It is for a reason that we admit patients for inpatient treatment. As doctors, we admit them and order medications and treatment, but the inpatient department (IPD) is mostly run by nursing staff. Normally, doctors are just there for the regular rounds and the emergency calls. Due to the large number of patients in the outpatient department (OPD), spending time with patients in the IPD must be wedged in between breaks and holidays. So, one fine Saturday morning, I decided to spend some quality time with my patients there.
The patient from bed number 1 has started to smile these days. I remembered that she was admitted at the OPD with a diagnosis
of severe depression. She used to be in the corner, shy, timid. She denied everything including the oral fluoxetine, the best medication we could supply in Achham. She never even talked to her cute 6 year old daughter, and was gloomy all the time. Yes, surprisingly she has improved, in just 10 days at the hospital. Her order for intravenous (IV) fluids has been stopped now and she is smiling! Someone whispered that she was talking to her daughter now and she takes her drugs without hesitation. I just wanted to peek through the door and try to note her smile and capture it. We had even discussed electroconvulsive therapy (ECT) for her treatment, but now she’s improving! “Yes yes” I said to myself; I felt happy to see her smile.
I was sharing my happiness with the nursing staffs when the lady in bed number 3 caught my attention. I wanted to talk to her and went near her bed. Her bed is near the window and the sun is always by its side there. She was from Bajhura, a 12 hour walking distance from Bayalpata. She said that her son is returning home to meet her since she is ill. She came to us 3 days ago with a swollen leg. She gave a history of a foreign body insertion on her right foot a month ago, and we drained 50-60 mL of pus from her foot in the emergency room. She felt better after the procedure, but even yesterday there was around 10 mL of additional pus, which had invaded below her superficial fascia. She told me that the pain and redness had improved, but I am praying that she improves more. I just added metronidazole to the cloxacillin injections on Friday and I assured her that she will have her dressing changes increased to two times per day. Her youngest son has been helping her these days to move to the lawn outside the IPD, where she likes to go during the evenings to see the sun sleep at Bayalpata.
I noticed that the patients have been good friends to each other. It felt so good when I saw my patients feeling at home here.
The mom with a one year old son, who was being treated for pneumonia, was talking with a huge smile to the old man near her bed. He had been on a continuous supply of oxygen via nasal cannula for a few days. I could see that with the new procurements, we now had two additional oxygen concentrators and few more nebulizer machines. Dhansara Sister (our nursing staff) told me that the work has been much easier with these new procurements, including 4 hourly nebulizations for the old man.
At tea time I offered tea to the staff there. We ordered 4 cups of tea and some biscuits from our nearby tea shop and had time for some chit chat. Life is good inside the IPD, they told me. When a patient is admitted for just a couple of days, they are able to share lots of feelings with the patient before they leave. Time flies inside the IPD, they said. My wrist watch struck 5 p.m. Then I saw a few patients making their way to the lawn outside. It was a wonderful day to spend inside the IPD. It helped me know my patients better and it felt good. Just as I thought to myself that I should do this more often, and on other days too, I saw the old lady with the swollen leg move towards the lawn. I followed her to the lawn outside to watch the sun sleeping at its best.
Dr. Bibhusan Basnet , MBBS graduated from B.P Koirala Institute of Health Sciences,Nepal. He has a special interest in Emergency Medicine and Psychiatry and is currently the Medical Director for Nyaya Health.