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‘Protocols don’t have to dehumanise healthcare’

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You may recall me mentioning my poorly knee once or twice? Too much yoga, football and hopping over the years. So, after far more visits to protocol-laden clinicians than such a simple problem required, a pleasant if tired-looking surgeon took out some meniscus and rearranged some ligament at a pleasant day surgery venue with attached shopping facilities.

And it all went very smoothly. The nurses were very good. I particularly enjoyed the experienced and skilful recovery nurse telling an agitated doctor who was looking for his friend, ‘the other surgeon’, that she had four patients in recovery beds and was too busy to help him look but had he tried the operating theatre? Or the tuck shop?

But if you are a nurse, or I imagine any other clinician, you can’t help watching proceedings with a slightly different eye.

I was struck, for example, by the fact that – while I sat behind a screen wearing what could only be described as a comedy operation gown and a hospital-issue bathrobe that fitted like a waistcoat, trying to get my feet into some thin sponges with holes in that someone had called slippers – there is nothing quite like dehumanisation to prepare you for minor surgery.

And you can’t help doing mini audits, either. While I waited for the operation, five people came to see me. One to make sure
I was who it said on the list, another to draw an arrow on my leg pointing toward the knee (reassuringly stopping short of writing ‘nee!’ under it) one to talk anaesthetic, another to look for something and another to take me to theatre. Only one of them, the anaesthetist, introduced themselves to me. And by introduced I’m not talking star signs and family photos here. I mean name and job. Who I am and why I am here. Odd, that.

Of course, they have a lot to do and nobody knows the pressures that are hidden from the patient – although calls to the bank for some staff gave a clue – but the best staff are the best because the central relationships of their day is with their patients, not the number of tasks they have to do.

Which brings me to the physiotherapist. Do they teach communication skills on their course? Call me old-fashioned but if you tell a patient you will be ‘more then five minutes but certainly less then 10’, don’t show up 45 minutes late – at least not without apologising. Particularly when said patient is blocking a recovery bed so putting pressure on your colleagues who have other, needier patients to put in that bed.

Some people say protocol-led services can dehumanise healthcare. The nurses showed it needn’t. The processes and protocols are all a bit fussy for such a small knee but perhaps that’s what makes them modern?

Want to read more of Mark Radcliffe’s opinions? Just click on the 'more by this author' link at the top of the page

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