Amparo and Rocío

Amparo, a 74-year-old woman, had spent much of her life surrounded by her family. Nowadays, however, the physical distance from them, as they were busy working in distant places, had left her alone most of the time. Although they visited her at Christmas and in the summer, the loneliness weighed heavily on her.
Age and infirmities had taken their toll on her body. Her children, concerned for her safety, had hired Lola to stay with her. Lola, a neighbour of Amparo’s, was loving and caring, but her fear of Amparo falling led her to limit her movements. She kept her mostly seated in an armchair that was tilted and raised to facilitate even the gesture of standing up.

Amparo’s life had fallen into a monotonous routine. She spent her days in that armchair, watching the world through the window and thinking about the most active days she had once lived. Every day she felt weaker, physically and emotionally. Sadness and apathy had wrapped around her like a heavy blanket.
One day, everything changed. A young physiotherapist called Rocío entered her life like a ray of sunshine. With her energy and positivity, Rocio brightened up the little room where Amparo seemed to be slowly dying. With a warm smile, she introduced herself as her primary and community care physiotherapist.
«Good morning, Amparo. I’m Rocío, your physiotherapist. Your family doctor told me about you and I’m here to bring you the elixir of youth: therapeutic exercise, healthy walks and dancing to your favourite music,» announced Rocío.

Amparo looked at her curiously, feeling a spark of hope that had been absent in her life for too long. Rocio began her work with care and patience. She taught her simple but effective exercises to strengthen her muscles and improve her mobility. Amparo followed Rocio’s instructions with dedication, surprising herself at how much she could do with a little effort.

But Rocío not only brought movement to Amparo’s life, but also joy and human connection. During their sessions, they talked about their lives, shared laughter and anecdotes. Amparo began to open up more, to remember the stories of her youth and to feel valued as a person.
Healthy walks became little adventures. Amparo, leaning on her cane and accompanied by Rocío, explored the surroundings of her house. She discovered the beauty of the flowers, the scent of fresh air and the warmth of the sun on her wrinkled skin. Rocío had awakened in Amparo a sense of vitality that she thought she had lost.

However, it was the dancing that really transformed Amparo. Rocio brought a music player and played the songs of Amparo’s youth. Holding her gently, they began to move to the music. Amparo felt the energy flow through her, how her body responded to the stimulus of the music and the joy of moving.
After a while, Amparo became stronger, more confident and happier. Her relationship with Rocío grew beyond therapy, becoming a genuine friendship. Rocio’s visits became the most anticipated moments of the week, filling Amparo’s life with light and meaning.

This story is a poignant reminder of how human connection, physical activity and love can transform even the darkest days into experiences full of life and hope. Rather tan confining our elders to the couch for their safety and fear of falling, it is essential to prescribe more exercise so that they can enjoy an active and healthy old age, strengthening their bodies and giving them extra confidence in their own abilities. The story also highlights how overprotection, however well-intentioned, can limit the autonomy and well-being of the elderly.

Amparo’s case is not unique. In an ageing society, our population pyramid increasingly resembles a spinning top, with the baby boom generation reaching the top of the pyramid. If we do not prepare ourselves, if we do not strengthen ourselves with physical exercise, there will be no social security capable of supporting our ageing. Active ageing, as Amparo experienced with Rocío’s help, becomes the key to a healthy, secure and sustainable old age.

With my sister always better

My mom was so excited about the doctor’s visit, they had to do something to me because I’d been sick of my throat, and I kept talking to dad about how they’re going to give me candy if I behave, or that he has to take my sister to the park in the meantime.

I don’t want my sister taken.

There were a lot of noises when we came in and a lot of kids were running through a small room screaming. I was wearing the headphones that my sister had given me with a lot of enthusiasm last week and that she had cut off the cable for me to use in an attempt to dwarf the impact of the noise of the world on my head.

«Mom… can we go? There are a lot of noises.» My headphones still filtered noises and I started to get nervous because of the number of people there.

«No honey, the doctor has to see you, we’ve already missed two visits,» my mother sighed impatiently.

I sat in a chair, away from as many people as possible and began to twist my hands in an attempt to calm down. I couldn’t.

I heard my name on the speaker in the waiting room and I felt like throwing up from my nerves, I couldn’t breathe quietly and people looked at me very uncomfortable because my mother was almost inside the office and I hadn’t even gotten up from the chair.

«Come on honey» smiled my mother in a sweet voice offering her hand as a support.

I love her very much, but I don’t want her support or her «all is well» hug when I enter the office. I want to go home to my sister.

Mom and the doctor were talking about things I didn’t understand and my brain disconnected until I noticed the doctor staring at me, I looked away awkwardly and he just smiled before getting up and saying every word hated by a little boy.

«I need to run some tests.» Needles… No, please.

I was guided by the kind doctor to a white room with a stretcher because, apparently, I had to do it already because, for children like me, the time that passes alters some factors that I do not know what.

What did he mean by «kids like me»? Weren’t all kids the same? I didn’t listen, I didn’t care. I wanted to go home.

When we stayed in that «little room» like the doctor said, I just wanted to kick the door and run out, I was going to vomit at any time or break the window of a panic attack, whichever was more useful.

I heard the door open and my mother protesting about how long we were there or something.

«We need to test your daughter,» the doctor said before smiling at me and asking me to go with him. » I’ve arranged everything so that it will take little time, I promise»

Mom also came with me and even took my hand and asked me not to be afraid.

«Your mom told me you have a little thing called Autism, right?»

I nodded, my parents had always said that word at home, so I assumed it meant the same thing, I was 6 years old, it’s not like I understood it either.

«Then I will need someone else to accompany you to your test to do it with you» When we arrived at a door that said «Extractions», the doctor opened the door and smiled.

My nerves, my anxiety, my desire divided between vomiting and running away, went nowhere.

On the other side of the door, was my sister sitting in a chair next to another empty chair, with a huge smile and waving at me, if she was, everything was easier.

Trusting your body

For years I have been treating patients who come to me mainly for musculoskeletal pain, as I am a physiotherapist.

When I left the race, I wanted to do something for them, to take away the pain they were in with manoeuvres, with different techniques, with apparatus, with bandages… I got frustrated when they didn’t improve and in my inner self I blamed them because they didn’t do the exercises, because they had a few extra kilos or because they preferred to watch the series than get the sleep they needed.

