Man versus machine

I was booked in to visit the nurse yesterday, just to make sure my recent fever wasn’t from any ongoing infection. Having been on antibiotics the week before, I wanted to make sure that that infection was cleared up completely. When the nurse took my temperature, she explained that I still had one and it was sitting at 38 degrees. Now I know my body pretty well, especially when I am feverish. And it was her little comment about today being a day when everyone had one, that made me question a little further.

‘’I am sure I don’t have a fever,’’ I said. ‘’I feel totally different when I have one.’’

We continued with the consultation a little longer, then I reiterated that I was sure I wasn’t feverish.

This further prompting from me made something click in her. ‘’Just a moment,’’ she said, ‘’I’ll take mine, I know I definitely don’t have one.’’ Apparently, this was a brand-new thermometer so she hadn’t thought to check its accuracy. And sure enough, the offending instrument was faulty when it showed that she was supposedly suffering from one too.

The nurse excused herself and came back with another, older model and placed that in my ear – 37 degrees, normal.

It was only the week before, when I’d visited another nurse and watched the blood pressure machine pump itself up and down several times, unable to measure my blood pressure, that set me thinking about my time as a nurse. In those days (mid 70s) we did all the basic observations manually. Temperatures were taken with the old mercury thermometers which had to be sterilized and shaken down after each use, blood pressures were done with a cuff and stethoscope and pulses were measured by holding the thumb-side of the wrist. Of course, these readings were only as good as the person taking them. Sometimes blood pressures were difficult to record and pulses too but we were able to discern if a person’s pulse was irregular, weak and thready or bounding and full. I doubt a machine could give out that kind of information, often valuable in ascertaining a person’s health status. I know acupuncturists rely heavily on pulse readings to work out the different flows within a person’s body.

For the intravenous fluids, we drew lines on the bottles to indicate where the fluid level should be each hour and adjusted the flow rate, each time we visited the patient. If the bottle was emptying too slowly, we’d increase the flow rate, and decrease it with the next visit if it showed it was now too fast. Often hit and miss. Now a days these intravenous fluids are set and monitored with a machine too.

When my blood pressure was being taken last week, I became aware of the thud, thud, thud, as the top reading (systolic) for my blood pressure kicked in and again when it faded out (diastolic). It was quite low. However, the machine wasn’t happy with what it was reading. Eventually the nurse had to get another cuff. This time, the reading was successful and although higher than what I had picked up, was still within the normal range.

I can see these new machines save a lot of time. It was a tedious chore in my day, for a junior nurse to have to sterilize and shake down a ward-full of thermometers. Before these were placed under the tongue, one would have to check that each one had been shaken down, and if the patient had just had a cup of tea, then an inaccurate reading could very well show up.

However, one can’t beat the one-on-one of holding a person’s wrist for 30 seconds as opposed to about five with a machine in the ear. Touch, even in this case, can go a long way to helping a patient’s healing, or feeling more secure in an unfamiliar hospital ward.

I am sure the machines are, on the whole, more accurate though, and being time-savers, they would definitely help these busy nurses who are run off their feet. That is something that hasn’t changed since my day, I am sad to say.

As for yesterday, my appointment was 12.30. I don’t know how many patients the nurse had already seen, but I would suspect, a lot. I suppose she would have to go through all her notes and readjust the fever part and perhaps contact some of her clients to reassure them they are not as sick as she thought. Damn machines!