I have no idea of the officially accepted normal strength or composition of the nursing staff in a rather large hospital ward. At Victoria hospital, on a night in early January last when I was considered to be very ill, I could see three gentlemen continuously occupied, coping with all the nursing duties in a ward with thirty-five or so sick or very sick surgical patients. From the badges on their lapels I gathered that one was the charge nursing officer and another a nursing officer. The third described himself as a health aid or assistant when I told him I could not read his rather distant badge with the glasses I had because the inscription was unfamiliar to me.

These three persons, looking earnest, confident and friendly, always seemed to be in demand. They were as a rule still attending to one person when they received a call to go to another. I wondered whether they had periods of respite that kept them fresh. But I noticed that there was not much occasion for that. My own conclusion was that they had learned to keep doing their work in an unhurried manner and do it properly, rather than get disturbed by the call, start rushing through the job on hand, and accumulate stress and the fatigue that stress induces.

I have been wondering how and where these men found the energy and the will to keep ministering to the needs and the requests of all the patients in their care. The tasks they have to attend to are not always as simple and neat as making a bed or giving an injection. They also include the personal hygiene of patients. The cleaning and bathing of a person who is not fully autonomous can be a difficult job requiring patience and skill, and of course a certain amount of compassion and fortitude. This is made even more difficult if the patient is grumpy or uncooperative. Indeed there are a few who try to resist all interference with their person and are downright offensive in their language. And there are those who call for assistance much more often than others.

Is the behaviour of individual patients a reflection of their pains and their apprehensions ? In spite of all the assurance given by the staff, the sick person cannot help feeling a little uncertain about the outcome of her or his illness and its treatment. It would appear that the nursing staff is as a rule sympathetic to all these feelings of their clients as they never seem to take offence. Apparently they have accepted human nature as it is, and even if they do pass judgment on some people they have resolved not to show it.

The steadfastness and the fortitude with which members of the nursing profession go about their work day after day inspired me to look a little more deeply into the details of their work. I thought the simplest way to start would be to get acquainted with the course they followed. I have had nursing instructors among my friends, and nursing officers and nurses among my relatives, but of course no one learns the details of the jobs of others. I therefore got hold of a textbook of nursing and leafed through it, reading a few pages here and there to gauge the depth to which it went in the subjects it treated. I found that the course is designed to give the trainee a good working introduction to a variety of disciplines like chemistry, physics, biology, psychology, social science, as well as to subjects of more immediate interest in their work: medicine, pharmacology, surgery, physiology and human anatomy. But apart from these mainly academic courses, the textbooks go on to explain the methods of going about the work. The course taught in the lectures is backed up by practical work in the wards.

A very important aspect of their course consists of training in the difficult and demanding art of making patients feel accepted, recognised and loved, and feel that their dignity is not suffering from the dependent state they are in. It is impressed upon nursing students that this psychological care contributes in no small measure to the recovery of patients.

After thus learning a little about the contents of the nurses? three-year course, I realized that the self-assurance I could see in the facial expression and the demeanour of nursing officers came from their certainty that they had the knowledge, the competence and the ability to cope with the situations likely to arise in their work. They know that doctors examine the patients and prescribe treatments, diets and the rest, surgeons come and see how the cases they operated upon are faring and give their recommendations. But the patients? comfort and welfare, the administration to them of the medicines and injections prescribed, periodical checking and recording of their temperature, blood pressure and pulse rate etc. are entrusted to the nursing staff. Most doctors recognise that certain procedures like inserting a needle for intravenous infusion, or inserting a tube for draining out fluids from the stomach are best left to the nursing staff.

Having been an in-patient in the hospital for a week an out-patient at the dispensary for three weeks, I have acquired an even greater respect, and a new admiration for the nursing staff. And of course a deep sense of gratitude. As has often been pointed out, their contribution to the recovery of patients is immense.

by Sanjai PADYA Sanjai Padya is a former director of the Meteorological Services