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'One day you might be a patient. Nothing but the best is good enough'

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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.

  • 4 Comments

Readers' comments (4)

  • I am glad to hear that your experience as a patient was so good Frank and I wish you good health for the future.
    My experiences have been less fortunate and took place at the previous trust I worked for about 4 years ago. Thinking about it even now makes my blood run cold!
    Potted version - an unresolved dental abcess drove me to A&E late on Saturday evening (presented facially like elephant woman) and sent home with additional antibiotics. Emergency ambulance late that night with general pain and drifting in and out of consciousness. Received at A&E with 'what is she doing here - we only sent her home a few hours ago'. A little fuzzy after that but suddenly heard that 'your mum has had a heart attack and we have to act quickly to save her life so we need your consent'. I tried to object (in my head cos couldn't talk) as I knew I had no cardiac symptoms and they were ignoring the obvious. However I was thrombolysed and admitted to ICU and for 2 days was mainly out of it. Day 3 saw numerous visits by different consultants to inform me that I had not had an MI but did have septicaemia and they started me on IV antibiotics. I swear that the only thing that saved me from death was my stubborness (I knew it would come in handy some day)! Later that year I needed a laparotomy and had a cyst removed from the large intestine. Massive wound infection and burst abdomen (won't describe any further cos stomach churning). The Trust apparently learnt from my experience and developed a septicaemia pathway which is the way it should be I suppose. However that year was my 'annis horribilis' but the one thing that remains a source of great disappointment and despair is the comment that a 'fellow' nurse made as I arrived on that stretcher - 'what is she doing here - we only sent her home a few hours ago'!! I hope she learnt her lesson.

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  • What this shows us is we DO NOT have a National Health Service at all. What we seem to have is a series of 200/300 local services. Some get it very right, some get it very wrong, but why?
    There are set standards and rules which we all know, some even have NICE guidance and yet someone or another blatantly break the rules.
    It begs the question; Do we need more rules, or do we need to apply the rules we already have?
    Good practice never changes, good practice is always good. There may be amendments to how we practice as research helps us to improve what we do.
    It seems that maybe the Trust in your case is not at fault but individuals who seem callous about your body and your needs. As you know when you are ill it really is a scarey time and I would plead to all readers, please, please help us to get better if this is possible, when ill, we know nothing, we wont criticise you for minor indiscretions, we have to be able to trust you to be on our side. Kindness and patience costs nothing and it really matters.
    Don't let our responders feelings ever happen again, it really is up to individual nurses and doctors and of course AHCP's to make a difference.

    Life isn't perfect so iF some get it wrong then you SHOULD COMPLAIN, but equally if some get it right, well you know what to do you SHOULD ACCLAIM.

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  • I was surprised that the patient is not sedated these days. I had an endoscopy in the UK under local but here in the US had to have both endoscopy and colonoscopy under sedation. When I told them about having it previously under local I was told that they used to do it that way 'back in the day'! It was as if it was now too old-fashioned to consider!

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  • Sedation was available to me, it was offered and accepted. Some people it seems manage well without it though and of course some sedations too frequently are not good for you anyway therefore it seems reasonable to me that we should tell staff our fears/worries and ask whether some level of sedation is appropriate for you. From what we hear and read in the press not all of our colleagues live up to the best of our expectations which is very sad and unacceptable as a little thought works wonders. Get a little knowledge. It pays to ask when you don't understand and as I said earlier praise when it's due and if you are let down do not let them get away with it.

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