On Monday, on Channel 4's Dispatches, Mark Sparrow brought proof of the sad state of much hospital catering to our television screens, after photographing and blogging about what passed for nourishment during his 10-week stay. Last night, Heston Blumenthal became the latest celebrity chef to offer a recipe for NHS food. But I really wonder whether you need to go that far.No, clearly, you don’t.
No high-profile gimmick using the latest popular chef (first, Loyd Grossman, then Jamie, now Heston – god, you can chart a chef’s celebrity career by this can’t you?) can possibly work, so why try it?
Sparrow found some obvious solutions: hospitals that cut out the money-making intermediaries, use their own kitchens and serve up the same decent food to patients and staff. He also showed experiments with tasty pureed food – so why not also soups and smoothies in spill-proof cups or finger-food, such as you find at party season in any supermarket? In many places, even much-maligned airline-style food would be an improvement.So why not bring them in, instead of the celebrities?
I mean, your plans are to do more than get a splash of publicity to make everyone think things have improved, surely?
In passing, Sparrow also divulged a dirty little secret of NHS hospitals: if you kick up enough of a fuss, you may get something better. Or, of course, as many patients fear, you may get victimised and determinedly neglected from then on. The gamble's yours.And this is why a lot of people don’t complain. Why is this not a bigger scandal than the state of the catering?
Which brings me to compassion – or lack of it, as exposed in the health service Ombudsman's recent report. I, too, have observed that compassion can run short. But if nurses can't do compassion (not everyone can) surely they could manage efficiency and competence? Shudder if you enter a ward advertising "team nursing". In my experience, this is a euphemism for no one in charge and everyone doing their own thing as and when they choose.Spot on. Because if it’s not something you may be held personally responsible for, why should you worry?
Relying on a sense of personal responsibility and everyone treating everyone else as adults is all very well, but unfortunately not everyone deserves that trust – including nurses, or rather the multiple specialists who now staff hospital wards.So can we finally lay to rest the image of nurses as ‘angels’ and start treating them as we would any other worker?
Someone needs to be in charge: to make sure everyone on the rota has turned up, that nurses' conversation doesn't keep patients awake at night, that monitors and drips etc are checked like clockwork, and that vanishing into side-rooms for a chat or an extended break is noted.And not just ‘noted’. Dealt with.
This unfashionable concept is called supervision, and it is achieved not by managers in offices, not by wandering matrons conducting spot checks, but through a hierarchy of responsibility on the actual ward. How, in other words, it used to be done.Indeed.
Anecdote-
ReplyDeleteMy mother's last cancer operation, for a huge colon tumour. I arrived with her first thing. We went to the desk in the ward and the nurse took us to a particular bed and sat my mum in a chair. We sat chatting. After an hour or so, nothing had happened. I went back to the nurse's station and ask if she was going to be attended to. They told us to go back to her alotted bed. Somebody would be with us.
Much more time passed. I went back to the nurses' station with my mother, a little irate, and said, "it looks like nobody gives a damn here. Aren't you supposed to be doing something with a patient who has arrived?"
Begrdgingly, a nurse came over and appeared to be, er, "booking her in". So, my mistake, I thought things were underway and left.
My sister arrived early evening, and found my mother, still dressed, still sitting in the same chair. My sister hit the roof. After repeated fob-offs, she said, "right mum, let's collect your stuff. We're going home."
This seemed to make the nurses realise that there might be trouble and they, er, sprang into action. It turned out my mother's notes had been lost. They had no idea who she was, or why she was there. My mother and sister explained she was in for major bowel surgery.
A young doctor (circa 15 years old) was found. My sister heard him ordering picolax(sp?) which the colorectal surgeon had specifically ruled out as it may clog the bowel. Luckily my sister was able to tell them this. My mother spent the night ebfore her operation having the enemas she was supposed to have had during the day she was just sitting there.
The astonishing thing is, the nurses knew the notes had been lost. They knew thus there was a big problem. They did nothing about it, as if ignoring the patient would simply make her disappear.
This is how people behave in a job where there is nobody who actually cares, like about evil "profits" and so on.
Don't worry, it'll all be better soon as all nurses will have to have "degrees".
ReplyDeleteThe last time time I was in hospital it was a young healthcare assistant who provided what I would call care.
From my experience, and your mileage may vary, I could only assume the nurses were tethered to the nursing station by some invisible force.
"This is how people behave in a job where there is nobody who actually cares..."
ReplyDeleteThat's pretty similar to a lot of my experiences with my late father's hospitalisations. I can honestly say he'd have got better treatment at my local vets.
And just imagine what it's like for people who don't like to 'make a fuss'. Or have nobody to do it for them.
"From my experience, and your mileage may vary..."
Not as much as you might think!