Gradually, as I have worked over the years, I have come to realise that pain is more complex than we sometimes think. Moreover, I now know that pain is not always associated with tissue damage, i.e. a person can suffer a lot of pain when the tissue is healthy – or practically healthy – and it can also happen the other way round, hence the placebo and nocebo effects.

Now I know that the patients who have the best recovery are those who have placed their trust in me, those who understand that it is a process influenced by different factors and that they are not passive subjects, but also have the capacity to make decisions and collaborate, but now, instead of getting frustrated when I try to influence their beliefs regarding pain, I try to be like the sea, like the sea that shapes the rock, constant, but without aggressiveness, with affection and empathy.

In this way, I can know that my octogenarian patient needs to move, to get up from her chair or, if she is unable to do so, to exercise in a seated position, to the extent possible. However, I cannot force her, I have to persuade her, I have to convince her that her muscles and bones need movement, progressive, moderate, adapted, but daily, whether she is with me in therapy or alone.

«I’m very undisciplined when it comes to exercise, I forget.»

He says to me with a cocked head and a half-smile. I know that this is true, that the need for movement in his tissue is fighting with the law of conservation of energy and, unfortunately, for years now, in their case the latter has been winning the fight.

«Hang a poster next to the TV, so that you can always see it from your armchair and be reminded of it».

He laughs, and I’m sure he’s wondering what I’ve got, but with a smile I insist.

«It can be something simple, a word, anything that reminds you to move».

The next week she hasn’t done her homework. I don’t get angry, I just insist with a smile and she laughs. We talk, she tells me things while we work. And when I leave, after a while, she sends me a message with a photo.

«What do you think?»

A smiling monkey that he has drawn on a piece of paper and stuck next to the television.

«I love it!»

And it’s true, it couldn’t be better, because the monkey smiles at her as if inviting her to come back to life through something as simple as moving, something that she has forgotten, something that at some point has even started to scare her. Can you imagine? Can you imagine being afraid to just turn your head?

The body, even if it is old, needs to be in movement, otherwise it remains locked in a cage, within itself.

Lately, this is the message I have been sending to many patients, that their body is often not asking for rest, but for different movements, perhaps adapted, but movements nonetheless.

I believe that the first thing we must give back to the people we care for is confidence in their own abilities, as we often bury them under the slab of diagnosis, tied to medication, afraid to do things on their own, and fear immobilises and immobility is the opposite of life, because without movement there is no life.

When I work, I think of you

Rosana had been in Spain for twelve years. She had returned to Ecuador on two occasions, both in the last five years. Just the same amount of time she had been working as a live-in caregiver, devoted to the care of Mr. Luis, a nonagenarian. In the five years before Rosana came to care for him, fifteen different people had passed through the house.

Mr. Luis’s daughters visited him whenever they could and told Rosana that her care couldn’t fundamentally change their father’s attitudes, but there were slow improvements noticeable. He no longer brandished his cane threateningly whenever he spoke to someone; he didn’t tip over the plate onto the tablecloth if he didn’t like the first spoonful or found it too cold or hot; he didn’t respond with «shut up, I’m starving» when Rosana talked to him.

Rosana was thirty-four years old. She took care of her personal appearance. Her smile was always on her lips, her conversation was measured, her words were always timely, and her tone of voice was calm. She treated Mr. Luis’s daughters with respect when they suggested aspects to which she should pay special attention, both in nutrition and in the way she moved her father. They noticed that she not only listened attentively but also put their advice into practice.
Over time, the suggestions decreased, and it was evident that she incorporated them into her routine. They observed the grid where she recorded the menu every week, the time he moved each day, the amount of water he drank, the times he urinated, and, most importantly, the times he had bowel movements. Just before joining, Rosana had a slight intestinal obstruction, which resulted in hospitalization and a difficult recovery.

She didn’t demand changes from Mr. Luis’s daughters; it was they who proposed them. Every year, they increased her salary, and on Reyes (a Spanish holiday), they gave her an extra amount to send gifts to her two children, whom she had left in the care of her mother. The gift she appreciated the most was when, after two years of working with Mr. Luis, they encouraged her to travel to visit her children. The offer was that the fifteen days she spent with them counted as vacation, were not included in the contract, and Rosana was surprised when she realized that she received her regular pay for that month.

The contract stated that on Tuesday afternoons, she would have four free hours to use as she pleased. Starting from the second year, they proposed that, in addition to Tuesday afternoons, she could choose another afternoon to go for a walk or do shopping—whatever she wanted. It was her time; she could go out or rest at home.

One of the things she did on some of those afternoons was go to the park with a friend, Diana, who had cared for Mr. Luis for four months during one of the relief shifts that occurred before Rosana’s arrival.

Diana would ask her how she was and how that mean old man was doing, the one who always called her starving and a whore. He even hit her with his cane.

«He’s still alive, he’s very old and very mean. His daughters don’t help. You should find something else, leave him, let them take care of him.»

«I don’t want him to die. He’s not a kind old man. Maybe he suffered a lot in his life, or maybe he wasn’t prepared to be sweeter. His daughters seem polite.»

«There are other jobs. Leave him.»

When Rosana talked to her friend Diana, she was the only one she trusted in this city. She had wanted to tell Diana what she had said to her mother the first time she visited them. She refrained from doing so out of fear of not being understood.

Caring for the elderly is very difficult, not so much because of the work, but because of the lack of affection with which they respond to the tasks you perform. At times, I feel they value me very little. I resolve this by thinking of you, of my family. I imagine that I’m taking care of you, that what I do for him, I’m doing for you. That way, I manage to smile at him while I clean him or take him for a walk. If any cloud of displeasure comes to mind, I brush it away with my hand.

Taking Care of my Health as a Team

My name is Ana, and I want to share how I learned the importance of taking an active role in my own recovery.

My story begins when I was diagnosed with an illness that shocked me, broke my plans and filled me with worry and questions. However, my meeting with the nurse, let’s say her name was Elena, was a turning point. She did not just limit herself to instructions on what medication to take, when to take it and how to take it. Instead she encouraged me and that I should be an active participant in my illness and in my recovery process. He explained to me how my daily decisions influenced the recovery process and the importance of diet, exercise, a good mood and medication would be the key to leaving this disease behind. He made me learn that I was not just a spectator, but the main actor in my health.

One moment that really resonated with me was when Elena and I discussed my meal plan. She helped me, far more than I realised, to adjust some foods that had more impact on me than I could have ever imagined. She helped me to make more informed decisions in my day to day life and to see how with small changes in my diet, I could feel myself getting better and feeling better day by day.

