As a patient in any hospital you realise just how dependent you are on nursing staff. Blair McPherson says the independent sector is no guarantee for empathic care.
A member of the House of Lords, Lord Mancroft, was recently extremely critical of the nursing care he received from the NHS. Would it have been different had he been in an independent-sector hospital?
I was recently an NHS patient in such a hospital. The surgeon and the theatre staff were all NHS staff working in the independent sector and the nursing staff were all NHS trained. Would the independent sector environment influence the way care was provided? Would the single room with en-suite in a small 30-bed hospital mean more personal care? Did the availability of room service, option of wine with meals and morning newspaper mean I would be treated more like a customer than a patient?
It all started well. My admission was more like checking into a hotel as they took my credit card details and suggested I visit the restaurant while my room was being prepared.
The room was like one in a Travelodge. The only hospital-like thing about it was the bed, which came complete with cot sides.
Unlike my experience in the NHS, I was not immediately required to get undressed and into bed. I sat in the chair, watched TV, and popped out of my room to visit the restaurant for a coffee and have a wander.
The next day I got up and dressed, collected my paper and went to breakfast. My operation was not until late afternoon. I had dressed smartly, as befitting my environment and my desire to retain my individuality as long as possible.
But, once I put on the hospital gown, I was no longer a customer but a patient. The choice of menu has no relevance if you have no appetite. A single room is no advantage if the door needs to be kept open to observe you. You have no need for an en-suite if you have a catheter.
Independent sector or NHS, no one likes working nights, hence a different nurse was on duty most nights – often from an agency. With minimum staffing levels, the focus was on the core tasks of administering medication and undertaking observations.
There was no conversation, not even the pleasantries of name and rank. And then there was the noise. My room was near the nurses’ station – an advantage you might think. But this was where all the nurses gathered to gossip loudly about what they did last night, what they were having for their tea and why they didn’t get on with one or other of their colleagues.
There was also lots of conversation about shifts, a general feeling that staff shortages were not their problem and they didn’t see why they should change their shift, and a preoccupation with breaks. Every other conversation started with a reference to ‘When are you going on your break?’ ‘Have you had your break?’ Or ‘I’m not starting this now, I’m about to go on my break.’
As I lay there – unable to get comfortable with the monitors bleeping and all the tubes and wires in my body, forcing myself to drink plenty of water and wondering how long I would feel this bad – I thought, ‘the teamwork here stinks’.
I don’t mean the theatre staff or those in intensive care. They were attentive, keen to have me talking and constantly explaining what was happening or what was going to happen. I mean the nurses – the ones who provided care once I left the ICU.
I have seen it before in care homes for older people – the staff become detached, bored and focused on physical tasks. A request for a cup of tea or a fan is an inconvenience. The request is noted but you are never sure if and when it will be acted upon. You are given the impression you are being demanding if you buzz for assistance, despite previous assurances that you should not hesitate to use the call system day or night.
When you are at your weakest and most vulnerable, this indifference makes you realise just how dependent you are on an individual you have never met before and you realise that some people are just not suited to this type of work. They lack basic empathy, warmth and kindness. They are certainly no ‘angels’.
Blair McPherson is director of community services at Lancashire County Council, Preston