Address at the National Awards for Nurses, Rashtrapati Bhavan, New Delhi

Let my care, remove the pain

?Nursing is a beautiful mission?

I am happy to participate in the National Awards Function organized by the Ministry of Health and Family Welfare for recognizing the meritorious services of the nursing professionals in the country as a part of the International Nurses Day to rightly remember the great nurse Florence Nightingale. My congratulations to the award winners and greetings to the doctors, nurses, medical professionals and distinguished guests participating in this programme. In a hospital when no doctors, no relatives are around during night time, the nurses provide consolation and relief to the patients. At that time nurses appear to be divine lights to the patients in giving treatment and confidence. As children, we are all nursed by our mothers. I would like to share with you all, few thoughts on the topic ?Let my care remove the Pain?

Lady with a lamp

As I am in the midst of nursing community, the legend of Florence Nightingale, the mother of nursing profession comes alive in my memory. She volunteered to work for three years in the battlefield taking care of thousands of wounded soldiers traveling from England to Turkey in a ship. She walked four miles every night among sick soldiers with a lamp for light. The grateful soldiers would kiss the shadow of Florence Nightingale as she passed by. She is definitely an example of ?giving? for removing the pain of the suffering people. She opened the first nursing school and she wrote the first text book of nursing in 1860. She inspired many women to take to nursing as a respectable career. I particularly like her view on education. She says ?education is to teach not to know, but to do?. There is a big message for educationists from this statement.

Now, I would like to share with you an experience, which I had in Tripura where care, compassion and technology allowed an young boy with a congenital heart disease to blossom.

My Experience in Tripura

In October 2002, I inaugurated the Care Hospitals telemedicine units at the G.B. Pant Hospital, Tripura, and I interacted with patients at different centers where I came across a 13 year old boy from Kailashar, Tripura. His parents are farm laborers and even a tiny peace of land they own was sold to provide medical treatment to this boy before CARE hospital diagnosed the problem of this boy. This boy was suffering from chronic rheumatic heart disease with severe mitral stenosis. His heart ailment was noticed three years earlier, when he had complained of breathlessness and chest pain. He was also coughing blood and lost weight, according to his elder brother Ismail Ali. Doctors at Agartala found that his condition was serious and needed specialized treatment which was expensive. He discontinued his studies as he couldn?t take the strain of walking down to the school or even play around with the other kids. He was taken to the CARE Hospital at Hyderabad, and was treated by Dr. B. Somaraju and Dr. Raghava Raju who carried out the balloon dilatation. I had seen the boy after the treatment by the doctors. Nursing and rehabilitation of the boy took more than a month. I saw the nurses rehabilitating the boy patiently, diligently and kindly. The entire treatment and travel expenses were borne by the hospital. The boy?s condition is being continuously monitored and he is doing fine. He has also started going to school. Now, I would like to discuss about blending care with knowledge.

Blending care with knowledge

There has been a division between the technological and scientific basis of nursing and its nurturing or caring role during the last 150 years. Nightingale believed very strongly that good nurses were the product of moral rectitude, maturity and a deep understanding of the character traits needed to care for sick and vulnerable people. The second wave of reforms in nursing was led by Ethel Bedford-Fenwick (1857-1947) in England, and Adams Hampton Robb (1860-1910) in America. They chose a medical model for professional nursing which emphasized education in the sciences. In 1909, Dr Ida S. Scudder started India?s first School of Nursing at Vellore.

In the 21st century, nurses have to become knowledge workers because of the advancement in healthcare technologies. Today, with the rapid advancement in healthcare system and creation of specialties and super-specialties in medicine, there is definitely a need to look at the super specialties needed in nursing to compliment the doctors. Now, I would like to share the importance of specialists training to the nurses, for providing modern healthcare brought out in the Conference held by a Health Institute in US.

