Wednesday, 28 September 2011

or, My Experiences With the NHS

Just a picture to illustrate the blue uniforms nurses wear
An iconic nurse's watch.They also wear black stockings if wearing a skirt 
As of September 20, 2011 I have finally been released from Nursing care for my leg. It is officially "healed". Because of that, I thought it was time for me to write a homage to all the wonderful and dedicated women (and a couple of men) who took such good care of me during the over two year period it took. For those who haven't heard, or read my post at that time--or to just refresh all our memories, here is what I wrote after my accident: 

     "(Written June 11th by hand, retyped by Robbie) Tuesday afternoon around 4:30 I took another tumble off the stairs out of our back door. Those of you I wrote to will remember how I slipped the first Winter I was here, but then I could at least blame it on the ice. this time I have no excuse other than the door sill or my own feet. I really don't know or can't remember what actually happened. One minute I was opening the back door with the laundry basket to take it out to the garage, I took as step and the next thing I remember was being on the ground. 
View down the steps. The ledge where I hit my face is on the left.

Robbie was in the living room and came out quickly but we had a very hard time getting me on my feet. I could definitely tell that my left hand was broken because it was at a funny angle and my left leg was hurt. At the time it seemed almost impossible to get me up but we finally managed and went straight to the car. We drove to St. John's, the nearest hospital, which is in Livingston. It seemed to take forever; it is a half hour to forty-five minute drive depending on the traffic (it seemed more like the second because of all the traffic). During the trip my leg began to pain me more and I started seeing stars. I had a huge bruise on my leg that was beginning to swell and I must have hit the left side of my face on the edge of the terrace because I tasted blood in my mouth and I had a huge gash inside my cheek and a large bruise outside. I felt around in my mouth for my teeth and they seemed fine, none loose, which was a relief. So Robbie drove to St. John's A&E (not the TV channel it's what they call the ER!), and I began to have excruciating pain in my leg because it was so swollen, and my wrist was fractured. I had to spend Tuesday night and Wednesday in the hospital. On Wednesday they had to realign my wrist by anesthetizing my arm and manipulating the bones back in place. It was just like the scene in Harry Potter "Chamber of Secrets" were he loses all the bones in his arm! I'll have to tell you more later about the nice Irish doctors and the lovely nurses and the laughing gas... At the same time the plastic surgeon was working on my leg and I ended up losing a little too much blood. Because of that, I had to spend Wednesday night in the hospital on bed rest. I wasn't even allowed to walk to the bathroom. I was kept in the observation ward with three other women in the room which did not make me comfortable but could have been worse. 
(written 16th June)
They finally let me come home Thursday evening and I've had nurses in every day to change the dressing on my leg. I'm still in quite a bit of pain and poor Robert has to help me do the most basic things - fetch and carry for me - since I am supposed to keep my leg elevated and they don't want me walking much. My left wrist is in a cast and my bruises are healing, but I'm having trouble sleeping because I have to stay on my back. I will recover but it looks like it will be a long drawn out process and may be harder on Robbie than on me. Pray for us please and I will try to keep you updated, that is if my "secretary" will cooperate."
First home from the hospital
Better view of the bruises on my face and my wrist in a cast

A good view of my foot! But you can see the bandages a bit.
As you see, this all happened in June of 2009 and here it is September 2011 so it took me over 2 years to get to this point. The bruises and my broken wrist healed in a timely manner as expected but this wound on my leg is what has taken so long to heal. One of the problems has been that in some ways the treatment itself has caused other troubles; having my leg constantly bandaged and covered for such a long time caused some of the skin to break down and we had to start healing whole different parts. The original wound covered the front of my shin but after time the skin of my entire leg was raw. The whole thing was also extremely painful a lot of the time. I once told Robbie the only way I could describe it was this: imagine setting your leg on fire and then while it was burning, stabbing it over and over with a knife. Yes, it really was that bad.

But enough of that! I'm better now and through it all I had the support and care of some really sweet and wonderful nurses. At home the District Nurses came every day for a while, no matter the weather, to bandage me. Mostly for a long time I had them visiting me every Monday and Thursday.

Let me now say that whatever you've heard or think of socialized or nationalized medicine is true. It is creakingly inefficient, slow to embrace innovation, bureaucratic, unfair and most facilities are old fashioned, shabby or appallingly bad. Just keep in mind the saying, "You get what you pay for", and even though it is subsidized by taxation the outcome can be shocking. A few articles in the national papers just recently have told about a "health-care lottery" where patients in certain areas are given cancer treatment above others and one story told about how a hospital will have to stop serving hot food because there is fear of infection in oven gloves! Speaking of food, I've heard that most hospitals are given the equivalent of $5 per patient per day for food. Most hospitals in Scotland don't even have kitchens, the hospital I was in, St. John's being the exception!
St. John's Hospital, Livingston. Looking much nicer in this picture than in person!

