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PRACTICE COMMENT

'A patient's perspective made me see nursing differently'

  • 2 Comments

I am a senior nurse, currently off sick following several inpatient admissions for spinal surgery. I want to share some of my experiences with you in the hope that they will stimulate both celebration and reflection

I recently spent two nights in a four-bedded bay on a ward while on bed rest. This enforced immobility meant I overheard things I would not be exposed to in a single room. On more than one occasion, as I lay in bed, I witnessed some excellent nursing care in action, which filled me with pride. Sadly, though, I also overheard difficult things that I was powerless to do anything about. I found it distressing wanting to intervene in others’ care but knowing I shouldn’t or couldn’t because I was there as a patient, not a nurse.

On the first night I was cared for by an excellent nurse. She had a calm and practical manner, and did small things that made me feel proud. I was aware that the ward was busy and staff were occupied with a particular patient. My fellow patients and I were waiting for medication and help to settle down to sleep, but we were pleased that the nurse made the time to come into our bay to calmly and briefly explain that they were busy. She then asked if anyone was in severe pain and needed their medicines urgently. Immediately we were on her side and happy to wait. This small act was reassuring to patients and demonstrated the importance of good communication.

On the second night I was woken by the lady in the bed next to me pressing her buzzer. There was a curtain between us so I do not know if it was a nurse or support worker who responded. The patient politely asked if anyone was going to bring her pain relief as she had been waiting since her admission to the ward, but she was told her nurse was on a break so she would have to wait. When the patient asked how long, she was told an hour.

I was very upset to hear this response and toyed with the idea of intervening, but decided not to and dropped off to sleep again. The next morning the close proximity of beds meant that, when the doctors came round, I clearly heard the same patient telling them that she had still not had any analgesia as there a problem overnight. I was shocked, having assumed her medication had at least been given later.

Adequate and timely pain relief is an essential aspect of care. If a healthcare support worker was involved rather than a registered nurse, it is vital that they know the importance of ensuring requests for pain relief are dealt with as quickly as possible.

As a nurse, being a patient is a useful way of seeing care from the patient’s perspective. But, fortunately, not all nurses will experience being a hospital patient. My experience as an inpatient reinforced two things for me. First, the importance, as referred to in the NMC code, of delivering care and treatment without undue delay. And, second, the power of reflection that can be made more powerful by putting yourself in the patient’s place.

Angela Houlston is matron, Oxford Children’s Hospital.

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Readers' comments (2)

  • As a patient myself i too have had the dilemma of whether or not to intervene on a fellow patients behalf. Your right in that it allows ourselves to reflect on our own practice and see things truly from a patients perspective. my hospital stay was also for emergency spinal surgery following a prolapsed disc and corda equina!!

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  • I would not condemn the nurse on her break.

    Either a nurse is entitled to an unpaid break in which case they should be allowed to leave the immediate clinical area - or - the clinical setting demands that they are not entitled to a break in which case they should be compelled to remain in the clinical area for the duration of their shift and be available to meet the needs of patients at any time.

    If the nurse is entitled to a break then it is the responsibility of management (not the nurse) to ensure that sufficient qualified staff are on duty to meet the needs of patients.

    No nurse would ever refuse to meet the needs of a patient in an emergency but here's the thing: I have lost count of the number of times I have been the only member of the care team not to have been able to take a break due to the workload being unrelenting.

    I would not complain about this except for the fact that the same management, which would enthusiastically condemn a nurse if something went wrong due to fatigue, is more than happy for the nurse to work one hour unpaid over every shift.

    Nurses professional obligations and natural instincts are being used to blackmail them. The situation you have described is happening a 1000 times a day in care settings.

    In one setting recently it was suggested to be in all seriousness by a deputy matron that I should take my break "at the nurses station".

    I rest my case.

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