Hospitals as if people mattered
Hospitals cannot but be a bit scary because we know that these workshops for the human body are also a focus for human pain, fear, apprehension, scary sounding procedures, and the invasion of one’s body and personal space.
We invented them because we needed some places where human skills and ingenuity could be concentrated on putting the human body to rights; and in some instances to keeping ‘ill’ people away from the rest of us.
But somehow in doing so we’ve lost sight of many things that are important to hospital patients and to their friends and families. So we might not be ‘inside’ of the hospital system for very long (at least we hope not) but we must never lose sight of the major and profound fact that, when we become inpatients, we more less voluntarily give the NHS power over most aspects of our lives.
It shouldn’t need saying but it does – when we are in hospital, we are placed in a very vulnerable situation. From the design and features of ‘our’ hospital bed, to the amount of bedspace and its features we basically rely on unnamed and unknown others to decide what’s best for us. Similarly, unnamed others decide where we can walk or not, or where we must rely on others to wheel us along. Unnamed others decide what we can look at from our ward window – pleasant green space or concrete and pipework. And unnamed others decide what if any ventilation and fresh air we’re allowed.
These are far from trivial matters. In our everyday lives, we take for granted being able to get hold of personal items like a toothbrush, soap, shampoo, comb and other toiletries. Having them in easy reach might seem a no-brainer but in reality this can be difficult if not impossible when you are in a hospital bed of all places. These items are not only vital for health and hygiene but have immense importance for one’s mental health to maintain self-respect and personal dignity. Likewise, being able to get hold of your own clothes can seem an insurmountable task if they are stuck away somewhere inaccessible.
It shouldn’t come as a surprise that an increasing number of inpatients (the majority?) rely increasingly on keeping in touch with family and friends via mobile phones, iphones and ipads, email, text messaging and the rest while we’re in hospital. But patients’ need for access to these essential means of communication are largely ignored! Little or no attention appears to be paid in the design of wards and equipment to ensuring that patients can easily charge their phones and other devices, and reach them without difficulty.
For example, I had the misfortune recently of spending time as a hospital inpatient. But could I find a reachable socket through which to charge up my devices? No! When I was finally told where it was, I found that it was placed right behind my head, out of sight and pretty much out of effective reach. Just who in the hospital thought this was OK and who was responsible for the design and placement of the sockets?
How in the 21 century can the need for easy access to a mobile phone be ignored or overlooked, especially when patients are largely cut off from the outside world because of the current restrictions on visitors?
Similarly, just who was responsible for deciding that my personal locker was tiny and really so tatty? Who decided that it would be a good idea to put it in an inaccessible place – on the floor – and that it would be a good idea to place it largely underneath my hospital bed? Do we really want to force patients to crawl on the floor in order to get access to their locker? Again, who was responsible for this seemingly mad decision? And by the way how can we replace them?
A related issue is the need for hospitals to recognise that patient access to personal items, communication and clothes is essential. While I was in hospital recently, I was aware that patients’ personal items were often placed out of reach or out of sight when staff were clearing up or cleaning. For example, I ‘lost’ my washbag because an over-officious ward staff member misplaced it during the process of changing my bedclothes and clearing a nearby shelf. Neither myself or a nurse could find it. Another ward member had to pull my bed away from a wall and only then could anyone see it or retrieve it!
This is not meant as a criticism of a member of staff, but to question policy and staff training regarding patients’ personal possessions. Our ‘things’ attain great importance when we’re ill and in hospital. We should not be made to feel that we are second class citizens.
So what’s to be done? Somehow hospital staffs and managers really must contrive ways of paying attention to this level of patient experience and, even more important, to implement practical and effective ways of improving every aspect of care of inpatients.
It isn’t as if it is difficult to find ways of storing and organising personal possessions. There are many cheap solutions available to us in our homes with all sorts of sizes and shapes of boxes, shelving, and furniture on offer in retail outlets that are also easily cleanable. Why is this too much to ask when we are in hospital?
“Going to hospital is rather like going to an alien planet.” – Quentin Blake
An excellent critique. When one hears some stories that patients tell, one can’t help wondering if Mike has pulled punches; of course that out of care of staff who, he implicitly notes, are also victims of a system. This appeal for simple manifestations of human focus design in hospital focuses the attention and, thank goodness he was able to observe some of the features of the landscape and reflect for us upon them. I do much hope he is widely read and quoted, especially those who have power to make changes. May their Will be reached.