Also, when the doctor joined my medical team, I felt very supported every step of the way. Instead of just listening, he encouraged me to ask questions and voice my concerns. Once, when we discussed treatment options, I shared my concerns, I felt heard and together we found an approach I was comfortable with. We were working together on my health!

As my treatment progressed, I not only relied on medical knowledge, but also on my ability to share my concerns and be part of the decisions. I felt empowered knowing that I had an active role in the road to my recovery and that improved my mood and strength. With each step we took I was aware of why it was being done, I felt I was contributing directly to my own improvement.

Finally, when the time came for me to be discharged from hospital, I realised that this was the beginning of the road. The nurse and the doctor were willing to follow up regularly by phone. I knew they were there and that I could count on them. Their continued support kept me confident and encouraged me to continue to take care of my health. Even though I was no longer in the hospital, I was not alone.

My story is a reminder that patients play a vital and fundamental role in our health. When we work together with healthcare staff, the road becomes passable and fear fades. Collaboration and being able to participate in the decisions that affect us empowers us. We are the protagonists of our health, but we are not alone, we have a team behind us that counts on our help and counts on us.

anaandresmoreno@gmail.com

Professional Deformation

They call me a geek, what can you do. It’s because of the professional deformation. At the first glance, I do a threshing. I’ve always been used to doing it. From the posture I assess if there is any lumbar pain, if it hurts a knee, if on the contrary it is an abdominal pain. I have time to take a look to see if there is a cut wound that needs immediate stitching or if there is an ulcer on the leg from an accidental blow against the leg of the bed. Eye colour I don’t see. Whether the patient is handsome or ugly I don’t see either. But if he has brought the list of medicines because it makes a mess, I look for a while to put them in the weekly pigeonholes. Until it’s clear, I don’t stop, because I’ve come across everything in this everything in this vineyard of the Lord, from those who have taken a stomach protector with each pill, to those who has left the thyroid pill on his own because the tests showed that he was fine, why take anything at all.

I think I’ve earned a reputation for being grumpy. The other day without going I managed to get Casilda back on track. With the bad circulation in those legs, the vascular ulcer and the bandage, twelve-centimetre high heels were not compatible, and even les so, if they were to squeeze her foot because the toe had to look pointed and thin. It took me almost a week to get her back in flat sandals, but now, at least she won’t twist her ankle again, that at more than eighty years old, he is not for balancing unless he wants to break his hip. That was clear to him because he talked to me about walking sticks because they give him some security. Not everybody takes advice.

For me, as I say, even in the street I have to look. And if I see a cast arm hanging, I think of the swelling, the compression against the cast, the pain, the complications of the fracture that has led to this immobilisation. The other day I dared to make a small recommendation, although it is true that it was in the middle of the street and to a stranger. «Your arm will swell up if you don’t wear it elevated» I earned an insult and almost a slap in the face. What had I thought. That I should mind my own business. That I didn’t care. I thought nothing and a lot. That most likely he would not end up being my patient.

But who would end up to be someone’s patient. That he had thought about his wellbeing, his health, about avoiding complications. complications. That most likely, before me, someone else had recommended the same thing to him. A sling. Arm up. To take care for his safety.

Even if the maxim is to treat everyone as if they were my father, my brother, my grandfather, my friend, there are times when one stumble upon wayward people who won’t let you take care of them. But I’ll keep on threshing, as geeky as it may seem. Because in no time I’ll be the one who falls down, who doesn’t know how to put my pills in the right order, the one who has to get around with a walker and the one who hopefully won’t break a hip.

Goodbye

At first it was nothing: a small, recurrent nuisance but already manifested by her as any her as any that requires some more particular attention.

Without stridency: we do it: we go to the surgery but we have to go from the neighbourhood to the major; we have to go to the major hospital. We celebrate in the local bar.

At the major hospital they opened her inside and closed her up and told us that this is more serious, a doctor friend predicts that she will live for half a year.

Family reunited: Shall we tell him? No; the friend has not made a formal prognosis. It’s not going to last half a year but three and a half and you’ll find out at the end.

We are back to the festive celebration, so keep the drinks on you. Don’t let your smile fade. Normal life: shopping, visits, friendships.

Visit now to the big city, we take the opportunity to consider what a cool train. Diagnosis of long treatment; don’t want to stop now at the station bar; back home.

House. Reorganise environment, objects. In the living room, the most comfortable armchair. Distracting TV programmes.

We have to buy a notebook where we will have to write down hours and days of consultation. And the notebook in that cabinet nearby.

Don’t over-emphasise comments and reflections on diagnosis; heavy visits and friendships Attention! The negative side – out!

Armed with the notebook we go to the surgery, thinking about the timetable, we have to be able to park in time if we don’t take public transport.

We found the sympathy we were looking for; both in the administration, the nursing staff, the doctor. That she talks a lot, we respect that, the doctor smiles and has the art, the artist, of not answering everything and of giving very concrete prescriptions. She and I left with conviction: we can do it.

And papers arrived «between people, papers», let’s make jokes, mother! She fluctuates at times, she gets restless. For the papers, green folder, please, they tell us.

We rearrange visits and outings, cinema, theatre.

And then comes the need for the car and the wig. How to combine the search, the selection, and the grace and good humour; we have to enhance hers with that friend of empathy and good relationship: going to the hairdressers as if preparing for a wedding. And the trolley is very good for shopping and it seems that they pay more attention to you.

And with the car we go to the planned wedding and take photos together; she smiles with satisfaction at the aesthetically pleasing wig («How well they’ve left your chignon» says one of them).

The important thing now is the timetable and the company. And not to take away the possibility, which she still wants, of doing certain things at home; she has to continue directing and commanding. You have to make the prescriptions well done, in consultation with her.

But now comes the armchair, the stillness, the immobility. Where we put it so that the pots and the sky can be seen. Not that fabric, no, what does it say, the one with fringes and little drawings. The bouquet that we carry there, in sight.

What about sex? He asks; she smiles, she’s been a polysemy for some time. You have to cure the entrance of the permanent needle, the daily shower, ahead, behind, above, below, the decay, love, teaching her a little with a kiss: girl, how beautiful you are; and she smiles.

And foot massage, best sex, head, arms, hands.

