The Holy month of Ramadan changes the daily rhythm drastically in Saudi hospitals. Basically the hospital becomes alive at night and quiets down for the day.
Read here how the Saudis usually visit the sick in hospitals. Needless to say the amount of visitors during Ramadan will at least double, especially during the last ten days. Visitors will come late and stay until early morning. They will bring along vast amounts of arabic foods to break the fast with like sambosa, all kinds of tiny pastries, cookies, dates, chocolates..
Large Saudi families come to the hospital to join in Iftar together with the sick family member. It’s not uncommon to find the family eating on the sheets on the floors! Saudis will generously give the nurses a taste of everything, sometimes offering huge trays full of different sweets or salty snacks.
Another peculiar thing that happens during Ramadan is handing out money to nurses. Patient or relatives might slip money into the nurses pocket or openly offer money anywhere from 10 to 1000 riyals at a time. The gesture usually makes nurses feel somewhat awkward and because of cultural differences might be misinterpreted to be some form of bribing. Nurses are naturally not supposed to accept the money very few will reject. The person offering the money will become very upset if the offer is rejected and they can become pushy and just stuff the pockets with the money! The reason behind this is Saudi families wanting to show their gratitude and appreciation to the nurse.
Only few patients will be observing the Ramadan fast, and they will also abstain from all medications including injections and intravenous drugs during daylight hours. That makes it a bit difficult to accommodate the medication regime to the fasting timetables. Basically it means that the medications normally given around 8-9 am will be given at fast breaking time around 6:30pm. The next dose will be at midnight and finally just before the morning prayer at 4 am.
For some patients it’s fine to fast and it will not make their condition worse. Every once in a while there will be a patient who insists on fasting even if doing so will severely adversely affect their health. The patients don’t want to miss out on the blessings of fasting. Some are diabetic which means their blood sugar levels will be uncontrolled and it might put the patient in risk of coma, or they will refuse insulin injections resulting in sky-high blood sugar levels. Patients with bowel problems might get complications like obstructed bowel, may even need surgery and then there is the odd patient who will even refuse to be operated on.
Toward the end of Ramadan the emergency room usually begins to fill with patients with bowel obstructions. Many are elderly patients needing full time hospital care. Patients suffering from gastrointestinal diseases and disorders, diabetes, metabolic disorders and other diet controlled conditions further crowd the ER beds making it the busiest time of the year in the hospital. Nurses and doctors are often exhausted from the workload this month brings along.
The Muslim nurses will often opt to work night shifts to make fasting easier or alternatively if they wish to work days they can work shorter hours. The total amount of working hours during this month for Muslim nurses and other muslim personnel is also cut down. Generally there will not be any operations other than the most urgent ones.
The patients’ sitters will all usually be fasting and the hospital kitchen provides food for them and the fasting patients in the early morning hours. A three course ‘breakfast meal’ called sohoor will be distributed at 2 am well before the Fajr prayer.
The iftar meal will be distributed to the rooms at 6 pm. Even though a patient is not fasting they will be up all night chatting with relatives, reading Quran or watching Arabic soap operas or the live televised show from the grand mosque in Mecca.
I personally enjoy working during Ramadan, patients and relatives are in good spirits and it’s nice to spend some extra time with them in the rooms having some arabic coffee and sweets. Generally the atmosphere is more laid-back and patients are not complaining as much as usual :)