Saturday, January 12, 2013

A new challenge

Questions. Raised eyebrows. Incredulity. Condescension. Sympathy...pretty much have had the whole gamut over the last few days. Have had an offer sitting with me for some time..would I step into the hubbub of unscheduled care? The chaos, organised or otherwise, that is a patients journey from their attendance to an Emergency department till they are discharged from hospital. 
And I mulled over it. The person who has based his life on instantaneous calls, based on gut reactions...sat down and mulled. Maybe its because I am close to my 40th birthday. Maybe a bit more maturity has set in. Maybe the "resolutions for 2013" list still hasn't got covered by other paperwork in my office. And point number 5 stared back at me.."No more new roles". Factor in the time I now want to spend with my family...the odds were not quite adding up. So I kept on deflecting the requests from personnel I trusted, admired...plus I had done something along these lines back in 2009. 6 months of that..and it was soul destroying. Achieved a few things, but lots of frazzled relationships, burnt egos of senior colleagues...and I recall at the height of those times..turning around to see very few there to support...all those who promised to be"right behind me"..had chosen simply to be there..or slip away into the shadows. So why again...why indeed?

And then something flicked the switch. Patient confidentiality does not allow me to say why..but I saw something which put a lump in my throat. I am known for my hard negotiation skills, being a renegade, rough edged...but that day I saw something which made me flinch. And instantaneously my mind was made up. My experience of diabetes care has taught me something...stop criticising the system and others, if you are not willing to do something about it yourself. So I have taken the plunge. Thankfully this time, there is support and the line up of folks around to help is quite impressive indeed. Doctors, nurses, managers...an enviable collection of folks from different walks or specialities have pooled together...folks I know look beyond the narrowness of their speciality and are willing to help. So we try together and I walk back into it...maybe some things cannot be sorted out by one person, sometimes it needs a group. In my usual comic book analogy, if Iron Man could win all the battles on his own, why the heck would he need the Avengers? 

Don't know why..but this time around, it feels different. On the commissioning side, there are folks who I have grown to trust due to the work I have done with them as regards diabetes. On the provider side, ditto..there isn't anyone in that mix who isn't committed...so you have to look forward with hope. A temporary remit- but one which maybe worth its weight in gold as regards experience. Myths swirl in hospitals- and the more systems are under pressure, professionals blame each other. Doctors blame managers, managers blame nurses, medics blame surgeons, surgeons blame pharmacists...the list is endless. Been there, done that, got the T shirt with diabetes amputation rates. As a community of healthcare professionals inclusive of doctors, nurses and podiatrists we are in the process of rising above it..so the question is can that same approach be brought to this one?

The one thing we perhaps need to change is the excuses. I am not willing to see any emails or have any conversation which has the following words in it.." Patient care is important BUT.." Sorry guys and gals...doctor, nurse, manager...after "patient care is important"...there is no "But". Yes there are resources issues but being kind to the patient in front of you, taking responsibility for them does not need a million excuses- as simple as that. 

So it begins...my role to ensure patients are getting what they need in a timely fashion on the wards, reviewed on time, transferred to the right ward, right speciality  being reviewed daily, having their treatment and investigations on time.. and when being discharged, having coherent instructions being sent to their primary care physician. Yes, its about improving the "flow" of patients...but its with patient care in mind- and while trying to deliver a good quality care, if "flow" does improve (which I genuinely believe it will) that can only be a good thing.

A difficult challenge? Well for this week, rather than mention any deep through provoking quote...its probably best to refer to a line Anthony Hopkins delivered with aplomb, albeit paraphrased..." Dr Kar, this isn't mission difficult, it's mission impossible. 'Difficult' should be a walk in the park for you". 

Let the fun...begin.

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