Last week I attended a pre-op clinic in preparation for my revision hip replacement next month. It’s fair to say that much has changed in the 15 years since I last underwent major surgery. Although some of my experience is new because I now attend a different hospital with different procedures, I was startled by the lack of humanity in the system.
At the pre-op clinic I was shunted about from one healthcare professional to another, clipboard awkwardly in hand with crutches, for them to tick off my list that they’d seen me – though it was phrased that I’d seen them, I wasn’t so sure. At one stage a nurse asked another, ‘Do you have Susanne? Can I have her next?’. I jokingly asked if I got a say…
I’d like to say that this system allowed for person-centred care but it felt like a highly effective system at the expense of individualism. Of the three or four health professionals I spoke to that day (not including my consultant, who has always been wonderfully person-centred in his approach to my care), only one treated me as an individual and took the time to find out what the situation is for me. She suddenly found that I am not a straightforward box to tick off and spent considerably longer with me than she expected. So, yes, I can see person-centred care is costly in terms of up-front resources but the potential is that by taking the time to find out about my individual needs, she will make my post-op recovery faster and easier. She also said it would help the nurses to have as much information as possible because they don’t meet the patient until they’re fresh on the ward from the recovery room.
At this hospital, like others, I will arrive on the morning of the operation, having followed hygiene protocols with body wash and nose cream, to ‘check-in’ my luggage and then join a waiting area. I will meet my luggage at my designated ward – to be determined during the op. While this sounds as though I am jetting off on an all-inclusive holiday I fear the ‘jet-lag’ may be worse and the culture shock considerable.
I am accustomed to being admitted to a ward the afternoon before surgery, meeting nurses, settling in and getting a feel for how things work. While many people may prefer the additional night at home, I think there is a lot to be said for this time to acclimatise – for the patient, their support network and for the nurses to get to know you; especially if you happen to be a slightly unusually shaped box, for example.
Of course, I fully understand and can see the efficiency of this system – I don’t doubt that it is saving money and has met many efficiency targets. However, when research shows that good communication and positive relationships with healthcare professionals and care givers aids our healing process it is hard to believe that this is the best approach. Additionally, research shows that being treated as individuals with our own identities (rather than ‘bed 3, revision hip’) lowers pain levels and heart rates, requiring less pain relief medication and leading to a speedier recovery.
Having had a lifetime of attending hospital appointments and undergoing surgery, I have just experienced the longest period in my life of not having open surgery. Previously I have been nonchalant about hospitalisations and I suspect my concerns about the forthcoming operation are influencing my feelings about these system changes. Perhaps the real issue is that I need the reassurance of familiar protocols? Oh Brave new world…
My Chronic Pain 