Thursday 3 November 2016

Survival Lessons Learned Beside the Hospital Bed - A Nurse's Perspective

Last year I covered a few lessons that I learned as a patient during a stint I had in hospital, which in turn gave way to the idea of writing about some of the lessons I have picked up on the other side of the hospital bed.

  This article is a collection of ideas that I have picked up over the last few years working as a nurse in various settings within the healthcare system, though my primary area of experience is in high-level Aged Care. During that time, I have picked up many personal lessons and had many survival theories that I am yet to put to paper, and these are the primary inspiration behind this writing.

   Medical personnel will have difficulty performing their duties without technology: Modern medicine relies heavily on modern machinery and electrical equipment. Whilst most hospitals and nursing homes have generators that can run their basic power if they lose electricity temporarily, should the grid go down for any extended period of time we will have a much different situation.
  Many air mattresses rely on electricity to prevent pressure ulcers, IV lines rely on power to give an adequate dosage of IV medications and from a security point of view, many of the locks to the hospitals and nursing homes rely on the facility or ward's electrical system to function. Without modern amenities, many new skills would become obsolete, and many old skills would need to be relearned.

  The elderly and infirmed would be left behind: Its an unfortunate reality, but many of our elderly and those unable to fend for themselves will be lost after a major event. Whilst those people may not be lost immediately, should the power grid be down for any longer than a week; I would envision many healthcare workers either walking out on the job or simply being unable to get to work. This of course, would depend on the event causing the grid to go down.
  Many of these people rely on nursing staff to manage simple tasks like walking to the toilet, eating breakfast or making an afternoon coffee and without those same nursing staff to perform those duties, their health would very quickly deteriorate.
  With this will come many mentally ill patients suddenly on the streets, without their required medications and health care. This will contribute to the violence and unrest already occurring in the are as well as putting those who live in close proximity to these facilities in immediate danger.
  Those with advanced cases of dementia who are known for wandering the facility in the later parts of the day(better known as "sundowners") will find the way out that they have been seeking and would not only put themselves in immediate danger but also be a danger to those in the immediate vicinity.

  Your co-morbidities may kill you before robbers, looters and marauders do: I covered this briefly in my companion article, however I feel that I should go into greater detail. Last June, my bowels decided to grow an abscess on the left side of my large bowel, causing infection, severe abdominal pain, vomiting and diarrhoea. It's safe to say that without adequate access to IV antibiotics, pain relief, anti-emetics and the correct diagnostic tools, I would not be around to write this article today.
  Whilst as far as chronic conditions go, I got off light with diverticulitis, this is the entire point. A seemingly minor and manageable condition such as diverticular disease, diabetes, nut or egg allergies, asthma and even a well managed mental health or personality disorder; can become a death sentence without the technology, infrastructure and knowledge in place to deal with condition when it becomes an issue for the person suffering from it.
  
  Hospitals and medical facilities are a survivalist's smorgasbord: Every time I walk into the store room to  get anything from continence aides, wound dressing packs, saline for injection, plastic bags for bin liners, surgical scissors or even just a pair of non-sterile gloves for day to day duties; I am met with the same thought, that this is a veritable supermarket for survival supplies.
  This in turn will make hospitals and even nursing homes hot spots for conflict, should a pro-longed event occur and we are living WROL. Forgetting the fact that essential medicines are kept on premises, with most hospitals even having a pharmacy on-site for quick dispensing of medication to the wards and as mentioned above, should the electrical grid go down, the electrical security safeguards would not be in place; and looking purely at the non-medication based supplies available there is still a wide variety of supplies accessible.
  Things such as bandages and wound dressings would be highly sought after, topical antiseptics and ointments would be looted very quickly, food would be taken from kitchens, even the fuel from their generators would be targeted and siphoned off.
  In essence, medical supplies would become a commodity and those who have formed together in organised groups may choose to either protect the facility or ward, including those in it, or they would choose to over-run the area, loot the supplies within and at best leave those who are left, in their beds to die.

  Hospital staff may become hostages: Whilst looters may very well steal the supplies they need, there is no guarentee that they will have a person within their group who knows how to use the equipment and supplies that they have newly acquired. It may be that either one or more of the nursing or medical staff will find themselves the victim of abduction and essentially become a hostage of the bandit group. As stated above, it is also possible that these looters may choose to take up residence in the ward or facility, taking on both the staff and patients as a part of their group.


  Whilst this has been my most grim and bleak piece so far, these are just a few issues that have been swirling around in my head and it's nice to have finally put this piece together. I may write another follow up piece further down the track. I hope that you find the information here informative and useful and I will hopefully write another piece for you very soon.