can help others and do this job properly. What is more, your number one priority has to be the person you are taking care of.
Thank you for the conversation, good luck in your work!