One week on. (in AMU)

Wow, one whole week has passed since I have been working in the Assessment Unit in Rotherham.*

Those of you who have been following this blog will know my back-story; I moved to work in Rotherham Hospital at the start of the year; for the past few months I was working on an acute medical ward caring for a range of people – young, old, in the middle; it was an incredible experience, mostly because of the great people I was working alongside, and probably, predominantly, because of the patients I met.

The patient who bought all the other ladies in her bay roses on Valentine’s Day; the younger man who was so caring towards all the other older men in his bay, helping them, tending them; the man whose novel and conversation and laughter took me and my family to visit the standing-stones at Arbor Low. Thank you for allowing me to be involved with your care and treatment!

On Monday I moved to the Assessment Unit, which is kind of strange as I undertook a very similar role back in 2009 – I think it was, in Doncaster (I can remember it overlapping with Obama’s inauguration and my reading his books – ‘hope’ was a dominant theme). This was when acute medicine was in its nascence and the most common analogy I used for the ward was a rental car – yes, the idea that staff, doctors, consultants, therapists, would come and go, do what they had to do with the patients and move-on without care or regard to who would be driving afterwards (other clinicians and the permanent staff left behind).**

Much has happened in the intervening years; the concept of this unit (which originally was called ‘Medical Assessment Unit’ then at some point was changed into ‘Acute Medical Unit’ – something that happens frequently in medicine, in an attempt to change what something is by calling it something else) (think ‘Freedom Fries’) – nevertheless, since its beginnings back in the early 2000’s Acute Medicine has grown, developed and become one of the dominant specialties in hospital medicine in the UK.

While I was in Doncaster, great progress was made with the department, building, recruiting, developing pathways and personnel.

Rotherham never received the same level of attention and has lagged behind the whole process of modernisation.

Let’s put it another way, the Assessment Unit in Rotherham has managed to provide fantastic care and treatment (I am sure there are exceptions out there, as there will be with anything in life – the Queen is sometimes disappointed with her smoked salmon), anyway, yes, the team and the department has provided great care at times against significant odds.

On Monday I moved down to AMU (it is on the floor below the other ward) to help provide care for some of the patients, and, really, because I am restless and eternally dissatisfied with my lot in life, another pair of eyes to see how we can make things better.

In my first week, I haven’t made any improvements, although I have made a few faux pas, likely because my enthusiasm has got ahead of me – sorry. Mostly, it has been a great time.

Yesterday, there was a moment; Enid, recovering from delirium –

R: Where are Enid’s (made-up name) specs? She had them yesterday.

A: I can’t find them, they don’t seem to be with her belongings.

C: Are you sure she had any glasses?

R: She had them on Monday; she definitely has glasses.

A: Maybe her family took them home, to prevent them getting lost.

R: Possible, although they have left her with a magnifying glass.

C: Things are always getting lost in the hospital – it’s the support workers, bundling things up in laundry.

R: I remember a time…

C: Ca, have you seen Enid’s specs?

Ca: No, I didn’t realise she had any

(and so on…)

Five minutes later Enid was wearing her specs, amidst the debate which all the other women in the bay were observing, she had produced the glasses from a hidden pocket in her dressing-gown.

We laughed.

It was the laughter that mattered.

For all there are terrible moments, tragedies, when a patient unexpectedly dies or bad news is shared, most of the time in hospital the atmosphere is light and, laughter, smiling faces and bright eyes are dominant.

I hadn’t laughed so much (about me, A and C’s stupidity) since arriving in Rotherham; this is the secret to significant improvements in health.

Staff who are stressed, depressed or pressurised don’t have the capacity to laugh; the wind is knocked out of their sails; they get by. They exist.

This has been my takeaway message from my first week on the assessment unit – the staff’s fortitude, good humour and ability to rebound from tragedy; the cliché of laughing in the face of adversity is very true.

So, I’ll end my petit reflection by thanking the staff for being so welcoming, for thanking the patients for being so understanding and allowing us entry into their lives.

I’m excited for next week.