Now, this is going to be a tricky one.
This is because, it is part confession, with a little pre and post-hoc rationalisation.
Are you intrigued?
I may as well just jump-in, like you do at the Lido, head-first, only concern that your heart might stop.
Now, I feel it is OK to come-clean about these covert events because nothing malicious has been done and, in essence they are not that bad. So, don’t expect any really dramatic revelations.
I have you prepared, well, here we go.
I wrote a couple of weeks ago about time; my relationship to wrist-watches and healthcare, you might say.
When I came to work in Rotherham I can remember the first encounter with, let’s call them ‘Person A’ – ‘bare-below the elbows, take-off your watch’ – that was the introduction; no, #hello my name is, or, ‘I can see you are new round these parts,’ just, ‘Watch’ ‘Policy’ ‘Bare’.
I can’t remember now what I did – whether I just looked blankly and walked off (what is the appropriate response to rudeness?) or complied; knowing me, I probably complied and felt bad, angry, frustrated.
That was the start.
This was followed by a few other staff members, all equally blunt and direct, ‘watch, bare, policy’ kind of thing.
I can’t go into the bare-bones of why I struggle with this – it is not just the subject of a blog, probably more a PhD dissertation. So, let’s say, it didn’t make sense to me, was counter to my experience of ‘the bigger picture’ and, well, you can read here, to get a sense of the emotional impact.
Before anyone says, >infection-control, hygiene, MRSA, bacteria<, to me, I will direct you to the evidence that demonstrates the lack of evidence for watch-wearing and infection; (you are meant to be able to really wash your hands when not wearing a watch, rather than just paying lip-service) – hand washing like this is what they do in theatre, before undertaking procedures – the simple – inserting a cannula to the complex – replacing a heart; I have never seen anyone doing the full surgical hand-wash prior to or after holding an old lady’s hand.
So, read from this, ‘silly rule, top-down policy, not thought-out’ – OK?
My confession is, that to circumvent this problem I developed, an early-warning system of informants who would tell me when ‘Person A’ was about, allowing me time to remove said watch or bury my hand in my trouser pocket, sufficiently deep so as to hide the timepiece.
The system didn’t always work, although I have a sense that it helped my team bond a little. ‘My enemy’s friend is my… Kind of thing’
Eventually it came to a head and I will not go into the details, but, I have stopped wearing my watch on the ward; you might say I have been defeated. 🙂
Funny, as I have been writing about my pet-subject, time-pieces, I have forgotten about number two; I imagine this is a psychological defence mechanism – designed to protect confessors; See auto-da-fé if you want to know more.
So, back to the exposition.
#2 visiting times
This is quite a recent event, so a potentially hot-potato still.
This came-out in a blog yesterday about two in the morning.
You see, it had an effect; it stirred-me up, made me upset and worried.
Those of you who read ‘Visiting times – the patient will see you now,’ will knowthe story (or, I might have told you.)
Here it is:
Again, if you have read this far, you probably have read some other blogs, and, will have a notion about my sense of both person-centred care and, rules and regulations.
Back in Doncaster, it is probably eight years ago, or more, we got rid of visiting times. The agreement was, that so long as there was a policy and, no one Taking-the-Mickey; friends, relatives, guests could come to the ward, stay as long as the patient liked and blur the organisational boundaries of them and us.
There was some resistance, but it worked and over the years has spread to hospital wards through the UK (although not yet Continental Europe who are sometimes a little conservative when it comes to such things, despite the Court of Human Rights being in Strasbourg.
Fast-forward to my introduction to Rotherham in 2018.
Visiting times abounded.
It was the norm;
Yes, you can imagine my response.
The initial transition on ward A3 where I started working, was handled well. A sign, a forget-me-not and off we went; no problem. There was some initial coaxing, but no real problem. The sign is still there today although the ward has closed.
The next place was the psychiatry ward I visit.
There too, despite all the patients having dementia or cognitive impairment and, the organisation signing-up to John’s Campaign, were, visiting times. 2 to 4; perhaps not as restrictive as that, but still limitations to the time you could spend with your mum or dad.
‘But, sure, if someone is poorly, and the relatives ask to stay we will let them,’ is often given as an explanation for the existence of the policy.
Come on now.
We are in England.
A country which has its own industry laughing at our sense of propriety and reserve; sure, some folk will ask, others will insist, but many, likely most, will take the times and make themselves scarce.
We went through a process; it was a tad more complicated because of organisational boundaries and a more tightly controlled hierarchy, but, eventually, the times were gone, relatives could come and go as they and the patients pleased.
(Don’t worry, we are getting to the ‘reveal’ in a minute) (please bear-with).
I think the patients were liberated for a few months until I visited this week and found the times reinstated.
I didn’t get the full explanation. This is however a theme of those parts of the NHS resistant to change – the mantra, ‘we tried, it didn’t work, we went back to the way it used to be.’ – this is like toxic mud, dragging the mud-skipper back into the pond.
I pulled the new sign off the door and walked into the ward. Part of the rationale was to address the disparity, for, the old sign, saying ‘open visiting’ hadn’t been taken off the wall.
Immature, as there are probably more sensitive ways to communicate my feelings. But, there you go. I am me. Immature as I took the change personally, the lack of communication, the reversion; immature as, the NHS is run by good people doing good work in difficult times, actions are not personal, despite them occasionally feeling that way.
Have I changed?
Time will tell.
This is me, it’s who I am.
Would it be better if I did not care, if I became numbed to the events surrounding me? This blog would probably take-on a different patina. My life would likely be easier or harder, who knows?