IN SIGHT
A model in compassion and duty, Nurse Phornsiri Ruansawang took the initiative to treat patients with infectious diseases at a time when few people would
SIRIPORN SACHAMUNEEWONGSE
Not everyone would be willing to spend 28 years of their occupational life at an institute for infectious diseases, but Nurse Phornsiri Ruansawang has not only done so, she's brought such dedication and compassion to the job that she recently received Thailand's first-ever "Humanised Healthcare Award" for her near three decades-worth of service.
The award was presented to Mrs Phornsiri by the National Health Foundation in a ceremony on March 14 this year.
One common story that has been told of Phornsiri concerns her first patient, an overseas prisoner infected with HIV, at the Bamrasnaradura Institute of Infectious Diseases.
The occasion dates back to 1986, when patients infected with the virus were almost deemed untouchable by nurses, who feared that they would contract the virus from simply coming in contact with the infected patients.
Phornsiri recalls the patient's feet and hands were chained and that because he had a high fever, he had been isolated in a separate ward.
Though she had concerns for her own safety, she also felt that the man had already suffered so much due to HIV, that to be tied down, bound by chains and abandoned in an empty hospital ward must have made life unbearable for him.
She wanted to help him, and eventually, carefully covering herself from head to toe, she went to care for the patient.
Several days after she began to visit the patient, he asked her if she was the only nurse at the hospital.
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| Nurse Phornsiri: "However undesirable the diseases may be, you can't choose patients." |
Phornsiri was immediately struck by the man's words, and in that moment, realised that she and the other nurses had been negligent. She still recalls the way the man was so disheartened by the hospital staff.
After the incident, Phornsiri also wondered whether it was the way she was dressed that had made the patient ask the question. It led her to question and examine her own conduct. She researched the topic and immediately learned that she would not catch the disease by treating the patient - an obvious fact, ironically, overlooked by medical staff at the institute in the 1980s.
She stopped using the unnecessary protective equipment, including the excessive protection of her nurse uniform. She also got personally closer with the patient, and eventually, it was her gift of genuine affection that helped guide the patient to his recovery.
Seeing the man's successful recovery inspired Phornsiri and gave her the courage to volunteer for a job that no nurse, at the time, dared to take on. The task involved caring for the patients that suffered from infectious diseases, particularly Aids, at the Bamrasnaradura Institute of Infectious Diseases.
Today her role at the institute, which lies on the Ministry of Public Health's Nonthaburi campus just outside Bangkok, involves supervision of many of the departments, such as the Intensive Care Unit (ICU), the Emergency Unit, the Unit for Kidney Diseases and the Endoscope Unit.
Mrs Phornsiri is the deputy of the nursing faculty and is also involved in training younger nurses. She is also the one who gets called in to offer technical advice when her nurses encounter new or problematic situations.
Chatting with Perspective at the institute, Phornsiri says that receiving the Humanised Healthcare Award from the National Health Foundation was very unexpected, and very rewarding.
She says that it is a source of satisfaction and pride, not only personally, but for her entire family.
"The award makes me feel that it was right for me to choose this field of work," she says, admitting that at the beginning of her career, there were times when she wanted to share the burden of her job with some friends. After all, the job was a dangerous and tiring one.
Nevertheless, she persisted, and today she has accomplished more than she had ever dreamed of. "I feel a great sense of achievement knowing that I have been able to contribute to the institute," she says modestly.
A risky profession
When asked why she had chosen to pursue nursing in the first place, Mrs Phornsiri explains that she had always wanted to take up a profession that allowed her to contribute to the community.
The daughter of a navy officer in Chon Buri province, Phornsiri has been instilled with values of discipline and order since her childhood. "My parents were also largely involved with the community and they had wished for me to become a doctor so that I could help people," she adds.
She opted to become a nurse instead, and attended Mahidol University earning a Bachelors degree in Nursing after having received a diploma in Nursing from the Naval Nursing School in Bangkok.
