Am I a caring person?

Something happened yesterday that made me really re-evaluate my opinion of myself as a caring person. At about two in the morning, the door to one of the bays on the ward opened, and I found myself face-to-face with an elderly gentleman who told me that I had to, “Stop playing this game”, and to let him out.

This is a common occurance here. “Confused” patients (often described as “pleasently confused” when we want to offload them – beware this phrase!) regularly present around midnight, and more often than not declare that:

• we are keeping them hostage
• this isn’t a hospital but a prison
• it isn’t actualy midnight because the sun is on outside (no dear, it’s the lights on the corridor)
• where’s my clothes?
• my wife was here a few minutes ago
• etc…

Almost always this can be attributed to a medical condition – pyrexia, hypoglycemia, UTI – which may be exacerbating already exsisting dementia or just causing the issues all by itself. In many cases this is reversable (a fan, some sugar) but we need to find out what the cause is first, and that is easier said than done.

This particular gentleman was insistent that we’d drugged him and dragged him from his home to what he believed to be a dodgy nursing home. Apparently, all the equipment we had was actually second hand, and our NHS ID badges were faked, with the aim of pretending to be the hospital. The other patients in his bay were in fact “heavies” who were pretending to be asleep, ready to beat him up if he misbehaved. His proof for this? I wouldn’t let him turn the lights on at three in the morning.

The joys of dealing with this chap went on and on, as he tried to leave the ward, break into female bays, repeatedly tried to wake the other people in his room, and make us phone his daughter at stupid o’clock am (yet more proof that we were in a conspiracy against him). How did we cope with this? Got him to sit at the nurses station with a cup of tea (“you’ve put something in it, haven’t you?”) and made fun of him.

Yup, you read that correctly. We made fun of the patient. Not made fun of him in an overly obvious way (throwing custard pies at him or using him as a makeshift drip stand), but in a more subtle way, amusing ourselves by the way we spoke to him and laughing at his responses to our questioning and actions, even those completely unrelated to him.

At seven, we relented to his constant requests for a phone call, and let the gent call his wife and daughter. At first, he didn’t believe them either (“they‘ve got to you too, haven’t they“), but after about half and hour of phone calls the message got through. And that’s when I began to feel awful. He started crying.

The chap grabbed my hand and shook it, and asked “Still friends?”. He apologised profusely as we walked him back to his bed, for swearing and at one point hitting us with a walking stick. He seemed absolutely mortified by the way he behaved, and so embaressed at his misunderstanding of the situation. He was still crying and saying sorry as I tucked him into bed.

And what had I done to help him? I’d laughed at him. I, and the other people working with me, had treated him like a game. Ooo, what’s that crazy old man going to do next? Oh look, he thinks we’re going to drug him, isn’t that a giggle? It was hard to hold on to the fact that he was actually ill, and needed our medical attention, and it upset me greatly that instead of just helping him I treated him as the source of a few cheap laughs. Sheesh, I’m even making fun of him now in my tone of writing about the incident!

Now, we do this a lot. Patients are a constant source of amusement to us. Should they be? I don’t know. As long as we provide the care they need to the best of our ability, is it ok to laugh? We did for this chap, did everything we could to protect him, and the other patients who he wanted to disturb. But was it right of us to treat him the way we did as a person?

In some respects, you’ve got to laugh, or else you’ll cry. It’s sad to see someone in that state, and even worse when you think, “that’ll be me in fifty years”. Laughing about it numbs the pain. And then, it’s our job. People in an office will laugh at their clients (they certainly did when I was temping), so should we be able to laugh at ours? But would I want the staff laughing at my grandad in the same state? Or my dad? Or me?

I want a nice conclusion to this post, but I don’t have one. I feel like I let the patient down, and although I can’t speak for the actions of the people with me, I let myself down. I’m trying today to be extra nice to the patient, though is this making it up to him or is it for me, to make me feel better about being nasty as I’m putting in hard work now? The important question is, was I a good carer, and I can’t answer that.

On another note, I’m determined that when (if?) I reach eighty-odd and if I still have my mental capacities intact, I’m still going to wander all over the place, make inane requests at night, and maybe even shit on the floor if the mood takes me. Because I have to deal with it in my job, I’m going to make certain the next generation has to too!

Royally pissed off

What he said

Dear healthcare assistant…

Dear healthcare assistant I’m working with

Thank you. You’ve demonstrated to me exactly why the NHS is struggling to find good HCAs, and why so many young people are leaving the job.

You see, because we haven’t been doing the job for “however many decades” (your words), we understand that modern healthcare is about looking after patients. A caring manner and a good clinical background are what’s important. Making the bed to an inch perfect standard is not.

