“Humane Touch is the most Important aspect of nursing”- Beautifully expressed view by Prof. Dr. A. T. Kora

“I attribute my success to this – I never gave or took any excuse.” Prof. Dr. A. T. Kora

These lines by Florence Nightingale has been fully lived up to by Prof. Dr. A.T. Kora as she says “ No work or excuse is more important than the life and care of a patient”.

Dr. Kora is the Nursing Superintendent at  St. Stephen’s Hospital, Delhi. She received the prestigious Florence Nightingale award from the President this year (2017).

As they say ‘You do not always have to look at famous personalities for inspiration’, Dr. Kora got her inspiration from her aunt who was the then Nursing superintendent for Delhi state. Her aunt became her role-model and motivator.

Dr. Kora joined B.Sc. Nursing at CMC College, Ludhiana in the year 1973.

For Dr. Kora at that time language was the biggest problem. She completed her intermediate in Kerala then directly went to Ludhiana and then got a Punjabi roommate  and to top it all both of us didn’t know english.

For the first year of her nursing studies she was not so sure about her choice, she wanted to leave nursing and join microbiology. “Somehow I always had that feeling, but I didn’t have the courage to quit nursing, so I continued with the studies”, she said timidly.

Dr. Kora joined St. Stephen’s in 1977 as a staff nurse and has been a part of the growth of Stephens for last 40 years. She tells us, “When I joined here it was predominantly a maternity based hospital. The old hospital which is nursing college now, was the maternity wing of St. Stephen’s. We had the pre-natal, post-natal, nursery, labour room etc. in that one building  and used to have 40-50 deliveries every day. I have seen all veteran doctors running in sarees to attend their patients.”

Dr. Kora recalls two events of all that innervated her to continue nursing and work for such a long period. On the second day of her joining, she had a fight with a doctor who was also the Director of the hospital. The doctor got a complaint that she is not caring properly for a patient but the story was something else. As she tells, “What happened was that while I was resuscitating a patient, some other patient started vomiting and the attendants of that patient started shouting at me to leave what I was doing and clear that mess up. I said I won’t come because resuscitating a patient is more important than cleaning mess at any point of time. The family of that patient complained to doctor and then I went on to say the same thing to the doctor as well, which turned into an argument and I didn’t know that she was the Director of the hospital at that time.” After this argument the director was amazed that a staff nurse was answering back to her and was quite impressed. She called Dr. Kora and gave her the keys to ICU section and asked her to set the unit.

Another incident she quotes as the turning point of her life was when she was posted in CCU in night duty and a patient got serious. Dr. Kora and her colleague Celine defibrillated a patient. When they saw the heart rate coming back on the monitor they started clapping hands and jumping out of joy. As she reminisces, “The treating doctor was Dr. Chabra, he saw us clapping and jumping. He continued to observe us without us knowing. At the end he came and said “well done children, well done”. “That was the turning point where I realised that by doing nursing we can save a lot of lives and then I decided to continue in nursing”. During the later years she went on to like teaching and was transferred to school of nursing just after two years of her joining.

As is said by someone, ‘Motivation is what gets you started, Commitment is what keeps you going’.Dr. A.T. Kora has committed 40 years of her life so far to nursing and teaching. What kept her going these many years?

“It started since I was in college of nursing, somehow I always had that feeling that I am not suitable for this profession. Mrs. Kanwaljeet Gill of Ludhiana was my mentor and was trying to convince me to stay back. When I joined St. Stephen’s Sister Mariamma Rajan came into the scenario. She was a very tough person but if she wanted something from you she would make sure that she is getting that out. In my starting year she would hide herself in curtains of ICU and watch me. She taught me the A B Cs of managing the school. When I would take theory classes, sister Rajan would come and stand outside the class against the wall and listen to what I was teaching, and when I went back to the staff room I’d have a lot of criticism waiting. It was as a scrubber is used to wash the vessel and shine it, the same way she brushed me up”

By 1982, Dr. Kora started officiating as principal in school of nursing. In 1989 she went back to CMC for her Masters in Psychiatric Nursing. She completed her MPhil in guidance and counselling in 2006 and Ph.D. in 2014.

