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.....That is the end

Eva Majdová
Language: English
Country: Slovakia
Typology: health care professionals
Text:
Mrs. Hana is desperate. Even on the day of her arrival to the hospital she worked in a garden as usual. She drove the car to the hospital before her surgery, her husband and son were just accompanying her. She was in full strength and expected to deal well with the surgery and recover fast. Now she is not even able to sit on the bed without help, her whole body hurts. She wanted to get up and go to the toilet but her head spun and she almost fall down. She rings the nurse bell. The nurse helps her to get up. Hana’s legs shake and after 2-3 steps she has the feeling of falling down. Her head spins. It appears that removing her uterus changed the whole world for Hana. Mrs. Hana is 56 years old, teaches at a college and lives with her husband. She has three adult children who have their own families now. She spends her free time with her husband and her grandchildren. She likes to work in a garden and goes for walks with her dog. She lives active, dynamic life and spends a lot of her time with her students. Up to now she did not have any physical restrictions. The last preventive examination at her gynecologist has shown that there are some problematic neoplasms in her uterus, which carry the risk of being malignant. The doctor recommended her removal of the uterus and taking into consideration her age he recommended also removal of her ovaries. Now it is about 6 hours after a successful surgery and everything has changed. Mrs. Hana is in her room in the hospital. She cannot sit on the bed, not even to get up on her own and take small steps. It is not her first experience with operation so she did not expect this. A nurse noticed Hana’s surprise and her quandary. Before she takes her to the toilet she has a talk wih her and asks her how does she feel. Hana is surprised by her sudden weakness and immobility. She does not understand what causes it and she is afraid what is going to happen. The nurse explains to her that the surgery she underwent causes blood loss and depletes the body and that Hana is just a few hours after it. She suggests her to rest for next 2-3 days and her body will regenerate sooner. If it would no go better it is on doctor’s judgement whether the transfusion could help. She teaches Hana how to sit up without the pain with the help of her hands and displacing the center of her body. She explains her how to get her cardiovascular system adapted to the change of the position, how to get up on stages and how to avoid vertigo. She recommensd her to call someone before she goes to the toilet until she will feell stronger. Hana has to learn to respect the new limits her body has after the operation. The nurse emphasizes that it is just a temporary stage in which she needs to gain some stregth and that there is no reason to be afraid of the future. Hana needs more professional explanations about the cause of the sudden change that she feels, so the nurse explains Hana with the help of simple examples the intensity and the range of intervention from which her body needs to recover. She compares Hana’s wound with the other she knows – she asked her whether she has ever cut herself in the kitchen, whether she recalls how it hurt and how long it lasted, how long it was bleeding and how long it took to heal. Hana starts to have more adequate idea about the range of the wound which is going to heal in her abdomen and why it is so tough to deal with it .She understands the context better and she calms down. It helps her to know what is going on, what is the supposed progress and also that something about what she feels as scary and dangerous is just normal post operational progress without complications. Under the influence of arguments Hana decides not to force her body into mobility and accepts the offer of help with things she cannot do on her own. She lets others to help her get up and walk her to the toilet. On the next day the nurse helps her to shower in a way that the wound does not get wet. The nurse also explains to her that sensitivity when urinating and unknown feelings are related to the operation and that they will end in a few days. Hana feels more confident after explanations so she can handle the discomfort better. When her husband and children come to visit her she can explain them that they do not have to be afraid because of her paleness because her body can handle it in a few days. Even though Hana is hurt and exhausted she cares about her family and does not want them to be afraid of her. She can ask for a support on her way to the toilet while she does not want to risk a fall. OBJECTIVES: Protection against a fall. Prevention of complications. Reduce fear. Remove the feeling of helplessness. Gradual regain of her self-sufficiency. MEANS AND STRATEGY: Clarifying and calming conversation, training of painless and safe movement after a surgery. Promoting confidence. CONCLUSIONS: Hana recovered after the surgery in adequate time. After a week she was released from the hospital to home treatment. In the first hours she had to accept that her body has its limits and regains its lost strengths slowly. When leaving the hospital she is able to safely get to the toilet, take a shower sitting and if something in her self help activities does not seem safe to her, she asks for help. For example, the relatives still tie her shoelaces.


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