Direct quote from a patient:

“This hospital is more for the staff than the patients… They’re more concerned about making it tidy than looking after me”

I see the point you’re trying to make, that an untidy room isn’t good for the patient and doesn’t give a fantastic impression of the NHS. But the exact angle the creases in a bottom sheet make with the bed rails does not matter to the patient, only to you. Which way round the pillows face does not affect patient care one bit, unless you can give me a sound clinical basis for it. Which you can’t.

When I’m making the bed for the third time because a sheet is overhanging by a centimetre, a patient could be falling over, or suffering chest pain in silence in a side room. Our job is to be there to help them, to assist the patient to keep their dignity, to provide them with the care and medical attention then need, or just to talk with them and make their stay in hospital as pleasant as possible. It is not to make ourselves happy that the bed is smart while someone who needs our help injures themselves.

And while I’m on it, I’d appreciate if you wouldn’t patronise me on clinical matters. I know my stuff, probably better than you. And if I don’t, I’ll look it up or ask. And don’t even think of trying to teach me the “correct” way of doing a procedure such as a glucose measurement, when you fail to realise you’re supposed clean the patients fingers first and don’t have the faintest clue what a normal BM is, when to refer a patient to a nurse, or what treatment you can provide for a hypo.

And finally, although this may not sit right with the little empire building exercise you’ve got going on because you’ve failed to progress in your career over forty years, unless it’ll compromise patient care, don’t ever, ever call me out in front of a room full of patients again.

Regards, Nick

Update! (Let’s try again)

So I wrote a nice long update after being repeatedly poked about the fact I haven’t written anything for over a month, and haven’t written anything useful for, well, ever. And in the middle of doing so, the SRCF was taken down. Let’s hope they don’t do it again.

Anyways, update. What’s been going down in groove town since I last posted? I guess the main thing is I’m now a Part III student. Only one year left! This is a scary fact, as it means that I might have to enter the Real World pretty soon. Career options for a Cambridge earth science graduate are:

• The oil industry
• PhD at Oxford
• PhD at Cambridge

Now, I’m not sure I fancy any of those. I tried the oil industry over the summer with my internship at BP. They even offered me a job. But I don’t think I want to work for them. The place was excellent, and I loved the work ethic (and bonuses!), however the whole industry seems overwhelmed by Powerpointitis, and job security isn’t exactly there at the moment (the industry is in the middle of a big hiring boom, so pretty soon there’ll be too many geologists and not enough oil to find). A PhD doesn’t quite float my boat either – the majority of academics (well, the majority of the noisy ones who you hear about and end up having most contact with) are so stuffy and up themselves, I couldn’t imagine working with them or even worse turning in to one of them.

Which leaves the obvious(?) option – grad medicine. Medicine has always been in the back of my mind, right from sixth form where I opted to go down a physicsy route through to university. I considered switching at the end of first year, but my grades were nowhere near good enough (you need to get around 120% in your exams I believe). And hanging around medics/working in a pharmacy/joining St John has got me more and more interested in the whole medical lark.

My mind is pretty much made up. Now all I have to do is get a first this year, apply to do medicine, get accepted, then do four years of very intense study (no vacations!) :S But I might as well give it a go while I’m still young (and foolish?) – nothing much to lose, and I can always fall back on oil assuming there’s still jobs available!

What else? Oh yes, Part III. This is for the MSci, and takes the form of one term of project and one term of lectures shared with the Part IIs. My project is on water – more specifically, sitting up in the Bullard doing seismic imaging of the Southern Ocean around the Falklands. This involves processing lots of old oil data from 1993 to look at relfections caused by water of different density/salinity/temperature (much like these guys), then try and work out what these reflections show and why they show them. It’s much more interesting that it sounds, honest! When I get time I’ll post some pictures…

Outside of academic stuff, life is moving along. I’ve moved into a house out in Trumpington, which is awesome because there’s a fantastic pub nearby serving 28oz steaks, and it’s a reasonable cycle ride up to the Bullard/into town to burn off the stupid amount of fat and calories I must gain from one of those steaks. I’ve completed a PTA course, which means that it makes it easier for me to seriously damage someone if I screw up. And I’ve discoved the joys of Twitter and facebook schadenfreude (hunt out the twats from school and see if they really are “earning two million pounds a week” of if instead their life sucks – I haven’t found one of the former yet).

And that’s about it. I really should get back to work…

Internships and such…

This weekend, I had the misfortune to spend an evening in Slough. However, it wasn’t all bad as I spent the Monday being dined, not wined but given free non-alchoholic drinks all day, and interviewed by BP’s graduate recruitment team in the lovely setting of Durdent Court.

The interview was split into two parts: Technical (seismic line essentially); and Competency (chat about all the amazing things you’ve done). I’ll write more about these when I have time, but I’m rushed off my feet at the moment. Anyways, to cut a long story short, it turns out that myself, Ana, and Alana have all been offered places, making it a clean sweep for Cambridge and making me very very very bouncy

Oh yeah, and other things have happened in life since I last updated AGES ago, but more on that later…