Happy Nurses Day and a bit about Nightingale

31 07 2013

The week long celebration started on Monday. I haven’t been to the hospital the entire week, so I’m not entirely sure what is going on there nor have I been able to have a heart to heart talk with my nursing friends and colleagues.

I noticed, when I was in India, that they celebrate theirs on the 20th of May which is the birthday of Florence Nightingale. Although we grew up with the image of her as a self-sacrificial figure in the care of fallen soldiers, she was much more than that.

As an educated, empowered woman, she is, to an extent a feminist symbol for rejecting the suffocating expectations placed on an upper-class woman to be a baby-making machine. Instead, she decided to be a nurse, against the wishes of her her family. She was also known to travel widely and work with politicians, write extensively and do big-picture planning.

It is also easy to forget her role as a pioneer of the hospital  as a well organised system. Her experience in the Crimean War showed that many soldiers were dying from diseases apart from the battle injuries. She seems, from my reading of her Wikipedia entry, to be an early adopter of some sort of Evidence Based Medicine. Which, to put simply, is the use of scientific methods to understand if your treatment is working and to tease out the risks of it. Her background in statistics probably helped and she actually compiled data on her patients as opposed to basing her ideas on “experience”. The patterns she observed from this eventually led her to place great emphasis on sanitation.

The next time the ward sister reminds you the clean your hands in the MRSA ward, it’s Florence Nightingale speaking through her 😉

On a more personal note, although Nurses play a great variety of roles, my experience of them has largely been as “guardians”. Watching our backs, administering treatment, actually caring for patients, apart from merely treating them. Often, they take the brunt of the aggression from angry patients.

As a friend of mine often points out, I do wonder if they are under-appreciated by physicians, although there have been a lot of hints that the system could do better in taking care of them. Perhaps it is time to reconsider how nurses are remunerated? Maybe there is a need to clearly define, or perhaps redefine nursing? I do not know what the future holds and I don’t have immediate ideas. Nonetheless, I am greatly indebted to those nurses I have had to privilege to work with, both personally and professionally.

Happy Nurses Day!

 

And here is a picture of Nurses going on strike in Singapore in the 60s. It is still on the wall at SGH, I think 😛 Not that I am encouraging you to go on strike (we will all die), just that I have faith in the community to be resourceful and make bold reforms.

Nurses on Strike!

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vodka grapefruit!

28 04 2013

I wonder a lot and I don’t always find answers to my questions, but when I do, it’s fabulous 🙂

Caveat: Ain’t encouragin’ no drinkin’ here. Photo by Vikingfjord US

This is a story of how a bunch of researchers discovered the wonders of Grapefruit. All medics know that grapefruit juice has certain compounds which affect how the body processes certain drugs. I took that for granted until one fine day, I asked myself, “How did they figure that out?”. Did doctors, while taking a history of a patient with some trouble with their drugs, ask if they had soy sauce, maple syrup on their waffles or grapefruit juice for breakfast? Did they then do the same thing with other patients with similar problems and see a pattern? I have rarely heard a physician go into that much detail about diet so I doubted that explanation. I looked up the literature (kidding, I just googled it) and uncovered an interesting story.

Sometime, either in the late 80s or early 90s, David Bailey and his team of Canadian researchers were doing experiments to see if consuming alcohol together with the blood pressure drug felodipine made any difference to the drug’s effectiveness. The participants were split into two groups, one was given alcohol plus the drug, and one, just the drug. To avoid the placebo effect, the experiment needed to be conducted in such a way that the subjects did not know whether they were having alcohol or not.  Turns out one way to do this is to use a mixer. Specifically grapefruit juice, the sharp taste of which would mask the taste of alcohol. When they ran tests on the levels of drug in the subjects’ blood, they found out that the drug levels were way higher than expected, even in the grapefruit juice group.  And that friends, is how we discovered the effects of grapefruit juice.

It turns out that pomelo and lime juice can also affect drug processing, while orange juice seems safe.