You don’t know what you’ve got…

Us humans spend much of our lives peering over the garden fence, looking at the grass that is greener and envying the neighbour’s floral features – we rarely stop and think, stop and appreciate what we have.

I imagine the reason for this is probably buried deep within our evolutionary past – we are designed to be discontent; had the tribesmen of Africa been content with their lot in life, they never would have wandered into Europe, indeed, they wouldn’t have struggled across the Bering-strait to populate America; you might say, had those early humans remained in Africa, we wouldn’t be in the pickle we are today – global warming, Middle-Eastern crisis, pollution, Donald Trump – yet, we would also not have the phantasmagoria of life that is all around us, that we have the privilege of experiencing every time we open our eyes.

I was engaged in an online chat with the staff on Mallard last night – I raised the issue of a small, yet, important technical aspect of falls prevention – that is, measuring laying and standing blood pressure; essentially, this means recording the blood pressure of our patients when they are laying in bed, then repeating that measurement with them standing.

Quite frequently, amongst those older people we look after, who have been admitted to hospital with a fall, we discover that their blood pressure drops – instead of rises (which would be the ‘normal’ response) – the outcome is less blood flowing to the brain, unsteadiness, occasionally disorientation, and at times falls, even loss of consciousness.

You see, the only way to know that this is an issue is to measure it – you can’t tell this is ‘a thing’ unless you check the blood pressure; indeed, many people are often misdiagnosed as having a variety of other non-specific conditions – Vertigo, Meniere’s disease, vertebrobasilar insufficiency, dizziness, when the answer is far more mundane – a blood pressure problem (which is often easy to remedy)

Anyway, I am getting off the point – which is, in discussion with my team, I told them that they were by far the best in the entire hospital at ensuring this measurement is completed – from my experience of working on many wards, and, at a number of hospitals in the UK, our ward, that is Mallard, at Doncaster Royal Infirmary, in South Yorkshire, is possibly one of the best in the country at consistently performing this measure.

(Those not in the know might think, ‘What is the problem? Just do it!’ – There is far more to this however – there is patient choice – those who don’t want their blood pressure checked, those who don’t want to stand-up, or who can’t, or, you don’t have the equipment to hand, and so on)

The point is not about blood pressure – the point is that some of my team did not realise how incredible we are; how much we are outliers, positive deviants – aberrations from the norm; I had taken this for granted…

I will list some of the ways my ward, that is Mallard, at Doncaster Royal Infirmary, is out of the ordinary:

And, this is in no particular order, just what comes to mind:

• We know our patients as people, we understand their needs and wants beyond any other clinical environment I have ever known
• We provide care that is designed around the needs of the people our patients are, all the time, every time
• We constantly think of ways to innovate and improve patient care and their experience
• We managed to have 50 days without a patient falling last year – that is, 50 days, during which people, most of whom were admitted to hospital having fallen, who did not come to harm from falls in one of the most hazardous places in our society (aka hospital)
• We have never had a case of C difficile diarrhoea on the ward – in over three years, despite caring for some of the most vulnerable people in society
• I don’t want to tempt fate, but we haven’t even had a complaint
• And our staff are happy – at least, I am, and when I talk to people they are, that, amidst the greatest period of pressure ever experienced by the NHS (tks Mr Cameron)
• Patients actually get better when on the ward, they eat, drink and become more mobile whilst in hospital, which is not what usually happens
• Our patients sleep soundly at night and those who don’t, we monitor, hour by hour, like no other place I know
• Relatives feel at home on our ward, they are welcomed and cared-for with as much attention as our patients
• We practice a more comprehensive form of person-centred care than any other acute hospital ward I am aware-of in the UK

I could go-on, but I guess most people will have stopped reading by the second or third point; you get my gist – we are extraordinary – and beyond all of this, we are a team that is closer than any other I know; when one of us is unable to work because we are sick, we don’t get frustrated at their absence, we worry for their well-being, we share the ups and downs, the joy, the frustration, for, it isn’t all plain-sailing, it is hard, physically and emotionally demanding work, it takes a toll, many of us go home at the end of the day carrying emotional baggage that can’t be shrugged-off.

And so, to my colleagues, the team of Mallard, I say, here we are – we are something special, we are the exception to the exception that allows magical things to happen.

And probably, most of us, in our daily lives, need to reflect on this as a model for who we are and what we are doing – when was the last time you sat with your husband or wife, son or daughter and told them how remarkable they are, how much they mean to you, how life is life because of them?

I don’t want to sound trite, but this is the essence of love, when work evolves into something more, when we realise that our very existence is predicated on our relationships with others, without which we would be nothing.

So, go on, give your kids a hug – don’t expect them to know how amazing they think they are, be explicit, and, team, you know how amazing you are.