Dr A S Bhatia
I t was Fathers Day when my article, “Falling leaves” was published in Daily Excelsior.Two days after penning down the write up, my eighty seven year old father suffered brain stroke. It was 3 pm, and I, as usual was sitting in my office chamber doing all my routine works, when I received an emergency call from my home. I immediately rushed and saw the old graceful man in unconscious condition! We took him immediately to Government Medical College , where CT scan and MRI were done, which showed that some blood clots had originated from heart and traversed to brain to cause death of some brain cells! From emergency he was shifted to intensive care unit in cabin number five. A team of doctors comprising of Anaesthesiologist, Physician, Cardiologist, Neurologist, Urologist and Physiotherapist with many more chalked out the next plan of action. Now the old grand man was to stay in the ICU, for how many days, no one knew? The ICU was echoing with Beep sounds and alarms of life saving equipments. Life in ICU is entirely different from the outside world. Each and every face wore an anxious look, praying to GOD! As our stay in the ICU was expected to be a long one, so I and my wife Dr Harleen chalked out a plan where she was to stay in ICU during day time and I was given the job to supervise the medical care during night hours. I had a long experience of being in medical field but to stay in ICU was after many years! The nurses kept moving throughout the night, from one patient to another giving them the prescribed medication. Their faces were filled with a sense of satisfaction, once they completed the scheduled round. There was a small girl of two years, who had a fall from roof and was in coma for the last one month. That little girl had become a part of the ICU family. At the turn of duty hours every nurse, first of all will go to that bed of the little girl in Coma and seeing her breathing will heave a sigh of relief. Everyone was contributing their best to take care of critically ill patients. Many deaths in hospitals especially in critical care units, all over the world, are attributed to the hospital acquired infections, where a patient admitted for one disease dies not because of the disease for which he was admitted but succumbs to the infection acquired in the hospital! And the chances of patient getting infections are increased with uncontrolled rush of visitors! Same situation was observed by Dr Harleen , a microbiologist by profession, during her stay in the ICU during the day time! People were forcing their entry in the ICU without any face mask, shoe covers or even sanitizing their hands! The situation was grievous. As this action of them was posing a grave danger to the medical security of already critically ill patients with the immune system weakened by the disease. This mad rush of visitors was definitely going to give rise to alarming growth of multi drug resistant organisms, which was not at all a good sign for the patients as well as treating doctors who were contributing their best to save their patients! But the invisible enemy was sitting there to neutralize all their sincere efforts! Cultures from different sites of ICU were taken and the Nightmare was true!! Something urgent was required to be done. First thing, suggested by microbiologist, was to control the uncontrolled rush to the ICU. People did not listen to the poor security guards posted there and threatened them of dire consequences by showing their mighty influences! But I noticed a big change in the behaviour of security guards, once they got the patronage of Harleen who stood by them at the entry gate of ICU and made entry strictly restricted and one attendant per patient was allowed at one time! Next thing which was noticed that most of the persons were not following the ICU protocols, what to talk of general masses! Asking them to wear a mask a gown, a shoe cover, hand sanitization before touching a patient was being taken as an action against their self respect! I was most surprised when a post graduate student of a main surgical branch was asked to wear mask and gown before entry to ICU, objected to it and soon after the head of the concerned department wasted no time to call and tell us not to interfere in the mal functioning of his post graduate students! Extensive sterilization with restricted entry of visitors to ICU with strict adherence to ICU protocols yielded its results with ICU being declared BUG free after seven days of tireless efforts supported by the microbiologist and the nurses and paramedical staff! A change in the behaviour of the society is urgently required in delivering medicare services in our set up. Although this act of her was not taken pleasantly by many at the helm of affairs but that did not deter her from delivering the Right! There was an incident when four men in Khaki made their forceful entry in The ICU without face masks , shoe covers and when stopped and requested to follow ICU protocols, got furious and delivered all kind of abuses showing the might of power showered on them by the uniform they were wearing! And strangely a complaint was launched against the doctor at police post GMC Jammu and hospital authorities were very quick to ask for explanation from the ICU protocol maintaining staff! Is this the way we can improve our ICU care! During the ten nights ,I spent in ICU made me realize the hard work our medical and paramedical staff is doing. The dedication and sincerity toward their duty is simply remarkable! But many a time these tireless efforts go in vain because of the unwanted rush of visitors to the wards. People in general should understand that thronging the hospital and ICU just to enquire about the wellbeing of their nears and dears admitted in health care centre is ultimately pushing their patient toward death there by neutralizing all the efforts put up by the medical staff! They should listen to the directions given by security and paramedical staff and should responsibly abide by these instructions instead of behaving arrogantly thinking this has marginalized their personality and ego. To reduce the death rate in hospitals , combined efforts of medical staff and general public is very important. The staff posted in the ICU are the real heroes, who deserves all praise and appreciation. Many untoward incidents have occurred in the past where medical staff was manhandled! These are the most unfortunate incidents in any democratic country. People should resist themselves from indulging in such type of unlawful activities. Strict laws are already framed by Government of India and now it is the duty of local law enforcing agencies to adhere to these laws. Religious and local political leaders should come forward to spread the message to common masses to respect the persons in White Coat! These people are life saviour, serving you day in and day out, even when someone in their family himself is on sick bed! These nurses in blue green uniform are taking care of your sick child by leaving their own kids alone at home throughout the night. Nurses are source of moral support to their patients, a voice for their voiceless patients, a listening ear and a shoulder for many to cry on! As Mirza Ghalib said, Kitaabo ki ahemiyat apni Jagah hai, par sabak wahi yaad rehta hai, jo waqt aur log sikhaate hai! (The author is Professor and Head department of Biochemistry, Government Medical College Jammu.)
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