Happy1
10-08-2008, 05:42 PM
THE VIEW FROM THE OTHER SIDE OF THE FENCE.
As a patient, and as a relative of patients, I have formed my own view of the NHS. And as a NHS worker I have formed my own view of the general public using the NHS. I could spend hours writing about how things are from the other side of the fence, but I am too tired right now. This is as a result of my 4th 10 ½ hour shift in a row, with no breaks (my legs hurt), no moment to sit down (my notes written whilst stood up), no hot drink (half a cold cup of coffee 8hours into the shift, drank whilst stood writing notes), no food (my judgement is getting clouded…) and no wee (although it really shouldn’t matter as I haven’t had a drink, but I probably do have a water infection).
But, apart from this (against EU regulations) challenging downfall, I absolutely love my job, as do most of my colleagues. It is extremely satisfying to assist vulnerable people in their hour of need. But in what other job do you face these testing conditions (nursing also being the lowest paid profession)?
The other major downfall, which is more distressing than the daily downfall listed above, is the verbal abuse and attitudes of middle class, normally respectable public, who, for whatever reason (and sometimes justified) walk into an NHS establishment deciding from the off that the NHS is substandard and that they are about to receive poor service, regardless to any other circumstances. At this point, their need becomes the only need that they are willing to consider. In these (very common) circumstances the patient/relative is NEVER going to be satisfied, no matter WHAT you do, because they have pre-conceived opinions that the NHS is substandard. These normally respectable patients/relatives arrive through the door with a bad attitude, dirty looks and criticism before we’ve even started, and as a result, are very difficult to care for. (In my own experience, the odd punch in the face from a drunken drug abuser is much easier to deal with).
I will give you just one example of the unreasonable patient/relative.
A middle aged, middle class lady and her husband walk into in the Emergency Department at midnight on a Saturday night. Lady has a painful foot. Present for 1 week, no limp, heat or swelling, no history of injury, no history of having taken any painkillers to see if the pain goes away. (Midnight on Saturday is never a good time to go to A&E, because as well as the REAL emergencies; there are also many drunken, abusive, and difficult to manage people there. And this was an inappropriate attendance – no accident, and certainly no emergency. The patient should have visited her GP). Upon triage (initial assessment) I examine the foot fully and the patient is informed that there is a long wait to see the doctor (there are only 2 A&E doctors on duty, both junior doctors, not the doctors’ fault or mine. And there is a full department of patients, of varying states at the time). I explain (kindly and sincerely) that there are many poorly patients in the department, and that it is also a particularly busy night with ambulance crews queuing in the corridor. This is met with a disgusted stare of total disbelief. I am told very aggressively and rudely, that it is not good enough, because this foot is painful. I offer my sincere apologies (and very, very long overdue painkillers) and say that they will be seen as soon as possible.
The next 2 to 3 hours (rightly so) focus upon one young man having an acute heart attack, one severe arm injury with compromised blood circulation, one asthmatic child who worries me and my colleagues greatly (and we’re not easily fazed), one miscarriage in advanced pregnancy and various other conditions of higher priority (and time of arrival) than Painful Foot. And all this takes time The team work excellently together (although slightly stressed and hungry), still filtering the various minor injuries from the waiting room, ever mindful of their wait as well as of the emergencies. During this time, Painful Foot and Husband have continually pestered the stressed out (only) receptionist, who is responsible for a great deal of admin work for the (seems like) millions of patients flowing through the department. Stressed Out Receptionist (in between booking in yet more new patients) is constantly ringing the nurse base to pass on Painful Foots complaints. Nurses are continually abandoning treatments and ambulances to go and apologise and explain. Eventually Painful Foot is placed in a cubicle (ahead of a frail elderly man on an ambulance stretcher with a possible stroke – just to attempt to pacify – imagine his relatives’ perspective). Not long after this point I am rushing past the cubicle with a drip for another (poorly) patient, when Husband (normally respectable), storms out of cubicle and aggressively shouts at me to “Get the bloody doctor in here now! This is disgusting service, we have waited long enough!” (I recall A&E before the introduction of 4hour targets, clearly Painful Foot doesn’t). I calmly step inside the curtain, stressed, hungry, thirsty and tired, with drip in hand, and attempt to explain the reasons for their wait. Twenty minutes later I am still there being challenged. The poorly, dehydrated, nil by mouth patient is still waiting for his drip (imagine his perspective). No reasonable person could dispute the sympathetic, professional and assertive explanations that I give. Except the patient/relative with the pre-conceived opinion that the NHS just isn’t good enough. Then through the curtain I hear a commotion, and peer out to see a paramedic running through the department with a baby. I hear the Sister shout for a doctor to go into the Resuscitation Room. I hear her shout for the Paediatric Resus Team. This is a baby in need of resuscitation. I soon realise that, unfortunately, this is going to delay Painful Foot (1 week old, no painkillers taken) being seen by the doctor. And I dare to tell her this. I politely say “As you just heard, a very, very sick baby has just arrived. The doctors have gone into resus to attend to this emergency, and this means that you may need to wait just a little while longer”.
