Whatever happened to patient-centred care? The NHS has gone to great lengths to inform the world that it provides patient-centred care. In other words they don’t do anything without the knowledge or permission of the patient. Yet my experience was altogether different. My concerns were completely ignored.
Healthcare Professionals and Patient-Centred Care
A handful of healthcare professionals reported me to my family when they didn’t get their own way. What on earth did they expect my family to do other than to intimidate or threaten me? They had a nasty way of getting their own way. It strongly suggested a need to control me rather than to provide care. Fortunately, my family left well alone.
I noticed the lack of care by the following people:
The Stroke Team
The stroke consultant at the first hospital should have gone out of her way to listen to me before deciding on the type of stroke I was having. She, however, did not consider me important enough. She, and her team, decided on the stroke and the treatment without considering that their basic assumption was wrong. How could I get better if I was having a stroke-in-progression? They were always in a hurry and they did not provide patient-centred care! They decided on the type of stroke I was having and planned the treatment without any input from me.
Nursing Staff Given a Bad Name
The nursing staff were actually alright apart from one who would report me to my family if she didn’t get her own way. She happened to be in the second hospital where I spent a further 6 weeks before I was discharged home. Here I had to learn how to go to the toilet, and therefore the bathroom, on my own. The physiotherapist made sure that I could do this before informing the nursing staff so that they could leave me alone to go to the toilet and to wash.
Nurse Vetoes Decision
One particular nurse vetoed this decision, not to the therapist but to me. She said that rules and regulations for nurses (as learnt at university) meant that she had to escort all patients to the bathroom. This meant that she had to wake me up to find out if I needed the toilet. In the end I had to agree to let her wake me up. I had no choice. An hour later her healthcare assistant (HCA) would also come to wake me up. When I complained to the nurse she said that the HCA also had to abide by the rules and regulations laid down by her university. I was adamant that I could go to the toilet on my own so she reported me to my family.
I don’t think that this nurse, a senior sister, had ever heard of patient-centred care.
Staff afraid of each other
There was an obvious conflict between the physiotherapists and the senior sister and it should not have been left to me, the patient, to sort it out nor should the senior sister have been allowed to get her own way. When I told the chief physiotherapist about her, he told me that he did not know what else to do because he had told the nurses that I could go on my own and that should have been enough. He was not willing to challenge the nurse.
Never heard of it
The physiotherapists, at the first hospital, had never heard of a progressing stroke and they were convinced I was lying. How, then, could they be considered to be providing patient-centred care?
Accident and Emergency
I really do not know what to say about this department. They let me down. It took them approximately 12 hours to decide that I could be having a stroke. All the while I was shunted from nurse to nurse and eventually from room to room. I was certainly not put first.
Stroke Outpatient Clinic
This was my second visit to the Stroke Outpatient Clinic. It was approximately 6 months after I had been discharged from stroke rehabilitation. The doctor asked if I was continuing the exercises. I told him that I was now doing the “Successful Stroke Survivor” exercises (Balchin, 2011). I am not sure why this meant, to him, that I was improving. All I know is that I was discharged from the clinic with advice to continue exercising. His decision was so unexpected that I could not even argue with him. One side of my body had become rigid and my arm oscillated several times before coming to rest but, according to the doctor, I was improving. I never again had an appointment to attend that clinic.
Doctor didn’t read my notes
Sometime after discharge I attended the Cardiology out-patient clinic. My systolic blood pressure was high and treatment needed to be reviewed. The Senior Housing Officer (SHO) had not bothered to find out about me (by reading my notes and the referral letter) and when she called me she asked me what my problem was? My spoken word was quite bad for unexpected situations. I would try to explain something and then give up because I couldn’t get the words out. Yet here was the SHO asking me what the problem was? I indicated that I was not interested in the clinic and preferred to go home. The SHO had the cheek to insist that I tell her why I was there. It ended up with the SHO informing her superior that I was uncooperative and the superior dismissing me from the clinic.
She did not tell the truth
How could my treatment be reviewed if the doctor didn’t know anything about me and I was not in a position to tell her? I noticed, in her letter to my GP, that the SHO wrote she’d only been trying to help me but I was uncooperative. I do not think that this doctor knew anything about patient-centred care.
Sestamibi Radiographer and Patient-Centred Care
Within the first year of the stroke admission I had a Sestamibi scan requested by the endocrinologist. The ledge, on which I had to lie down for the test, was so narrow that I didn’t feel safe. The radiographer had enclosed herself inside a radiation-safe cubicle so I could not tell this to anyone. At the end of the test I tried to point this out to the radiographer and was surprised to find that she didn’t believe me. As far as she was concerned, they’d done this test to thousands of patients and none had pointed out that they didn’t feel safe. She went on to tell my son, who’d been in the waiting room, that I’d complained throughout the test. She didn’t bother to tell him about the point I’d tried to raise.
Healthcare Assistant Texting
This happened when I was admitted for one day to have a parathyroid operation some three years after the stroke was diagnosed. There were four of us on the ward and our blood pressure had to be checked regularly. The healthcare assistant texted, on her cell phone, throughout the blood pressure measurement. Texting was done while walking to the next patient and while waiting for the monitor to take measurements. She was so caught up in what she was doing that she didn’t immediately disconnect the monitor after the measurement. Her assumption was that we didn’t know she was texting.
Bibliography
Balchin, Tom (2011) The Successful Stroke Survivor: The new guide to functional recovery from stroke. Great Britain, Bagwyn.
Royal College of General Practitioners (2014) An Inquiry Into Patient Centred Care in the 21st Century. Implications for general practice and primary care. Royal College of General Practitioners. Available from: https://www.rcgp.org.uk/policy/rcgp-policy-areas/inquiry-into-patient-centred-care-in-the-21st-century.aspx [Accessed: 10 June 2019]
