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Health & Fitness

Patient comfort, safety key part of healthcare

patients
Being in hospital can be a most disruptive experience. FILE PHOTO | NMG 

Qn. “I was recently admitted to hospital, but my condition kept worsening each time I saw another seriously ill patient. I am lucky to be out of hospital, but what could explain my experience?”

You do not tell us why you were in hospital or even how long you remained there. If you were in hospital with a broken leg, then, as a human being you would be right in feeling bad if a fellow patient was brought in paralysed from the waist down. Yours will heal in a few months, his will take much longer.

In a similar vein, if you were in hospital, on a drip receiving care for diarrhoea and vomiting after a weekend of eating nyama and mutura, then your heart would sink and you might feel worse if a 50-year-old man is brought in with a heart attack that threatened his life. you will get better, he might not.

Some years ago, the ICU department at the Nairobi Hospital held its annual meeting and invited me as one of the guest speakers. Some doctors objected “because psychiatrists know nothing about ICU care”.

At the end of the day, many doubting Thomases had seen the light and confessed that they were unaware of the facts around mental health and ICU care, which could be one of the things you might have noticed.

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In one of the studies quoted at the seminar, more than half of former ICU patients reported symptoms of mental disorder, including anxiety, depression and Post-Traumatic Stress Disorder (PTSD). To put it simply, being in ICU, can, itself lead to psychiatric disorder. Sadly, it was also found out that the chances of dying in the two years after surviving ICU care were also high; at 47 percent! So, if you survive ICU care but also have depression, chances of death are high! Is this your question perhaps?

Are you perhaps telling us that you being in hospital could have led you to experience symptoms of anxiety and depression that you call “worsening of my symptoms.”

As a specialist in mental health, our experience is sometimes in the opposite direction. Upon admission to one or other of our hospitals, many are the people who report feeling better and relieved upon admission.

A few months ago, a woman was admitted for the treatment of depression. At the age of 32, she was married and had two children. Her relationship with her husband had deteriorated over some time before her admission; sleeping separately and were considering separation.

In hospital, she found herself in the same room as another mother, who had spent 10 days in the hospital receiving treatment for a depressive illness. Their stories were very similar and they ended up talking for many hours, and later became good friends.

The woman she found was aged 36, had two children and had a good job. She came into hospital after an attempt at suicide. Her husband had moved out of home and was staying with friends. She had felt hopeless and useless and life had lost meaning for her.

Upon examination at the hospital, she had lost much weight, was not sleeping well at night, and had become extremely irritable. She cried a great deal and often shouted at everybody around her including her husband, children and house help!

Her husband had moved out after sending the children to a boarding school to save them from the wrath of their mother. The two women were so alike!

During history taking, it emerged that this was the third episode of depression she was going through. The first was while she was at university and followed (or was preceded) by a breakup in a romantic relationship.

The second was in her early 20s after the birth of her first child. This third one had “no reason” because she and her husband loved each other and were both doing well professionally. They were the ideal couple and the envy of their peers in the estate and at church.

This was the story told by the more experienced older woman that might at the end of their contact, both women gave testimony to the usefulness of being able to talk to each other in a safe environment.

The new patient felt understood and not judged on her first day at hospital. She soon opened up to her doctors and psychologists and was grateful for the experience of being in a hospital.

Her experience is clearly the opposite of yours, but perhaps to make the point that different people have different life experiences in part driven by the nature of the illness that took you to hospital.

It also in part depends on the hospital you found yourself in. Being in hospital can be a most disruptive experience and all efforts must be put in place to ensure comfort and safety to patients.

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