Friday, June 01, 2007

St Elsewhere's

It’s been a long time since I have had anything to do with hospitals on a regular basis. Yes I’ve attended the odd meeting, visited an occasional patient, and for a few years either side of the millennium our out of Hours co-op sat cheek by jowl with A&E, but in all I’ve not had much call to spend time on hospital wards for yonkers. That all changed recently for reasons that need not worry us for the purpose of this post. Suffice it to say that I have been spending a couple of hours a day on a ward for the past fortnight, with time to observe what goes on, and with a mole on the inside to fill me in on the patient’s perspective.

Some things have undoubtedly changed, gone, for example, are the old “Nightingale Wards” of my medical youth. It’s all four bed bays now, and almost all single sex as well, and not before time either. Though it does rather deprive current inmates of those all too precious “Carry On” moments of yesteryear.

Thanks to the working time directive, perhaps helped along by decades of deficit and finally entrenched by the recent MTAS debacle, Doctors, even callow “Juniors” are now invisible. In two weeks of visits I think I saw a “Housemonkey” once, but it might just have been another visitor with lots of pens in his top pocket…

It seems in Patsy’s modern dependable NHS all the work of the ward is done by super-nursies instead. Not that there’s anything wrong with that per se, but I do rather wonder what has happened to the doctorin’ we used to be allowed to get up to between clinics and theatre lists.

On the other hand there is much that remains the same, and somehow, probably, always will. Rubbish gowns that show your bum to the whole wide world, horrid foam mattresses and pillows seemingly guaranteed to deprive even the soundest snoozer of the last vestiges of a restful kip, shabby flowers in greenish ooze in manky vases….


But the main thing I couldn’t help but notice is just how infantilizing the whole business is. From first thing in the morning to last thing at night the day is regulated and governed just like the Victorian nursery. You are woken at a set time. Breakfast follows. All the food, all day is nursery food, Cauliflower Cheese, Sponge and Custard and so on. And sometimes Nanny is “nice” and sometimes Nanny is “nasty”, but never Mary Poppins. The inmates are almost all and almost always talked to like three year olds by everyone from the Cleaner to the Modern Matron. Visitors command scarcely more respect. And despite the best efforts of Medical and Nursing Schools up and down the land the fine art of communication is abandoned in favour of the tone and ethos of the workhouse that once stood on the same site as the shiny new PFI hospital.

In such a regime the poor benighted inmates shrink visibly day by day, both bodily and emotionally to the same level. No wonder they are all so desperate to get out and reclaim their stolen adulthood.

4 comments:

Chairwoman of the bored said...

Only 3 weeks until my appointment with the Nurse Specialist to discuss my 6 weeks admission to a hospital 2 hours drive from home.

Wendz said...

Heavens what a dire picture you have painted. And it's TRUE!

I hope I never have the misfortune to end up in an NHS hospital again.

I was admitted to Walsgrave a few years ago for pneumonia, in the
middle of the night. Terrible experience. The following morning, as I lay in bed still trying to dare to breathe, a doctor waltzed in, surrounded by a zillion other learner doctors, ripped my manky gown down, exposed my chest, held up my x-rays and droned on at length about the various aspects of my ilness, leaving me lying there like a right muppet with my boobs on display.

Then I was transferred to a freaking geriatric ward. The old lady next to me was so out of it she just lay semi-comatose all day, peeing and pooping constantly. The stench was horrendous! And her bed was rarely changed..when it was, the nurses were horrible to her. I was disgusted.

But, having said that, I had Fabien there as well, a year later,(C-section) and that was an amazing experience. I was so well looked after and actually had a blast with the cleaning ladies. Even the nursing staff were uber-cool.

Shinga said...

They do vary enormously, don't they? I've visited relatives on wards where it has been like a social club with a couple of patients acting like the life and soul of a party, and other patients taking over a side-kitchen and providing a tea and toast service to all and sundry.

Others have been completely miserable, infantilising and dehumanising - staffed by irritable people whose irritation is well-grounded in their completely unrealistic workload.

I hope that need for the visits has abated in a successful manner with a good outcome.

Regards - Shinga

Doctor Jest said...

madam Chair'-- I do hope all goes well as and when. Oh, and how does it feel being a "Celebrity Mum"?

wendz-- funny how maternity units almost all have a rather different atmosphere. Must be all that new life thing going on, mostly with good outcomes and all. So Fabien is a midlander eh? Does he speak his french with a Coventry twang?

shinga-- interesting it was the ambulant patients doing the tea and toast in place of the long lost (and doubtless hopelessly un-PC "ancillary staff" of yore). And you're right about th eworkload. Happily my vicarious experience of the receiving end of "secondary care" is at an end and a full and increasingly speedy recovery is anticipated, but thanks for asking.