David Oliver: Reflections from a hospital bed

Just before Christmas I was struggling to complete my ward round, as I was increasingly breathless and trying not to cough. I went to the acute medical unit to get checked out. I soon discovered that, despite having no history of smoking or lung disease, my oxygen saturations were worryingly low.

Within hours I was on a 40% venturi mask with my saturations stubbornly refusing to increase, and I discovered that I had both respiratory syncytial virus and pneumococcus. I was admitted to hospital for only three days, but the whole episode made me reflect on the patient experience.

I realise that I’m not exactly a “mystery shopper” when admitted to an acute medical unit, given that I’ve worked on it as a doctor for two decades and know most of the staff. And understanding the terminology and procedures takes a lot of anxiety out of the situation (although insight isn’t always reassuring—such as when my National Early Warning Score was triggering alerts).

But I did learn a few things. First, in any open ward area—curtains or not—it’s hard to maintain anything like confidentiality. In my first few hours, before moving to a side room, I heard every clerking of every patient in intimate detail, all the conversations doctors were having about patients, and the conversations patients were having about doctors and nurses. There was no privacy. I even found out about my own investigations before I was told. More broadly, noise pollution with phones, alarms, buzzers, chat, and arrivals makes sleep or rest hard. Sleep is important, and between my endless coughing and the noise I snatched a half hour here and there, at best.

Second, the vast majority of your contact time as a medical inpatient is with nurses and healthcare assistants. Between observations, medicines, blood tests, and food and drink, they’re the staff you see right through the 24 hours, shift after shift—so the quality of interactions you have with them is crucial. My own experiences were great, and as an aside, they really emphasised to me just how much our system relies on staff trained overseas or from ethnic minorities. Our system would be lost without them, and they need more respect.

I did note that, even with the best will in the world, these staff have so many tasks to deliver that the time for more personalised care is limited. The thing that most bothered me (and clearly some fellow patients) is that I couldn’t stop having prolonged coughing fits, sometimes panic inducing. Nor could I get comfortable as a fairly tall person on a hospital bed, so I slept all night in the chair. These kinds of problems are often low priorities for busy clinical staff (as I know from my own day job), but they can be more distressing for patients than we realise, and we rarely have time just to sit with people and reassure them.