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.




58 comments:

  1. whew...i am glad it passed...ugh though in the moment that has to be brutal...44 hours...smiles at the comraderie of those on the ward....but glad this is over for you...

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  2. The same all over the world, it seems, and it never gets any better. Patient, heal thyself! I love the picture of you spotting that the crisis is over and ACTING ON THE SPOT! "I stood perfectly still and listened intently, turning all my attention in on myself." Great move. Glad you are out of there, and may it be so for a long, long while.

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  3. 44 hours is a very long time, and how good the problem stopped. Home and your own bed never looked so good, and I am glad you are probably home by now.

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  4. Friko, did you just make an emergency stay at hospital sound like an episode of General Hospital? (I'm guessing because I swear I've never seen a single episode of that horrendous programme.) I'm glad you're feeling better though more stories from the ward would have been entertaining. BTW, that doctor sounds most drool worthy.

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  5. Publishing this so close to the US election might be considered interference by some, Ha Ha. For you have described the very experience that some have been made to fear under 'Obama Care.'
    But most importantly, you got care denied to millions of uninsured Americans who must turn up at an emergency room at the worst moment with no regular physician, medical history, or preventive care!

    Of course you have described the lunacy of being in a modern hospital QUITE well!
    Unless you and I become plutocrats, we shall have to avoid them when possible, and be deeply grateful for the medical circus the next time it saves our life!

    Much love to you, Friko


    Aloha from Honolulu
    Comfort Spiral

    > < } } ( ° >

    > < } } (°>

    ><}}(°>

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  6. I am glad you're out of hospital and feeling better now. Have been in there a few times myself over the past few years with health problems, I am always so glad to go home.

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  7. In my 57 years on this planet i've never been a patient in any hospital in Australia. The only time i go to hospital is to visit someone then get out as quick as i can.

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  8. 44 hours! Goodness. I am so glad you are better. You can make great reading out of any experience. You have my respect for putting up with these conditions. Hospitals are no fun.

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  9. Such an entertaining account of your hospital stay - frustrating, to say the least, but your powers of observation were not at all hampered by the AFib. I'm so glad the episode is over.

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  10. I don't understand. If he needs your permission, but you said you wanted the nurse, why did he do it anyway?

    I'm glad you're better.

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  11. All so familiar, but reassuring too, in some odd way. We take for granted the fact that we can go to the hospital, call a doctor, seek treatment no matter where we are in the country - and we'll be treated. I can't imagine living in the US and being without insurance. Families are only one illness away from catastrophe.

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  12. I wonder what it would take to stop your observations of life, Friko. You must have been quite ill, I suspect you do it without knowing. Wonderful word pictures. I'm glad you are home and well again.

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  13. I too, am very pleased you are home, safe and well.

    Seems to me the indian doctor must surely be closely related to my GP. They sound so alike ;)

    Wherever did you find the energy so soon, to do this amusing post for us to enjoy Friko?

    Fond wishes and rest up.

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  14. Frico, how well you're out of the hospital.
    I also do not like hospitals: listen to stories told by patients, the noise in the ward and the hallway, the inability to sleep. Terribly!
    Finally you're home!

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  15. What a nightmare ... maybe we should switch to the Chinese Traditional Medicine method where your doctor helps keep you well - and is adversely judged by the number of sick patients!!!

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  16. hoe mooi dat het er allemaal is maar als je dan weer naar huis kan,dan ben je weer gelukkiger.

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  17. Oh dear! I am glad it finally stopped! And you described the stay in the hospital very well. I have been there many times myself and it is so distressing. I am hard pressed to understand how anyone gets better staying at the hospital! It's a looney bin for sure. Lights...sound..action! Sheesh
    Hugs
    SueAnn

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  18. Hello:
    We too cannot speak highly enough of the National Treasure that we consider the NHS to be. However, the scenarios you describe are, sadly, so very familiar to us.We learned very early on that a doctor taking blood is never a happy option...far too lacking in practice...better to just do it oneself!!!

    We are relieved to read that you are now at home safely once more and the ordeal over. That is where the true healing can begin.

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  19. Having spent the last couple of years accompanying my Dad in and out of hospital, I recognise your account very well, but thankfully from a visitor and protectors view.
    (yes I mean protector) I held on to a good many of my fathers meds, until i new they were administrating them properly, as for the first few weeks on one of his first prolonged stays, they lost all of his meds including much needed eye drops.
    There were many times when an elderly lady or gentleman cried out in distress, or was on the way to falling out of bed, and nobody took any notice, until I pointed it out, or if i could help them i would. My Dad hardly ever got any sleep, when ever he was staying in hospital, for the very reasons you pointed out.
    Anyway, im pleased for you that you aree out and home with your beloved, where real air abounds, and the views astound.

