Tag Archives: nhs staff

When an NHS relationship ends

Oh how sad it is when a relationship ends.  The pain of losing that one person who understands you more than anyone else.     No more chats as you lie in bed.  No-one around who you really trust as much as you trusted him.   Having to start a new relationship with someone else who might not prove to be as reliable, or thoughtful .

I have lost my consultant.   And I am grieving.

It sounds daft doesn’t it?  But for us NHS patients, having a long term  relationship with a doctor who we really trust makes a  difference.   I met my consultant  11 years ago.  I’d spent 2 or 3 years being passed around the NHS, short term dates with doctors who knew very little about my immune system problem and often couldn’t even remember my name.   I remember hearing his voice for the first time outside my  room, telling a cluster of junior doctors about my condition.   ‘This might actually be someone who can help’, I thought.

And he did.  I’d been warned to have no more children, but he said I could.   I’d been told there was nothing that could be done to stop the damage to my kidneys, but he said there was.  I’d been left with no hope but he gave me bundles of it.

Over the past decade, he has fought to get me the best,  and often very expensive,  treatment.  He has rushed me into hospital on a few occasions, insisted I got a bed on the right ward.   He’s overridden hospital procedure when it’s not in my best interests.   He’s been blunt with me about the future when I’ve been scared about new therapies. He’s given me his mobile for whenever  I needed to talk directly to him ( I’ve used it twice in 10 years).  He’s been the only person in a long line of medics who asked me how I felt emotionally after being put under sedation for five days in intensive care.  Without doubt he has saved my life on a couple of occasions, and without him my cheeky, lovely 9 year old son would not be here.

And now he’s gone.    And unlike most normal break-ups, I’m given no warning and no reasons.  I turn up to clinic a few times and he’s not there.  I ask and I am told that he’s taking leave, and then it’s extended leave, and then it’s ‘no we don’t think he’s coming back’.

It has to be this way of course.  Anyone is free to move jobs, retire, take a break.    You can’t have patients knowing about a doctor’s personal life.  It’s just not appropriate for anyone in the NHS to tell me why he’s no longer my doctor.  I completely understand and accept that.

But I am bereft.  And worried about him and his sudden departure.  I hope he is well.  I can’t even write him a note to thank him.  To point out to him the immeasurable effect he has had on our family.

Instead, somewhat wearily, I start the search for a new relationship.

Careless Words

I have an amazing friend.  After years of struggling with alcohol, she’s managed through a great deal of pain and endurance, and a little help from AA, to stay off the booze for 4 years.  She pointed this out to her GP recently.  His response? “Good .  Now you need to lose some weight.”

Another friend tells a tale of talking to a doctor about fibroids.  They discussed whether it could affect her fertility.  On finding out she was 35, the doctor said, “Well, what have you been waiting for? You need to get on with it.” She promptly burst into tears.

I can tell a couple of stories too.  The time a midwife gave me an injection just before I was due to have a D and C to remove my miscarried baby.  ‘Injection done.  That’s the worst over with.” Really?  The time a doctor berated me for putting on weight before realising I’d been on a large dose of steroids for six months.  The time a consultant who’d never met me before insisted I was facing the rest of my life on dialysis.  He was wrong.

Everyone can put their foot in it now and then.  I’ve dropped some right clangers in my time.  But I think working with patients requires an extra effort in choosing the words you use.

I have another story of a junior doctor, who came across me in tears after I’d received bad news.  “Fiona,” he said.  “This time will pass.”  He was right, and like the ill chosen words above,  those 4 words he uttered have stuck with me and helped me through the darkest of times.

Dear NHS staff.  Us patients are really vulnerable.  We’re often at one of the most difficult points in our lives.  Our conversations with you are about intensely personal subjects.   We’ve waited for hours for the doctors round on the ward.  Or months for the outpatient appointment.  You are the person who we think can cure us.  Or who we trust to care for us when we can’t care for ourselves.  We hang on your every word and analyse them after you’ve gone.

Careless words might not cost lives, but they can cost peace of mind.   And a loss of confidence in those who are treating us.   But well chosen words can bring hope too.  Remember that when you talk to us , and remember that your words will stay with us long, long after you’ve moved onto the next patient.

 

 

Living on a NHS ward

Everyone should be made to live for a week on a NHS ward.  Especially our politicians.  No, not to see how over stretched the staff are. Not to experience how bad the food can be. Not even to see how long you sometimes wait for treatment. But for the simple reason that when you live on a NHS ward you’re forced into close contact with ‘people who are not like you.’

Let’s be honest, we all have our tribes and we all have our prejudices about people who aren’t like us.  For most of us – I hope – it’s not based on colour of skin or sexuality anymore but the prejudices are still there. Perhaps nowadays it’s more about what someone is wearing, the newspaper they read, the television show they watch, the way they vote, the place they live, the school they went to.

