In the time waiting for my operation (being an elective rather than an emergency admission) my mind ran a bit wild with thoughts and emotions. Was I going to make it through? What impact was this having on my family? What would life be like again! Emotions were high as I thought more and more about the seriousness of what I was about to do, literally putting my life in the hands of a few highly skilled and experienced professionals. The key for me however was that I trusted them 100%.
The build up to my admission to hospital was seamless, though I remain impressed with the focus on me as a person by all staff members. My admission to hospital took place on the 14/11/2019 at 7.15am, which just happened to be the same day as my daughter’s birthday. I got prepped and ready for theatre. The world started to disappear as the effects of the anaesthetic began to kick in - the next leg of my journey had begun.
I remember waking up in the High Dependency Unit the same evening at about 6.30pm surprised to see my surgeon at my side who promptly told me that the operation had gone very well. I also later found out he had personally phoned my wife with the good news. A true example of compassion and dedication through a person centred lens. A theme I might add that was evident right through to my discharge from hospital.
The road ahead
It’s fair to say that despite their very best efforts, professionals cannot fully prepare you for life back at home following a major operation. Whilst in hospital, all you want to do is return home, but once there it felt unsafe and at times scary.
At home I missed the contact with fellow patients and certainly the confident reassurance provided by staff throughout the day and more importantly night. My pain management was reduced, with more responsibility being placed on me to manage things. The term DIY Care comes to mind as you realise that there is no community support coming to visit and check on you. At that moment I fully realised the extent of the financial constraints placed on the Hospital Trust Board and how these impact on patients.
I’m fortunate to have support at home and some personal experience in providing care to others but it does make me wonder how others cope who might be alone or lacking experience to self-care when the hospital infrastructure is removed.
Strategic thinking required!
Social care as an option for people is not only in limited supply but also only introduced late in the day. Time to assess and plan for people’s discharge is short. If discharge planning took place earlier in the journey, this would facilitate a much better experience and preparation for returning home. Even within the hospital, the different professional groups appear to be working together but are managed independently. Integrated services need to be encouraged and championed
Individual staff in my experience are very person focused however it does not appear to be part of the overall strategy of acute health delivery. Whilst in the hospital I could feel the pressure to get people through the system and discharged and the negative impact this had on the time spent by staff with individual patients, thus bizarrely promoting interdependence within the patient community rather than independence.
Key points from my experience:
- There is no doubt that high quality care and empathy is at the heart of staff motivation
- Senior staff visibility on the floor is key to maintaining morale levels across the workforce – this was lacking in my observations
- High expectations from patients with a finite number of staff to meet these demands can sometimes impact negatively on personalised care
- There is a real need for integration of services across the Community, Social Care and Hospital.
So, what can be done (if already not in place)
- Introduction of a peer to peer recognition system at ward level amongst all staff (e.g. Health Care assistant of the week) for going the extra mile.
- Continually ask patients about things they may find difficult to do and ensure this information is passed on between shifts (e.g. ability to cut one’s own food)
- Improve communication between senior (Board level) and operational staff, ensuring two way communication is maintained throughout
- Review current practice in relation to how integrated services can be further developed in partnership with the workforce and patient representatives
I decided early on within this experience that I would use my professional social media outlets to promote any good practice at the NHS Trust involved with my care. I didn’t know whether I would have much to promote but I’m pleased to say that I have had much to celebrate. Specifically, the dedicated, passionate and skilled colleagues working at James Cook Hospital.
I hadn’t expected to be in receipt of care at this stage in my life, however I can say that my professional experience has been greatly enhanced as a result. Thank you to the staff and patients who have made this possible.
The NHS clearly needs more resources, but so too does Social Care. If we are truly to see a unified and cohesive service for all who have health, care and support needs, we must act in a timely and fair way. I truly believe from my recent experiences that integrated and joined up services can make a positive difference and enhance the individual person’s experience at no extra cost to the system.
There are many people working within the health and social care system that strive every day to do a good job. Their positive attitude and dedication are clear to be seen. If we neglect the very people that keep the system working, we do so at our peril.