And this is where the middle class, tax paying, normally respectable public astound me. (And most other NHS workers, most of which could tell you a different, but similar story). Painful Foot, and Husband, simultaneously, disgustedly huffed, sighed and proclaimed aggressively “And exactly how long is that going to take?!” I wanted to say “Well, hopefully for you, the baby will die, freeing up the doctors quickly, to come and see your painful, but perfectly well foot”. Instead I looked at them, firmly, assertively, and said, “I do not know how long that is going to take” and I walked out. I then ran into resus to assist with what the NHS does best. The next (and last) 4 hours of my shift pass in a blur. Myself and six other members of NHS staff fight and work so hard on this dying 9 week old baby boy. We perform CPR; administer complex life-saving drugs, struggle and fight like mad to bring life back to his tiny body, all the while attempting to support a hysterical and distraught mother and father. It took 4 hours of sweat and tears for him to be stable enough to transfer to Intensive Care. Alive.
At some point during this time, the A&E doctors left us nurses with the Paediatric
Resus team and the anaesthetists to continue our battle. They resume (in a bit of a daze, and very tired and hungry) seeing the rest of the A&E patients, including Painful Foot (who was equally rude to the doctor who had just performed life-saving CPR on the baby). Painful Foot was diagnosed with a sprain in 5 minutes, and advised to take simple painkillers. They then went home; no doubt disgusted with our care (I had already provided them with the requested complaints leaflet). I didn’t sleep after that shift. I couldn’t shake off the irony (or the anger) that I’d gone from spending a significant amount of time attempting to pacify a disgruntled NHS patient with a bad attitude and a well but painful foot, to attempting to pacify a mother who’s beautiful baby son was dying in front of her eyes.
Sometimes there’s a reason for care not being as ‘gold standard’ as expected. And I agree that sometimes it isn’t gold standard. As a patient and as a relative I have been on the receiving end of disappointing care myself, but I know that most NHS staff work extremely hard under extremely challenging circumstances, often feeling frustrated, exhausted, hungry, undervalued, and under constant attack from patients/relatives with (often) unrealistic expectations. And this is why I would never pre-judge any healthcare experience that I am about to have. I am due into hospital for surgery soon, but I would never walk in with a bad attitude based on my previous disappointing experience, because for the dedicated, hardworking nurse/doctor, doing their very best against the odds, this can more soul destroying than a drunken punch in the face.
As a patient, and as a relative of patients, I have formed my own view of the NHS. And as a NHS worker I have formed my own view of the general public using the NHS. I could spend hours writing about how things are from the other side of the fence, but I am too tired right now. This is as a result of my 4th 10 ½ hour shift in a row, with no breaks (my legs hurt), no moment to sit down (my notes written whilst stood up), no hot drink (half a cold cup of coffee 8hours into the shift, drank whilst stood writing notes), no food (my judgement is getting clouded…) and no wee (although it really shouldn’t matter as I haven’t had a drink, but I probably do have a water infection).
But, apart from this (against EU regulations) challenging downfall, I absolutely love my job, as do most of my colleagues. It is extremely satisfying to assist vulnerable people in their hour of need. But in what other job do you face these testing conditions (nursing also being the lowest paid profession)?
The other major downfall, which is more distressing than the daily downfall listed above, is the verbal abuse and attitudes of middle class, normally respectable public, who, for whatever reason (and sometimes justified) walk into an NHS establishment deciding from the off that the NHS is substandard and that they are about to receive poor service, regardless to any other circumstances. At this point, their need becomes the only need that they are willing to consider. In these (very common) circumstances the patient/relative is NEVER going to be satisfied, no matter WHAT you do, because they have pre-conceived opinions that the NHS is substandard. These normally respectable patients/relatives arrive through the door with a bad attitude, dirty looks and criticism before we’ve even started, and as a result, are very difficult to care for. (In my own experience, the odd punch in the face from a drunken drug abuser is much easier to deal with).
I will give you just one example of the unreasonable patient/relative.
A middle aged, middle class lady and her husband walk into in the Emergency Department at midnight on a Saturday night. Lady has a painful foot. Present for 1 week, no limp, heat or swelling, no history of injury, no history of having taken any painkillers to see if the pain goes away. (Midnight on Saturday is never a good time to go to A&E, because as well as the REAL emergencies; there are also many drunken, abusive, and difficult to manage people there. And this was an inappropriate attendance – no accident, and certainly no emergency. The patient should have visited her GP). Upon triage (initial assessment) I examine the foot fully and the patient is informed that there is a long wait to see the doctor (there are only 2 A&E doctors on duty, both junior doctors, not the doctors’ fault or mine. And there is a full department of patients, of varying states at the time). I explain (kindly and sincerely) that there are many poorly patients in the department, and that it is also a particularly busy night with ambulance crews queuing in the corridor. This is met with a disgusted stare of total disbelief. I am told very aggressively and rudely, that it is not good enough, because this foot is painful. I offer my sincere apologies (and very, very long overdue painkillers) and say that they will be seen as soon as possible.
