Friday 23 May 2008

Doctors and nurses

I've always been pretty lucky and haven't had to spend much time in hospital, so I haven't had much experience, but a fair bit of what I've observed or experienced has been quite negative. Most, of course, is more or less neutral, and I'm not getting at people in a demanding job, but actually I think that one's behaviour influences how one reacts, so if a person behaves pleasantly and politely they will feel better about themself and what they do.

When I had El, I had a private obstetrician. Nothing too good for his darling, said the Sage. Mr B, the Obs, was charming. Far too ready to intervene, but couldn't have been more kind or considerate. Ten years later, blimey, NHS is quite good enough, I had the same consultant. I was a slab of meat as far as he was concerned. He'd forgotten me, of course, and he couldn't care less.

I said the other day that I woke up in the early hours with contractions, that continued for the rest of the night. It so happened that I was due a routine check-up that morning, so I asked the Sage to take me and took a suitcase, in case I was packed off to hospital. We waited ages, don't know why, no one explained or apologised to all us heavily pregnant women, some of us trying to placate toddlers. Finally, I went in, greeted Mr B, who didn't bother to greet me, told him I reckoned I was in labour as, although it was still fairly early, I'd never had a false alarm before. He grunted and said he'd examine me. It hurt. He didn't reply to what I'd said but told me to make an appointment for a fortnight hence. When, later the same day, I was in hospital I wondered if he'd remember me if he made his rounds ... but he didn't. I had two lovely midwives and mercifully didn't see a doctor.

Back in those days, the whole thing about birth plans was just coming in and I was asked if I had any particular wishes when I went for my first hospital appointment. I asked if I could keep the baby in the ward with me, as my first one had been bottle-fed against my wishes that first night. I was assured that was fine and it was noted. So, back in the ward and the Sage had left and I was settling down for the night. The nurse started to wheel out the cot and I told her that I wanted to keep him. She said that was out of the question. I said that I'd asked particularly and was told there would be no problem. It was July, there was no question that he needed a warmer room. She said that he'd make a noise and keep everyone awake. I looked round the empty room. She said that it wouldn't be later (indeed it wasn't. Squeaky beds were wheeled in all night and some of the new mothers were just coming off their birth drugs and groaning loudly; I literally didn't sleep a wink). I said, however, that it was a fair point and if we were too noisy then he could be taken away (new born babies are pretty tired and just want to sleep). Then she said "I can just take him away, you know, and you can't stop me." "Indeed I can't," I said, "all I can do is phone my husband first thing tomorrow morning and ask him to fetch me and tell him why." She snuffled bad-temperedly and stalked away, which rather disgusted me, as it proved what a bully she was, but without any backbone. Anyway, I didn't let him out of my sight and we left the next day anyway.

My mother had several stays in hospital because, after a successful hip replacement, she had a bad fall and it dislocated. Over the next seven years, it spontaneously dislocated six more times. It was made clear that it was assumed that she had been careless or even attention-seeking and was rather wasting medical time in demanding so much attention by not being able to get out of bed for a couple of days after it had been reset. As time went on and her health deteriorated, in part because of the stress of constant fear of a dislocated hip, she became quite difficult and I saw her being treated more and more as a nuisance. Furthermore, the consultant who had been delightful, charming and considerate when she saw him privately (she was entitled to her hip operation under her insurance) couldn't care less when she was an emergency patient under the NHS. Finally, several years after I said I reckoned her hip was damaged and should be pinned, she agreed with me and the same man X-rayed her from a different angle. Ah. Her replacement hip had been damaged in the original fall and was cracked; it didn't show in an X-ray from the side, which was all he'd done after each dislocation. He'd never questioned why it dislocated, but assumed it was her fault. No question of an explanation or apology of course, but at least she got a new hip, which gave no trouble in the final two years of her life. However, the only kindness she ever received in hospital under the NHS was when her cancer was diagnosed; those nurses (mostly Filipinos) and young doctors were lovely.

A few years ago, I took an old friend to visit her husband in hospital. He had had a stroke some years before and had completely lost the use of his left arm and hand. He was in bed and couldn't move much. We chatted for a while, and then he said that he needed a bedpan urgently. A nurse was with a patient across the room and we asked her for a bedpan and help. I saw her lips tighten as she said that she'd come when she had finished. She tucked the patient in, slowly. I saw her slow down. "I need to pee!" said Frank anxiously, "I can't wait". "When he needs to go, he can't wait," agreed his wife. The nurse looked irritated. "It's too late, I've done it," said poor Frank. So, for her petty meanness - she was doing nothing that couldn't wait for a couple of minutes - she had to wash him, change him, change the bed - again, I was disgusted.

