Acute

Acute.

Not cute.

Not sassy, silly or enlightening.

Acute;

When things happen all at once, with a sense of urgency, that, if you’re not careful, can overwhelm. (Our Iceberg is Melting).

Acute care

Acute ward

Acute nurse

These are some of the acutes you might encounter in a UK hospital.

They are a shade off emergency –

When there is an emergency, you had better stand-back – blue-light, cardiac arrest and battle-stations.

Acute, is a degree less critical, less threatening to life,

But still very serious.

Indeed.

It is when acute blends with care that, like hot and cold waters mixing in the sea, there is turbulence; eddies of not quite hot, not quite cold – no, not tepid, you mustn’t get complacent!

Acute, is pulling-out the stops, getting things done straight away – pressure, it is the dumplings exploding in the boiling broth, the edge of Compassion Fatigue and exhaustion.

It is when it cannot wait, when you must get on with the job as the workload is mounting – the ambulances are queuing, the referrers on hold and threatening to go elsewhere; the customers in revolt!

Acute is when soon or shortly is no good, when ‘in a minute’ is perceived as procrastination, poorly prepared, disorganised; inadequate. NoW!

Call the porter, the technician, phlebotomist, assistant, move, move, move – think Navy SEALs under fire, running fast, the fire-fight hasn’t broken-out yet, but things can go awry at any moment.

It is exam-time pressure that has become part of life, a component of nine to five, when you better get a move-on or there will be repercussions!

Not enough time to chat; eye-contact is a distraction; calm, smooth, flowing; the melody of human interaction is left on the side-lines and you had better get on and complete the discharge letter, order the medicines, call the transport, the family, the care home; ondale! No time to waste…

Like the blur you sometimes see in movies when the central character is frozen and around them is a blur of movement; I am thinking Donnie Darko. I am reaching-out to the split that sits at the heart of a personality breakdown.

The pressures, tectonic plates pulling you apart, requiring resilience that is not always forthcoming.

Again and again and like a treadmill, the processing keeps on going.

Acute, now, get on with it, and before you do this, do that, and here is another thing, and the pile of to-dos gets so high you do the urgent and important and the other aspects of the role are demoted.

Hand holding, discussing the olden times, family, a joke, a smile; cup of tea – listening, learning, hearing, tasting – sensations, moments that add-up to experience.

Rush.

You can’t step in the same river twice.

You can’t lie in the same hospital bed for more than the average length of stay which in your case, for your disease, disorder or condition is 3.76 days.

I am now thinking that A-ha video – the one that is all pencil drawing.

Sketchy.

Smudges of grey as the light fades.

Let’s see if we can’t reinvent,

If we can determine a better way to care,

To provide hospitality.

I remember a few years ago asking a group of medical students whether patients should have the same experience as those staying in a hotel.

Strangely the students thought you couldn’t – perhaps even, shouldn’t, provide the same standards of care and support as say the Hilton or even the Holiday Inn. No, the NHS, cash-strapped and pressurised, acute in care and nature.

My belief was the opposite – hospital care should be the model that the hotel industry follows (it certainly is on Mallard Ward) – our standards of improvement, innovation and creativity maintain a perpetual culture of growth and love.

Acute is a threat to love.

You can’t love someone when the clock is ticking.

You need somehow to separate the experience, the compassion and caring from the process, the deadlines and targets;

I don’t have an answer to this beyond my usual… Person-Centred Care – The Golden Rule, Would I appreciate a trip to the X-ray department in the middle of my minestrone soup? Multiple needle-pricks at three in the morning, an enema when four other people can hear the outcome? A hospital gown where by bottom is showing and rushed to the ambulance to carry me not home?

If not for me, then not for my patient.

I see my patient as me.

Acute leads to the patient becoming an object. An item whizzing past on a conveyor belt.

Think Brucie and the Generation Game – ‘Clock Radio… VCR… Teasmaid… Cuddly…’

Slow down.

You can still operate at high speed with compassion, with care.

Remember… more haste, less speed?

Remember… look left and right, then cross.

Don’t just jump-in and not live to regret it.