Monday, 29 October 2012
The NHS - Who’s Complaining? Not Me.
"It’s not even eight o’clock yet and I’ve already told you the story of my life.” The young woman sitting on the edge of her bed had indeed been chatting about her life for a good long while.
Hospital days start early; at five a.m. the night shift comes clattering in to check and record vital signs before they hand over to the early morning shift. If you’ve been able to get any sleep at all you are lucky; most of the time there are night admissions, which means that there is a constant flow of medical staff with their apparatus, their loud voices and question and answer games. This you can forgive, we all want attention when we are poorly; what is far more annoying is that the so-called modern NHS requires reams of form filling which is nothing to do with medical matters. In the middle of the night even Job might lose his rag.
“Do you mind if I ask you a few questions?” An assenting grunt is all you are going to get from me, after all, I know the drill. I am here because I feel ill, so bloody well get on with it.
“Do you live in a house, a flat, a bungalow?”
“Owned or rented?”
“Do you live alone?”
"Who lives with you?”
“Do you wear dentures, glasses, a hearing aid. Do you walk unaided, do you use a stick or Zimmer frame?”
“Can you get to the toilet unaided, do you have trouble with your waterworks, your bowels?"
“Do you smoke, drink?” How much?”
“Do you have a religion?"
“Are you happy to look after your valuables while you’re here?”
With someone like me, in full possession of their faculties, these questions require asking only once. The majority of emergency admittances are elderly people, deaf, confused, frightened; they often have no idea where they are. Some of the ‘care assistants’ (once upon a time, before we all became customers of the NHS, they were called nurses) are forced to bellow the same question, with variations, over and over, and still get no coherent reply.
The afternoon before, we, the four patients in ward six of the Acute Medical Emergency Unit, (one jaundice, one severe headache, one atrial fibrillation and one dehydration due to bowel problems) had congratulated ourselves that we all seemed compos mentis and relatively stable medically. We planned to switch off the overhead lights for the night and shut the door to the corridor, thus creating a barrier between us and the gaggle of noisily caring staff outside. Fat chance. Two of the patients were moved and two new ones arrived; one of these was moved again within a couple of hours and replaced, at about three a.m., by a very elderly patient, totally deaf and oblivious of the shouting staff.
I usually cheat - I know I probably shouldn’t, but can’t be arsed to ask for permission, which wouldn’t be given, in any case - and take an extra dose of sleeping pills. We are meant to hand in all prescriptions but I always sneak a couple of pills into my handbag beforehand. Consequently, I was the only one of the other three who managed to doze for a few hours.
I had been seen by a young houseman during the evening. He crouched down on his haunches in front of my bed and asked the usual questions: “When did this start, do you have any idea why, has it happened before, when and for how long”.
Do these people have time to read patients' notes at all? Answering his questions, I was fascinated by the sweat pouring off his forehead, he was waving a sheaf of notes like a fan and shifting on his heels. I can assure you that I was not to blame, I am no Jezebel at any time and in the throes of AFib and in my shabby dressing gown a female less likely to inflame the carnal urges of a young man would be hard to imagine. Eventually he stood up and asked if he could take some blood. It is policy in the modern NHS to ask the patient’s permission before performing any medical procedure. Nurses do it constantly, now doctors do it too. When I pointed out that this was a stupid thing to do, how else would they be able to arrive at a diagnosis, the nurse said,” it’s the rules”. My veins are thin, the doctor poked about desperately, while I begged him to call a nurse or a phlebotomist. “No, I’ll do it myself,” he boasted, “it’s my job.” Leaving me with a livid bruise, he went off triumphantly, half-filled vial in hand, never to be seen again.
There is an instant camaraderie on such a ward. The jaundiced young woman was very friendly and chatty and the older woman in the bed next to hers was only too willing to tell her own story. “I’m meant to be at Bob’s,” she said. Bob was her boyfriend. They had found each other relatively late in life and she was obviously very happy at their joint good fortune. The previous day the elderly man had sat by her bed for many hours, quietly and patiently, while his girl friend dozed in her dehydrated low level of consciousness. The young woman was mostly concerned with the hairy state of her legs. “I haven’t been able to shave for four weeks,” she said. Apparently jaundice causes unbearable itching and blood was running down her legs every time she scratched. “Wear gloves,” the nurses advised. Nina, that was the girl’s name, wailed in frustration. “The only time I don’t itch is when I’m asleep, why do you insist on waking me up at five in the morning?” Nina’s doctor was a very handsome young Indian, tall, with a short black beard and a mop of curly hair. The nurses all gawped at him whenever he appeared. Nina too made the most of him. She was a voluptuous young woman with a mane of long, dark, wavy hair, which she brushed assiduously in the way of the siren on the rock luring smitten swains to their death in the floods below. The jaundice gave her skin a golden sheen. She was actually very ill, had been in hospital for weeks, and faced a liver biopsy the next day. The woman with the headache knew that she had a brain tumour. I was probably the least seriously ill patient on the ward.
If I hadn’t been worried enough to ring my GP after 30 hours of AFib, I might not have been admitted at all. She didn’t even bother to make a house call, just said,” we’ve been here before, you know what to do; the ambulance is on its way.” In my book that’s called ‘passing the buck’. There was a time when women doctors had to fight to get into the profession, now they’re happy to shift responsibility away from their surgery.
The AFib stopped as suddenly as it had started, after exactly 44 hours. I rushed out of bed to catch a nurse who’d promised me some paracetamol for chest pains, dragging cables behind me and setting the monitor pinging wildly. Another nurse in the room panicked, shouted “ what are you doing, what do you want?” I stood perfectly still and listened intently, turning all my attention in on myself.
“It’s stopped, it’s all over,” I said, finally. I looked up at the monitor. The last time I’d checked it said 198. Now it said 67. I knew that within a few short hours I’d be home again. Safe again.