Tuesday, 1 May 2012

"After you.."

A patient this morning was a little surprised that I called them into my room and then allowed them to enter first. "I s'pose it's age before beauty' said a lady a tad younger than me." "Nah, it's just good upbringing, 'manners maketh man' and all that," was my somewhat confident reply. My dear mother would have been proud of me.

So what place manners in modern medicine? In an article by Christian Patterson of the Independent , as part of it special report on there Crisis in Nursing, she closed,
Let's, by all means, train people in compassion. But when I was in hospital I'd have settled for good care, and good manners.
Sadly I too have witnessed very poor care and compassion by nursing staff during the hospital admissions of both my mum and dad over the last 4 years. There have been exceptions, of lovely thoughtfulness and concern. However this was almost exclusively whilst both my parents, at different times, were inpatients at the local hospice. Why the difference? I guess higher staff to patient ratio helps, I guess the lack of tests and investigations for the terminally ill, lessens the interruptions in care on a ward. But it's more than that. At the hospice there just seems to be the expectation that our fellow human beings merit the best we can give, whether patient or concerned family or friends.

On a general hospital ward there so often seems a failure to realise that although the patient may not be dying, they are by definition, in some way un-well. A bell may be rung several times before a nurse responds, confidentiality is ignored with the sham of the curtain drawn around the bed having no effect at all on the transmission of sound, and patents are discharged with little or no information about what to expect or what they should be doing upon return home. (Just today I received an apologetic phone call from a consultant at one of our spanking new central London hospitals about one of my patients who was discharged on a Saturday with a dressing left over his anus preventing evacuation and having had no examination by the discharging doctor, 'we rely on locums at the weekend' was all my colleague could say in defence.

Thank God some people are trying to reverse the trend. I'm impressed to read of Andy Bradley who founded Frameworks4 change to train' health professional in compassion, and especially for those working with those who have dementia. He must have felt like  Popeye who would say, 'I can't stands it anymore'. But rather than just complaining Andy is doing something about it. 'All the is necessary for evil to triumph is for  good men to do nothing' as Edmund Burke is purported to have said, although what he actually wrote was,
 "when bad men combine, the good must associate; else they will fall, one by one, an unpitied sacrifice in a contemptible struggle."
Think that means the same thing
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