The next 2 to 3 hours (rightly so) focus upon one young man having an acute heart attack, one severe arm injury with compromised blood circulation, one asthmatic child who worries me and my colleagues greatly (and we’re not easily fazed), one miscarriage in advanced pregnancy and various other conditions of higher priority (and time of arrival) than Painful Foot. And all this takes time The team work excellently together (although slightly stressed and hungry), still filtering the various minor injuries from the waiting room, ever mindful of their wait as well as of the emergencies. During this time, Painful Foot and Husband have continually pestered the stressed out (only) receptionist, who is responsible for a great deal of admin work for the (seems like) millions of patients flowing through the department. Stressed Out Receptionist (in between booking in yet more new patients) is constantly ringing the nurse base to pass on Painful Foots complaints. Nurses are continually abandoning treatments and ambulances to go and apologise and explain. Eventually Painful Foot is placed in a cubicle (ahead of a frail elderly man on an ambulance stretcher with a possible stroke – just to attempt to pacify – imagine his relatives’ perspective). Not long after this point I am rushing past the cubicle with a drip for another (poorly) patient, when Husband (normally respectable), storms out of cubicle and aggressively shouts at me to “Get the bloody doctor in here now! This is disgusting service, we have waited long enough!” (I recall A&E before the introduction of 4hour targets, clearly Painful Foot doesn’t). I calmly step inside the curtain, stressed, hungry, thirsty and tired, with drip in hand, and attempt to explain the reasons for their wait. Twenty minutes later I am still there being challenged. The poorly, dehydrated, nil by mouth patient is still waiting for his drip (imagine his perspective). No reasonable person could dispute the sympathetic, professional and assertive explanations that I give. Except the patient/relative with the pre-conceived opinion that the NHS just isn’t good enough. Then through the curtain I hear a commotion, and peer out to see a paramedic running through the department with a baby. I hear the Sister shout for a doctor to go into the Resuscitation Room. I hear her shout for the Paediatric Resus Team. This is a baby in need of resuscitation. I soon realise that, unfortunately, this is going to delay Painful Foot (1 week old, no painkillers taken) being seen by the doctor. And I dare to tell her this. I politely say “As you just heard, a very, very sick baby has just arrived. The doctors have gone into resus to attend to this emergency, and this means that you may need to wait just a little while longer”.
And this is where the middle class, tax paying, normally respectable public astound me. (And most other NHS workers, most of which could tell you a different, but similar story). Painful Foot, and Husband, simultaneously, disgustedly huffed, sighed and proclaimed aggressively “And exactly how long is that going to take?!” I wanted to say “Well, hopefully for you, the baby will die, freeing up the doctors quickly, to come and see your painful, but perfectly well foot”. Instead I looked at them, firmly, assertively, and said, “I do not know how long that is going to take” and I walked out. I then ran into resus to assist with what the NHS does best. The next (and last) 4 hours of my shift pass in a blur. Myself and six other members of NHS staff fight and work so hard on this dying 9 week old baby boy. We perform CPR; administer complex life-saving drugs, struggle and fight like mad to bring life back to his tiny body, all the while attempting to support a hysterical and distraught mother and father. It took 4 hours of sweat and tears for him to be stable enough to transfer to Intensive Care. Alive.
At some point during this time, the A&E doctors left us nurses with the Paediatric
Resus team and the anaesthetists to continue our battle. They resume (in a bit of a daze, and very tired and hungry) seeing the rest of the A&E patients, including Painful Foot (who was equally rude to the doctor who had just performed life-saving CPR on the baby). Painful Foot was diagnosed with a sprain in 5 minutes, and advised to take simple painkillers. They then went home; no doubt disgusted with our care (I had already provided them with the requested complaints leaflet). I didn’t sleep after that shift. I couldn’t shake off the irony (or the anger) that I’d gone from spending a significant amount of time attempting to pacify a disgruntled NHS patient with a bad attitude and a well but painful foot, to attempting to pacify a mother who’s beautiful baby son was dying in front of her eyes.
Sometimes there’s a reason for care not being as ‘gold standard’ as expected. And I agree that sometimes it isn’t gold standard. As a patient and as a relative I have been on the receiving end of disappointing care myself, but I know that most NHS staff work extremely hard under extremely challenging circumstances, often feeling frustrated, exhausted, hungry, undervalued, and under constant attack from patients/relatives with (often) unrealistic expectations. And this is why I would never pre-judge any healthcare experience that I am about to have. I am due into hospital for surgery soon, but I would never walk in with a bad attitude based on my previous disappointing experience, because for the dedicated, hardworking nurse/doctor, doing their very best against the odds, this can more soul destroying than a drunken punch in the face.