The doctor has called her adding with kindness and firmness: «There is no more treatment» She will raise her arms and summarize it in two words: «I love you».
And Mahler’s third.

The error is ours, the live is yours

I will tell you two stories related safety and therapeutic management.

Story 1

Nurse Ana was on her night shift at the hospital pediatric unit. It was a quiet night until it was time to administer the medication to one of the patients. Ana was tired and distracted for different reasons, and due to a mistake in the dose, the patient received an excessive amount of medication. Despite the efforts of the health team to save the baby, the patient died. Ana felt devastated and guilty about what happened, it was an accident. The experience of the death of a pediatric patient is very difficult for any nurse, and Ana was no exception. Ana had to face the consequences of her mistake and the pain of the patient’s family. Although it was an accident, Ana felt responsible and had to deal with the emotions and grief that this entails.

Story 2

Nurse Ana is very careful and responsible, she knows that the preparation of medication was a crucial task for patient safety so before administering any drug made sure to follow the following steps:

Hand washing with soap and water to prevent infections and prevent spread of germs, check the prescription carefully review the prescription to make sure the dosage and medication are correct, When preparing the medication follow the instructions of the manufacturers and safety standards established by hospital protocols as verification of the correct route by which to administer the medication.

Thanks to the care and care of Maria, pediatric patients are in good hands, the preparation of medication is a task that should be taken very seriously knowing that any mistake may have serious consequences for the health of patients.

The mistake is ours, but life is yours. By paying attention to each of the actions we perform and verifying them, we will improve the safety of our patients.

Which of the two stories do you stay with?

The Heartbeat of Care

In the realm of medicine, where time is precious and lives hang in the balance, there exists a place where patient care is elevated to an art, where artificial intelligence intertwines with human compassion to create a symphony of safe and loving attention.

At Sant Joan d’Alacant Hospital, renowned for its commitment to patient safety, lives a nurse named Marta. Her smile brightens every corner, but it’s her heart that truly shines. Marta tends to patients with a tenderness and care that only a compassionate heart can offer.

One day, Marta met Miguel, a patient whose frailty was inversely proportional to his inner strength. Miguel battled a cruel disease, yet his spirit remained unbroken. In that moment, Marta understood that her role was more than administering medications and monitoring vital signs; it was to be a beacon of hope in the ocean of illness.

However, modern medicine also had its place in this tale of care. Artificial intelligence, in the form of virtual assistants, joined the healthcare team. These assistants relieved caregivers of administrative tasks, granting them precious time for genuine human connection.
Marta and Miguel stood at the crossroads of safe care and love. Together, they composed a symphony of healing. Marta learned the nuances of Miguel’s illness, while artificial intelligence kept impeccable records of his treatments.

Algorithms predicted potential complications before they surfaced, allowing for preventive interventions. Marta not only cared for Miguel but also became his confidante, his friend in the battle against illness.

In this hospital, patient safety wasn’t just a slogan; it was a tangible commitment. Nurses, doctors, and virtual assistants worked together to safeguard lives and foster trust.

The day Miguel could return home, Marta couldn’t help but let tears of joy fill her eyes. Artificial intelligence had paved the way for successful recovery, but it was the human connection that Miguel would carry with him as a treasure.

At Sant Joan d’Alacant Hospital, it was proven that safe and compassionate care is an art that blends technology with the heart. Artificial intelligence cleared the path, but it was the heartbeat of human care that truly healed patients’ souls.

The Handrail

The carpenter went through a lot to park on that narrow street with the long handrail on the roof of his car. When he arrived at the noted address, he unloaded it and placed it vertically to ring the intercom.

• Maslow Street, number five. – He rehearsed.
• Ring, ring…

After a long wait, which caused him a few moments of impatience and multiple calls, a small voice answered:

• Who is it? Are you Violeta?
• No, ma’am, I’m the carpenter, and I brought the handrail.
• A handrail, you say? I don’t have stairs. This is a flat, and it doesn’t have stairs…
• Let’s see, ma’am, I have two names written down here: Mercedes and Violeta as contacts. Are you Mercedes or Violeta?
• Yes, I’m Mercedes, what a coincidence! And I have a granddaughter named Violeta, another coincidence! But she’s not here; she comes by occasionally.
• She’s at the University, studying Medicine, you know? She’s really smart! But why am I here talking about my granddaughter to a stranger through the intercom? Oh well…
• Ma’am, please open the door, and we can talk.
• No, I won’t open to strangers, it must be just a coincidence that you asked for our names. I don’t need a handrail; I don’t even have stairs… Well, yes, I have a step ladder, but I haven’t used it since I fell trying to reach a blanket…
• Goodness!

The wood professional searched for his mobile phone and dialed a number… Mercedes’s number.

• Hello? – The elderly lady answered after several rings.
• Ma’am, I’m the carpenter, and I brought the handrail. See, it’s me calling on your phone.
• But what’s going on? Are you pestering me over the phone too? Unbelievable! Well, I’m going to hang up, there you go!
• Mrs. Mercedes, please call your granddaughter Violeta, she knows…

But Mercedes had already hung up.The carpenter looked up and down, sighing, hoping to find an answer to figure out how to convince Mrs. Mercedes to open the door. He rang the doorbell again, but Mercedes didn’t respond. Coincidentally, a neighbor came out at that moment, to whom he had to explain that he had a handrail for the third-floor lady. He mentioned his name. The neighbor didn’t pay much attention to the explanation; he seemed to be in a hurry. So, the carpenter took the opportunity to go up to the third floor and ring the doorbell directly. Mercedes appeared after a good while and, with the door slightly ajar, secured with a metal chain, said:

• I already told you, the names are just a coincidence. The only staircase I have is a step ladder…
• Ma’am, please listen: the handrail I brought is not for any stairs; it’s for that long hallway you have there. Your granddaughter Violeta gives it to you so you won’t fall anymore.
• Oh, well, if that’s the case, come in, and forgive me! It’s just that us seniors get so confused, and we think we’ll never need these new handrails. But I commend you for your good idea; now I won’t have to hold onto chairs anymore.

Stars in the Sea

The hallways are empty. There are some slightly ajar doors, but most of them are closed. A dim light flickers from the ceiling as the dark night swallows every corner of the hospital. I see shadows huddled in the corners and dust collected in invisible specks.

I breathe in a heavy air, filled with the suffering and agony of lives fading away behind closed doors. It seems that death strolls quietly tonight, claiming the souls that have reached their end.

