Tuesday, 8 June 2010

Entertainment on the NHS

Free Entertainment in NHS Hospitals

I had a short stay in one of our tax paid hospitals last week. Whilst immobile, I had some amazing entertainment to keep me amused.

Steven is about 80, pretty fit overall except that he appears to weigh nothing at all. He’s here because he had a fall and broke his wrist. Unfortunately he’s a little confused, isn’t sure what town he’s in, and thinks this is an odd hotel. He looks quite striking as he has a magnificent shock of straight white hair, and as he gestures with theatrical enthusiasm he reminds me of one of the Muppets. And to make it all harder for him, he had a tracheotomy which deprived him of speech as he could no longer pass air through his voice box. Steven communicated with the aid of a buzzer which he placed against his throat and his speech was like Steven Hawkins, except that he wasn’t very good at using it yet.

My first fit of the giggles was during the night. I had realised that Steven; in the bed opposite from me, was likely to be ‘active’ during the night, since he had been spending much of the day being persuaded by nurses to undress and get into bed. He would do this, only to shortly arise, get dressed, grab a zimmer frame and walk up and down the ward. His navigation was somewhat lacking, since he seemed to stop by crashing into a trolley, chair, bed or door. He would then get back into bed, keeping his clothes on for a quick return trip a few minutes later.

So; I closed the curtains around by bed and settled down. The trouble was, hearing Steven crash about with his zimmer was funnier without the vision. I imagined a frantic ‘Animal’ from the Muppets with white fur, tearing up and down the ward pushing his piano. The trouble is, once you start giggling, it’s difficult to stop.

Next to me was Jim, poor Jim really was confused. Dementia takes many forms and in Jim’s case it had deprived him of some powers of reasoning, memory and speech. However, it hadn’t turned him into a vegetable, it was just that conversations would follow unexpected paths, and a response to a question wasn’t always conventional.

It was interesting to watch the reactions of nursing staff to meeting Jim for the first time. For some, they just didn’t get that he was confused. They’d just ask the same question in a louder voice, taking Jim’s response as if he was being deliberately awkward. Others would understand that he needed help in understanding, and would engage with him, gaining trust and approval from him.

Jim had fallen and broken his hip, which had been replaced. He was now recovering from the operation and the anaesthesia, which meant a whole new world of drips, catheters and a bed with sides to stop him falling out. So; from time to time, Jim would make a bid for freedom. Various nursing staff would come to his aid, to try and persuade him to not get out of bed, not to pull his catheter out, and that everything would be all right, his wife would be there soon, etc etc.

On this day, Steven is very concerned about his car. His written down the make, colour and number and wants me to go and look in the car park to find it. I point out to him that the reason we’ve been sharing the zimmer frame is ‘cos I can’t walk. I try to take the problem from him by promising to speak to one of the nurses about it. They aren’t convinced that he even came by car with a broken wrist. But he’s insistent, and can’t stop worrying about it. Lots of head shaking, holding his brow and sighing. Steven really should have been on stage.

Jim struggles to sit up, grabs the water jug and tips it over himself. Several nurses surround him and attempt to get him changed, the bed changed, and floor dry. Quite a lot of activity. When Jim doesn’t understand he tends to reach out and grab something. Anything, ID badges are good, or a hand. He has a strong grip, the nurse appeals to him to let go. Jim says ‘Yes’ but still hangs on tight, or will swop hands if he can. The staff are wonderful and patient with the patient, but it’s amusing, there are laughs in-between the appeals to ‘let go pleeeese Jim’.

Steven is hovering around the periphery of the action, buzzer at his throat, trying to convince a nurse to go and look for his car. Eventually he gives up and goes away. There’s a lull in the activity, and Jim’s voice is clearly heard:

“Now what you don’t seem to understand, is that it’s me that’s trying to get out of the garage”.

There’s a silence. One of the nurses looks out of the window.

“Good heavens, I’ve just seen someone fall over!”

“Oh, it’s OK, there’s someone to help them”

“Look, it’s the old man from this ward.”

Steven, frustrated at not getting anywhere with his car search, had decided to take matters into his own hands and had tumbled down a substantial grass bank.

He was brought back in a wheel chair, rather quiet and suffering only from grass stains on his chinos and a conviction that this hotel wasn’t any good at all.

Jim got sorted out and everything dried off properly. Peace broke out on ward F.

Conversations with Jim were fun. Moments of lucidity with sidesteps. He had been a very keen golfer. I found out that he had at his best got down to a handicap of nine. It took a lot of playing to keep at that level. But it was OK, Jim was convinced that we were on the winning team. At one time he suddenly asked me:

“Do you think we could do it?”

“Do what, Jim?”

“You know, make a break for it”

I feel sure that I’d have really liked the complete Jim. He didn’t lose his temper, or swear at anyone, and tended to talk to himself quietly. I heard him call his wife’s name, and than he said: “You’ve got the most beautiful hair”. In one of his golfing conversations with me he asked how many clubs I played with.

I’m sure that he would have played with a full set.

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