In the 18 years since I qualified as Physiotherapist, I’ve worked in government and private hospitals in both South Africa and England. It’s fascinating how similar and very different the hospitals in the two countries can be.
In 2007 I left my job at a government hospital in my small home town in Kokstad, South Africa and headed for the UK. At the time, ARV’s were not yet freely available in SA, and we had some of the highest HIV infection rates in the world. This meant that the majority of my patients were battling with co morbidities of being HIV positive and were not yet able to access the anti retroviral therapy so imperative in HIV care.
I remember saying to my Dad once “who used to be in hospital before the HIV crisis?”
When I got to the land of the cold in mid February and began working in the NHS, I soon realised who takes up the majority of the beds in a first world country. The elderly.
While the average temperature of my days had dropped significantly, my average patient age had gone from 35 to 80 in a matter of weeks.
For my first few years in London, before I began working solely in Pelvic and Women’s health, I locummed in a variety of NHS hospitals. A locum post is a short term contract versus a permanent position and was very popular at the time with South African, Australian and New Zealand Physios like myself who were keen to work and travel as much as we could on our working holiday visas.
While I moved between various contracts and hospitals, I was surprised over and over again by how the ‘feel’ or a ‘culture’ in the medical staff in a ward could vary so acutely.
The environment on a ward is palpable after just a few hours. I found that where the staff were friendly and helped each other out, it seemed as though the patients got better faster. When the nursing staff had the capacity and enthusiasm to assist patients out of bed to a chair or commode rather than being in bed all day, healing happened quicker.
A softer touch and patience during a bed bath or words of encouragement to finish a meal can be the magic ingredients in medical care. A Physio who is happy to go over into their lunch break so their patient can walk a little further to go to the toilet rather than use a commode, is my kind of Physio.
So when I found myself in a ward or department like this, I did all I could to extend my contract. I became dear friends with the Aussie physio who was once employed to ‘locum for the locum’ when I was headed off on a 2 month Europe adventure. I was delighted to return from my travels to a ward that embodied what I valued and she was sad to leave it once I returned.
It was on this ward that we had a recurrent patient. Henry was in his 80’s, had no family at all and lived in a nursing home. He was confused, resistant to the frequent medical care he required and loved nothing more than a cigarette. Being bed bound and quite muddled on a good day, he was unable to take himself outside for a cigarette like so many of our other patients did.
Every day, one of the nurses would give up their precious tea break to open up the double doors on the end of the ward and we would help to wheel his bed outdoors. Whoever was helping that day would light a cigarette for Henry knowing it was his one pleasure in the day. Most of the nurses weren’t smokers themselves, and I don’t need to discuss here the irony of a nurse giving an ill patient a cigarette, but in those moments that I watched Henry out the window smiling as exhaled a plume of smoke, he looked more peaceful than he ever did while inside the ward.
I have a memory that presents itself like a photograph in my mind, as some of my more profound recollections do. It’s cold but sunny, perhaps around May, where you feel the hope of the UK spring approaching and daffodils begin to emerge from the cold ground, but it’s still chilly. A nurse is leaning over the hospital bed so Henry can have a puff of the ciggy she is holding for him, and she is smiling at the obvious joy on his face as the sunlight streams through the branches of a tree and onto his pale and wrinkled cheeks.
If you have ever been on a busy ward, you know how hard nurses work and how little time they have to sit down, go to the loo or make a cup of tea. Yet every day someone would sacrifice their break to give some joy to Henry. A confused, elderly man who so often resisted them as they tried to care for him.
I remembered this story yesterday of kindness that wouldn’t be rewarded or celebrated on any KPI’s or staff performance reviews. Just gentle human connection that is so often forgotten in a frantic world.
And I wanted to record it here too, for myself, to continue to remember the value of slowing down, seeing the human within the patient and being compassionate in a busy world.