Getting lost in the memories of past she tells us how different things were back then. She and her colleagues were not at all time oriented people. She would enter the ward in the morning and work until the task is complete.  At times in the middle of night she would get a call and rush back to hospital (with half saree fixed and half in hand) for one or the other emergency. Gallantly she speaks, “I remember, nobody would say that it is my time to leave, so I cannot do this work. Never ever anybody had any complaints and everybody enjoyed working. Those days you are not looking at the watch, instead you are looking at the patient and you are talking and listening to what he/she has to tell you”.

She feels that nursing is a noble profession and outlook of general public towards nurses has not changed much. They still look at nurses with a lot of hope, but nurse’s outlook towards nursing has changed. Those days nurses were more concerned for scientific principles, but now, that terminology has gone off and the word rationale has come in, but nobody asks why we are doing it. Without knowing the actual purpose as to why a procedure is done, nobody can practice successfully, she says. The patients whom we took care of 15 years back when they revisited the hospital after some years they would come and touch your feet and tell you how good they felt because of your care, but now these things are seldom seen. The humane connect is also going away, she added.

Patient’s response gives Dr. Kora a lot of satisfaction in her profession but she also loves teaching and never misses a chance of teaching anywhere. She has written a book  Essentials of health economics for nurses and was a part of nurse’s dictionary. She is also the content editor for revising ‘Fundamentals of Nursing’ by TNAI (Trained Nurses Association of India) and is planning to write another book on nursing administration.  People consider her a strict teacher and administrator but there is another side of her where she also cares for her students and colleagues when they are sick and even prepares food for them.

She also likes visiting old age homes since her starting years. She narrated one particular incident that pulled her even more close to old aged people, “I used to visit sister Dayal regularly in St. Mary’s home. One day she introduced me to one lady who was also a nurse and lived in the room next to sister Dayal. I tried talking to her but she would not respond. When I was leaving that day I hugged her and said that I’ll meet her soon and to my surprise she smiled at me. After that I would meet her regularly and talk to her and take her to church. We celebrated her birthday and that day she was really happy. I saw remarkable change in her. That was the time I realised that every human being has the need of somebody to talk to and if you try you can bring these people to mainstream social life again. It may seem a very small thing to you to spend 10-15 minutes with them but for them it is very important”.

How does she manage to do so many things at a time? She replies firmly, “I don’t waste time and I also don’t waste any opportunity”.

Dr. Kora has received many awards and recognitions in her efficacious career of 40 years. Dr. Prof. A.T. Kora has been awarded Nursing Excellence award from TNAI in 2012, award for excellence in healthcare by RKP foundation and India’s Highest recognition in nursing ‘National Florence Nightingale Award’ in 2017. Other prestigious awards include university gold medals by Punjab University in 1991, Jawaharlal Nehru Memorial award for outstanding work in M.Sc., and award with three ties for maximum membership enrollment in TNAI. Dr. Kora has also been conferred with the award for maximum contribution to humanity by Kerala Christian Association in 2017. Very modestly she gives all the credits of these awards to her seniors and mentors.

At the end of the discussion Dr. Kora gives a message for the young nurses joining nursing. Humane touch and connect is the most important aspect of nursing. Learn to practice communicating with people and use touch and listening as the basic techniques. Giving proper care to patients and listening to them is important for both the patient and your job satisfaction. Don’t waste your time and never miss an opportunity if you want to grow in your profession.

Ergonomics In Your Practice

63-93% Dentists all over the world complain about muscle pain in one or the other part of their party. That is not too surprising considering the positions many dentists adopt when working. Mind you these kind of pain and posture problems reduces the practice hours and effectiveness and in turn harms your career. Most of the dentists retire early in their practice due to such musculoskeletal disorders (MSDs). Here comes the role of Ergonomics.

Ergonomics is the science of the physical relationship between you and your environment. It means that you adapt tools and procedures to fit you, rather than adapting yourself to fit the environment.

Incorporating ergonomics, while performing any dental procedure is very important. Correct operator position is the key to preventing MSDs. It is also known as the neutral position and is the ideal positioning of the body while performing any work. All the dentists, in their study years learn to work on patients in the neutral seated position but we all know that when they come out of college in real life dental practice, all the ergonomics learning goes away and MSDs creeps in. To refresh your memories, the neutral seated position comprises of forearms parallel to the floor, weight evenly balanced, thighs parallel to the floor, hip at the angle of 90o, feet flat to floor, back straight and head and neck upright.

