By Ramani D.Wickramaratne

The word ƒÆ’‚¢ƒ¢-¡‚¬ƒ…- NurseƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ embodies a paragon of nobleness and virtue which most of us fail to realize. A patient puts his/her life in the hands of the nurse with the hope that a nurse will be able to help him/her back to normal life with due care and nursing. As a child, many are the times that the writer has been amazed at the serenity and calmness with which a hospital Nurse or Sister carried out her duties in the wards whether in private or government hospitals amidst the crowd of patients under their care.

The writer through her own personal experiences and observations during the last 22-25 years, decided to write thisƒÆ’-¡ƒ”š‚  with the sole purpose of engaging the readers with the nursing services provided in this country and what and how best such services could be provided to those who seek it.

The word ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-NurseƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ consists of the following noble and profound essence of the profession to begin with- ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-NƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚-nobility; ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-UƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚-understanding;ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚RƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚-responsibility; ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-SƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚-sympathy and simplicity; ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-EƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚-efficiency and equality. When we thus understand the meaning of the word ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-NurseƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ the readers will be able to understand why Florence Nightingale has left such a lofty & valuable legacy for all the kind-hearted Nurses who wish to go on a path of service towards the feeble, sick and ailing people in the services of a nurse to help patients on their path to recovery.

To fulfill this necessity of providing nurses and nursing services to the terminally ill and aged citizens of this country, the concept of ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-Home Nursing ServicesƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ developed and entered our country during the last 20-25 years. No doubt families having elderly parents who require constant monitoring and companionship were and are, relieved to note that Sri Lanka too has organizations that provide such ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-Home- Nursing Services.ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ whereby their elders could receive nursing care in their own familiar home environment rather than in a hospital.

The writer had the good fortune of becoming acquainted with this concept of ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-Home-NursingƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ during 1995-6and most importantly, to get an incite into the workings of such service, the doƒÆ’‚¢ƒ¢-¡‚¬ƒ¢-¾‚¢s and dontƒÆ’‚¢ƒ¢-¡‚¬ƒ¢-¾‚¢s and appreciate the good, the bad and the ugly as witnessed in our country about which we need is be aware of, if we hope to gain maximum benefit both for the nursing service and the clients involved.

Nursing is a professional service which has no time limits for providing care to the sick and ailing, at times it could very well be a 365 day service extending to many years of selfless caring for patients who cannot fend for or help themselves. (quote: Nursing is a great service whichƒÆ’-¡ƒ”š‚  cannot ƒÆ’-¡ƒ”š‚ be valued by monetary means since the nurses are expected to look at a patient not as a ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-clientƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ but as a ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-human beingƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ which is described as ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-Holistic care.ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ The nursing profession and holistic care is based on a great philosophical description where Environment, Humanity and Nursing are the pillars of Health. Health is described not just treating patients but described on maintaining health status,ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-Promoting health,ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-wellness,ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-recreationƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ and lastlyƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ the care of ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-Dying.ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ (end quote: Sunday Observer 13-5-2012 page 78 ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-The Holistic care and Uplifting the Nursing Profession,ƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ Thoughts for International Nurses dayƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚). ƒÆ’-¡ƒ”š‚ ƒÆ’-¡ƒ”š‚ 

As mentioned above, the writer became acquainted with the ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-Home Nursing ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-concept in 1995-6 due to contact with the late Mrs.Srimathie Amerasinghe herself a retired Nursing Sister who at the time was in charge of Ceylinco Home Nursing Services located at Ward Place-Colombo 7.when the writer required such services to look after her mother during her waning years. It is with deep gratitude that the writer wishes to state that the contact with the late Mrs. Amerasinghe and the service provided at the time were extremely useful. Contact with her also gave the writer a rare chance to watch how her Nurse-aides( at the time they were not called ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-NursesƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ but ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-Nurse-aidesƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚) were trained to take care of patients. Hers was a life of commitment to the nursing profession and spared no pains to understand the individual needs of her clients. The building which housed their office also happened to be the never ending training centre for her young employees. It is indeed sad that the company lost such a wonderful human being. However it needs to be stated with regret that with the demise of Mrs. Amerasinghe, the quality of service offered by Ceylinco Group in the field of nursing also saw a downward trend.

ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-Home NursingƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ is a service that needs to provide to the sick, irrespective of whether or not a patient is undergoing western medication or Ayurvedic medication and the nurses sent on duty must not be mere human robots used as a source of earning money for companies or individuals claiming to provide ƒÆ’‚¢ƒ¢-¡‚¬ƒ”¹…”Home NursingƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ services. The young nurses must be briefed well about the specific individual needs of the client/patient to understand how to provide the required care and service. Such nurses must understand the suitable dietary patterns of a patient be that person a heart patient, a diabetic, a stroke patient or a patient suffering from any other specific ailment.

The writer herself suffered a stroke in March 2011 and had been using the services of yet another ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-companyƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ providing ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-Home NursingƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ and during this one year made certain observations which no doubt would enable or help those prospective ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-clientsƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ how to determine the most suitable and reliable provider of ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-Home NursingƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ services for their near and dear family members if and when such service is required. It is necessary for providers to understand that the client who pays for the Home Nursing service have every right to expect that they are allocated nurses who understand what their duties and responsibilities are, serious and kind hearted nurses must familiarize themselves with the specific requirements of the client or patient.

Companies providing ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-Home NursingƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ staff must understand the serious nature of a human life that is handed over to them and must be careful not to manipulate their clients but go all out to help such clients. Honesty is of utmost importance when staff is allocated. The nursing staff must be able to report truthfully, all incidents which take place at their duty station to their managers and family members of the client/patient.

ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-Home NursingƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ is an extremely holistic and noble service with a highly committed duty and responsibility that the service provider undertakes and must not undermine the intelligence of their clients. This is a service that has tremendous scope in countries like ours where there is a dire need to have professionally qualified nurses and not glorified ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-attendantsƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ posing off as nurses. Therefore, the writer with all sincerity hopes that both the service provider and the client/patient both understand each otherƒÆ’‚¢ƒ¢-¡‚¬ƒ¢-¾‚¢s duties and undertakings given the fact that it can be a matter of life and death if nursing care is not done with commitment and care. In this effort, the writer would request prospective clients/patients to kindly satisfy themselves on the following points before making the decision to employ a ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-Home NursingƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ company:

(1)Do such organizations have recognized affiliations with either The Dept/Ministry of Health?;(2)Is the Manager or owner of such a company herself/himself professionally qualified in the health sector and/or nursing?; (3)Is the company registered with The Registrar of Companies or The Ministry of Health? If ƒÆ’‚¢ƒ¢-¡‚¬ƒ…-yesƒÆ’‚¢ƒ¢-¡‚¬ƒ”š‚ check year of registration and under which government department?;(4)Does the company have a bank account under the registered company name? It is important that the account must be in the name of a company and not a personal account with the name of an individual;(5)The period of time a nurse is trained in Home Nursing once they are employed and before being assigned for duty?;(6)Do the staff sign an employment agreement or contract with the company?(provide proof);(7)Does the company contribute to EPF/ETF?; (8)What facilities are offered to the staff to further their academic qualifications- specifically the nursing profession? The writer is of the opinion that qualifications in Science subjects is not a must provided the individual is committed to learn and serve;(9)Do the staff have a regular roster for them to relax and rest? It is a must that the staff are rested well to give the best nursing care to their clients/patients?;(10) Does the company obtain regular staff evaluations from their clients? Such evaluations may be supplied to clients upon request; (11)What training is offered to nursing staff regarding the nutritional/dietary requirements in relation to your own specific patient ailment?;(12) Does the staff undergo a medical check-up at time of employment? It is important that the nursing staff are healthy, for them to be able to offer nursing care to your patient.

All those involved in the health sector need to understand that the services provided by them is to ensure the recovery process of the sick and therefore no psychological burden is put on the patient/client who requires such Home Nurses services. The service provider must feel duty-bound to take their role in this society seriously and understand the seriousness of the assignment undertaken to ensure that this country offers a trusted Home Nursing service to the citizens of this country. It is not asking too much for the sake of the feeble, lonely and ailing clients/patients of this country, that a trustworthy, dependable Home Nursing

Service is provided to the tax paying citizens of this country and the writer sincerely hopes that the relevant authorities monitor discrepencies and rectify the situation before it is too late. Without a doubt, majority of the service providers are responsible while a minority few may not be. It is this minority that we need to be worried about!