Some views from NHS bed 5
I have been ill. (You can read about that here. Warning, it involves the word âcancerâ. It also involves the word âtoiletâ).
Iâve been in the hands of the NHS again. It is hard to describe just how amazing the NHS is as an institution, despite its faults (more on those later). I honestly believe it is the best idea this country ever had.
During my unexpected stay, to stave off boredom, tiredness or fear - and sometimes all three - I jotted notes in my phone while laying in one of those beds that moves in directions you never knew existed. These jottings - âTricks of the tradeâ they would probably call them before âreal life hacksâ became a saying - are just my views.
Actually, these days it might be âThese 29 things about the NHS will blow your mind.â
They wonât but here it is. My unofficial guide to being an NHS patient, visitor or even member of staff. With a little bit of politics.
After more than three days in hospital, you will start hoarding vaguely useful things - as if you are a prisoner of war. Salt and pepper sachets, clean plastic spoons, medical tape, that sort of thing. Itâs not like you really need them. It just feels like you should. Itâs as if, on an unspecified occasion, you and your ward colleagues will need to pool resources to mount an escape bid.
At some point, you will inadvertently sit on this âcall nurseâ button. (Or, if you are a seasoned professional, you will pull it out of the wall while trying to scratch your backside). As the nurse arrives, you will smile warmly, thinking that he/she has arrived to give you some comfort or solace. The smile will freeze on your face as you realise that the ward-wide âboopingâ noise is your fault and you had no idea. No amount of apology will suffice.
Without fail, if you are being wheeled to a scan, an X-ray or a blood test, you will come face to face with another patient who is going in the opposite direction to you. You will immediately conduct an internal mental audit. âDo I look as ill as them? Christ, I hope I donât look as ill as them.â The beauty of this process is that they will be thinking the exact same thing. The answer, of course, is you both look as ill as each other.
It is a universal truth that the patient with the most sophisticated sleep mask and the most serious-looking earplugs will be the loudest snorer you have ever met. As you watch them recline at night, all dignified, looking like Hugh Hefner in an oxygen tank, the deafening sound of a log being sawn lengthways will puncture the entire room and never go away.
A doctor is called Doctor. A surgeon is called Mr or Mrs. At some point, you will get that wrong. You will call the surgeon âDoctorâ. You will call a the doctor âMisterâ. And then you will freeze. Like youâve let a bad smell in to the air. Worse than that, you will then confuse the two, bidding farewell by saying âThanks very much Dister ⊠er ⊠Moctor.â
Nowhere in the western world is the word âpopâ used more than in the National Health Service. âJust pop your clothes off.â - âWeâll just pop a needle in here.â -Â âPop yourself up on to the table.â -Â âSo, weâre going to pop one of your organs out.â - âIâm just going to pop my finger up there.â I donât trust the word âpopâ any more.
Vomit bowls still make funny hats. Even now. Doesnât matter how many times you put one on your head (with mock âhorrorâ that it is a full bowl) it is still a winner. Thatâs a medical fact.
If you are encouraged, as I was, to âget up and aboutâ after an operation to build up strength, take the doctors at their word. Have a wander round the hospital, in your standard issue pyjamas, with a drip in your arm and a tube emerging out of somewhere unknown. Dressed like that, you become like a piece of fresh roadkill. Nobody looks directly at you, but everyone knows you are there. Itâs a magnificent way of observing British manners. One person will do a slight, sudden swerve out of your way, another will give you a benevolent but nervous smile as they hold a door open. You can also see people playing the âwhatâs wrong with him?â game, that we all love to play. Dressed like that, I queued in the hospital canteen for a coffee among all the suited and booted admin workers. I have never felt more like a salmon swimming upstream - and loved it.
Happiness is a working cannula. Believe me on this. This (above) is a cannula. Itâs a way of getting medicine into you quickly, if needed. But cannulas often hurt. And they fall out. And they fail. Recently, I had four cannulas put into me on a single day. Only the last one worked. If you get a working cannula, you protect it like itâs your first-born baby. You growl at anybody who comes within three feet of it. You are prepared to fight as-yet unborn assassins who might threaten your beautiful, brilliant cannula.
