DURING a recent hospitalisation overseas, I was subject to a less than pleasant encounter with one of the institution’s nursing staff. One of the stories I grew up reading about is that of the British nurse, Florence Nightingale, the Lady with the Lamp, whose kindness to soldiers injured in war set a standard for nursing to this day. Maybe, considering my own unfortunate familiarity with hospitals, I’ve a romanticised and hence unrealistic concept of what nursing should be, yet even compensating for that I’ve found that patient care, particularly as practiced by the foot soldiers of the health care system, can be vastly improved.

First of all, there are some professions I believe are callings more than they are careers – teaching, for example, or military service and nursing. What I’ve found unfortunately, in developed and developing countries alike – even though there may be a difference in the degree of training required for certification – is that there seems to be an attitudinal problem with health care as delivered by nurses.
In hospitals I’ve visited, whether locally or overseas, there are only a handful of nurses that I’ve encountered that I can say embodied the spirit of the Lady with the Lamp.
Another area of health care that I believe urgent attention is needed is the management of pain. If there is one thing that cuts across persons who have to be subject to in-patient healthcare is some degree or the other of pain, since pain is the body’s natural way of telling us that something is fundamentally wrong. While admittedly I am speaking from a layman’s perspective, I believe that there should be a difference between dealing with incidental pain and dealing with chronic pain – a difference of suppression and management respectively.
What I believe we are lacking, and this is again from a medical layman’s perspective, is a system of pain management. Apart, as I have stated before, from the fact that I was employed in the health sector, the evidence that there is the need for, at the very least, a greater focus on pain management in this country is that the very term “pain management” is missing from, or under-utilised in, the institutional and medical language here.
At its most basic, what this indicates is a need to identify the management of chronic pain in the treatment of those suffering from whatever manifestation of it. There is nothing I can suggest in this regard that has not been established and institutionalized elsewhere, with pain management specialists, pain management programmes, and pain management centres occupying a vibrant niche in the health sector
of various other countries. The establishment of a pain management centre here, with outreach programmes throughout the country would in my
estimation be a sound investment in complementing existing health care
initiatives in Guyana.

Related to the issue of pain management is that of patient education. For example, potentially addictive painkillers, or potentially addictive regimens of painkiller treatment, should really be the last resort in the treatment of any pain related condition or illness, and whenever the decision is taken it should include comprehensive patient education about the pros and cons, in addition to extensive psychotherapy throughout the duration of the treatment. This would save the patient a great deal of pain in the long term, whether actual pain or the psychic trauma that comes with dependency and the attendant stigma attached to it.

Related to this of course would be the issue educating patients about
their rights as patients, which presumes of course that those rights are clearly articulated in some inscribed and communicable form. While the concept of patient rights remain the subject of some contention
internationally (the US for example unsuccessfully attempted to legislate it in 2001), there are certain common tenets which characterised any such encapsulation, and these are summed up by the World Health Organization in the following paragraph:

“There continues to be enormous debate about how best to conceive of this relationship, but there is also growing international consensus that all patients have a fundamental right to privacy, to the confidentiality of their medical information, to consent to or to refuse treatment, and to be informed about relevant risk to them of medical procedures.”

In my humble opinion these are perfectly sound benchmarks to aim for, ones which I hope will find increasing traction internationally in the years to come.
Written By Keith Burrowes