Bluergh

I think that the health sector, and hospitals in particular, work really hard to be patient centred and deliver good service. But I'm not feeling that much at the moment, I'm sure mostly due to the acuity of the situation. Everything is urgent and hurried and I'm feeling rushed along. 

It is still less than a month since my colonoscopy and bad news and I'm three weeks away from major surgery. I've had so very many appointments and they keep coming. This morning I had anaesthetic pre-assessment which in the past meant a lot of waiting to see the registrar before demonstrating that I could open my mouth widely and put my head back. Today's anaesthetic pre-assessment was therefore a shocker:

• Meet the nurse taking my weight, BP, height and who performed an ECG. My height and weight were the same as last week, my BP slightly lower and I've never had an ECG before.  I thought that it would take ages, but it actually took longer to put on all the sticky connections than get the print out. 
• Meet the anaesthetist who went through all notes from previous operations, listened to my chest and confirmed I could open my mouth. Lots of questions and discussions re pain relief.  Those anaesthetists have some nifty tricks I'll tell you what.  There seems to be just about nowhere that they can't stick in an epidural or similar and pump you full of morphine.  Good to know.
• The 'enhanced recovery' something nurse who went over the hospitals 'expectations' of me while I'm in hospital. Very little lounging around will be allowed! They also went through a check-list to see if I had made sufficient arrangements to be out of action. This felt patronising, although I get it is important. Given I spend most of every day at the moment making arrangements for the care of the girls, I was unimpressed with their query.  In the end I just said it was covered.  I have a little book that I am supposed to fill in each day in hospital detailing my eating, drinking and time up (up means sitting up at least in bed). 
• The stoma nurse. This was sobering. She did have heaps of good written info, pictures and knowledge about life between surgeries and after the second one. I got an inappropriately cheerful free 'gift bag' of stoma stuff. I need to drink more water and eat more salt after the operation.  I asked about resources to explain the stoma to kids, she will look into it.  Stoma look dreadful and alarming - they are bright red. I'm not currently inclined to let the kids see it.
• The first nurse came back in and gave me an enema pack for the morning off the operation and some yellow carb drinks for the morning of the op. The nurse sounded as though she didn't quite believe the reasoning behind the drinks.  It sounded kind of 'pseudo science' to me - but then the drink is produced by Nutricia, and I'm still kind of anti them from my breastfeeding days.
• A House Surgeon and Trainee Intern then came in to ask me every single question I'd just been asked again. At this point I got annoyed with the repetition and started explaining where they could find the info rather than giving it again.  This was kind of pointless as it made things longer, but the duplication was starting to seriously annoy me. The TI listened to my chest, got all excited when she thought she heard something, and looked a little crestfallen when the House Surgeon disagreed.  The Anaesthetist listened longer and more thoroughly than either of these guys so I was not bothered by this.

Each of these talks required moving between identical rooms and returning to reception. There was no good reason for shuffling us between the different rooms other than clinician preference. Notes were kept at reception so it wasn't even because the notes or materials were in specific rooms. I was so over it that I felt like asking my daughter for some good tantrum tricks.  I was supposed to have a whole bunch of blood tests, but they are just a formality so I'll do them another day.

As someone who has developed hospital forms, and audited them, I can't think of a solution to this problem.  Everyone wants there own clearly identifiable form, and everyone wants the form filled in using the most current information (usually from the patient).  But there needs to be some consideration of the patient experience as well, and it is hard to have confidence in the system to communicate when information in consecutively completed forms is substantially repeated.

No parking ticket thank goodness - even though I was more than an hour past the maximum time.

I'm still kind of stunned at how much the appointment took out of me.  I found it gruelling, and got very close to tears for reasons I can't quite work out.  I'm glad it is done, and at this stage I have no notice of any more tests/ appointments/ imaging/ procedures.    The surgery is still on for 27 May.