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  20. Glad you are home and fibrillating correctly once again...if that is what one does. Health care is like this for everyone except the very wealthy in private rooms and the medical person who is in the hospital where he/she works and being treated by those who personally know them. I try to get their names and address them directly...sometimes that helps.

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  21. What a great story. Glad you are OK again. It seems everywhere these days you are asked endless questions over and over again. Even to call customer service with the phone company. Three time you have to give them your name, address, last four digits of your social security number. Doesn't any of that information get transferred to the next assistant?

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  22. My husband too knows when his crisis is over, when it is safe to return home...and does so at speed.
    He doesn't have the same problems of company as he is in the intensive care area and on his own apart from the machines and tubes - and his rapid exit avoids acquring any!

    The NHS is wonderful institution...and we are delighted to meet its equivalent in Costa Rica.

    Your account echoes my mother's experience though...constant nocturnal disturbance and no end of pettifogging nonsense becasue people are now litigation crazy.

    Good to see you well enough to write about it.

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  23. So glad you are back home. I really dislike hospitals. Try my best to stay out of them. Try not to touch anything when I am there visiting someone. Haven't had to be admitted to one in many many years. Next time pick up a pair of ear plugs. I like those soft squishy foam ones. They block out 90% of my husbands snoring when I am right next to him.

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  24. How mysterious. And they actually did nothing to help you, it seems, other than make life pretty darn uncomfortable. So glad to hear the episode has passed.

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  25. Those of us who have spent time under the care of hospital staff can really relate to your experience. Waking someone up to give them a sleeping pill is classic procedure. I love that you had brought your own supplements! heaven forbid that I should bring my thyroid replacement meds along - when the hospital can charge $15 a pill for something I get at about .30 cents.

    Good that you are back at home - you don't need a repeat!!

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  26. and to think we are going to get your kind of healthcare
    frightening
    Now we have private rooms, our own doctors and good meds
    that help with afib
    frightening experience
    44 hours of afib..wow
    maybe you should visit here
    glad you are on track and feeling better
    sneaking in a sleeping pill....how friko
    hug

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  27. Friko, Does this Afib occur often? Is it just a 'wait and watch' situation? I guess what I'm asking is did they actually 'do anything' or just monitor you?... or is that all they can do with Afib? Whatever the answer, I'm glad the emergency is over and hope you are home and well again.

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  28. Glad you are home. Your experience at the hospital was so interesting. Much the same as here in the US. Take care now...Hugs, Balisha

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  29. Dear Friko, thank heavens. Peace.

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  30. Hospitals give me the heebie-jeebies, and just reading your account leaves me with a certain heightened dread of them. But thanks for the tip about sleeping pills! Great idea.

    I'm so glad you're feeling better and hope it continues.

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  31. Glad to hear you're better. I laughed at the vision of the young, sweaty doctor. I go to see a rheumatologist who is seriously the most unhealthy-looking man I've ever seen claim the name Doctor. It's most disconcerting, being seen by him while he's puffing and panting and barely able to get out of his chair and sweating profusely.

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  32. Makes me think the best way to be in hospital is unconscious. You're frighteningly conscious. Love the part where you "stood perfectly still and listened intently, turning all my attention in on myself." Glad you're at home.

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  33. Anything, even remotely related to doctors and/or hospitals makes me really, really edgy and paranoid. But you tell it all so engagingly, despite the pervading gloom and killing apprehension of a hospital room.

    Glad you are home and better. Take care.

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  34. So glad that you are back home again, Friko.

    I am lucky to still be working for an employer that offers excellent health care insurance (I pay part of the premiums;the company pays part.) I now also qualify for hospital coverage under our Federal Medicare system.

    I know many folks without insurance whose health would surely benefit from coverage similar to your NHS. No system is without faults (after all, humans are involved!) Still, it's grand to have access to some health insurance.

    Did you have ambulance transportation home, or have to find your own way? Aren't I nosy!

    xo

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  35. Nothing clever or wise, but a well wished glad you are back home.

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  36. It's always a source of great satisfaction to have survived the hospital care and be able to leave . Though I do worry that home might seem rather quiet at first !

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  37. Friko, so glad you're safe at home again. I think the RSH staff are brilliant (as a rule) The worst thing about being in hospital is that it's impossible to sleep through the night and then just as you do finally manage to doze off somebody's waking you up with a bowl of cornflakes.

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  38. What a post - it gave me chills of apprehension. I'm glad you're back home. With a normally beating heart. From my heart to yours - thank goodness.

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  39. I had a friend who used to say "It's worth it for the stories." If nothing else, your hospital stay gave you the material for a lovely little story. Hope you're feeling better and that your heart behaves itself.