I enter room 302. Mr. Román is sitting on the bed, with the IV stand on the floor and his pajama pants at his feet. It appears that during the shift change, they forgot to raise the bed rails for him. He greets me with tired, sorrowful eyes, a blue gaze that must have once captivated thousands of young ladies.

«What happened here?» I ask him.

«A cat took off with my pants,» he replies.

«What a mischievous cat.»

Although his gaze remains fixed on an unseen point, his hands are warm when I help him back into bed. I move him carefully and flip the pillow over to make it cooler. I inspect his skin thoroughly and find some scars from old falls.

«It’s a moonless night,» he tells me. I smile with my eyes.

«It certainly seems that way.»

«My wife used to say it’s a good time to contemplate new goals and projects.»

«Do you want to go on a cruise?» I ask as I apply ointment for leg discomfort.

«I don’t think I’ll ever see the ocean again.»

I pause for a moment. Honest and harsh words from a man who survived three wars. We remain silent as I check the IV drip rate and ensure the catheter is clear and infection-free. Román is someone who has never complained about the needle pricks, even though his veins are truly complicated.

As a nurse, I want him to feel safe and cared for. He may have palliative cancer and a reserved prognosis, but that doesn’t mean he doesn’t deserve a dignified death. That’s why I make sure the sheets are comfortable and free of wrinkles to prevent pressure ulcers. I raise the bed rails to prevent untimely falls, as he can become disoriented and attempt to go back home at any moment.

Finally, I spend some time with him, listening to his stories from his youth.

Learning about his history moves me and makes me think about the brevity of life.

«If you look closely,» I say to him, «you can see the ocean from the sky and paint stars up there.»

«Maybe María is tired of waiting for me,» he whispers, his eyes fixed on the window.

«She will always wait for you, Román.»

He soon falls asleep, enveloped in a cottony dream. I place the call button near his hand so he can reach it at any time, even though I know this is his final journey.

At some point in the early hours of the morning, his heart stops. Then, a star streaks across the sky quickly, and I know that he has finally reunited with his beloved.

He´s drunk, or not

-Any day they get into our house -Pepa protested knowing that no one heard her, it was a relief to herself while she kicked her back gently trying to get her to react.

He had been found like this, lying behind the door of the lobby of his building when he returned from dinner with friends late at night. They had celebrated Christmas and toasted with cava, and it was noticeable.

She was undecided, doubting what to do with that lump thrown aside in a corner of the doorway of her building and that did not give signs of waking up with the stimuli that applied. When she saw Rosa enter and Paco was relieved to be able to share the problem with a neighbor.

– Good night, Pepa, what are you doing? Who is that?

– I don’t know, I talk to him but he doesn’t answer, he’s unconscious.

-So young! What a pity! It is almost a child! And drunk! , sleeping the monkey you do not hear him snoring? – intervened Paco- Leave it. It will pass.

– Yeah, but it’s on our doorstep and if he throws up, it makes us all lost and tomorrow is Sunday, and let’s see who cleans it up.

-Hey! Hey! Hey! You! Wake up! – Paco accompanied the screams with shoves on his shoulders trying to make him come to.

Escolástica, on the first right, was always attentive to the warnings of her chihuahua, and that night the dog kept barking stuck to the door of her apartment. Dressed in a wadded robe she looked down the stairs:

-What are you doing? Who is it? What is it?

– Good night, Esco, here, deciding what to do with this one. You see, drunks and drunkards will end up throwing us out of our homes.

– But you know him?

– ¡How are we going to know him! I found him lying there when I opened the front door.

– But he breathes, right?

– Yes, woman, don’t you hear him snoring?

-Oh, I don’t know! Nowadays you hear so many things…

-Poor boy! So young and already in this!

-Don’t feel sorry for him. They already know where they are. It’s not like we were ignorant before.

-Let’s see if he dies and gets us in trouble!

– Okay, so we call the police and have them take him anywhere.

– Bah! Anyway, these junkies don’t pay any attention to them. Other times would have to come back!

They no longer paid attention to it, they had made a run and let off steam by repeating their ill-fated opinions about youth.

As Paco tried to communicate with the local police, the street door opened and Fran, the boy from the third, entered. They had finished the first trimester classes and came loaded with books under his arm and a backpack on his shoulder. He was planning on taking advantage of the holidays to prepare for the January exams.

-Hey, Fran, kid, here we are thinking what to do with this junkie, or drunk, or whatever.

By then, more neighbors had gathered in the hall than those who attended the General Meeting each year. Fran studied Health Sciences, became interested in the drunk and came to look at the bird’s face.

—Ooh! That smell! Acetone, like apples, does not smell of alcohol -he looked up at his neighbors while thinking about that phrase that had come out without thinking- It may… be… a diabetic coma. We need to call an ambulance.

The «drunk» was saved. The previous month he had been diagnosed with diabetes. To celebrate the holiday he had food and tardeo with his friends and was not put limit to the intake, nor was injected the dose of insulin. That recklessness almost cost him his life. He never thought he would have to wear a medal around his neck with the diagnosis: diabetes.

The Wizard King had visited him and gave him another chance without judging his behavior.

Happyness

Happiness was the last assistant who had joined the nursing home and after a month, the change in residents was evident: they smiled permanently.

The human resources manager questioned the worker about her practices to find out what justified that improvement in the quality of life of the users of the elderly center, but Felicidad was limited to answering that she was only doing her job.

It was one of the elderly women who revealed the mystery: the auxiliary included in the routine of the elderly a delicate and laborious hygiene of the teeth and gums, without forgetting those tiny brushes for the gaps between the teeth or the washing of the tongue. It carefully cleaned prostheses and moisturized dry lips of grandparents.

The elderly regained the pleasure of fresh breath and the pleasant vision of impeccable teeth and gums. How can we not smile? Her improved self-esteem positively influenced her mood.

This routine also had a positive impact on the general health of the users, since it was well known that there was a greater tendency to inflammation of the gums in diabetics, the danger posed by a dental infection in a polymedicated patient, fungal infections under prostheses in the absence of cleaning and difficulty feeding in cases of dry mouth.

All this greatly interested the medical staff of the residence, who decided to elaborate a protocol of action to standardize the procedures of that singular auxiliary.