A few weeks ago, I met a friend in town. She is nursing her father through the final stages of cancer, and he has been on morphine for months. He had to spend a night in hospital to have a stent replaced. She ensured it was on his notes that his morphine must be renewed and told the nurses in hospital. The next day, he was returned to the local hospital in great pain and vomiting from morphine deprivation, because he is, of course, addicted as well as dependent. They hadn't bothered to replace his morphine patch.

I could go on - although, as I say, I haven't spent much time in hospitals. This is not lack of money or equipment (though don't get me started on lack of cleanliness, I've seen too many nurses and doctors not wash their hands or remonstrate with dirty visitors; I trust there is considerable improvement in this regard over the last year or two) and it isn't even an indication of low morale, judging by the chat and laughter often coming from the nurses' station. Most nurses are fine - the ones who behave professionally and kindly are the norm of course - but how are the others allowed to get away with it? They must so hate their jobs, but I am convinced that if they behaved better then they would have more self-respect and enjoy their work more. And the trouble is that one bad experience colours your whole view. You remember the outstandingly good and the bad, not the unremarkably competent.

7 comments:

Dandelion said...

I'm looking forward to pi's view on all this.

I have a couple of stories of similarly disgusting behaviour, which I shan't bore you with.

I think in older days, certain rather arrogant attitudes really were the unchallenged norm. And now, I think it's down to a mindset which is fostered and facilitated by the introduction in the NHS of Managers who have ZERO medical training or experience, just a mickey mouse management degree, and couldn't care beyond their own egos. Add to this the appalling treatment of nurses and doctors that began under Thatcher, and the present trend for agency staff and for farming out more and more of doctor's work to less skilled (ie cheaper) workers, and you have a recipe for disaster, in which the patient is the loser every time.

Having said this, it's not much better in the public hospitals in the states. While I'm grateful that they saved my loved-one's life, I am very glad to be from a medical family, and thus not averse to emptying overflowing catheters, lifting from bed to trolley and back, basic physio, doing the bedpan thing and so on. It was that, or see more suffering. With the exception of one lovely nurse, to whom I shall be forever grateful.

Things are very wrong when the vulnerable are treated so unkindly. Which is what it amounts to.

And I think the remarks of your would-be baby-snatcher are very telling. It's a power-trip for the powerless. Sickening.

Mr Farty said...

Youngest Daughter is a nurse. From what she says, the patients seem to like her. I'd hate to think she was the type to mistreat them. I couldn't do her job.

Z said...

The nurses when I was having El had a pretty bad attitude, actually, and that was a long time before the Thatcher years. I have a friend who is married to a lovely hospital consultant and I'm sure there are many of them, but some I have seen have a difference in attitude to their private and NHS patients - for both of which jobs they are paid a great deal - that I despise. I know it's a sweeping statement, but I find the well-spoken middle-aged white male consultants are the most likely to be arrogant (with many exceptions, to whom I apologise).

Mr F, of course she isn't. And I'm sure any nurse could tell stories about dreadful patients too. It is a minority, I'm sure, but the most vulnerable people seem to bring out the worst in some people.

Yoga Gal said...

You're correct it must suck being a doctor or nurse! it's being surround by bad unhealthy energy and bad karma! Hope all goes well with you.

How do we know said...

Zoe, am glad you point it out so rightly. Here in India too, the public health system sucks big time, but thankfully most people are able to afford private care..

Am on my way to an important meeting, but cldnt resist going thru your blog first :-)

Dave said...

As a (sometimes) well-spoken middle-aged white male myself, I have to echo z's comments about consultants. I do delight in responding in kind to their put-downs.

I'm lucky, though, to be intelligent and articulate enough to do it. The trouble is they have power - our lives are (sometimes literally) in their hands, and some people do like to abuse their power (it corrupts, apparently).

Z said...

Yoga Gal, it's a good point - maybe they so harden themselves to deal with it that they become callous. But that's still no excuse -nurses and doctors in children's cancer units, for example, have a reputation for great professional kindness and care and you'd think that would be the most stressful of all places.

If they can't be kind, at least they should not be unkind.

HDWK - British people are going to India for operations now because, including aftercare and flights, it's cheaper than this country. I wonder how well that goes down with your countrymen?

Having made a broad statement, Dave, I'm glad that you don't think it's an unfair (broadly) one. I'd not mind them being so arrogant if they were like that with everyone, but being friendly to the ones they perceive as 'their kind of people' - ie, the ones going privately - makes me angry. One should be kinder to the weaker, not the richer.