Saturday, 28 July 2018

Reflections on care: Blue badge blues 6

Blue badge blues 6

So I’ve been home for almost two weeks, phew. I’m gently easing off the burden of a long hospital stay but it’s taking time and energy. Gradually I’m building confidence in my mobility and my pain is reducing, although it’s not a linear process; particularly with a broken leg!  I have to be careful not to decline with a bad day and not to over do things on a good day. « It’s going to take time » is the mantra from all of the professionals who are supporting me. I find that phrase a serious challenge! There have been moments of hilarity too like when I couldn’t find the knickers i had taken off, then spotted them attached to the velcro on the moonboot! Not the look i was going for! 

 I’m setting myself goals as encouraged by the OT and physio and thats helping me recognise progress, however slow. The community team have been impressive so far with aids delivered quickly and I do have a sense of them working together to support me. They encourage mindfulness and positive psychology and evidenced based practice, to aid recovery and I’m genuinely enthused by their holistic  approach. Preparing to leave hospital I was anxious to ensure rehabilitation once I was home and that is working so far. I was also acutely aware that the focus of the OT and physiotherapy team in the ward was to get you home.  The impact of targets on discharge and waiting times are evident; even as a patient I was aware of and indeed felt some of that presssure. It’s complex because I also recognised that I needed to get home to improve my physical and emotional wellbeing. BUT I was very aware of my need to be in a safe environment.  The impact of falling was only too present for me, of course. The nursing and medical team were very supportive that I make a decision on whatever was right for me in the main but I remain concerned that targets on discharge from hospital do affect judgement and specifically challenge person centred care. It was right for me to be home but was enough done to ensure my safety initially? I’m not entirely convinced it was. But no pain relief could relax my body like the moment Koshka jumped on the bed beside me and started to purr. My best sleep ensued.
The turn over of beds during my stay in my ward was astounding. I was in hospital over a holiday period and yet never was a bed empty. The patients were all complex and in vulnerable situations; in my bay towards the end I was by far the healthiest! The ability of the nurses especially to shift focus between patients was really skilled and impressive, as was their compassion, whatever the situation. 
The ward itself was old and poorly designed so the working conditions were hardly supportive and the shifts worked were tough. Twelve and a half hour shifts with nurses moving from day shifts to nights and back within a week being fairly typical. The ward will move to new facilities soon thankfully but several times I thought of how hard it would be to work in that way as you got older. By the end of a shift the team of nurses were jaded no matter what their age. How will that be sustainable in the long term?
My experience was generally one of very capable teams, doing their best ( which was pretty good) under significant pressure. But alongside that sits the pressure on the system, of enough beds available, of safe staffing, of waiting times and that creates a huge tension which the teams were left holding. And we as patients in the system are holding it too. When you consider these same teams were caring for and surgically treating people with brain and spinal problems of a very serious nature, you have to question whether this is wise and it’s certainly not helpful or fair. 
I can only conclude we need more capacity and some give, in the services and organisational systems to take pressure of the teams and of course those requiring the service. We need kinder systems and by that I mean they are focussed on human impact and not just efficiency.
I’m so deeply grateful for the care I have had again and it’s helped me refresh my personal commitment to influence that quality service is the norm and sustainable into a transformed future. Also in order to achieve that, it’s vital that the service responds to learning from those with lived experience, we can really help.

So I’m slow, yes, but determined as always to make that difference in whatever way I’m able. 

2 comments:

  1. So good to hear of your progress Audrey. Wishing you a good recovery x

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    1. Thanks Marie! Holding in my frustration still but learning! X

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