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  40. So glad you are okay and home with your wonderful stories. :)
    Me, I would be at home crossing my fingers I survived it because I can't afford to go to the doctor, let alone the hospital. I've been in them in the past, though--several times myself and many times with my son--and it is so difficult to ever sleep at the hospital here, too, because they wake you up all night long. You always meet interesting people, though, I think.
    I hope this doesn't happen to you very often! You poor thing! 44 hours is a long, long time. Be well. Get lots of rest at home now.

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  41. Friko, I'm rocked by this post. My heart goes out to you, to Nina, to Bob's dehydrated girl, to the hard-of-hearing patients hassled by questions which, as you mention, who could have the time to review them all once they've been collected?

    My mouth went a little dry with worry reading this. I send you my very best thoughts.

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  42. A brilliant blog Friko, which demonstrates the apparent stupidity of many in the medical fraternity - mainly the managers. I'm glad you came right eventually - Dave

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  43. A beautifully observed description of your hospital stay, Friko. It sounds like things have got a lot more hectic and rule-bound since I was last in hospital, yet we must always be grateful to have the NHS there when we need it. I'm very glad the episode passed so completely and that you are now safely home again,

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  44. Fascinating account of your time in hospital! Thanks for your comments on my blog; am glad to have discovered yours! Hope you're feeling much better by now.

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  45. safe again. Was für ein Abenteuer. Danke für diesen interessanten Einblick in das Krankenhaus-Leben. Das einzige Mal, das ich hier eins gesucht habe, haben sie alle gestreikt.
    Einen guten November dir.

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  46. Fascinating and well written - but so glad to hear you're OK.

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  47. Love the tongue and cheek. Of course we mostly complain, although the medical staff are doing what they are told.

    I complain when I fill out the same form everytime I visit the same doctor, or a different doctor in the same hospital. Good grief, I have signed every waiver known to man or woman and free access to my medical records can be had by all interested parties.

    Nevertheless, we want to know people we love are receiving the best care. Dianne who is none the worse for wear owing to Sandy the storm.

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  48. Gack, I hate hospitals, not so much the hospitals, the noise, the never ending "check-ups" the inappropriate wake-ups. The noise. The noise. The terror. The plastic food on plastic trays. The uncomfortable beds. The unyielding pillows. The dry heat. The smells. The noise.

    Oh I am so sorry - glad you are well.

    XO
    WWW

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  49. Glad to hear you are mending. I've been away and am just catching up. Keep well and keep blogging (I read the previous post, too).

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  50. Hi Friko - crumbs .. I'm glad you're safe. Having had a few hospital experiences with my mother and uncle - I quite understand what you're saying .. I'm just so glad you're able to jump up and say enough is enough .. I'm off home! I know - NHS doesn't quite work like that does it ...

    The surgeon recognised us one early Sunday morning .. and said no worries - I'll fetch my tool box and we'll sort your mother out ... then the five hour wait for the ambulance! Oh well - at least we didn't have another night. We'd arrived at 1.30 am ...

    Those fun and games are over thankfully - I'm just so pleased you are able to get back home .. cheers and with thoughts - Hilary

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  51. Dear Friko, I hope you are better now that you've gone home. Please do take good care of yourself. Peace.

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  52. Dear Friko,
    So glad you are on the mend, what a tiring experience, but also a comforting picture you paint. To know that if one is in a similar situation there is camaraderie on the ward, all in the same boat. You are home and safe now and Millie will keep an eye on you. Keep well!
    Di
    xxxxx

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  53. I am glad you feel better now, Friko. I always wonder if it is better to have some cameraderie or be alone when in hospital. Anyway I am glad you are home.

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  54. I know it's annoying to be asked the same questions repeatedly. There can be sound reasons for doing so, including to see if individuals are able to consistently report the same responses which might have significance. Glad you were able to resolve the Afib independently and return home, but glad you wisely sought medical care earlier.

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  55. First I am worried for you, then I am laughing. How'd you do that? You collide with the wall of humanity in an interesting & amusing way. That is a gift. ~Mary

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  56. I'm late reading this and know you are out and about hopefully well and caring for Millie. The description of events in an ER are so vivid and very true to what goes on. That you snuck a pill with a heart that's not happy is rather risky buy that's just how I figure you, gutsy lady. But what did they give to stabilize your condition? Chest pain is a symptom so do you have a known condition?
    I have ends up in ER many times with tachycardia with a pulse rate of up to 235. Usually it is caused by a food or environmental sensitivity and has to work it's way out of the body. Doses of antihistamines and bicarbonate of soda are use to speed up the process. it has never crossed my mind to put that experience into a blog. Thanks for this idea.

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