Continence specialist and Nursing Times blogger Frank Booth on being on the other side of the treatment table
I write this blog post in a personal capacity.
Those of you who know me will be aware that I have a passion for what is right. This matters to me, and should matter to you as a fellow specialist.
Having gone from a seriously healthy person to a seriously unhealthy person in 18 months, I have experienced health care from a most unexpected perspective.
I’ve had significant heart problems, surgery for cancer, treatment for diabetes and now the dreaded gastroscopy and colonoscopy. Recent years have been eventful.
The majority of care that I have received has been from ordinary level nurses and allied healthcare professionals, but I have also had significant involvement from clinical nurse specialists and, unfortunately for me, specialists from my own area of continence, urology, and gastrointestinal areas.
I have tried to factor in that I may still be known across the local health trusts and usually have to answer, ‘yes, I am “the” Frank Booth’.
I usually go on to say that I am a patient first and foremost. My knowledge means nothing, and can actually get in the way of my care. Staff can become more wary or cautious when they are treating patients that are experts in the field.
So how did they do in my home area?
Following a recent hospitalisation for chest pains and shortness of breath, it was quickly resolved that it was not specifically cardiac again. Thank goodness for that, but what was it?
I was referred for a gastroscopy and also a colonoscopy. My Hb had fallen to a little over nine so a bleed was a possibility. A week after discharge I received a letter from the hospital, requesting that I call them to arrange the procedures.
Is this good?
Well it was for me. I discovered that the procedures would be done together. What? At the same time? Reassured that it would in fact be one after the other, I was questioned about my health and answered truthfully. I was told the basic facts, and that a letter was to be sent out with specific details.
I explained about my fears, and fellow experts should be assured that this expert was frightened.
The day of the procedures
On the dreaded day, well actually 24 hours earlier, things started. From 12 midnight I commenced fluids only. Fairly unremarkable really, the problem with not eating surprised me, the longer I went without food, the less I wanted it.
Then at 0800hrs dose one of Pixolax… I waited for diarrhoea, and waited…. and waited and at 1500hrs took dose two, and waited and ….. ah!
Suffice to say that on arrival at gastroenterology, the effects had just about finished. I suspect that nil by mouth for a diabetic on tablets and insulin could be scary, but my literature advised me what to do and how to get help should I need it.
I was first in. My first contact was a departments nurse. I was made to feel more relaxed and there was the right amount of humour and decorum. I was moved to a private room and told what to change into. We went through the standard blood pressure, a needle inserted to allow a sedative to be given later, and I was moved to the third area.
All good up to now.
The nurses who were to be with me at the procedure arrived at bedside, curtains drawn, and asked me to remove underwear and hop onto the bed. Dignity OK. Now came the re-checks, yes it is me and yes I do know that I am having two procedures.
I was then given basic information about what would happen when we left this area. What seemed like moments later, we were off and into the procedure room. Before being asked to lie down I was asked whether I would like a throat spray or sedative for the first procedure. I said that this was the one procedure that really frightened me as, ever since my coronary, I get panic attacks if anything goes into my mouth, even on a routine trip to the dentist.
This was not a problem, and we agreed that I would be sedated. The procedure started with a mouth gag placed in situ by the nurse, and immediately I panicked.
This is where nurse specialist skills come into play. I was allowed to remove the gag and put it back myself a few seconds later. This allowed me time to adjust and the procedure was delayed for no more than 20 seconds. I was listened to and supported.
Maybe more frightening (but not for me) was the colonoscopy. My experience was just the same: positioned, exposed no more than was appropriate, and before every stage the doctor or nurse told me what was going to happen.
It is not a pleasant procedure, and at stages it moved between uncomfortable and painful, but hand-holding, reassurance and almost constant verbal chat made things quite acceptable. This took longer than the gastroscopy but was not too long. I relaxed. Finally back to the first bed, a rest with oxygen and obs. Then sitting up, breakfast, pills, insulin, and I was ready to go!
My thoughts for you
Staff at my Gastroenterology Unit did a great job for me. Whether you are specialist or generalist nurses, doctor or admin staff, it worked for me and I thank them for that. If the care you gave me is ‘normal’ then you have got it so right.
I believe that praise should be given where praise is due and specialists or generalists alike in all specialisms should take note that even though patients expect the best from you, a kind word and sympathetic ear is also part of the job, but not always given. Please remember how important this is to us. What you say can be as important as what you do.
My local lot did a great job, something that I have come to expect from the services I have come into contact with and this makes a refreshing change from all of the poor press that we keep hearing and seeing. Do not allow me to be the lucky one, let me now and in the future be the normal one, the one that is the standard because one day, maybe you might a patient. Nothing but the best is good enough.
And of course a big, big thank you to everyone who has cared for me during my last few years. I appreciate you even though some of the things done to/at me were less than pleasant, but they were done in the best possible taste. And you can quote me on that.