I know what it is to not to give elderly patients the time and care they deserve. On the ward round at the beginning of a busy day, isn’t it easier to stand at the end of the bed of the elderly patient who’s ‘waiting for social’ and wave rather than stop and talk to them about what’s bothering them? Why is it that I don’t get close and make it clear that I’ve got time for them? The superficial reasons are all too abundant; often I think I know what they’re going to say – I heard the list of problems the day before and I couldn’t help speed the process of finding a bed in a community hospital, or get them more physiotherapy, or get them an occupational health assessment. Or the patient is confused and I think they won’t remember our interaction or be able to say anything sensible to me. Or maybe, and worse, I know they won’t complain about being ignored on a ward round as a younger patient might.
But what’s the real reason I don’t make time for these elderly individuals? I think the only reason I don’t bother to care for them in the way I would like someone to listen to and care for my own grandmother is because I think too much of myself. I think I’m more important than that patient and the other people I work with. This patient should understand that I haven’t got time for their problems. Can’t someone else listen to these non-medical issues? Isn’t my time more valuable than theirs? Isn’t my day more stressful than theirs? Don’t people know how long I trained to get this job? Someone else should be sorting this out – this isn’t my problem.
And as I lead that ward round, what am I teaching everyone with me? I’m telling my juniors that we as doctors shouldn’t bother with people once we’ve ‘fixed’ the list of medical problems. I’m showing them that if someone’s a bit confused then there’s no point in listening to them. I’m saying that if something’s not ‘our job’ we shouldn’t engage with the problem. And it’s not just the doctors who will be watching me; I’m showing the nurses and other ward staff what I think an acceptable way is to look after people. I’m modelling how to protect your own time and not work as a team.
Each day I listen to my sinful nature and consider myself better than others. My attitude is the opposite of Christ Jesus. I am worth nothing and yet Jesus, God incarnate, gave himself completely for me and for my sins on the cross. And yet I still don’t imitate his humility, I still think that I have more worth than those around me. Jesus has died for each of those patients on my ward, whether they are young or old, with the sharpest of minds or confused, wealthy or poor, and I in my pride can’t be bothered to talk to them.
So how can we change attitudes in the NHS? My first battle has to be with my own heart. I have to pray for and strive to have the humility of Christ so that I might give myself sacrificially for those He has put in my way. And I know those people won’t just be the patients I see but my medical colleagues, the nursing staff I work with, the administration staff I ask to help me; every person I meet each day as He has ordained. Maybe once I’ve learnt to consider others better than myself I will be able to behave the way I want to when I sit at a computer and think about this. If through God’s grace and sanctification I can learn to do this then at least one attitude in the NHS will have been changed.
“In humility consider others better than yourselves. Each of you should look not only to your own interests but also to the interests of others. Your attitude should be the same as that of Christ Jesus, who being in very nature God, did not consider equality with God something to be grasped, but made himself nothing, taking the very nature of a servant, being made in human likeness. And being found in appearance as a man, he humbled himself and became obedient to death – even death on a cross!” Phil 2:3-8
Posted by Sarah Howles
Urology Trainee and CMF member (based in Oxford)
This blog was posted as a response to:
VIDEO: Is ‘care’ the missing component in the NHS? by Steve Fouch, CMF Head of Allied Professions Ministries