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African Health Sciences
Makerere University Medical School
ISSN: 1680-6905 EISSN: 1729-0503
Vol. 6, Num. 2, 2006, pp. 85-85

Untitled Document

African Health Sciences, Vol. 6, No. 2, June, 2006, pp. 85

Is there need for a desensitization program for patients who shared the same ward with a late colleague?

Misaki Wayengera

MU-UMDNJ, Tel: 256(78)450610, E-mail: wmisaki@yahoo.com

Code Number: hs06020

It is Saturday morning, and though still battling a sleep deficit from last night’s ordeals in the Casualty Emergency Room, I have to head to my new residency posting at the National Tuberculosis and leprosy Program (NTLP) in-patient wards.The “aha”insight central to the theme of this filler is birthed in two occurrences on my first day here.While patients in most Western and developed country settings enjoy a relatively better nursing privacy, the picture in most developing and especially African hospitals is that of an open aura-except of course in a few private settings.

On this day, a long staying male in-patient of TB pleura (recurrent bilaterial effusions) is seen by his colleagues heading to the “loo”never to return (reason! He is found dead several hours later after collapsing and hitting his head on the door).Considering his tender age, I rule out the possibility of a Vaso-Vago manouvre-most probably it was respiratory distress leading to the syncope then head injury.That same evening, on the female ward-another seemingly stable two-times retreatment ISS patient develops DIB due to PCP-passing away despite all my “conventional interventions.”The following day, two male and three female in-patients request undue discharge.As I struggled to empathize with these patients- three facts became clear to me:

The dying process is quite a traumatizing one, especially to patients(relatives and attendants aside) who shared the same ward/Cubicle as the late colleage.-regardless of the diagnosis and prognosis.The open aura scenario doesn’t allow for privacy at this time, and the consequence is that witnessing non-medics are traumatized.
Often, we in the medical profession take for granted ‘a’death, having perhaps been desensitized by our training and past experiences-yet to the lay person, the picture is that of his saviours failing their mission-hopeless.
Death apart-what about those bedside and corridor procedures we undertake using our seemingly ‘conventional’yet scarely maneuvers-the tools: saws, blades, name it! While these may seem routine to a medic, Oh!, what a horror they are to the stranger-more so when they fail to yield good results.

While still caught up in trying to explain to those 5 patients that their stay on the ward did not mean they will be the next –it hit me hard how privacy during the dying process is a much needed thing in this setting! What do you think? May be a desensitization program for patients (&attendants) who witnessed a death could serve the purpose-given the high morbidity (or should I say poverty and poor governance) rates here that wouldn’t permit the Western picture. Regardless, such a program should serve to explain the reason for the occurrence of death, reduce fear and ultimately offer hope and trust in the system to the “survivor”.