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|Year : 2015 | Volume
| Issue : 2 | Page : 147-148
A Bhalla, V Suri, P Kaur, S Kaur
Department of Internal Medicine, National Institute of Nursing Education (NINE) PGIMER, Chandigarh, Haryana and Punjab, India
|Date of Web Publication||13-Mar-2015|
Department of Internal Medicine, National Institute of Nursing Education (NINE) PGIMER, Chandigarh, Haryana and Punjab
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Bhalla A, Suri V, Kaur P, Kaur S. Authors' reply. J Postgrad Med 2015;61:147-8
The points raised by Senthil et al., are pertinent an extent, but border on nihilism.  The first and the most important aspect of caring for the sick in an emergency is the social fabric of society. A strong family bond coupled with compassion for the sick individual drives the first-degree relatives to the bedside to provide care. In developed countries, resident medical nurses are at the patient's bedside to take care of elderly, violent, agitated, and very sick patients. This is the ideal setup, where trained personnel who are not emotionally attached to the patient, provide evidence based care at the bedside. This, however, requires both manpower and training and adds to the cost. In resource-constrained settings of general/government hospitals/institutes that exist in the public sector, allowing a single attendant by the bedside is cost-effective. Maintaining strict control over the relatives visiting the patients would reduce the risk of infections and this policy needs to be developed by institutes or hospitals at the local level.
The point regarding communication has been adequately addressed in the original paper.  The authors did state that communication needs to be improved. There is a need of clear and frequent communication that updates the caregivers and also allays their anxiety.  Involving the family members in daily care gives them an opportunity to witness changes (improvement/deterioration) in the patient's condition and should, therefore form an important component of care. Frequent briefing can prepare family members for adverse outcomes, when they are expected. Preventing from being part the caregiving team may in fact lead to anxiety and discontent.
The point regarding the presence of caregivers during invasive/noninvasive procedures is not well taken as these procedures are always carried out in specially designated areas and never in the presence of a relative and after consent. The need for separate procedure rooms and resuscitation units cannot be emphasized enough. Crucially, any hospital is only as good as its residents and staff. The need to train staff and residents in communication skills and nonverbal communication, a highly ignored aspect of care, is paramount. While we appreciate concerns by Senthil et al., these are not backed up by evidence and we reiterate that as the caregivers are important cogs in the wheels taking the patients on the road to recovery in resource-constrained settings.
| :: References|| |
Senthil KS, Benita F, Manikam R, Thirumalaikolundusunbramanina P. Relatives' experiences in acute care settings: Barriers and remedial measures. J Postgrad Med 2015;146-7.
Bhalla A, Suri V, Kaur P, Kaur S. Involvement of the family members in caring of patients an acute care setting. J Postgrad Med 2014;60:382-5.
Jagannathan A. Family caregiving in India: Importance of need-based support and intervention in acute care settings. J Postgrad Med 2014;60:355-6.