“Abuse of the body” barked the Orthopaedic Consultant at me and my mum. I was a quiet, shy, under-confident 11 year old boy, who had just got into the Under 12 Scotland Gymnastics team, when I noticed a lump on the left-hand side of my left knee. A cyst on my cartilage, apparently all due to me “abusing my body” as a gymnast. I needed an operation I was told and would have to stop doing gymnastics; otherwise “the same might happen to the right knee”. I can remember my mum driving me back to primary school that day, me crying with fear in the back of the car.
Although there was a Paediatric ward in that DGH in Glasgow, the Orthopaedic Consultant told my mum that I was to be admitted to the Orthopaedic ward where “they know what they’re doing”.
Several weeks later, wide-eyed and terrified (both me and my parents) I was admitted to the Nightingale Orthopaedic ward, which was full of elderly patients, every one of them lying in bed. I was clearly the youngest in the ward by far! An officious Nurse showed me my bed (on the left in the middle of the ward) and started asking me questions about my past medical history. My mum and dad wanted to speak to the Orthopaedic Consultant, just to clarify what was going to happen the following day in theatre. They also wanted to know who would be doing the operation. But he wasn’t available the Nurse said and anyway visiting time was over and my parents had to leave. And there I was, with only books and comics and no mum and dad, until the next day. My parents never did get to speak to the Consultant before I went to theatre.
The next day, all that I can remember is vomiting after I was given some intravenous sedation before I went to theatre and then waking up in recovery, vomiting again. My parents were not allowed anywhere near me. I had excruciating pain in my left knee. My next memory is waking up with a bandage wrapped around my left knee and coming round, just as my parents walked in (at visiting time of course). No-one spoke to my parents before they entered the ward, so when my mum approached my bed and saw a tube sticking out my left knee, with blood draining into a bottle lying on the floor, she promptly fainted. When evening visiting time was over, my parents were ushered out the ward. My last memory of that day, was watching my ashen-faced parents walk down the ward to go home, pulling the sheets over my head and crying myself to sleep. Lonely, scared and in pain.
The next day I was still in pain, but that didn’t coincide with the “drug round”, so I had to wait. Never mind, my younger brother (6 years old) and sister (9 years old) were coming to visit me that afternoon –they’d soon cheer me up! But no, they were “too young to come into the ward”, so they had to sit outside and wait. During visiting my parents reported to the Nurses that I had developed a temperature. The Nurses asked my parents if they “wouldn’t mind opening the window behind his bed to cool him down.”
Eventually my parents did get to meet the Consultant who explained that there had been a “bit of a problem”. He had been called away to an emergency and his Junior had performed the operation. He had “nicked an artery and a nerve”, but “don’t worry, everything will be fine”. And on that note, he had to leave, as he had an important meeting to attend.
Okay, so I can hear you say – “it was just a cyst on the cartilage – nothing serious”, and “it was nearly 35 years ago and things have changed since then”. But have things really improved since then? Do you communicate appropriately and effectively with your patients? Do you actively listen to them? Does your ward have open visiting hours? What are your patients lying in bed at night worrying about?
And here’s the challenge. What can you do to make your service truly person-centred?
Dr Ewan Bell is a Consultant Clinical Biochemist and is Clinical Director for Diagnostics at NHS D&G
Next Weeks blog will be by the Patient Safety Team who will be giving us some highlights from the International Forum on Quality and Safety in Healthcare 2013