About a month ago I wrote about Everyday Heroes and how I want to use the blog to acknowledge and celebrate the extraordinary work carried out by CM Health staff. With that in mind, I’d like to share a very powerful story with you today which singles out the amazing staff on Ward 24.
You will recall me talking about the Granny Test and the importance of making sure that compassion is at the centre of everything we do. Below is a story that encapsulates those very values. It tells of the care we gave to an elderly man in his final stages of life. It’s made all the more poignant by the fact it is written by the man’s son, Ron Paterson, former Health and Disability Commissioner and now Ombudsman. Ron is someone who, for many years, has been a leading advocate for ensuring that the health system puts patients first, and as such, his account of the care his father received is high praise for the work that we do.
But putting aside the people involved, at its heart, this is a simple story of people caring for a sick man in his last weeks of life. It makes me incredibly proud of the work that you do and I have no doubt you will join me in applauding all the staff on Ward 24 for their amazing efforts. As ever, please don’t hesitate to email me at firstname.lastname@example.org if there are heroes working alongside you who you would like to acknowledge. I really am delighted to read your nominations.
A Story of Great Care – by Ron Paterson
When I was Health and Disability Commissioner, people used to wonder how I coped with hearing so many complaints and stories of poor care. But I knew that most patients receive very good care. In 2007, the Advocacy Service advertised for people to write in with examples of great care. We had an excellent response and published a booklet, The Art of Great Care. Since then, the Advocacy Service has continued to gather stories and publish them online at www.hdc.org.nz.
Let me tell you my family’s story of great care on an Assessment, Treatment and Rehabilitation Ward at Middlemore Hospital in October and November last year. The patient was my father, Ian, photographed here with his grandson Hamish.
Dad, aged 82, had a major heart attack at the gym in Papakura on October 14th but was recovering in the cardiac stepdown unit at Middlemore, being closely monitored and well cared for. Four days later he suffered a major stroke affecting the left side of his body and causing his speech to be badly slurred (though he could still sing a favourite Irish song!). Things looked grim but my Dad was tough, and he recovered sufficiently to be transferred to a rehab ward.
This was where Dad received wonderful care from a team of nurses and allied health professionals on Ward 24. Here are two of them: Megan Ward, occupational therapist (left) and Jess Besley, physiotherapist. They were part of a multidisciplinary team, meeting every week to review Dad’s care with input from nurses, physiotherapists, occupational therapists, speech therapists, dietitians and social workers, and led by a remarkable geriatrician, Dr Jeff Okpala.
What made the care so special? First, everyone treated Dad with warmth and respect, care and attentiveness. He was not just “the stroke patient in room x”. Staff introduced themselves to Dad, smiled and encouraged him, and were attentive to his needs and current situation. Nurses Mark, with his humour, and Beverly, with her unfailing cheerfulness, set a high standard for their colleagues. New graduate nurse Doris exemplified attention to the details of care and comfort.
Everyone listened to Dad, who could speak only with the greatest difficulty, and to our family. One of us was with Dad every day and we were made to feel totally welcome – a tribute to the initiative championed by Dr Mary Seddon, in welcoming families as partners in care at Middlemore. Even Mum and Dad’s small dog, Monty, was allowed to visit occasionally, lifting Dad’s spirits and bringing a smile to the faces of patients and staff on Ward 24.
Staff were alert to the risks that Dad faced. On one occasion, experienced healthcare assistant Cathy told nursing colleagues (during the difficult task of turning Dad, a tall man), “Listen to the son, he knows his father.” Dad had severe dysphagia, but Emma and Sara, the speech language therapists, gave us meticulous advice about Dad being restricted to a diet of soft pureed food and no oral fluids, and we learnt what and how to feed him.
Megan and Jess planned a careful programme for Dad to begin rehabilitation, and to help him move in a hoist from the bed to the shower or the gym. “Zero tolerance” for falls in hospital is unrealistic. If we want to achieve rehabilitation we have to allow patients to take some risks, but the team was always vigilant to keep Dad safe.
When Dad developed a secondary stroke and could no longer leave his bed, Megan, Jess and Jo the physiotherapy assistant still checked in with Dad every day, and gave him small arm and leg raising exercises – realistic goals that gave Dad a task to practise and something to aim for. No one gave up on Dad, right up until his discharge on November 21st, and he was farewelled with warmth and affection. Dad died peacefully on December 3rd.
We often talk about patient-centred care in health care, but are not always clear about what that means. This is what it looks like: the patient is treated as a person, not a number; their family are welcomed as partners in care; the patient’s dignity, comfort and safety is always paramount; services are well-organized and coordinated; and staff are kind and caring.
The care Dad received during his month on Ward 24 ticked all these boxes. It helped that the setting was not an acute medical ward and there was time to develop relationships with carers. A determined and responsive patient, and a committed family, no doubt played a part. In response, the ward functioned as a well-oiled machine under the leadership of Charge Nurse Manager Vicki Rawiri. Dad benefitted from a devoted group of nurses, healthcare assistants and allied health professionals, overseen by Dr Okpala and his house surgeon, Mata. The Middlemore staff were warm and friendly, and worked together as a team to provide great care for my Dad.
My family will forever be grateful.