Brainstorming in John Hopkins University

Institute of Health in US in a recent survey found that 95,000 deaths occur per year in the United States due to medical errors. We should estimate the exact numbers for our country. Though this information can be debated, it is indeed very disturbing. It was recognized that there is a need for change in approach in medicare to improve the safety and quality of care to patients. In this connection, it was felt that it is important to train the doctors, the nurses, paramedics, technicians and everyone connected with medicare. Modern hospital is a very complex organization and there are challenges ahead to improve the safety of the patients. Quality medicare is possible only when people work together as a team. Recently a seminar was conducted in John Hopkins where there was a brainstorming session between the doctors, medicare personnel, patients and the relatives of the patients which brought out all these factors very clearly.

I will be very happy if our hospitals conduct such type of review periodically in the combined meeting of doctors, nurses and paramedical staff. I am telling this audience, because this type of integrated conference has been conducted after the occurrence of tragic incident in John Hopkins Hospitals. A child?s life was lost because of judgement error in their diagnosis at the right time. The mother of the child briefed the whole incident to the combined gathering of the hospital team. It was a very moving experience. Particularly while attending the patients in pre operative, operative, post operative and recovery period, large number of sophisticated instruments and monitoring systems are used. In this scenario, experience of treatment and the problems have to be shared together on fixed days of the week and the results documented. It will become a teaching wealth for the nursing community and the medical professionals.

Nurses as Teachers for Patient?s families

Recently, there was a meeting of cured patients, their doctors and a few social workers in a hospital. One important point emerged during the interaction was, that the relationship between the patient and doctor extends to patients? family. This in turn, transmits effective messages from one family to another family on advice to prevent diseases, necessity of periodic checks, the dietary habits and the need for life style changes including exercise for good health. Actually, I believe this good contact between the doctor and patients is very valuable. If we have specialists nurses performing this role, it can enable the families to understand the disease prevention method leading to a healthy way of life. I request every nurse to become a teacher for the families of patients. By this complimentary role, the work load on the doctors will come down and the patients and their families will be benefited substantially.

My Experience in Philippines

In 2006, when I was in Philippines, I addressed and interacted with the students and faculty members of the College of Nursing of University of Philippines. Pilipino nurses have established the credentials of nursing profession all over the world. Just like Indian nursing community, the hard work hard work of Pilipino nurses in world?s best hospitals has kept alive faith of people in modern medicine. The nursing college of University of Philippines is indeed a unique college that has a Ph.d programme in nursing. Qualified nurses can practice medicine in the rural primary healthcare centers. In India, we should conduct number of Post Graduate nursing degree courses for our working nurses through distance education system, so that we can give them career growth potential.

I have discussed with both Philippines and Indian nursing experts. Dr. Josefina Thazn, Dean of Nursing in University of Philippines visited here. It is essential that there should be common classes in physiology, psychology and anatomy for graduate and post graduate nurses along with MBBS course participants. Also, the Indian Nursing Council should review their nursing courses continuously in view of the continuous technological changes taking place. I was very happy to see certain Post Graduate education coming up recently through a distance education programme in CARE Hospitals in partnership with Netaji Subhas Open University (NSOU), Kolkata. These courses empower the nurses to take up carriers in Hospital Managements and as Nurse Clinicians. I would suggest other hospitals spread in different parts of the country to consider institution of such in-house training facilities for the nurses so that they can have continuing educating programmes to upgrade their skills and knowledge.

Conclusion

We need good hearts to treat the ailing hearts, we need helping hands to remove the pain, and we need beautiful minds to give happiness to the patients. I have discussed with you certain features on blending care with knowledge, importance of brainstorming in hospitals, nurses playing the role of teachers for patients? families and my experience with Philippine nursing system. In this context, dear members of nursing community, I have designed a six point oath for you. Can you repeat the oath with me? Oath for Nursing Community

1. I love my profession of nursing, the noble mission.

2. I realize, removing the pain is a great Godly mission.

3. I will treat all patients equally with kindness and care.

4. I will take special care of at least 20 rural patients.

5. I will be a life long learner in nursing.

6. I will follow the motto ?Let my care, remove your pain and bring smiles?.

Once again let me congratulate all the award winners and my best wishes to the nursing community for success in their mission of removing the pain of the needy patients.

May God bless you.
Dr. A. P. J. Abdul Kalam