Special Report, Day one: NHS organisation is at the top of the political agenda. But what about the vital basics that more and more patients say are being neglected?
Just over a year ago, at the RSA, I gave a talk. When I got to the lectern and took a sip of water, I could see that my hand was shaking. I’m usually a bit nervous when I give a talk, but I’m not usually so nervous that I can hardly swallow. I was nervous because the talk was supposed to sound spontaneous enough to work as a live event, but polished enough to work on the radio. But most of all, I was nervous because of what I was about to say.
I had, I told the audience, recently had an operation. It was, I said, my sixth in the past eight years. The surgeon, I said, was lovely, and so was the anaesthetist, and so were the nurses. But I was surprised that the nurses were lovely, because what I’d learnt, during my six stays in hospital, was that surgeons were often lovely and so were anaesthetists, but nurses often weren’t kind. The first operation, I told them, was on the day we bombed Iraq. I had just been told I had cancer and was still in shock. I was worried, I said, about losing a chunk of my breast, worried that I might get lymphedema from losing my lymph nodes and worried that the cancer might have spread. But I wasn’t, I said, worried about the nursing. It had never occurred to me, I said, that the thing you should worry about when you went into hospital was the nursing.
And then I told them about how, when I woke up from the operation, and was still in pain and still had tubes going in and out of me, I was told by a nurse that I had to get my own breakfast. I could, I said, work out how to clip the drips and drains on to a kind of trolley thing and use it to propel myself to the room with the table and the toast. But I couldn’t work out how, when you’d just lost the lymph nodes under one arm and had drips going into the other one, you were meant to pick up and pour a giant tea pot. And that, I explained, was when I realised that nobody seemed to care whether I got a cup of tea or not.
It was useful, I explained, to learn that the nurses didn’t seem to think things like food and drink had anything to do with them. And to learn that it wasn’t a good idea to press your buzzer. It meant that when I had the next two operations, I knew the important thing was to keep quiet and not to make a fuss.
When I told the audience about the fourth operation, which I had two years ago, I thought my voice was going to crack. It made my heart beat faster to think about it then, and it still makes my heart beat faster now. I was worried about losing a breast and worried that the chunk of flesh and blood vessels from my stomach that were going to replace it might, as the surgeon had warned me, go black and die. I was worried about having an eight-hour operation and worried that my cancer had come back. But I wasn’t worried about the nursing. I had switched to this hospital because I’d been told that everything that happened in it was good.
It took just a few hours for me to realise that it wasn’t. It took the nurse, in fact, who told me, when I finally pressed my buzzer after waiting two-and-a-half hours for someone to check the blood vessels I’d been told had to be checked every 15 minutes, that she was “busy”. And who, when she finally came back to me, an hour later, didn’t seem to notice I was lying in a pool of blood.
And who asked me, when I winced, what was wrong with my stomach. Who didn’t, in fact, even know what operation I’d had.
In that elegant room, in that Robert Adam house, I tried to explain what it feels like to be lying in a hospital bed in so much pain you can’t even reach out for water, and feel that if you press your buzzer, you’re going to make someone cross. I tried to explain what it feels like to hear the groans of people around you whose calls for help aren’t being answered. And what it feels like to hear nurses who aren’t even trying to whisper complaining about the other patients, and you. I had, I said, and was embarrassed to say this in front of an audience, and embarrassed to talk about losing a breast, never felt so abandoned, or alone. And I said that I thought it was time for nurses to start recognising that they have a choice about whether to do their job badly, or well.
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