A hospital is like a big village. Get to know who has the information. My tip? The porters. Get to know the porters. They are like the cabbies of the joint. They know the back routes and the best times. Like lighting riggers on film sets, they have the best humour, the best gossip and they deliver it all with a grin and a grimace as they wheel you between scans and X-rays. The porters are the ravens at the Tower of London - without them, the place would crumble. Porters are the best.
If I designed a hospital, the place where they do endoscopies would be located down a long, narrow corridor that gets darker and darker before you arrive at a well-lit room. Just to make me laugh. Also, the maternity unit would be a cavernous, warm room - then as each happy, exhausted new mother emerges, they would be wheeled through a door that is slightly too small for them.
When giving you certain drugs (the more powerful ones) there has to be two nurses present. They check your name and your date of birth. If you are there long enough, you get to know your NHS number off by heart. I found myself reciting mine - in the manner of a captured soldier giving his name, rank and number. In the end, different nurses would come over just to hear me say it - to humour me.
Your attention span is very limited in hospital. People will bring you books, word-searches - all sorts of magazines. The truth is, you last about fifteen minutes with any of them. Before you either drift off or a nurse wants to conduct some sort of painful procedure on you. Get used to âcapsule attention spanâ. Itâs kind of comforting not to think too hard. (Sorry, Duolingo).
If you have a catheter fitted - Iâm talking to men here - when they take it out, it is like the scene when Oliver Twist pulls all those knotted handkerchiefs out of Faginâs pocket. It goes on much longer than you expect. And you donât catch your breath for quite a few minutes.
Likewise, if you have a nasogastric aspiration (a tube into your stomach through your nose) - they will remove it at some point. When they do, just imagine itâs the longest ever nasal hair and they are going to pluck it. Then think about how many tears you will have in your eyes. You will be wrong. Double that.
It is 2016 and medical professionals can transplant pretty much every organ in the body. But still the NHS insists on dressing you in smocks that fasten at the back and leave your arse swinging in the wind. My theory is that it is the longest in-joke in history. I propose a competition - design a hospital gown that doesnât involve an inadvertent full moon every time you move. Get Vivienne Westwood on it. Iâm talking phone votes and Saturday night television. Call me.
Being a colorectal patient has some upsides. Itâs probably the only place (outside of a late night Channel 5 documentary) where you can be told âThereâs a good boyâ by a woman half your age because you have opened your bowels. And the best thing is you actually feel proud, too.
When you become an in-patient, this table (above) is your only domain. It distills all your belongings down to what you can fit on here. And what you can reach with one hand. (Your other arm is nearly always attached to a drip). Learn how to work one-handed. Learn how to order your possessions in order of need. And make sure you donât knock anything off that table - or you wonât get it back for at least two hours when the next nurse is passing.
On that front - those grabby sticks that people use to pick up litter? They should be general issue on the NHS. Grabby sticks for all. And - hereâs another morale boosting idea - each ward should employ one person who has a single job. It is to walk between each bed and ask every patient âhave you dropped anythingâ or âdo you need me to reach something from your cupboardâ? A low cost job, with the opportunity to make every single person smile on an hourly basis. These people would qualify for OBEs every year.
You never truly go to sleep in an NHS ward. You know that feeling when you are falling asleep then you âstep off a kerbâ? Thatâs what you do - about one hundred times a night - at nights in a ward. But I tell you something - that descent towards the kerb can be a beautiful, serene second or two. Learn to savour it. Then settle in for the next one.
The last hot drink of the night is ridiculously important. A quick tip. If you ask for coffee instead of tea you are scientifically 50 per cent more likely to be given an unexpected biscuit to go with it. Itâs like a morsel from the heavens. As a quick aside - the first meal you are likely to have after a big operation is jelly and ice cream (above). There is not a meal I have savoured more than this. It is the meal of victory.Â
Visitors. The odd part about being ill enough to go into hospital is that people will come to see you. If you were feeling a bit sick or had a cold at home, youâd go to your bed and wait until you felt better. You wouldnât invite people to come and sit at the end of your bed and look at you with your hair sticking up, dribble on your t-shirt and a strange ache in your bones. You wouldnât say âI feel terrible. I know - letâs get my friends round here to gawp at me.â But thatâs what happens in hospital. They want to show you they care. They want to see you for themselves. I understand that.
