• In March I had open heart surgery in Glenfield Hospital and stayed for over a week. In early September I had robotic surgery on cancers attached to my remaining kidney in Leicester’s General Hospital. Both were successful. I am profoundly grateful to all staff. Comparing the two gave me an insight into the difference between limited family visiting and no visitors at all.
No-one in the medical and caring professions chooses that career path it for money: it’s a calling, a little bit like becoming a vicar. The core reason is the word: ‘care’, and despite different disciplines, caring for patients is always the prime driver. The perfunctory explanation by the surgeon; the brief check on catheter output; the automatic, wrap-around of the blood pressure strap: each one involves an element of direct care for the patient. It is intense and pressured; there aren’t enough staff and there’s too much to do, even before the patients make it harder and slower.
In March my wife and daughter visited me in Glenfield Hospital in the days just before ‘lockdown’; In September I got a taxi to Leicester General, and walked alone to Ward 23 realising that I was not going to see anyone except nursing staff for several days.
In March I knew that the ‘no visitors’ rule was coming alongside lockdown, and my first thought from my hospital bed was that this was good. Nursing staff and doctors would be able to carry out their work without interruptions and wouldn’t have to give quite detailed explanations to outsiders who have limited knowledge. This was time they could dedicate to medicine.
In September I saw ‘no visitors’ in action, and it was a jolt of reality. Visitors take up chairs and ward-space; they demand nurses’ time; they need to be supervised, but what’s missing runs deeper and probably has a direct impact on the patient’s health and recovery.
Hospital wards are pretty soulless: there’s no offensive dust, no shoes tucked under the bed alongside the missing cat’s toy, no rumble of passing traffic through the open window, no deep sense of belonging. There shouldn’t be. Family and friends don’t bring these, but they bring the notion of them, the inconsequential gossip, the little parcels of clean pyjamas, gifts and cards, the descriptions of overgrown lawns and blooming flowers. These conversations may, when visitors are allowed, be meaningless on the face of it, but to a patient, an hour or so later, on reflection, they mean a lot.
Being told not to worry because someone else has put the bins out is all about the real care of home life; being administered a life-saving injection is also caring, but very different. Nursing staff at all levels are the most caring people in the world. For hours on end they are at the end of a wave, a subdued cry, or a loud bell and flashing red light, but it is enormously difficult to replicate family and friends when the patient is ‘theirs’ 24 hours a day, sometimes naked, both physically and mentally, often getting very personal treatment and procedures. Patients can be confused and upset, and it is often the elderly who are most alone and frightened, and confinement for any reason will have an adverse effect. Putting up the restraints each side of the bed to prevent falling out does look, and feel, like being caged, for example.
Doctors, staff nurses, healthcare assistants, specialists and tea-troller-pushers work as a team. The HCAs are more numerous. Day staff appear with the sun and leave with the moon. Towards the end of that shift, when they are tired and weary, dementia seems to kick in amongst the more elderly patients, and it is a fact that nursing dementia calls for specific, trained skills. The professionalism and care summoned up by young assistants left me wonderstruck. In the past, the faces these elderly patients recognised and trusted, played a big part in helping them calm down for a long and lonely night. Covid-19 has stopped that.
I believe visitors play a big role in patients’ getting better and leaving hospital sooner. That is shallow psychology, and I am no psychologist. And right now, Covid-19 means no visitors.
Is there a solution, a way of improving the situation? Not in terms of allowing visitors, but modern technology offers social media, photos and videos, as well as digital interaction. My suggestion looks more to helping the hard-working hospital staff who are at the sharp end of this personal deprivation.
Stop the horrendous shift system. Nursing staff are under intense pressure at every level and 12-hour shifts are bound to lead to mistakes.
They do in business, in travel, in factories. I wouldn’t put an innocuous chequebook in front of someone who’s worked half a whole day, or a spanner in front of a someone on a production line. It is nigh on criminal to ask tired, and sometimes quite emotional, nursing staff to carry out life and death duties for twelve hours, not even including handover.
Stop the gestures and pay NHS employees at all levels more. They save lives, they care, they return loved ones to their homes. How lovely it was to see people clapping, how impressive to see an old aeroplane flying overhead, but neither paid the bills. NHS staff deserve financial respect.
I’ve looked at life from both sides now, from family visits to nursing care. It’s obvious to me that those who make the rules don’t understand life at all.