I have been a voluntary hospital visitor at a big London teaching hospital for the last three years. I only go in one day a week, it is not much in the way of ‘putting something back,’ but even in those few short hours I have seen quite a lot. At first I was outraged by some of the things I saw, then I got used to it. Latterly I have not noticed anything very acutely, perhaps getting a bit comfortable in the job.
This week, Tuesday 28th October 2014, the Anglican chaplain was not in the hospital so instead of attending a religious service with him in the chapel, I went straight up onto a ward at breakfast time, one where there are a lot of ‘bed blockers,’ meaning old and senile people.
One of the old men is a neighbour of mine, who I have known for years. At first I didn’t recognise him as he has become so thin. He was asleep and his breakfast, two large pieces of thick, uncut, unbuttered white toast lay on a tray near his bed. If he’d been awake it would have been beyond his reach, and as he has few teeth I could not really see him chewing those big slices.
As he hadn’t eaten anything or had any of the tea sitting in a mug going cold, I woke him up and encouraged him to drink and have something. He didn’t want the toast and asked for soup. I went off to the kitchen where I met a Spanish speaking supervisor who said the patient possibly needed some ‘build up soup,’ but sadly they didn’t have any. He disappeared, I thought to get some of this ‘build up’ stuff, but he didn’t return. A Chinese woman in the kitchen was more friendly and I think more intelligent. At least she showed an interest in what I was trying to do. She said there was some powdered soup, but unfortunately it was in a very large box which couldn’t be opened for one person. I did not manage to get him any soup at all.
I returned without any soup but a nursing attendant, who could have been Thai, was very unhappy that I had gone into the kitchen at all. She might have been directly involved with the catering, I’m am not sure. On the ward people all wear trousers and shirts, which differ in colour according to what they do, and I am not up to date with this code. She seemed to have something to do with delivering the patients’ food and was affronted that I’d asked for a patient to have soup rather than toast.
The patient also admitted defeat and went back to sleep, so I gave one of his unwanted slices to an old man opposite who is senile and cannot talk. He’d finished a bowl of porridge and began to try to cut the toast with his spoon. I tore it up for him and he ate it hungrily. I do not think the nurses or assistants on that ward ever butter any toast or even cut it in half let alone make it into small pieces so the older ones can eat it. I will never forget the way he smiled at me, with such gratitude and delight, perhaps not just because of the bits of toast, but possibly because I’d been really attentive to him.
He had a charming smile but he couldn’t speak a word and couldn’t ask for anything. Someone working on that ward had to be able and willing to observe his need. Imagine being someone unable to speak, and feeling hungry. Food is banged down in front of you, but you can’t eat it without assistance, so you eat nothing. Most of us can envisage what that would be like but I am not sure that all the NHS nurses and nursing assistants can. Later, as I left the ward, the woman I took to be a catering assistant came up to me and said very pointedly: ‘He says he wants the soup later.’
The issue was getting back at me for my interference, not getting food into an old man. It seemed to me she was not interested in the patient’s immediate needs or really motivated to help him, nor I thought, was the supervisor. They didn’t seem to see any needs. Hunger is hunger for most of us, and you stop it by stuffing in some food. In the NHS these days, work is about following a routine and doing things according to set practise. These are not I fear the kind of iron routines they had in the old days, which nurses today dismissively call ‘ritualised nursing,’ which were about thoroughness and putting the patient first. The new routines seem to be about providing food and employing the people who give it out on the cheap.