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The role of ventilators is critical for critically ill patients like Covid Nineteen. The life and death of the patient often depend on having a ventilator. The ventilator artificially supplies oxygen to your lungs and expels carbon dioxide, which means that the ventilator allows the patient to breathe artificially when they cannot breathe alone.
But giving this ventilator does not mean that it will save the lives of all patients. That is why it is up to doctors to decide when they believe the patient is no longer alive and to discontinue ventilator therapy.
Juanita Nitla, Chief Nurse of the Intensive Care Unit at the Royal Free Hospital in London, said: “ Turning off the ventilator is a very stressful and painful time. Sometimes I feel like I’m responsible for that person’s death. ‘
Born in South India, Nittala has been working for the National Health Service (NHS) in England for the past 18 years. She is a nurse specially trained in intensive care. “It’s my job to turn off the ventilation,” said the 42-year-old nurse.
Last wish
One morning in the second week of April, when Nitla joined her shift, a doctor from the Intensive Care Unit (ICU) told her to stop treating a patient with Kovid-19. The patient was a community nurse by profession, in her 50s. Nitla told the patient’s daughter about the entire process.
“I assured him that his mother was in no pain,” he said. He is very calm. I asked him if his mother had any last wishes and if he wanted something religious.
The beds in the ICU are next to each other. All the patients he cares for around Nittala are unconscious. ‘All the patients are seriously ill. I surrounded the patient with a curtain. And I turned off all the alarms. All medical personnel stopped working for a few moments. The nurses stopped talking. Respecting the patient and giving him comfort is our priority then. ‘
Nitla picked up the phone near the patient’s ear and told her daughter to ‘speak’. “It is just a phone call for me,” he said. But for his family it was a great find. They wanted to make a video call. But unfortunately, the use of mobile phones within the ICU is not allowed.
The machine is off
At the wishes of the patient’s family, Nittala played a certain music video from the computer. Then he went and turned off the fan switch. In his words, “I sat next to him, holding his hand until my breath came out.”
Only doctors decide to stop all breathing equipment and treatment and they do it with great care considering all aspects, such as the patient’s age, if he has any other illness, how he responds to treatment, his recovery. Analyze all the possibilities. The patient died five minutes after turning off the ventilator. “I saw the red light on the monitor and a mechanical signal to stop the heartbeat on the monitor screen.”
Lonely death
Nittala opened the medicine they were giving him to keep him asleep. Since the patient’s daughter did not know what was happening, she kept talking to her mother. I was listening to some sentences on the phone. Nitla had a hard time telling him, but she still took the phone in her hand and told her that her mother was dead.
As a nurse, she says: ‘Responsibility does not end with the death of a patient. With the help of a colleague, I cleaned him, wrapped him in a white cloth, put his body in a body bag, and, before closing the bag, religiously marked the cross on the patient’s forehead.
Prior to this coronavirus outbreak, doctors would speak to family members before stopping a patient’s treatment. Close family members were allowed to enter the ICU before the artificial respiration device was turned off. It has now been closed in many countries around the world for fear of becoming infected with the coronavirus.
“It is very sad to die like this alone,” said Nitla. He says he is trying to overcome emotional pain by being able to help those who are dying. Matini has seen patients who cannot breathe, who are holding their breath: “It is very difficult to see.”
No bed
So many people are being admitted to hospitals that the number of critically ill beds has doubled. All beds are admitted by the patient. The beds in our hospital ICU were 34, now 60. 175 nurses work day and night shifts.
Typically, a nurse is responsible for each patient in the intensive care unit. Now a nurse cares for three patients. If the condition worsens, a nurse will have to care for six patients each.
Some nurses on your team have been diagnosed with symptoms. They are in voluntary isolation. The hospital is training other nurses quickly so they can take the helm if necessary.
‘Before the shift starts, we hold hands and say to stay safe. We keep an eye on others. We make sure everyone wears gloves, masks, and PPE properly.
Fans, pumps, oxygen cylinders, many medications are missing now. However, your hospital has enough PPE for the entire team. One dies in the ICU every day. This number is much higher than before the epidemic.
Being the head of the nursing team, she often repressed her fears. He said: ‘Panic engulfs me at night. I can’t sleep. I just think I’ll get infected with the virus. We talk to each other Everyone is afraid.
She was diagnosed with tuberculosis last year. I couldn’t go to work for many days. He knows that his lungs are less stressed. He said: ‘Everyone says don’t go to work. But now the epidemic continues. I am working to eliminate all thoughts. Every day at the end of the shift I think of those who died for my service. But I try to get all the worries out of my head after setting foot out of the hospital. Source: BBC
Dhaka Times / April 17 / AK
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