Dementia ward: Tobias Schlegl has written a book about everyday life there

Dementia ward: Tobias Schlegl has written a book about everyday life there

Tobias Schlegl is an author, presenter and paramedic. In his new novel he tells about everyday life in a dementia ward. A conversation about the fine line between life and death and the state of our healthcare system.

Tobias Schlegel writes to deal with everything he experiences as an emergency paramedic. His new novel “Strom” is all about his experiences in nursing. During his training as an emergency paramedic, he spent a total of 720 hours in the hospital in a dementia ward and experienced a lot. On September 25, 2023, he will read from his book for the first time – as part of the Harbor Front Festival in Hamburg’s Laeiszhalle. He told Stern in advance what the book was actually about and what the care industry urgently needs.

In your book, readers get an impression of the everyday life of the three main characters in the dementia ward. One of them is Frank. At some point he succumbs to the “rush of saving,” as you call it. Is this rush something you also know?
When you save a life yourself, it naturally sends you into a state of intoxication. Unfortunately, it’s not the case that all resuscitations are successful, but when they do, you’re just happy and relieved. But with Frank it reaches a completely different level. He deliberately injects patients to the brink of death in order to then save them. So for him it’s really just about the kick, not about the patient.

How nurses stay healthy

Have you ever met someone like Frank in real life?
Luckily not yet. But the character is of course still based on true events, even if such nurses remain the exception. That’s why I have two other main characters in the book, Nora and Diddy, who hopefully show the positive and human sides of care. It is not intended to be a novel against nursing, but rather a book that authentically draws attention to the things that are going wrong in the system.

For example?
Frank is narcissistic and carries trauma with him. For people like him, with mental health issues, the hospital structure as it currently stands is definitely unhealthy. We’ve known this since the case surrounding the murderous nurse Niels Högel, but nothing has really changed since then.

So there is still a lot to do.
Yes, and that is actually the hidden appeal in my book: We need to pay more attention to care. Only if we have well-rested and mentally and physically healthy nursing staff can they take proper care of the patients.

Paramedics rarely stay until retirement

Many nursing staff and paramedic change industry early because the job is too demanding. Can you actually do this until you retire?
Given the current working conditions, hardly anyone manages to last until they are 60. I decided not to do the job full-time and I’m doing quite well with it. You definitely need a good balance.

Criticism of working conditions in nursing is not new. Do you have the impression that politicians are doing enough to improve structures?
On the contrary. There are currently many cuts in the healthcare sector. The main problem is that our jobs are so unattractive that those who do them are burned out. Because of the high volume of work, they are unable to take care of themselves and therefore leave the job early. The result is that patients die every day because there are too few staff on the wards. This definitely has to get better.

Patient deaths due to a lack of staff?

A direct impact of a shortage of nursing staff on patient mortality cannot be proven, at least scientifically. However, there are studies that suggest that the care ratio is one of several factors that can lead to increased mortality. For example, British researchers have found that patients’ risk of death increases when a nurse cares for more than 10 patients. According to the study, published in “”, the risk increases by 20 percent compared to nurses who only treat five or six patients.

Despite all the hurdles and challenges, you enjoy your job. Why?
I have the privilege of having created a good balance to the hectic blue light world through writing. You get so many impressions there and for me it’s the only chance to process it all. The best thing about the job is that you can make an immediate impact. You learn how to handle extreme situations. I know that I can do something when someone is suffering physically or mentally – and that makes me less helpless. And when I see patients progressing positively, it’s just the best feeling. These are the moments when I know exactly why I’m doing this.

Nursing is an extremely demanding profession. How do you deal with extreme situations?
I now also work for the Red Cross crisis intervention team. This means that I provide psychological first aid at the scene in particularly difficult cases. In the event of violent crimes, suicides, sudden infant death, the delivery of news of a death or a tragic accident, I stay on site and endure the grief and suffering of those affected. Of course, this only works to a certain extent. That’s why it’s mandatory for our team to go to regular supervision anyway. And that is really valuable, because although I have a fairly high level of resilience, I realize that you also have limits and that I have to let out all the suffering that I have taken in. Either through writing – or in conversations with the therapist.

Why did you choose crisis intervention?
I got to know the team when I didn’t know what to do after a dramatic mission during my training as an emergency paramedic. At the time, I thought about canceling the whole thing. At that time, the crisis intervention team was called in for me. Talking to the employee helped me enormously.

In what way?
For example, I understood that my reactions to the shock were normal and that I was not crazy. That what I’m feeling is completely okay. That it’s okay if I can’t speak, suddenly get a headache and feel like I’m seeing myself from the outside. These are all human reactions to shock, which I was then able to classify. I also wanted to help others – and started further training.

You yourself say that you often move between life and death in your job. What has changed in your life as a result?
So much that I can hardly count it all. For example, many little things that I used to get upset about are completely irrelevant to me today. But the biggest learning that I would like to express with my new book is actually this: the more often you experience the threshold of death, the more you appreciate life. I am very grateful to be healthy, breathing and having people close to me. That sounds totally blatant, but I’m reminded of it again and again.

You also describe this joy of life in the book when it comes to the patients in the dementia ward.
Of course, dementia is always a difficult topic. But these people also experience funny moments, and I wanted to show that. There is something very life-affirming about facing your illness and still appreciating life while you have it. I have personally experienced how those affected experience their environment – and there is everything between crying and laughing. All in all, dementia patients are very honest people; they no longer have a filter that masks their emotions. This can also be extremely refreshing.

Unfortunately, dementia is often associated with shame; sooner or later those affected will no longer be able to take proper care of themselves and are dependent on help, which does not always come immediately. How can we still enable them to live in dignity?
If we want nurses to be able to care for patients, then we must also care about the lives of nurses. Only well-trained and well-rested nurses can act professionally and process what they have experienced in such a way that they remain empathetic towards their patients for a long time. In the end, that’s what matters: not to lose empathy, not to dull it. But that’s easier said than done – many people can do it, but by no means all.

How not to lose empathy

Maintain empathy – you can do this their operations still?
The fate of older people in particular always affects me. I experience a lot of loneliness during our interventions and have the feeling more and more that we are forgetting the older generations. They hardly ever occur in our everyday lives; I don’t see them in museums, in the subway or in restaurants. Instead, they live in seclusion in their small apartment in sometimes frightening circumstances.

What needs to change?
We should take more care of older people again. This means that the younger generations should take a step towards the older ones, include them and learn to understand them. It starts with the wording. If we continue to talk about social burdens and aging, we are also isolating people. We can learn so much from each other if we really listen.

Is that also the reason why your new novel is set in the dementia ward?
My main aim was to show a world that would otherwise remain closed to most of us. We already know the intensive care unit and the emergency room well enough from films and the Corona period. And everything that makes up life takes place in the dementia ward. What was particularly important to me was to portray the whole thing as realistically as possible. That’s why I also talked to other professionals about their impressions and experiences. I want nurses to see themselves when they read the book. And regardless of that, I just wanted to tell an exciting and touching story.

Source: Stern

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