Monday 22 November 2010

When it Goes Wrong...


I've very consciously avoided making a detailed judgement on how I find the NHS this time round. With my very obvious left leaning views, it would be too easy to jump to criticise things, just because we've had a change of government.

I had planned tonight, to write a post highlighting all the wonderful improvements that have been made over the last decade or so. There have been some great strides taken that have benefited the patient enormously, and I will come back to "Howard's Post" tomorrow or very soon.

In the meantime, there was a little incident today that I wanted to share with you. It's a tiny cameo of the type of incident that happens to most patients at one time or another, and one that can be the most distressing part of any stay. They don't come down to funding or efficiency, they come down to people.

The NHS is vast. I believe, for instance, that Addenbrookes alone employs around 6,000 people and that at any one time there are around 1,000 patients. It is absolutely inevitable that amongst those 6,000 there will be saints and sinners, angels and demons, heroes and villains. Sometimes, we just take a dislike to someone for no particular reason - we do it in life, why wouldn't we here? Other times you might catch a nurse or doctor at the wrong time, at the end of a week of nights or a dreadful shift or with personal worries clouding their day.

Years ago, the patient/nurse or patient/doctor relationship was much less balanced than it is today. Patients were rarely consulted, often ignored and too frequently mistreated. Over the years, starting with John Major's "Patient's Charter" and developed extensively by Labour, the patient became the consumer and her rights became the focus of care rather than an afterthought.

Still, with all that said, there are a very few nurses or doctors who are simply awful at their job. It is a shocking thing to say, totally taboo unless the Daily Mail finds itself sexed-up by a Harold Shipman. Very occasionally, a nurse is simply cruel - there, I've said it. Just as priests may occasionally be more interested in choir-boys than God, so a nurse or doctor may be more interested in wielding absolute power over the vulnerable than they are in providing care.

I could tell you some stories, from over the years, that would make your hair curl. (I won't here, but I'm sure I'll drop a few posts into the mix here and there over the months ahead.)

Last night, it was about 7.30pm when I came up to my new ward. I was dropped off at the bed and then saw no-one at all. I didn't know where the toilets were, and if I'd been a bed-ridden, hospital virgin, would have had no idea how to call for help or get a drink. No problem though, little things like that stopped stressing me years ago. After a couple of hours, I wanted to go for a cigarette, so I asked a nurse if I could. She asked if I would mind asking the Healthcare Assistant to do a set of obs first, just to make sure I was safe. A few minutes later, the healthcare assistant wandered into our bay and I started to ask her what time she normally did obs. (That's the double-PHD in patient-hood kicking in there, never ask someone to do something, just ask a polite question that makes them offer and think it was all their idea in the first place.)

Amyway, I didn't even finish the sentence before she snapped "I'm busy at the moment." A second or two later she added an "As you can see." A staff nurse caught my eye and raised her eyebrows at me, but I just shrugged and smiled. A while later, it was time for me to ask for my painkilling injection, so rather than interrupt her (as I'd gathered she didn't like interruptions, lol) I pressed my call button. She looked up and said "Do you want something?" I explained that the injection was due but she answered - in a stupendously patronising tone - "The nurse will know when to bring your medications Susan." I paused for a moment to control my temper, and then replied calmly that the injections were PRN - meaning I have to ask when I want them, they aren't given routinely. She didn't answer.

We had a very disturbed night, nobody got any sleep. There is a severely disabled patient in the bed opposite mine and she was frightened and confused, away from her usual routines. She finally went quiet at about 5.00am but just before, I heard the old lady in the bed next to mine beg the HA for a little peace and heard her  answer "She can't help it you know!" No sympathy or care, just a ticking off.

I'd only been asleep for an hour or two, when I woke with a start to find the healthcare assistant standing by my bed with blood pressure machine and thermometer. She was very young, with one of those glowing, scrubbed-clean complexions that you only have when you're in your late teens. For a few moments, I couldn't remember where I was and when my eyes focussed and I remembered I was in hospital, I noticed that she was just standing by my bed staring at me. Suddenly she asked "Have you got a problem?"
It wasn't even a "Have you got a problem (I can help you with?)" it was a "Have you got a problem? (Oi, you outside... NOW!)"

My blurry brain, instead of focussing on the matter in hand, chose to wonder when anyone had last spoken to me like that? Primary School? Secondary School? I hedged a bit, and asked her what she meant.

"You're glaring at me so you obviously have some kind of problem, what is it?"

My brain cleared a bit more and assured me that, yes, she really was picking a fight with me!! Astonishing!

I managed, even then, to keep my temper. I didn't shout at her, I wasn't rude or insulting, I explained that I hadn't been sure where I was when I woke up, and that if she had been woken up, at 7.00am, by a stranger standing by her bed, she would surely need a moment to gather herself? Even more astonishingly, she answered "Or you might be the problem? Maybe you're just rude?"

Now I'm easy going, but even my children know not to bother me with anything until I've drunk my first cup of tea. I am not a morning person and my tolerance levels rise sharply after about 9ish.

I gave up on mollification, and answered her question.

I told her very quietly and politely, that in the 16 years I had been an in-patient at Addenbrookes, I had never come across a member of staff with such little regard for her patients. I told her I had not heard her say a single kind word to any of them, nor had I seen her smile. I said she had been efficient, but patronising - and in my case, aggressive - and had not shown any sympathy or kindness at all. Finally, I explained that in the many, many months I'd spent as an in-patient over the years, I had never been moved to speak to a member of staff as I was now speaking to her.  

I wasn't really cross, but I know I would have been beside myself a few years ago. I didn't complain or even mention it to anyone else, but I did notice that she was a much better nurse for the last hour of her shift.


  1. I suppose it is possible that she may have just experienced some trauma in her life, in which case she clearly was unfit to do her job.
    I would have made a complaint at such bullying.
    You seem to have made an impact with having a "quiet word". I would not have had your patience.

  2. Pam - Sure, you never know what's going on in people's lives. You do get a feel for their personality though and some should just never be let anywhere near a ward at all.

    As it's just you and me Pam, I'm umming and ahhing over posting about how bloody useless this ward is compared to the other one, but not sure anyone would really be interested, what do you think?

  3. Sue,

    I am sorry to hear about that ordeal. It is one of the problems of services like that, that nurses etc... can slip into the beleif that you are getting your treatment for free...

    Of course, you know that a life of taxes by all and sundry more than pays for your treatment...

    They need better trained to be more aware of that I think..

    The same dilemma exists in other services

  4. I think I'd wait a while and see how things go, monitor it, if it doesn't improve then make an officially complaint. Sorry for delay, busy day at work.

  5. I know only to well sue there is always at least one staff bully on a ward i have had this many times over the years and I'm afraid to say things are unlikely to improve