For Happiness, on the other hand, the most important thing was that those elders had smiled again.

the lesson learned

Throughout my life, I had always presumed to be a person who did not value my health. It was very rare that I was seen to go to my family doctor or a specialist doctor or a specialist when I had any kind of discomfort or pain. My response was always the same when I was reproached for not going. I will go when I can, while I rummaged through a mountain of medicines (some even out of date or obsolete) for a balm of fierabras.

You know you can’t self-medicate without a doctor’s opinion,» my partner muttered to me. I’m not going to waste my time queuing up waiting for him to see me, and right now, work is more important than health»- I replied to her-

And then came the night, the moment when my incipient or chronic illness was accentuated, taking advantage of the lowering of my defences immune system. I kept tossing and turning in bed with a feeling of suffocation. I could feel that no air was getting into my lungs and every breath I took was screeching with a whistling sound identical to an old broken guitar. I got out of bed and trying not to make any noise I went to the dining room. Everything was silent. I looked at the clock on the wall and it was 2:15 in the morning. From the window I could hear a group of kids coming upstairs laughing and kicking a can of booze. What a good time! – I thought to myself – no worries, just living day to day and abusing what they like even if it’s harmful. When you’re young you think you can do anything and everything, but how wrong you are. If I could turn back the clock of time, the first thing I’d do would be to open the drawer of my bedside table where I had the cigarette packets and the lighter to throw them out of the window. That was my big mistake, smoking from a very early age.

I came back to the reality of the night and with it the unblocked feeling in my lungs, which together with the exhausting effort of not being able to breathe and the tiredness of the stressful day’s work weighed on my body like a slab. I went to the drawer where my wife kept all the medicines and, desperate as an addict, I rummaged through the boxes looking for an inhaler that my family doctor had prescribed for me a year ago, more than by chance, out of obligation to my wife. – I finally found it – I shouted inwardly. I started reading and the prescription said that it was a bronchodilator that prevented asthma attacks and relaxes the muscles in the airways.

He knew that he was going to take an expired medicine and was unaware of the consequences of a brainless man who by day was a strong man and by night was wandering around like a soul in pain in search of solutions. Take the cap off the inhaler. The medicine in the form of a large suppository was white in colour with a thread and they gave it a quarter turn and made a noise – click clack- The inhaler was loaded like a gun. I put my mouth on the top of the canister where there were exit holes and inhaled with all my might into it. The medicine entered my lungs like a bullet, tearing my insides apart and causing a sharp pain in my chest that made me fall to my knees in front of the sofa. For a moment, he was like a boxer knocked out by the first hook and was being counted down to ten seconds. I struggled to my feet because I didn’t want to lose this fight and stumbled into the bedroom, collapsing on the bed. Minutes passed. I don’t remember how many.

I began to breathe in again and appreciate how my lungs had accepted the obsolete medicine and filled with air like a fresh jug of water. Each breath I took was softer than the last, one after the other, until the moment came when, due to exhaustion and the effectiveness of the medicine, my body gave in to sleep.

The next day, in front of the mirror, I vowed to go to my GP, which I did. The specialist on duty diagnosed me weeks later with obstructive pulmonary disease, known by the initials COPD, due to my smoking.

I have not gone back to smoking, but neither have I gone back to using expired medicines.

– The lesson has been learned-

Durante mi vida, siempre había presumido de ser una persona que no valoraba la salud que tenía. Era muy raro que me vieran acudiendo al médico de cabecera o a un especialista cuando tenía algún tipo de malestar o dolor. Mi respuesta siempre era la misma cuando me recriminaban por no ir. Ya iré cuando pueda mientras rebuscaba entre una montaña de medicamentos (algunos incluso caducados u obsoletos) un bálsamo de fierabrás.

Sabes que no puedes automedicarte sin que te osculte el médico – me murmuro mi pareja – No voy a perder el tiempo haciendo cola esperando que me atienda y en estos momentos, el trabajo es más importante que la salud – le conteste a ella-

Y llego la noche, momento en que mi enfermedad incipiente o crónica se acentuó aprovechando la bajada de mis defensas y haciendo tambalear el sistema inmunitario. No paraba de dar vueltas en la cama con una sensación de ahogo. Notaba que no llegaba aire a mis pulmones y cada inspiración chirriaba con unos pitidos idénticos a una vieja guitarra rota. Me levanté de la cama e intentando no hacer ruido me dirigí al comedor. Todo estaba en silencio. Miré el reloj de la pared y eran las 2:15 de la madrugada. Desde la ventana pude oír a un grupo de chavales que subían riendo y dándole patadas a una lata de bebida. ¡Que buenos tiempos! – Pensé – Sin preocupaciones, viviendo el día a día y abusando de aquello que les gusta, aunque sea perjudicial. Cuando uno es joven piensa que puede con todo y con todos pero que equivocados estamos. Si pudiera retroceder el reloj del tiempo, lo primero que haría seria abrir el cajón de mi mesita de noche en donde tenía los dichosos paquetes de tabaco y el mechero para tirarlos por la ventana. Esa fue mi gran equivocación, el consumo de tabaco desde muy temprana edad.

Volví de nuevo a la realidad de la noche y con ella la sensación de atranque en mis pulmones que junto al esfuerzo agotador de no poder respirar y el cansancio del estresante día de trabajo pesaba sobre mi cuerpo como una losa. Fui al cajón donde mi mujer guardaba todos los medicamentos y desesperado como un adicto rebusqué entre las cajas buscando un inhalador que hace un año me recetó más que por casualidad por obligación a mi esposa, mi médico de cabecera. – Por fin lo encontré – grite para adentro. Me puse a leer y en la prescripción ponía que era un broncodilatador que prevenía las crisis de asma y relajaba los músculos de las vías respiratorias.

Sabia que iba a tomar un medicamento caducado y desconocía las consecuencias propias de un descerebrado que por el día se las daba de hombre fuerte y por las noches deambulaba como un alma en pena en busca de soluciones. Quite la tapa del inhalador. El medicamento en forma de un gran supositorio era de un color blanco con una rosca en su base de color rojo. Mis dedos índice y pulgar cogieron la rosca y dieron un cuarto de giro sonando un ruido – clic clac – Estaba cargado el inhalador como si de una pistola se tratara. Puse mi boca en el extremo superior del recipiente donde había unos orificios de salida e inhale con todas mis fuerzas hacia adentro. El medicamento entró como una bala en mis pulmones desgarrándome por dentro y provocando un fuerte dolor en el pecho que me hizo caer de rodillas delante del sofá. Por un instante, quede cao igual que un boxeador noqueado al primer gancho y le están contado la cuenta de diez segundos. Me levanté a duras penas porque no quería perder esta pelea y me dirigí a la habitación a trompicones desplomándome sobre la cama. Pasaron los minutos. No recuerdo cuantos.

