Your health-related questions answered here
Re: Asylum-keeper's mentality, Health Supplement, September 27th
As a registered psychiatric nurse for the past eight years, I can assure you that neither I, nor my colleagues in clinical psychiatric practice, are "un-empathetic custodial asylum keepers". That's the role ascribed to us by Mr Pat O'Brien in his feature, Asylum- keeper's mentality.
Our concern always, as professionals in our field, is to prioritise the care of our clients. And yes, while we use elements of the traditional medical model for identifying symptom clusters and relating them to a specific illness as part of our planning for client care, we mainly use contemporary care models.
But Mr O'Brien's almost exclusive references to the traditional medical model masks the fact that personalised nursing care plans are devised daily in an holistic assessment of the client's needs using elements from numerous nursing models, both contemporary and traditional. Peplau's interpersonal relations model, which focuses on the nurse-patient therapeutic relationship as central to a person's recovery, is the model of choice in most psychiatric centres.
That relationship is nurtured in the daily contact nurses have with clients, through which they closely monitor a client's wellbeing. This is a vital nurse's role in psychiatry and by no means routine as Mr O'Brien suggests. That daily contact provides us with a clear indication of how well a client is responding to his or her personalised care plan. To gain a true picture of how a person's illness manifests itself and inhibits their normal functioning, the monitoring is deliberately discreet. But to confuse "discreet" with "non-existent" is doing a dis-service to the sensitivity and professionalism with which we deliver care every day, maintaining the dignity of those who may be unable to adequately care for themselves.
Thelma Kennedy Power, Paulstown, Co Kilkenny.
Re: Accident and Emergency care
Two years ago I crashed off my motorbike, and ended up in the A&E department of a large Dublin hospital.
My admission and examination was handled efficiently and professionally. The triage nurse marked me as a priority case, and I did not have to wait too long. My motor cycling leathers were removed by an attendant, my injuries assessed by a houseman and confirmed by the radiographers. I was put in a sling, given a prescription and an outpatient appointment, processed, packaged and sent home. The system worked well. I had nothing to complain about. I received a good service from our health service. And it all cost me only €40.
But there was something missing. Arriving in hospital, the victim of a road traffic accident, I was upset, in pain, hardly able to walk and probably slightly shocked. While I was indeed treated correctly by the busy and efficient staff, nobody actually asked me how I felt, nobody comforted or sympathised with me, nobody put an arm around me and told me everything would be fine, nobody wiped my brow with a cold, damp cloth, nobody "nursed" or "mothered" me.
In fact, I was acutely aware of the absence of anyone fitting my image of the old fashioned angel of mercy in the white uniform with time for a kind smile and a calming word. A self-indulgent whinge from someone who should be more grateful for what he did get? Maybe. But I do hope that pressure of work, demands of emergencies and modern efficiency will not eliminate tender, loving care from our places of healing.
Rodney Devitt Sandymount, Dublin