Nursing By Numbers
Brian Booth, RGN
‘Person-centred care aims to ensure a person is an equal partner in their health care. The individual and the health system benefit because the individual experiences greater satisfaction with their care and the health systems is more cost-effective. If it is to become a reality, person-centred care needs to be introduced at all levels of health care from governmental policy-making to an organisations’ interpretation of policy in the way that they operate’
I’m thinking about taking a mercifully brief play, which is based on real dialogue (only the names being changed, I hasten to add, in case someone at the NMC takes a break from counting the money spilling over the floor from our increased subs, and has a look at what ground-level nurses are really concerned with), up to the Edinburgh Festival.
I am not a number: a play in one short act
The time: early in the 21st century.
The setting: a large district general hospital.
Act one, scene one: an orthopaedic trauma ward. Enter a staff nurse; he approaches a male HCA, who is not doing very much.
SN: Would you mind taking this iced water to Fred Jones?
SN: Fred Jones.
HCA: That don’t mean nuffink to me.
HCA: What bed is he supposed to be in?
One thing I’ve learned over the years: you can always trust some nurses, the ones who rarely don a pinny and get out on the floor, to bang on about how things ought to be, without coming up with any realistic plan for how change might be achieved. I’ll make a small bet with you: I’ll wager that you have, at some point within the last two years, had to attend a course where the word ‘dignity’ has been rattled off at regular intervals.
Call me naïve (most people do); but there was a time when I thought we were moving away from talking to each other about ‘the diabetic in bed three’ or ‘the overdose in bed 17’. I probably dreamed that golden age, anyway (although I still like the image of ‘the overdose’ being a Bertie Bassett Liquorice Allsorts figure, made up of various tablets and capsules). In my few years away from the bedside, it seems that we lost even the distinguishing diagnosis.
If you’re agreeing with me so far, I suggest this plan of action. When someone says ‘bed 5 needs the toilet’, meet the patient’s needs, then wheel their bed out of the bay. Now ask the person who passed on the request for help in getting it through the toilet door.
In the 1960s, there was a series called The Prisoner, with Patrick McGoohan as a man who finds himself in a bewildering place, where he is referred to only as ‘Number Six’, and where everyone seems to want to provide the best for him – without really explaining what they want in return, other than an explanation of why he really resigned his (presumably secret) job. I remember it vividly, and have watched re-runs which haven’t aged that badly; younger readers, I highly commend it (but not the rubbish American remake). I long ago learned by heart his defiant statement from the title sequence:
I will not be pushed, filed, stamped, indexed, briefed, debriefed or numbered. My life is my own. I resign. I am not a number – I am a free man.
Our patients are not to be identified by the number of the bed they occupy. They have names. Their lives are their own; we, as nurses, just happen to have been granted the great privilege of trying to improve those lives, some of which include achievements that put our puny efforts to shame.
I thought we were moving away from talking to each other about ‘the diabetic in bed three’ or ‘the overdose in bed 17’.