And for most of our lives we succeed in spending time with people like us.  Our families often, though not always, have a similar outlook.  We pick our friends.  Our work colleagues, if not from the same tribe, are often from a similar one.  We live our lives most of the time within a common consensus about what is ‘right’.

And then we get ill and we’re forced to live with total strangers, thrown together because of similarities in the ways our bodies have let us down, rather than similarities in education or income.  We eat together, sleep together.   We’re together 24 hours a day, sometimes for weeks on end.

We don’t just share magazines and bathrooms; we share nurses, doctors, healthcare assistants.  We share knowledge about which ones to ask for help, and which ones seem like they couldn’t care less.  We know intimate secrets about each other’s bodies; we hear hushed conversations through thin green curtains, telling us things about our bed neighbours we’d rather not hear.  We notice who has regular, loving visitors ..and who doesn’t.  Even when one of us retreats behind the curtains, desperate for privacy,  we can see the red eyes when they return to view.

I’ll be honest.  I often arrive in a ward in a foul mood.  Depressed and frustrated at being back in hospital, worried about my illness, my husband and kids, I retreat into non-communication with my fellow patients.  No eye contact, monosyllabic answers to those who pry too much, I pull the curtains and lie alone, trying to avoid the reality of what is happening to me.

But after a couple of hours sulking,  I have no choice.  I’m forced to engage with those around me whoever they are, whatever life they lead, however old they are, whatever their faith, whichever newspaper they choose … and life on the ward is generally better when I do.

And it does broaden your view of the world.   We all know in our heads that there are people who are poorer than us or posher than us,  less or better educated, or who vote for parties we might consider unthinkable …but until we actually meet those people, it’s the differences that stand out rather than the similarities.  Living on a ward can make you more tolerant, less sure of exactly what is ‘right’ and ‘wrong’, more appreciative of the difficulties other tribes face.

And that’s got to be a good thing. Hasn’t it?

It’s time to talk about the NHS

So ’tis the season when those who run our country fight over the NHS. Like a girl ignored all year by the good looking boys, she is suddenly surrounded by suitors offering to take her to the prom. ‘I care about you more than him,’ ‘No I’ve always cared about you!’ ‘I care more! He hasn’t got enough money to look after you anyway!’

As patients it’s almost impossible for us to make sense of what’s on offer. GPs available seven days a week versus a guaranteed GP appointment within 48 hours? Erm.  I’ll have both please.  £400million versus £2.5billion?  Oh I’ll go for the £2.5billion  please….. but hold on a minute, where is the money coming from?

We look helplessly from one offer to the next while those really in the know warn us that none of these plans will stop the crisis we’re heading towards.   The NHS in her too-tight dress and faded corsage is looking for a hero to fly in and rescue her.   She needs radical action, a combined effort by all her suitors and some new shoes so she can dance all night.

She’s probably not going to get it. As much as the politicians try, they are bound by us.  Patients on the one hand, tax-payers on the other.  We all want a wonderful NHS, we’re not all willing to pay for it.

But at least we are giving the old girl in the corner some attention and that has to be good.   Maybe, just maybe, we could turn things around for her. She is still well loved, trusted and utterly brilliant to most of us on most days.  We don’t want to lose her.   Maybe a fierce election debate is just what she needs.  A national debate where all of us, patients, policy makers and staff demand more for the NHS.  One where we agonise over choices while being inspired by new ideas.   It shouldn’t be about party colours.  It should be about keeping the NHS at the party.  Bring it on.

Dr Who (or the Physician Associate)

One of the things I’ve always found confusing in hospital is trying to work out who’s who. Is the person taking my blood pressure a nurse? If he or she is the same person who makes my bed, then possibly not. Is the person making decisions on my care a consultant with many years experience or a registrar who has only just stopped being a student, possibly more knowledgeable about Minecraft than medication?

Well now the government plans to confuse us patients even more with what they are calling ‘ a new class of medic’.  The Physician Associate.  A sort of Doctor’s Assistant if you like,  with fewer time travelling duties than Sarah Jane ,Rose or Clara, but with the responsibility of examining us, deciding on our treatment and admitting and discharging us from hospital.  Sitting somewhere in the hierarchy between nurses and doctors, the Physician Associate will be a science graduate with two years intensive training. They won’t be able to prescribe drugs.

Inevitably my initial reaction to this, along with most of the other patient groups, is one akin to Clara when she sees her doctor change from a youthful Matt Smith to a grizzly Peter Capaldi.  I want a real doctor please.  With seven years training, a stethoscope and notches in his or her belt of complicated cases.  And while you’re on my case, NHS, can I also have a proper nurse to take my blood pressure, an eagle-eyed cleaner with obsessive qualities, and a Michelin starred chef to make my toast?