Empecé de nuevo a inspirar y apreciar como mis pulmones habían aceptado el medicamento obsoleto y se llenaban de aire igual que un jarro de agua fresca. Cada inspiración que realizaba era más suave que la anterior, una detrás de otra, hasta que llego el momento en que por agotamiento y efectividad del medicamento, mi cuerpo cedió ante el sueño.

Al día siguiente, ante el espejo, juré que iría a mi médico de cabecera como así hice. El especialista de turno me diagnostico semanas más tarde a causa del tabaquismo una enfermedad pulmonar obstructiva conocida por las iniciales de EPOC.

No he vuelto a fumar pero tampoco a usar medicamentos caducados.

-La lección esta aprendida-

The Pill

I made sure to prepare all the necessary medication for the next day in the pillbox. It wasn’t just any day, and I didn’t know how I would be after the breast cancer operation. Parkinson’s, which has been my companion for twelve years, didn’t seem to have any intention of leaving me, so I had to have everything under control. My husband supervised everything, as he always did, to ensure that I had all the necessary medication. We didn’t know exactly how long I would stay there, and we weren’t sure if they would have it in the hospital, although we were previously informed that the hospital staff would be responsible for prescribing, administering, and controlling the medication.

Parkinson’s disease, unfortunately, is unknown to most people, but what’s terrible is that it’s also unknown to many healthcare professionals who don’t have a connection with it. I’m not saying they have to know every detail, but they should at least inform themselves before a surgical intervention when there are patients with multiple pathologies, as in my case.

I entered the operating room obsessed with the terrible consequences that could arise if I wasn’t given the correct dose of levodopa at the right time, and I made it clear to the medical team who was going to operate on me.

After a surgery that lasted several hours, in the recovery room, still groggy and surrounded by machines, I tried to ask if I had been given my medication, but I couldn’t speak. I began to feel extreme stiffness in my neck and upper limbs that quickly spread throughout my body; I couldn’t even blink. Then my right arm started to shake, followed by the left, then my legs, and then my torso, creating an exaggerated movement of cables and sheets that alarmed the healthcare staff who were monitoring my condition at that moment. Immediately, all emergency devices were activated, thinking I was having a cardiac arrest and convulsions. I tried to tell them that I just needed my medication, and everything would return to normal, but I still couldn’t utter a word. On the contrary, the more I tried, the stiffer my body became. At that moment, one of the surgeons who had been informing my family about the surgery’s result entered the room. He had heard about my concern before the intervention regarding Parkinson’s medication. My family showed him the medications and gave him all the medicines that had to be administered immediately, as more hours had passed than necessary, and my body could react by locking up or trembling, as unfortunately was happening. The surgeon immediately contacted my neurologist to authorize the medication administration. As I couldn’t swallow anything due to my stiffness, they administered it intravenously, and in what felt like endless minutes for me, my body gradually returned to normal. I stayed there for a few more hours before being taken to my room, where I was pleasantly visited by the specialist, the neurologist.

But that wasn’t the end of it.

The medication used to treat Parkinson’s disease varies greatly from one patient to another, as do the dosages. There isn’t a common pattern. The timings also usually don’t coincide with breakfast, lunch, and dinner. In fact, in many cases, they shouldn’t be taken with food. Probably, it’s more convenient in terms of hospital organization to follow a standard schedule, but in the case of this disease, and I assume in many others, it’s dangerous to disregard the patient’s personal schedules. It can also be observed that hospital pharmacies don’t have all the necessary medications for the hospitalized patients, so it’s necessary to bring them from home. In my case, during my hospitalization, I was only given Sinemet, and in different doses than I needed; there was no sign of the other medications. I didn’t understand this, and apparently, neither did the healthcare team, as they left the pill on the bedside table before the three daily meals. Fortunately, I still manage this aspect, but what would have happened if I didn’t?

I’m sure I haven’t been the only case, and unfortunately, I won’t be the last.

Hopefully, healthcare will manage to provide every hospital with «THE PILL» necessary for each patient and their specific conditions. And may all professionals wish to acquire more knowledge about various diseases, even if they’re not their specialty.

Looking to the future in health

Like every Thursday, it was a team meeting. There was nothing to talk about but the current problems with young people and their mental health, all had heard again a local news hopeless of a suicide at an early age.

«This is not normal, have you seen the suicide figures of the INE?» – Gema regretted the younger nurse.

«Yes, it’s creepy! , also in self-harm and risky behavior.» – Teresa completed the most meticulous nurse on the team.

«The challenges that surround social networks are a danger! So much information, that they do not know it is real, true or good They are very lost!» – Rodrigo added that he had teenage children.

«They have lost confidence in the people in their environment and consult anything on the internet» – Isabel sighed uneasyly.

Elena and Tina, two nurses crazy for their work, looked at each other with the conviction that they had to take the first step, they felt that although the pandemic had turned everything upside down and it seemed a feat to start any community project again, that was the time.

«What if we look for alternatives to stop these behaviors?» – asked Tina before proposing something that had been hovering in her head for some time.

«What if we give them that trust back?» – added Elena, a community nurse.

It seems that a light bulb went on in everyone’s head because they answered in unison: «We have to do more!»

They quickly set to work, it was time to give health promotion a chance. What followed were days of hard work full of stress, nerves and ups and downs. Seeking cooperation from different sectors, they held countless meetings, developed dynamics, workshops and designed a plan that, thanks to the involvement and participation of all, could meet the specific demands of the population.

The great day came when we stood before them, that forgotten population, that which is always outside the focus on health care, the healthy population that lacks tools to express itself or sometimes is silenced: Children and adolescents. However they as good hosts welcomed us with their best smile. Seeing us in the classrooms, their eyes filled with expectation, we began our adventure there.

We introduced ourselves and the first question we were asked was:

«Are the nurses also teachers?» – they looked forward to the answer.

“Nurses have other different functions to put band-aids and pricks, sometimes we have time to come to explain things so important for your health such as management and emotional expression, food and physical activity, hygiene… Then you will know how and what to do to change things that are not good for you and you can transmit it to others. Also teach you techniques that we can use to save lives with our own hands such as resuscitation or Heimlich maneuver…» – explained Tina without being able to hide his enthusiasm.

