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A doctor’s plea

Tuesday, April 3, 2018

So it appears that the answer to last week’s question, “Are parents still being asked to leave their ill children alone in the ICU in T&T?” is yes.

We were informed that, “Parents are allowed to visit the Paediatric Intensive Care Unit, between 10 am and 7 pm.” Nothing about family.

This is insulting. Such disdain for people. “Allowed!” There is a world of difference between “allowed” and “you are part of the team that cares for your child”. Fifty-odd years after independence and we are still aping discarded colonial rules.

These things no longer apply in the UK. Our paediatricians know this and have been trying to adopt a family-oriented approach to hospital care. It seems some of the nurses and “hospital administrators” are the problem. They know little about modern hospital practice, especially where children are concerned.

Please do not repeat the old canard, “Yuh in T&T, yuh know!” Or, “Trinidadian mothers will not do that”. Anyone saying that knows nothing about Trini mothers who are no different to any mother anywhere, good, bad and indifferent.

Trini mothers will do anything to help their child. And why not? Why would they not do this?

Forty years ago, when we started the Oral Rehydration Program for the treatment of dehydration from Gastro, I was told “those mothers won’t sit down for so long and give their children fluids by mouth!” They story!

They did so eagerly and have continued to do so.

Forty years ago we were told that Trini mothers did not want to breastfeed their children. Bah! Humbug! Our mothers are no different from other mothers. They want to do the best thing for their children.

Stop that “Trini different” nonsense. It’s how you approach the mother that makes the difference. Yes, there will be problems with a new dispensation. But the possibility of a problem should never prevent anyone from trying to improve.

It was a similar struggle when Eric Cameron, June Webb and I returned home in 1977, a new group of paediatricians. Family was not allowed on the children’s wards. You brought your sick child up from Casualty, handed it over to the nurse at the door of the ward, were “allowed” an hour or two in the afternoon “visiting” hours to be with the child and promptly issued out of the ward, grieving child or not. The screaming that ensued kept children up and sick and kept them longer in hospital.

With the assistance of a remarkable social worker, Miss May Cherrie, we were finally able, after 10 years, to convince the then medical chief of staff, Dr David Quamina, that the place for mothers was on the ward, with their children. We were resisted for years, not only by the older nurses, but by hospital administrators until they tired of us. Dire warnings were made: mothers would disrupt the ward efficiency, transmit infection, make the children behave bad. Nothing of the sort happened. It just took a different nursing attitude to the mothers, accepting that they were important members of the team.

The results were clear. Wards became quieter and children recovered faster. The mothers made the work of the nurses different. Mothers changed and comforted their children so nurses could do real nursing work. Most nurses thought about their new roles and changed their attitude. Others left. Good riddance.

The same thing has to happen in our Children’s ICUs. The evidence is clear. Having parents in the ICU helps. Encouraging families to visit helps. Children recover faster. There is less crowding. It saves money.

Morale amongst ICU staff improves. Families are pleased with the care. Hospitals care! National morale improves. There’s one less thing to complain about.

To paraphrase Madeleine L’Engle, we must regain the joy of life. Sadness hurts but there is comfort in caring. Without comfort our hospitals will fail and collapse. By extension, our country too. Kindness and competence go a long way.


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