Posted by: zdy1 | 14 June, 2009

Identity?

One of the things that has been striking for me in the first couple of weeks of being at the hospital is how often the nurses and doctors don’t know the name of the patients they are treating. I suspect there are multiple reasons for this including the fact that there is such a large turnover of patients, higher patient to nurse ratio and often patients on the floor as well as on beds which makes any bed labelling system difficult to manage.

The name issue is not too hard to overcome – fortunately “what is your name?” was one of the first Runyankore phrases to learn or if I just have a set of notes then it is not seen as unusual to go and stand in the middle of the ward and shout out the name until you get a response!

However what I have found hard is how little else I know about the patient. There isn’t a culture of comprehensive history taking here. From the notes I can usually find out the tribe and age of the patient, and also the home village (which may or may not mean anything to me), however occupation, family, type of accommodation, and other social history categories are not included. With my limited Runyankore I have not got to the stage where I can ask these questions myself (well I can ask a few – I just can’t understand the answers!!)

I can see how easy it could be for people to be reduced to just being their condition or bed space and that as your knowledge of the identity of a person becomes so limited how easy it is to just pass by that bed. For me as a Christian, I rely heavily on who I believe people are in God’s eyes as my motivation for providing treatment and time even on a manically tiring and busy day (and also rely heavily on God’s strength to help me try and do that!!).

However knowing more about the patient doesn’t necessarily make the job easier. Yesterday I was in a car with a American and Ugandan friend and they were discussing the fact that the brother of a good friend of theirs had died this week and the impact that was going to have on the family. A little later on we happened to pass the house of this man and saw the huge gathering that had turned out for the funeral. At one point my friends mentioned his name and I realised that it was someone who I had been working with this week. I knew he had died and somewhat accepted the death with resigned inevitability (several of my patients have died in the last two weeks!) but seeing and hearing about the people who had been affected by this death made it all the harder.

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