To My Healthcare Assistants

To my Healthcare Assistants, 
           Healthcare Assistants (HCA) can’t do an awful lot for me because I’m mostly able to wash, feed and change myself and I can go to the toilet without help. So HCAs tend to only really do my obs and answer my call bell. However, I had two very different HCAs when I was admitted to hospital recently. One was brilliant and on the Night Shift, one was terrible and on the Fay Shift. Ironically, the one on the Day Shift was training a student at the same time, which worries me that she was learning from her not great example! 
          So night HCA was really friendly. As soon as I got to the ward, you appeared and said hello, what your name was and asked if I needed anything straight away. Then once my new intake had been done, you came straight back and asked if I wanted a sandwich or a drink because you knew I’d been through a&e and they don’t automatically give you food there.    When you weren’t actively involved in patient tasks, you wandered around (quietly), keeping an eye on your patients, rather than gossiping with the other staff. That’s how you knew I hadn’t been to sleep, so you came to ask me why. I told you I was in pain and too hot, so you talked to the nurse in charge and came back straight away- which isn’t always the case- and said they were sorting some cocodamol and a fan. I said I’d maxed it all out so was there anything else and you immediately went back to him, again, not always the case, and got him to give me some oramorph. From the point you asked me, to getting the morphine was about 5 minutes- that’s bloody impressive on such a busy ward. My canular exploded everywhere and looked like a murder crime scene but you didn’t make a big deal, you made sure I was ok before cleaning up the mess. I didn’t feel well afterwards so you stopped to chat with me until I did, even though there was nothing you could physically do for me, it was a case of riding out the horrible feeling. But I really appreciated it because that’s actually what I needed- someone to chat to me and make me laugh rather than me sitting and crying. You talked quietly but politely to all of us so as not to disturb other patients.

         In the morning you brought us a cup of tea while you did our obs at 7am. What a luxury- that’s never happened before but it made such a difference after a bad night! But it was so nice waking up to a caring face rather than being shouted at and having light shone in our faces like on previous admissions. I was genuinely sad when you went off shift and you’re by far the best HCA I’ve ever had. 

          Day Shift HCA was kind of polite but abrupt. You were more interested in talking to the staff noisily over the ward, talking about patients as though we were tasks rather than humans. I know you had to explain things to your student sometimes but I’m also sure we don’t need to hear absolutely everything you’re doing with patients and their names in great detail when she’s not in the room. Particularly if you can just stand a bit closer to the person you’re talking to. It makes us feel like a source of gossip. You introduced yourself to all of us at the start of your shift, but you said very little to me. In fact, during the whole time you were looking after me you said ‘sit in the chair while I make your bed’ and ‘yes’ when I asked a question. Well, I’m afraid I can play the game too- Night Shift HCA actually changed all of our beds (in a very friendly, efficient way), so you didn’t actually need to do them all again. Maybe it was good practice for your student, but usually I would say something and try to be friendly and helpful. I didn’t really feel like it though. You talked to the elderly patients while working with them but you didn’t really talk to me- 1 sentence and a word. I might be ‘fine’ by your standards but Night Shift healthcare made me feel like I was being looked after, so I feel you could have made a bit more effort to interact with me. I do know all about your army career though, because that’s what you were talking to your student about. Your student tried to talk to me while she was making my bed but you didn’t (I actually found out later that it was her first day, in which case I thought she was bloody brilliant initiative and compassion wise- take note!). I also wasn’t impressed that when a porter brought me a stretcher so I could go to X-ray (he couldn’t find a wheelchair) you stage whispered to him ‘what’s that for, she’s perfectly capable of walking’, to which he replied ‘she said she can’t walk that far so I got her this’. Not satisfied with this, you said ‘I’d make her walk’. Erm, excuse me, I can hear you?! And also, if you’d bothered to ask me, I could have explained this to you- I look ok and sound ok but I can only walk to the toilet and back and even that requires a rest and a lot of sweating, shaking and dizziness afterwards.
          Interestingly, when I did almost pass out and felt sick on the way back from the bathroom and you had to help me get back in bed, your attentiveness changed. Suddenly you wanted to find out what my AI is and what you needed to be aware of. You came back to check on me regularly. You talked to me. I appreciate the attentiveness but would you have known what I needed if I had passed out? Why weren’t you talking to me before? What did you think I was in hospital for- just because I felt like it? Your student made the effort but you didn’t. 
             A lot of being in hospital isn’t about what you’re being treated for, it’s about the way you feel about it. The science behind it, in most cases, is straight forward, but people aren’t machines and can’t just be scientifically fixed and moved along the conveyor belt. We need to be cared for and looked after and supported in order to recover the best we can. And for young patients who are independent, we get very little interaction sometimes because we don’t need hands on help. But the way we get better quickly is if our moods are good, we’re not feeling depressed and we aren’t just left to fend for ourselves with pills and meals being brought to us periodically, and talked about as if we’re not there. Because, frankly, that’s what prisoners who are locked up get, and we deserve better as patients. Night HCA was brilliant. Day definitely wasn’t (student was though).

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