That all being said, and the fact that, with the budget crises worldwide, nurses and nursing positions are being cut putting much more strain on the current nurses. I can't think of anything worse to cut.  Yet another newspaper article this week told about patient's families being asked to feed and bathe patients because the nurses don't have the time to see to all patient's needs. Another fact that I found shocking was that here nurses are expected to work 12 1/2 hour shifts and in hospitals they have to work both night and day shifts sometimes during the same week. I've worked night shifts and it takes time for your body to adjust and to get your sleeping patterns changed. I can't imagine getting settled into a routine and then having to change it all within a week! 

Well, before I get off into a social and political rant, I need to bring this back to my personal experiences. Because no matter what you think about it all, behind the bureaucracy and administration and all the system failures, there are REAL, hard-working people who love their jobs and truly try their best to serve and heal and care for every patient. As I have always known, nursing is a calling and you don't go into it for the money or the prestige or the holidays! I have, unfortunately, been in hospitals and have had care on both sides of the Atlantic. For the hospital environment, facilities, doctors and equipment I would rather be in a hospital in the US. After all, here they still have wards and when I was in the hospital for 2 weeks here I was in a room with 4-5 other women. In the US I had a lovely room at Chesapeake General comfortably decorated all to myself. 
Chesapeake General Hospital. 
Flowers aside, which one would you like to stay at if necessary?

Still, when it comes to my personal level of care from the staff--and this is no condemnation of the nurses who cared for me in the US--I would say that the nurses who work here in the UK are far, far, far better!

Long ago, when I went, VERY briefly (3 months) to nursing school, we were taught to be detached, professional and not to get "involved" or emotional with the patient. Well, they must not teach that sort of thing in the nursing courses here because it just seems to be more relaxed and friendly. In the hospital the nurses would call you "sweetheart" or "dearie" and treat you more like a family member. I found it very comforting, in fact I once had a discussion with one of the new nurses who said she thought she'd never be the "gushy" type but found herself doing it anyway when she got on the ward. I assured her from a patient's perspective it was much nicer to be treated by a person who was cheery and kind than just cold and business-like. 

That's not to say that they didn't do their jobs in a professional manner. There was one Head Nurse in the hospital that I thought of as "Matron". I don't think they use those titles any more but she was everything you'd expect from that name: very no-nonsense, eagle-eyed and yet she always dispensed either the pills or tea with a smile and sometimes even a joke. She was the kind who made you want to get better just so you wouldn't disappoint her!

My District Nurses were the same. There's not a one of them I didn't welcome into the house and enjoy spending the time with. I had many nurses but there were three "regulars" that I saw most often: Alison (the head nurse), Caroline and Anne. As I said, they came every day and then twice a week in all weathers and if you remember how awful it was last winter--in fact the last 2 winters--and since we live on the top of a hill which ended up snowy and icy that was really going "above and beyond". 

If you look at the fence to the left you can see how high the snow got piled
I'll never forget last winter poor Caroline having to try to get through snow piled up almost to her waist to get to our front door. When our neighbors and the council plow came and cleared off the court it all got shoved to the front of our house. Robbie had cleared out a path from the back door to the car so he could get out to work but he had left the front. I wasn't able to catch Caroline in time and there she was trudging in all that snow. At least I was able to let her out the back when she was done. See what I mean though? That's dedication and it happened over and over during the winter. One of the  nurses told me stories about having to leave her car and walk quite a ways in the dark in Longridge (next village over) on Christmas Eve to get medicine to a dying cancer patient. For her it was matter of fact, like having a sandwich for lunch--all part of the day. I found a BBC news story from last winter that illustrates this. It's in England but the same thing happened here as well:

I guess when you are around people often you can't help but get to know them better and in two years I had a good opportunity to talk and hear about some of these ladies' lives. Most of them have sons so we spent lots of time talking about raising boys and they shared stories about their holidays to, I think, exotic places like Turkey, the Canary Islands, Spain and Mexico. Caroline was the one whose husband surprised her with a trip to Mexico for their anniversary but she had never flown over the Atlantic and she was afraid of flying. I had to talk her through international flights and reassure her it wasn't bad at all. Last Thanksgiving Alison and Ruth, the specialist nurse who did my Doppler test on my circulation, came by when I had an impromptu buffet (see previous blog post). Robbie's cousin Robert Owen took our picture but I've never posted it on the internet before because I thought it might be an invasion of their privacy but I have permission to show them now:

Ruth on the left and Alison on the right

I told Alison I didn't want to get her into trouble because they were really there to look at and check my leg and re-bandage it--which they did. She just said that she would say it was part of the carer routine of learning about and participating in patient's cultural traditions! Plus this was the first time they'd ever had pumpkin pie and Alison thought it was really good. 

So, I can't say how grateful I have been for their company and their care. I know that there are lines that shouldn't be crossed and I can't really claim them as my friends but they really made an impact in my life not the least of which, helped me to heal after my accident. They were good company and I have to say, I will miss them. Thank you all! 

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