The little things

It’s the little things that make all the difference.

Getting there

The traffic has been mad and it has taken me ages to get to the hospital. Then finding parking is the usual nightmare. I find this is the usual starting point for a trip to any heatlhcare facility. A recent visit has made me reflect on the many visits I have had in my life.

Taking a family member to an appointment, wanting to be on time, be in the right place. Navigating the corridors with often someone who is struggling to walk but determined to get there. The letter you clutch and the random signs tell you to go to block C, or department A or clinic 2. The map is vague at the best of times. Sometimes, on rare occasions someone will stop and ask if you need any help.

On these many occasions you need to get for a clinic appointment or a blood test or an MRI etc you are resigned to the traffic even to get into the entrance to the site, the parking that usually means you endlessly drive around car parks in the hope that someone is leaving, the eternally poor signage because you know you will figure it out eventually.

But I have also had that visit. That visit when you need to be by someone’s side as quickly as you can. You have been rung, there is a problem, “you need to get here”. I always think of those visitors more than any. They are overwhelmed with emotion, cant think straight, the signs become a nightmare, the corridors endless, your heart is beating so hard you can feel it.

It is the little things.

If only signage people (these must exist surely) spent their days as patients or walking along with patients before they sorted out the signs and maps. Maybe they do, I am astonished if that is the case and we are left with the result. I have visiting more hospitals than I can remember, both for work and for life. It is a rare, glorious time when you seamlessly find your way. The very least we can do for patients and their families is to help them find their way.

Being there

Visiting a friend in need, wanting to spend time talking about how they are, what you can do to help, or just listening to them and giving them much needed company. I am greeted with electronic speakers, or ‘wait here for someone to let you in’ signs. No response, so I slip in when someone is going out, wondering if I will get caught. I find my friend. I am not entirely sure why but I am disconcerted by the clutter, I am itching to tidy up her bed space. I may not be wearing a uniform but I will always have the mindset of a nurse. I am itching to tidy up the entire bay, even the entire ward if I am honest. When did it become so chaotic?

You sit and you observe. You observe what all the staff are doing, you observe their body language, what they say, how they say it. You instantly know the ones you can connect with, the ones with the kind eyes. You instantly know the ones who are not interested in either you or even their patients. You observe what they are doing and wonder why they seem to be sitting staring at a computer the whole time. You witness the interaction between staff.

It is the little things.

You notice it all. You notice the clutter. You notice the times you get help and the times you get a little eye roll or a look of ‘I’m busy’. You notice the staff that engage and smile, the kind words, the gentle way in which they tend to your loved ones and friends. You notice the times when it feels a bit less kind, not hurtful or neglectful, just indifference. Every patient and every visitor notices it. You genuinely feel it when people care and when they don’t.

Safety

When people think about safety, they are often thinking of the big things, the incidents, the investigations, the things that get discussed in meetings. We rarely talk about the little things that make people feel safe, that help healthcare professionals work safely.

Do we simply get used to the mess, the clutter, the search to find things because we are not sure where people have placed them. All well and good on a day to day basis but what if it is needed quickly, in an emergency? Why are we setting ourselves up to fail by being surrounded by the chaos?

Do we get to the point where we don’t see that a smile or kind word is actually a key part of what we do as healthcare professionals? We may be busy, we may be at times overwhelmed but it is essential that our roles are to care. It makes a world of difference. If not, then why are we in health care. Have we lost the ability to be compassionate, show empathy and if so how and why has that happened?

Impact on staff

I talk about it, in this blog, mainly from the perspective of being a patient or a family member. But all of these are the same for a healthcare professional. The new person to the team, the management trainee, the student nurse, the resident doctor, the physio, the receptionist, (yes now I am just listing so I will stop!). All of these people will notice the clutter, notice the interactions, the relationships and whether someone is being kind and being not so kind to them. If we want staff to work safely we need to understand how it feels to work in the area they work; the conditions and culture that they work in. This is found in the little things that happen every single day.

Does all of this impact on patient outcomes?

Of course it does.

Clutter and chaos not only makes people feel unsafe, uncared for, it can lead to infections, delayed treatment and actually takes time when time is precious.

Caring (or not) impacts on patient wellbeing, their sense of being in a place that is there for them, when they are struggling, when they are in pain, when they need physical care, there will be someone who will do this with kindness and compassion. That is the very essence of what it is like to working healthcare, what it is like to be a nurse.

When patients feel unsafe, their immune system is impacted, their blood pressure is affected, their anxiety and fear is exacerbated.

What staff feel unsafe – guess what – they feel the same.

When we study safety – study the little things. You never know, it might actually stop the big things from happening.