Friday, August 10, 2007

Patient Journey

There is much discussion these days in medical circles of "The Patient's Journey" and how it could be improved. By this term they mean the patient's journey through their illness: the bigger picture of it all.

The bigger picture is, however, composed of lots of smaller pictures. They're the ones that have a big impact on the patient's well-being. They're not given enough thought.

This morning the Communist had an appointment at the hospital to have his blood checked - he's on Warfarin tablets to make his blood thinner to stop it clotting and causing a thrombosis. Too little Warfarin and you can get blood clots: too much and you can bleed to death internally. So it's important to check it.

The nursing home asked if I could go with the Communist to push the wheelchair and generally keep an eye on him, and this I was happy to do.

They had ordered an ambulance to take him. So he was dressed and in a wheelchair from about half-past seven. I arrived at the nursing home at 8am as they weren't sure what time the ambulance would arrive. His appointment at the hospital was 9am.

At twenty past nine the ambulance arrived at the nursing home. It was rattly and the Communist - who can't pull himself up in the wheelchair as he can't press on his feet as they're so heavily bandaged and painful - was worried that he might slide out of the chair. The ambulance collected another patient on the way, which made the journey even longer.

In the ambulance a commercial radio station was playing very loud rap music, interspersed with very loud commercials. I'm not sure for whose benefit this was - the paramedics showed no interest in it. I doubt whether this would be the music of choice for any of the patients being transported.

This seems like a minor point, but I don't think it is - the uncomfortable, rattly journey was stressful enough for the patients without uncomfortable, rattly music.

We arrived at the hospital: the Communist was pushed through many dreary corridors and finally we arrived at the Warfarin clinic. After a half-hour wait, he was called through into another room and they took some blood. We were told it would take about three-quarters of an hour to process it.

After about three-quarters of an hour, the Communist was told that his blood was just the right thickness.

Then I pushed him through more corridors to wait for the transport back. The wait took another hour.

We arrived back in the nursing home at half past twelve. By this time the Communist had been in the wheelchair for five hours and was totally, totally exhausted: so tired he could barely speak. I was pretty tired myself.

If I hadn't gone with him, I expect they would have found people to push the wheelchair, but there'd have been nobody to keep him company or bring him a cup of coffee, and these things are important when you can't move.

All the staff we met during the course of that long morning were very pleasant: I'm not complaining about any of them - oh, all right, except perhaps the paramedics who had the loud music playing in the ambulance.

Surely, in 2007, you'd think there'd be a simpler way of checking a tiny sample of blood from an ill old man. A way that didn't involve a five-hour ordeal.

1 Comments:

Blogger Silverback said...

Was wondering how he was doing....thanks for the update.

Yes when you can take samples of other bodily fluids to wherever they need to go, it shouldn't be out of the question for someone qualified at the nursing home to draw some blood and arrange to have it taken to the clinic.

But then 'out of the question' in NHS parlance always means from their point of view.

10:35 pm  

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