«You have a right to many things, including health and to be able to participate in the process of achieving it. Expressing what concerns you or interests you we can help you, so we will come to visit you many more times.» – added Elena with a contagious motivation.

This is how we start going to school and high school every month with different learning dynamics. When they saw us right away they greeted us or called us by our name to talk with us and to know what other surprises we were bringing them, a very relaxed atmosphere was breathed full of confidence. They had regained control, finally felt useful and valuable, communicate from another position, with greater responsibility and volunteered to help others:

«I told my grandfather that next to me does not have to be afraid to choke because I can save him» -said Manuel super animated.

» Now we go for a walk together every day to control my diabetes» – Victoria’s mother told us that she had also regained communication with her daughter taking advantage of the walks.

» Thanks to the self-image dynamic my daughter confessed to me that she did not feel well with her body and now we are working on it with a trusted psychologist» -confessed Berta’s mom relieved.

«They will be the generation most prepared to take care of themselves and others, this will greatly benefit the communities in which they live» – reflected the nurses of the health center proud of their profession. Then they sowed lots of new ideas to follow the path begun but that is another story.

I will build you a world

There is a before and an after in our lives in our home in our family.

How to explain that the test my husband was given was a new starting point. Positive in Huntignton, 42 repeats!

We were breathless, you cry, you hug, lots of hugs.

And here I am being his main carer.

A lot of things had to be thought of quickly, to be able to put everything in its place.

Safety at home, planning all the medical records, tests, etc. I gathered my children together and explained the situation, it was not easy, it was not easy to have a 50% chance of inheriting Huntignton, it scared them a lot in a million questions, no feelings at the surface. I am a fighter, I do not give up, lean on me for everything you need. I’ll have to rest too, I’m not made of iron. Let’s work together, because now it’s dad who needs us. I’m going to recruit family and friends, anyone who joins us is welcome.

Everything works, we have divided up the tasks, bathing, feeding, medical visits, walks, stays in the hospital, etc.

Each of us according to the time we have available. The first action I took was security at home. Three days after the test he was so restless that he started wandering around at night, without us realising it while we were sleeping. One morning at eight o’clock, I found him in the kitchen with a screwdriver in his hand, he had dismantled all the cupboard doors. He was fine, but I was scared to death.

There was no time to lose, I removed all the sharp, cutting, flammable objects from the house. And the fragile ones put away. I put corner protectors on all furniture, secured doors and windows, plug sockets, put carpets away, cleared passageways. Handles on the bathroom wall, a slippery bath chair, his slippers also on the sole, cups and containers all made of plastic.

The point is that all objects he handles cannot fracture, as glass does, when dropped by an involuntary movement, or puncture, or cause injury, or slip or trip.
By this I don’t mean that I do everything myself, on the contrary, I support and encourage him to be autonomous as far as he can, if he puts on a garment inside out, I help him to see where the label is and although he often gets angry because he doesn’t succeed, when he does, he is happy.

Another very important issue is the bed, it has an articulated bed with side protectors. After a couple of night falls I got it. The multiple positions it has helps the mucus flow in respiratory infections, bronchitis, pneumonia, etc. which are common in patients with Huntignton’s and other pathologies, improves rest and I can attend to him more easily without hurting my back. The height makes it easier for him to lie down and get up more safely.

He also has dysphagia, he drinks water with thickener, in summer I give him a few drops of non-alcoholic liquor to brighten up his life so that everything is not so insipid, I surprise him with the odd milkshake with a rat’s head and he laughs with happiness.

I am very inquisitive and I am always consulting with the health professionals who take care of him and the members of AVAEH, our association. Tips, tricks, everything to improve the quality of life in our home.

All the medical reports, records, tests, etc. I keep them in filing cabinets in a single cupboard and selected by specialities. My diary, a big calendar at a glance. I mark, with coloured markers, each follow-up and control of a symptom, whether it is a change in medication or a new alteration that appears, so that I can better communicate it to the health professionals and treat it as soon and as well as possible.

I use a pill dispenser, I can better detect forgetfulness or avoid overdosing. Safety in health care facilities is acceptable. Two wheelchairs without footrests and an old metal bed with a broken railing also happened to us in an admission. A dead point in safety in health care facilities is the lack of a warning button in case of an emergency. In the bathrooms for general use. I had to go out for help. We, the families, are always grateful for the work and support of the health staff.

Because nobody wins a game playing alone.

I´ll watch over you

She wake up early, she deconected the intercom that communicated with the adjoining room.

At 12 a.m., Lucía, try to stand up, at 3:10 p.m. she was crying, at cuarter past five p.m. she start shoutting because the kids didn´t want to play with her.

He had been all night traying to calm her down: reading storys, playing riddles, preparing tea…but anything worked.

He aprproached her bed, she slept, exhausted, overcome by the pulse thrown at a jundred ghosts nocturnal.

While he prepares a strawberry-flavoured proteinshake, Mónica, remembers how they were the first symptoms of the disease: the first tantrums, forgestfulness and aggressiveness. It comes to his memory the day he got lost in a department store. Aftertwo distressing hour, he appeared in the toy section, breastfeeding a huge doll. I was happy, withoy understanding the worry and the burden thathad unleashed the innocent situation.

From that day on, Mónica took action. He gave Lucía a pendant in the shape of heart. She was delighted with her jewellery, a victimo f her congential flirtatiousness. He always put it on before going out with her “mother” for a walk, completely ignoring that in his interior contained a samll locator, witch in case of alert would be all her movments.

When she finished to prepares the shake, she enter the room with purple walls and curtains of flowers in pastel tones, singing their favourite song. He doesn´t understand like that Little song of two litlle pigs, it i sable to reassure Lucía more tan medication.

– Good morning honey! Today you take your breackfast, like a queen!

Monica gives her a kiss on the cheek, fluffs the pillow and props her up until her back is at a right angle to her legs.

Lucia doesn’t stop watching her, she is quiet, moving to the sound of the tune. She mumbles something incomprehensible, which she repeats clearly:

– Moniquilla, I love you.

After the last sip, Monica leaves the glass on the bedside table, caresses Lucia’s face, discovering that it is still there, hidden in that capricious little body, in those innocent, childish, mischievous eyes.

– – I love you too, mummy!

Then, a strawberry fart stamps her face.