Environment

How quickly can you tell that an environment is right?

Right must be more specific –

Right for a swimmer is different to a cyclist.

A teacher of maths and a long-distance lorry driver will differ in their preferences – not necessarily, but probably.

I am talking about environments of care. And, more exactly, hospital wards.

How long does it take you to work out that the place is good? By good I suggest, safe and effective, the staff caring, the beds comfortable and the noise-level tolerable?

In the world or nursing there is something called the 15-step challenge; it says, that within 15 steps of arriving on a hospital ward you can determine whether the place is good. By this I mean my description above. (I can probably tell you in five, but I have been around).

Do you wait too long for someone to open the door?

When you enter the ward how quickly does someone smile? The speed of eye-contact, you might call it;

Are the patients dressed, out of bed? Are they in pain? Can you see exposed 90-year-old buttocks and thighs?

Is there laughter?

Is it clean?

Is there clutter?

How many signs tell you not-to – usually an indicator of ineffectiveness.

Is there a smell? Is it pee? Is it poo?

Is there no one around? The tumble-weed sign. You seek a nurse a doctor – all you can find are pale, passive patients tucked-up in bed.

The light, is it poor? Is it the definition of night in the middle of the day?

Is it secure? Can you read about Old Man Jacob’s prostate in wide-open notes, or overhear a conversation about Enid’s failed mastectomy?

Blood spatter and torn curtains, leftover food and, you get the idea.

The question I guess is what can you do if you find one, two or three of these indicators of care awry?

You can complete a friends and family test; the NHS’s way of measuring patient and carer perceived quality. You can speak to the doctor, the ward manager, the chief executive;

‘I didn’t feel safe on your ward.’

Who is to say what safe is; who is the arbiter?

How far are you away from becoming the next dissatisfied customer? Sent to the back of the queue of complaint?

We, that is those working in health and social care live with the spectre of Mid-Staffs hanging over us; the comparison, the worst you can imagine, like telling someone they are ugly.

These ideas interweave with compassion fatigue, for, it is often in such environments, where the patients are un-washed, and the medicines or breakfast delivered late that individual nurses and healthcare assistants carry a burden of guilt and regret that weighs them down, that challenges their aspirations, that flattens them; diminishes resilience and cleans them out.

I squash your resilience and exhaust your recovery, I walk all over your essence and, like an obscure Hunger Games I throw you into the middle, ill-prepared, your killer-instinct non-existent.

Where is this blog taking me?

Is it here to help or just observe?

Perhaps you can decide.

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One comment

  1. Very helpful I Would think to know what to notice and how to bring it to someone’s attention. Which 5 would be the one’s you would notice – or would it be any 5 of the above? A PALS service is now called ‘patient experience’ I’m told. Patients, family and friends may still sometimes fear being label!ed , maybe victimised. Staff themselves need to be treated with person-centred care. When care plans are recorded do people have time to become familiar with them? Environmental factors are so important.

    Liked by 1 person

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