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Background material by Professor Omar Hasan Kasule Sr. for Year 2 Semester 1 PPSD session on 15th October 2008
Background
Hashima Hashim is well known in the hospital. She retired as a nurse 20 years ago and has been coming to various hospital clinics with one ailment after another. Although fondly called auntie Hashima she is also known as a difficult patient. She refused the advice of the gynecologist to take hormone replacement therapy (HRT) for her osteoporosis arguing that steroids would cause cancer. She also refused the advice to undertake regular light exercise arguing that since her bones were already fragile they would break during exercise. While working in her kitchen she fell and could not stand up. She called an ambulance using her mobile phone. At the hospital she refused to accept that her femur was fractured because of osteoporosis causing her to fall down in her kitchen. She argued that it was the fall that fractured the femur and not the other way round. She readily agreed to surgical reduction of the fracture but insisted that the immobilization using plaster of paris should be modified to enable her pray normally. The surgeons tried to persuade her that this is impossible. Eventually a young physician who had graduated from UBD offered to help persuade her to change her mind. He remembered knowledge taught to him in the first year and successfully convinced Hashima. He explained to her how to perform ablution and how to pray in various positions.
Discussion
- Discuss the benefits and side effects of HRT and physical exercise. What would your advice be for Hashima in this case
- Describe how an immobilized patient can perform ablution
- Describe 3 ways in which an immobilized patient can pray