Now if you have already started feeling pain in your body due to your dental practice, you can reduce or eliminate your pain with evidence-based interventions. Effectively resolving work-related pain in dentistry requires correctly identifying the risk factors, and then targeting those risk factors with specific, evidence-based interventions. These interventions can be divided into different parts-

1. ‘Ergonomize’ your operatory. It is very basic to watch dental experts burning through cash on chiropractic alterations, fitness coaches or costly devices, just to come back to the operatory condition that conceivable caused the pain issue in any case! It is nothing unexpected that the pain normally returns, and all around it goes. Along these lines, as a matter of first importance, you have to determine ergonomic issues in your operatory. Be that as it may, before you put resources into ergonomic gear, it is useful to know which stools, loupes, instruments, gloves and seats will profit your wellbeing and not aggravate it.

2. Pick the right healthcare professional. On the off chance that you have had diligent endless pain for longer than six to two months, you ought to presumably counsel a doctor. So who is the “right” doctor? The principal individual the greater part of us swing to when we are in torment is our essential care medicinal doctors. While doctors get a colossal measure of preparing in restorative school, their tutoring in helpful recovery is very restricted. However numerous PCPs are settling on treatment choices that can significantly (and frequently adversely) affect your musculoskeletal wellbeing and vocation life span. Consider asking for a referral to an expert that particularly tends to the key etiologies of business related pain in dentistry.

3. Resolve your trigger points. Real trigger focuses ought to be settled before any reinforcing exercise is endeavored. Excruciating trigger focuses are regular among dental administrators because of body asymmetry, poor stances, poor body mechanics, redundant development, absence of development, supported muscle constriction and mental anxiety. Tragically, trigger focuses are regularly ignored in conventional Western medication and patients are sent from pro to pro with no determination to their torment.

Among dental specialists and hygienists, trigger focuses happen in various muscles—excessively many to examine in this short report. In the operatory, trigger focuses can create from shameful situating, inadequately balanced degrees and a bunch of other ergonomic traps, and require unique operatory adjustments. On the off chance that permitted to hold on untreated, trigger focuses can cause a horde of musculoskeletal torment and dysfunctions. It is essential to diminish trigger indicates as quickly as time permits reestablish supplement stream to the muscle, avert muscle irregular characteristics and forestall pressure on nerves. There are different strategies to treat trigger focuses, however because of costs, time limitations or comfort, self-treatment is frequently the most down to earth and sparing thought.

4.Develop Good Flexibility. Chair side stretching will enable you to recover full scope of movement and set you up for fortifying. Overstretching muscles with dynamic trigger focuses may cause smaller scale tearing of muscle, which is the reason extending is prescribed after trigger point treatment. Since dental experts are inclined to muscle imbalances, it is essential to guarantee you are focusing on the right muscles with your stretching. As opposed to stretching muscles that are as of now stretched, concentrate on the muscles that have a tendency to wind up noticeably short, tight and ischemic. Chair side extending is a vital procedure to perform all through the workday to anticipate smaller scale injury and muscle uneven characters, particularly for men, who are more inclined to musculoskeletal damage because of poor adaptability than ladies. Stretching is particularly vital after drawn out static stances, and considerably more so if clumsy positions were expected.

5. Strengthen Specific Stabilizing Muscles. Studies demonstrate that dental specialists with better perseverance of the back and bear support muscles have less musculoskeletal torment.
Research demonstrates reinforcing the lower trapezius can help decrease neck torment. Nonetheless, on the off chance that you over-reinforce muscles with trigger focuses, your torment may decline, which if why this is the fifth step in our grouping. Consider holding up till the zone is without torment to start fortifying.

Guaranteeing a torment free profession includes tending to various hazard factors. Keep in mind, that executing just a single hazard factor (i.e. buying another stool, seeing a physical specialist, or doing just seat side extending) infrequently settle torment totally. Set aside the opportunity to additionally teach yourself on each progression of the above succession