If you are a visitor - the best piece of advice I can give (and heard myself) is that if the patient asks for something, it will be a specific thing. One flavour of yoghurt, one piece of clothing, one specific book or magazine. Bring that. Donât bring others. Donât bring things like it. Donât forget that little table they have. They want the thing they asked for. In their tabletop domain, it has to fight for its place. A friend told of how she burst into tears when the wrong pyjamas were brought in. Itâs that important. Other than that - come along. Smile, listen and be ready for your loved one to fall asleep mid sentence. Itâs a sign of happiness.
A proud moment for me. I was at my physical and mental lowest point. It happened to accidentally coincide with the junior doctorsâ strike. My mother and @gibbzer were on their way in to visit me after I had sent them some rather scared texts. As they drove up to the hospital, they stopped, hooted and waved at the striking staff. Those guys would be making me much better only hours later - but they got the support they deserved from my loved ones and it made me swell.
Your priorities change when in hospital. While global events raged on, while celebrity news bashed around the news channels, the biggest source of conversation in my small corner of the world was the colour, consistency and regularity of everyoneâs lavatory attempts. Get used to it - this is the gossip that counts between nurses and patients. Itâs more talked about than BeyoncĂ©, of higher importance than EU votes. Itâs the stuff that matters.
People read newspapers in hospital. From cover to cover. As a newspaper man, I found this enormously comforting. When I was able to get out of my bed and down to the shop, I would voluntarily do the newspaper run. I bought the Sun, the Mail and the Express. Never my own newspaper - but it cheered me to be delivering newsprint to readers. One of the last happy bastions for those inky-fingered dinosaurs like me.
There are moments you will always remember. Danny Willett won the Masters golf this year. I was watching the late-night drama on a scratchy internet connection, sat in near-darkness on the end of my bed - with a nurse redressing the painful wounds on my stomach and chest. The nurse knew nothing about golf but, as the drama unfolded â and the unfancied Brit won one of the sportâs biggest prizes â Â I laughed in between winces. The nurse pulled the sticky plasters from my guts, ignored my whimpers of pain and said with beautiful understatement âHeâs going to be able to afford a better haircut nowâ before turning my bedside light off and tucking me in.
A little bit of politics. There is a strange disconnect when you are seriously ill in hospital. You could be frightened, you could be on strong drugs, you could be sleep-deprived, you are highly likely to be in pain. Many patients I saw also have mental health issues. When the doctors come round most mornings to update you on your progress, or lack of it - you are probably at the least receptive to detail you will ever be. You will hear bits. You will remember chunks, but not all. I believe there is a massive space for patients to be given a âcheat sheetâ of their daily condition. That way, when visitors come to see how you are - they can read it. They can digest it. And they are not left feeling they are not being told whatâs happening. I believe itâs part of the communication that the cuts and âreorganisationâ has left by the wayside.
(Addendum: Iâve since been informed that NHS Lanarkshire do this. Bravo. More please. http://www.dailyrecord.co.uk/news/local-news/nhs-lanarkshire-pioneer-method-keep-7783427#Sqo6Ad9eh9ePlXEx.97)
The NHS is not just the doctors and nurses. The amount of ongoing care, effort and commitment that goes into getting patients home, safe and cared for is so impressive, inspiring and daunting. During my stay, I was seen by dieticians, physiotherapists, specialised nurses and pharmacists. I saw other patients being sorted by social workers, mental health professionals, Meals on Wheels - the lot. Never think of the NHS as just the medical blood and guts merchants.
I also believe it is being unfairly degraded, run down and picked apart. From my (now pretty extensive) experience, I believe the staff still work as hard, they are still as committed and compassionate as ever. But their job is being made harder to do, the systems hinder them and - as a result, good communication that is so critical to good care is often left behind. We must reverse that.
I honestly think the NHS should change its slogan. They should change it on all stationery, all discharge notes, all medicines dispensed. Put in on mugs and t-shirts. Even on medical uniforms. When you are at your most grateful. When you have been saved, patched up and sent on your way, When your husband is delivered back home in one piece, when your frail daughter finally gets out of bed for the first time in weeks, you should read these words. They should be everywhere:
âTHIS IS THE NHS. WE DO THIS EVERY DAYâ