Phornsiri says she has known since enrolling in nursing school that she was choosing a profession that required an endless amount of sacrifice on her behalf. She was also aware that the nursing profession is a risky one, as it entails contact with sick patients for extended periods.
In her case, working with patients with infectious diseases, it is particularly a high-risk profession, and Phornsiri recalls that while treating her first Aids patient, her family was extremely concerned of her health.
"My parents would ask me if I had made the right decision. I also had questions from my husband and we had to think about our son, who is now 25 years old."
In time, her family saw the confidence Phornsiri exhibited in her job, and came to respect and support her decision.
Phornsiri has never been particularly bothered by this risk. She says she has always felt she has the advantage of knowing about a patient's condition and can take precautions accordingly. "It is not like you didn't know if the person was ill or not," she says.
The nurse also points out that there are a number of preventive measures that nurses can take to avoid catching disease. She notes that for her, this includes a regimen she began two decades ago of regular exercise, sleeping well and avoiding working too many shifts all at once.
"All nurses have to know how to protect themselves from each disease," says Phornsiri. She gives a basic example of wearing a mask to prevent catching germs from a patient's cough.
Phornsiri notes that today there is a standard, universal uniform for nurses, and that nurses choose the extent of precautions they want to take based on the nature of the disease they are treating.
Being passionate
What got Phornsiri recognised in her profession was her dedication to the job. "I always asked myself who I am and tried to do the best I could in my duties," she says.
When training the nurses today, Phornsiri says that she tries to make them realise the importance of their role in society and their duty towards patients. Tolerance and discipline are the qualities she believes need to be emphasised.
"In the nursing profession, no matter how undesirable the diseases may be, you can't choose patients. Nurses should realise that the patient is the person who is suffering and as a nurse, it is important to respect the patient's right to obtain proper care and treatment. This applies to all patients, regardless of status," she adds.
She notes that instilling these values in the new generations of nurses was like planting seeds or grains of rice, where some seeds may develop well while others yield mixed results, and still others may be constrained by limitations.
"Like different seeds or grains of rice, each person has a different nature," she says, adding that this methaphor is valid not only for the nursing profession but also for society at large. "But then to be a good seed or grain also requires proper care and nourishment."
With only eight years left before her retirement, Phornsiri says she wants to make the young nurses more passionate about their job.
"The younger generations are always concerned about what they will get in return from their profession. I want to tell them that they should be more devoted to the task at hand, and they should just do any task they are asked to do well and without thinking of the returns."
"I say this because these days, I see more people that want to take more than they give, whereas before, people were more willing to give. And when one goes on expecting returns for one's efforts, the task becomes a source of pain, because expectations have to be met. If one doesn't expect anything in return then one simply gets pleasure from it. You can do any job you are happy with."
Phornsiri believes that in work, it is important to give one's best effort. "At first one may not be an expert, but with persistence, professional skills develop," she comments, citing her own experience.
Phornsiri says it is regretful that patients with infectious diseases are discriminated against, but she is not surprised by it.
"This is natural," she says, noting that in the past, there have been a number of cases where family members of patients abandoned them in front of the institute, where the guards find them in the morning.
That said, Phornsiri also acknowledges that there has been a fair amount of positive change in attitudes regarding infectious diseases, as well as the way in which families have become more accepting towards patients' circumstances. "Sometimes when cousins and relatives of patients see how we treat the patients properly, they realise the contradiction of their own behaviour."
BIO DATA
Mrs Phornsiri Ruansawang was born on September 5, 1956 in Chon Buri province.
She holds a diploma in Nursing from the Naval Nursing School in Bangkok, a Bachelors degree in Nursing from Mahidol University and a Doctorate in Human Resource Management from the National Institute of Development Administration (NIDA).
Mrs Phornsiri was awarded the Humanised Healthcare Award by the National Health Foundation on 14 March 2008.
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