This is the transparency I encounter when I visit patients at home, in their poorliness or vulnerability, on their death-beds, in their terminal loneliness.
Locked in a room, when you are 90 and if you have dementia and significant physical and cognitive impairment is horrible. It is cruel and harmful. It is what our older folk have to do, whilst we, the rest are out and about, living it up.
Interestingly, hospital can be the least-safe place for older people, with home being what most want and with far fewer hazards such as the risk of institutionalisation, over-medicalisation, polypharmacy, falls and a host of other healthcare associated ills.
Out optic blind-spots continuously adapt to provide us with a seamless sense of reality, only becoming real when we reverse into a wall that we didn’t see.
For today, I hope to keep popping out, spending quality time with patients, understanding what is important to them, their preferences, hopes, fears and aspirations, and supporting them to stay outside acute care.
..when you see society deteriorating, when there is so much potential for improvement, that is surely depressing; when you see vibrant doctors and nurses forced into early retirement because the work has become too much, that is bad; when you know that people have and will die because of cuts, what could be worse?
Thank you to my friend and avid reader Freda for pointing-out something I had missed in today’s blog about the Jean Bishop Integrated Care Centre in Hull. ‘So many assessments – completed individually or as a panel? Tiring? Was thinking Doris would have to stay overnight?’ That was her consideration of someone visiting the centreContinue reading “Health Care Support Workers (Jean Bishop II)”
People are good.
People are beautiful.
This to me is a fundamental of humanity.
You’re safe; you have a key safe – a digital lock on the outside of your house to help the carers get-in. I heard this week that since Grenfell there has been a thing about the safety of key safes and they are now considered unsafe, perhaps providing too tempting a means of entry toContinue reading “Key Safe”
This was a recruitment poster from WWI – designed to create a feeling of guilt in young men, chivvying them to volunteer, head-off to Flanders, Ypres or somewhere on the Western Front and, likely die. At least they wouldn’t have to face their children… ‘I stayed at home, because I didn’t want to participate inContinue reading “Daddy, what did you do?”
…where, through an over reliance on targets, process and objectification, people became dehumanised, and where, with the current extreme pressures within the system, fixating on waiting times, bed-occupancy and length of stay, we risk falling into a similar trope.
Could you Facetime your doctor when you are on holiday in Greece rather than having to wade through the complexities of health insurance (yes, Brexiters) and a foreign health system?
She survived. She could have died – I never asked the question.
Thank goodness for those who push the boundaries, who are open and transparent, showing the world that we aren’t infallible, perfect beings. That we are all human.
You are unconscious, the focus for the doctors and nurses is maintaining your physiology with particular attention to your brain and heart.
The point, as is often the case, is my aversion to patients. Or rather, the existential construct that relates to the ‘patient state’ = they who suffer; with the principal goal of my life being to obviate suffering, my objective is to really stop people turning into patients.
And that is the role of the interceptors.
Anyway, back to being blocked.
So long as you are still able to participate, join-in with the conversation, your perception of self is just as valid as that of the doctor or nurse.
How to change the system?
I try my best to ensure the continuity of care, of relationships, particularly on my ward, which is critical as so many of the patients themselves are lost – being lost within a system which is itself lost, must be terrifying.
And so, back to the junior doctors –
If you take away our air, our water and our food, we will not survive, that is the situation being foisted on doctors and everyone else in the health service.
They came from across South Yorkshire and it was inspiring to be in a room with so many bright, young people
Our actions at times border on the holy, and we cannot allow the profane to defile the sanctity of the experience.
These are questions I will never be able to answer.
Call me Rod and I’ll be happy;
There has been a silent revolution happening…
Why should you follow them?
We are human, all too human.
In healthcare, it seems, like dominoes, different parts of the NHS are falling-over, systems and organisations toppling, stumbling
An old man living alone, is that the problem? Is the problem that it is a problem?
Alan Paton wrote Cry the Beloved Country, I sometimes cry for the beloved, the forsaken who don’t fit into our systematic boxes.
We can look at quantity of life – something we have very little influence over, or, we can address, quality – an area we can influence tremendously.
Patients in pyjamas – it might sound a little flippant, but I think this is something that is very important. I cannot comment on the behaviours of other patients outside of the UK – we, in Britain, approach hospital attire in a special way; pyjamas. I don’t know when pyjamas began in hospital – whether backContinue reading “Patients in pyjamas”
So, I have a problem with the elderly; what do I do when I have James, a 95 year old man, with coal tattoos crisscrossing his knees from years down the pit, as he coughs and lies in bed worrying about his wife who is at home, struggling to cope herself.
I have spent the past few days feeling bad – It is strange, when you discover that something you have been doing, that you had considered ‘right’ is explained to be wrong; it is a little like breaking the law when you don’t know something is illegal … I can’t think of an instance (or,Continue reading “Therapeutic lies and false promises…”
On Friday I attended the Yorkshire and Humber Patient Safety Collaborative ‘One Year On’ conference. A number of speakers from the region discussed the work they are doing to make predominantly hospitals, but all care in the wider sense, safer, less likely to result in inadvertent harm. Primum non nocere – first, do no harm,Continue reading “Human Factors, space-time and Yiddishkeit”
Earlier today I watched a TED video by writer Andrew Solomon about his experiences with depression. It is a mesmerizing performance from someone who is both stunningly articulate and strange. Solomon describes his experiences with depression and one of the most significant moments in the piece relates to him discussing the idea that depression isContinue reading “Depression & hospitalisation”
I hate it when one of my patients falls over on the ward. Each time this happens, I feel as if I, somehow have personally failed to keep them safe, safe, when they are unwell and at their most vulnerable. It is true, that people falling in hospital is complex, it is equally true thatContinue reading “Falling over & knots”