Ah. My Utopian NHS. We all know the NHS hasn’t got enough money and unless we fancy paying a load more taxes, that isn’t going to change. It doesn’t mean we shouldn’t all be entitled to see a doctor when we need to of course. Mark Porter, chairman of the British Medical council,  is right when he says these posts cannot replace doctors. They can ease the burden though, so that when we do need to see one, they are able to give us their full attention for more than a couple of minutes.

But it is absolutely vital that we patients are completely clear about exactly WHO is standing at the end of our bed, something which is a tad hit and miss at present. Then, if we’re not happy with the level of experience of our Physician Associate,  we can ask to see a real doctor.

So NHS, here’s what I propose. For a start make everyone wear a name badge with their rank on it. No, I mean really make them. It seems to me it’s a rule followed by some nurses and healthcare workers but not all, and virtually no doctors. Make it a disciplinary issue if they don’t. Us patients need to know who they are.
Then in every ward put up a notice explaining the different levels of experience that different staff have. That’s right – there’s plenty of space between the Clean your Hands posters and the leaflet telling us your survey showed everyone was happy with the food. And when you do it bear in mind barely anyone outside the Health service knows what a registrar or a house officer is. And don’t kid yourself in thinking that we can tell who someone is by what they wear. Thats a sort of NHS secret code that us patients generally can’t decipher. Frankly a white coat can mean the person is a doctor, a pharmacist, a dietician, a physio, a student nurse, an agency nurse or that science kid from Cloudy with a Chance of Meatballs. How are we supposed to know?

So by all means bring in your Doctor’s Assistant. The physician associate might be able to get on with some of the routine stuff leaving my doc to scratch her head over complicated issues. Just make sure I know who I’m dealing with. More Dr Know please. Less Dr Who.

 

Sleep in hospital

Sleep.  The great healer. The time when our bodies recharge and mend themselves.  Without it we quickly feel poorly.  Scientists have linked lack of sleep to, among other things, diabetes, obesity, and even speeding cancer growth.  It is without doubt a great natural cure for our ailments and the reason our doctors, and our mothers, tell us to ‘Get a good night’s sleep.  You’ll feel better in the morning.”

Why then does the NHS put so little value on it?

It’s a recognised fact among us patients that we won’t get much sleep in hospital.  The staff from consultants to porters seem to recognise that too.  The cause is generally put down to other patients, snoring, the crazy ones who shout all night, those who simply weep, loudly.

But as much as other patients do sometimes keep me awake, without doubt, it’s more often the hospital staff and procedures that leave me tossing and turning in frustration at 3am.

Let’s talk about last night.  Lights off about 11pm.  I’d shoved in my headphones to drown out the sound of the two elderly, confused ladies alternately crying for help and ranting at the poor care worker on shift.   Then I’d managed to drop off to sleep.  Until, at 11.58pm,  I heard a voice. “Fiona.  Sorry love but can you wake up?  We need to move you to another ward.  Can you get up and pack please? The porter will be here in a few minutes.”   I travelled down some cold corridors, porter commiserating with me, (“It’s not bloody fair love, they shouldn’t move you at this time”), and probably woke everyone else on the new ward as I clumsily tried to unpack in the dark.  I was not surprisingly then a tad unrelaxed and didn’t manage to get to sleep until about 4.30am.  And of course they woke me at 6.30am to take my blood pressure.

Now if this was a rare occurrence I’d accept it as inevitable in a busy  hospital that has to admit patients through A and E in the middle of the night.  But in some wards, in some trusts, it seems to be an  acceptable, common way of behaving.  The night before last I’d been woken from my slumber by first one patient moving out at 2am and another moving on half an hour later.

And it’s not just the procedures but sometimes the staff themselves. There are those who seem to understand that it is in fact nighttime, who get on with the stuff they have to do but at a lower decibel level than they’d use during the day.  But there are many who carry on as if it’s the middle of the afternoon, switching bright lights on, talking in hearty, loud voices, waking us all up to ask a patient a few questions which could perhaps wait a few hours until morning.

So, NHS, here’s what I propose.  Let’s introduce sleep-protected time zones in the same way we have protected times for meals.  A period between midnight and 7am when everyone talks in whispers, lights are dimmed and no-one should have to move beds.  Of course there will be times when these rules will have to be broken for essential medical care.  Most patients would recognise that.   But if it’s not essential, let’s keep the ward quiet and dark so we can get a few hours uninterrupted kip.   We’re ill for goodness sake.  We need our sleep.