Visiting time, or, what is 21st Century Medicine?

In many respects, 21st Century Medicine is high-tech, sophisticated, complex, even, impersonal. Think flashing monitors, buzzing alarms, young people in scrubs rushing to and fro, responding to emergencies – crashing blood pressure, haemorrhage, pain.

We, who work within the healthcare system know that the reality of 21st Century Medicine is, by and large a lot more mundane.

Sure, there are the whizz-bang departments where lasers, robots and fancy computers are utilised to achieve feats of clinical wizardry, there are the technical skills achieved by surgeons peering down laparoscopes; but, mostly,  the care, the treatment, the intervention is very old-fashioned, very human.

I wouldn’t call it primitive, as that would be somehow to devalue the power, the vitality of it, yet, when we look into what happens when one person makes eye-contact with another, smiles, holds their hand, you will realise that the sophistication of being human is, potentially, more elaborate than any array of technical machinery.

And, so, too to visiting time.

You might have guessed, what I am getting-at, are the people (often, older) who occupy the vast majority of hospital beds in the UK, indeed, they consume the vast majority of our health and social care budget, they are, healthcare (the stereotactic neurosurgeon is also healthcare, but they, are on the periphery – they are the odd ones out, not us.)

So, here is the importance of visiting time, a term which to me, at the very least, is alien; it somehow harking back to another time when hospitals and healthcare were more about the order, the organisation and the system than the people they serve.

Person-centred healthcare is growing in importance, more and more people are realising that unless care has a person at the centre, it is not care; unless the systems within a hospital or clinic are at the beck and call of patients, they aren’t working.

Why should our loved ones, even, sometimes ourselves, be restricted in our access to those closest to us? The healing-power of love is beyond question; family and friends are the panacea to much suffering – restricting that access, is not right, well, yes, it is, to my mind, cruel.

Everything that happens in a hospital has to focus on the details of the person, on providing the person with what they want.

How ironic; when I recently asked a group of medical students whether hospitals should be more like hotels, they were split in their opinion. Why on earth shouldn’t hospital care provide the best, the most fantastic hospitality available?

Most of the time our hospitals do achieve this goal – they ‘allow’ those people needing support, care and treatment all that they desire; yet, how can we, that is, me, and those people running and working in hospitals hope to achieve this goal by allowing the imposition of any form of restriction to access?

Another aspect of visiting times is the creation of visitors. This presupposes that our patients aren’t visitors – are they resident? Who is on the outside and who inside? I can tell you from experience, patients feel every bit as much like visitors as the ‘visitors’; and to repeat, who are hospitals for?

We need to move beyond the them and us, the power-base needs to shift, so that really, when I go to work in the hospital, I am the visitor – it should no longer be, ‘The doctor will see you now,’ Instead, ‘The patient will see you now.’ (This is even the name of a book by Eric Topol).

The model needs to be turned upside down, with less reverence for the tech and more attention to the care; only once we have worked-out what our patients want, can we be in a position to supply the tech.

People first, patients second, even, in those emergent situations where protocol and procedure take-over; cardiac arrest, advanced trauma and life support; we, the humans operating within these systems, providing the treatment, cannot ignore who we are treating, who we are supporting, what we are doing;

Our actions at times border on the holy, and we cannot allow the profane to defile the sanctity of the experience.

Walls must fall and borders must be overcome, to allow the creation of a relationship that although sometimes giving more than it receives, is weighted in favour of the patient, the client, resident or person.

So, let’s end the visiting times, let’s open our doors, and open our arms, open our hearts and engage.

For Sarah.

Disney-Dali

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