Welcome to my latest blog, written again (in part) whilst on holiday in sunny Greece.
As a word of warning there are some troubling topics in this blog, so be aware that some of the content may be upsetting.
I didn’t set out to write an emotionally charged blog. I also didn’t set out to write a blog that is all over the place, topic hopping. This blog, I’m afraid, weaves in and out of subjects like a river through pebbles. It does get there in the end (I think). As I started to write this I was (as stated) on holiday and extremely chilled out, reflecting on how fortunate I am. This year, for example, we’ve had two holidays abroad (one week each) within a short space of time.
Normally we go for one longer holiday for two weeks, but my good lady wife and I wanted a break away alone, without the daughter (who is now 18). So, we did one week with three of us and one separate week as a bit of a second honeymoon (wink, wink).
Just a bit of clarity for those who don’t know me. My eighteen-year-old daughter is technically not my biological daughter. She is my wife’s daughter but adopted me as her dad when she was seven years old. She’s never really seen her biological dad and has no desire to (so far). I class her as mine and treat her as mine. I refer to her as my daughter and she refers to me as dad (or daddy, when she wants something). I actually get somewhat wound up if anyone ever uses the term “step-dad” to describe me.
My youngest (currently aged seventeen) is my biological daughter from a previous relationship. She lives with her mum and her mum’s partner, a decent guy, who my daughter often refers to as “dad”.
As for holidays, the youngest has been away with us previously, but she gets very homesick indeed. Although we’ve had some great holidays in the past with her in this country, she’s not really into the foreign holidays we enjoy. We’ve chatted with her about it but she’s genuinely not bothered about coming away with us on a hot, beach holiday. She tends to prefer a slightly cooler climate and a more active holiday (unlike the lazy, loungy holidays that we like).
Although I understand it’s very much her wish, I can’t help but feel guilty for not taking her. I also feel guilty for being a part time dad. I used to see her a reasonable amount when she was younger, but now she’s older, I guess I’m just not hip enough, so I see her as and when she can come. I’d love to see her more and be more involved in her life.
Needless to say, I carry guilt that I shouldn’t, but I can’t help it. This can sometimes affect my behaviour and I may show more leniency with the youngest than I do the oldest. This isn’t due to a difference in love but is purely down to the chains of guilt that I feel burdened with. I think it’s something I will struggle with until the last breath has left my body.
This guilt led me to write a poem back in 2007, which I will share with you here. Having reread the poem I am in a different place now, but I still carry that knot of guilt. I’m also now not that keen on the poem either, but it exists, so I’ll share it with you.
The clock face stares back
As I wait.
The seconds drag, yet steal my precious time.
As I wait.
As I wait.
The life of an estranged father
Is tangled with guilt
Competing affections of
A new love, a new life
A child not of my loins.
A smiling child hungry for affection,
Stomach rumbling in anticipation
Of a new love
A new life.
Will time ease the guilt I feel towards my own?
Will time make affection come more naturally?
For the seconds steal my precious time.
As I wait
As I wait.
But the clock never gives.
And now the time has come to bond with my own
And I await her arrival.
My stomach rumbling in knots of guilt
As I wait.
As I wait.
Her smiling face,
Her loose pony tails,
Her childish wit and exuberance
Wash the knot loose
And we laugh.
And we laugh.
Her giggles ignite in me a love that is not surrogate.
One so small yet strong enough to lift me higher than anyone can.
Strong enough to lift me.
To lift me.
Our time together precious
Stolen by the clock
As the seconds race away.
Like falling water lost in the rapids
Water that I can never taste again.
And we play.
And we play.
Until the clock has stolen the time we had.
Until her giggles turn to goodbyes.
Like the rapids she rushes on,
Never looking back.
Takes for granted that goodbye kiss that she forces
A tidal wave of fun that leaves silence in her wake.
And my stomach knots with guilt.
As I sigh.
As I sigh.
As I turn back,
To my new life.
To my new love.
As I turn back
But never turning my back on the giggles in the memory of my heart.
The life of an estranged father Is tangled with guilt.
A carousel full of cases,
And bursting with guilt
Awaiting collection from Terminal Three
So I’ll drag behind me my cases.
To Terminal Two
Where I try to offload them to you.
But you have some too.
So together we drag our cases.
Together we carry our knots.
With some sideways movements but little progress.
And we wait
And we wait
And we wait.
I know, having spoken with a lot of estranged fathers, that I don’t have the monopoly on this, so maybe it will ring true for others.
Anyway … I have digressed. I started off by saying that I’m writing this on holiday. I’m writing it piecemeal so will probably be home by the time I finish.
That said, as I type this (using my fat thumb on a small smartphone screen) I am lounging by our private pool, on a beautiful holiday complex in Kardamena, Kos.
My good lady wife is in the pool and I am chilling on a lounger.
Just a quick snap with my smartphone, so forgive the quality. Shared to show where I was when I started writing the blog. The photo doesn’t do the view justice.
View from our hotel complex.
Panoramic picture from the beach.
I have noticed how we simply take such things for granted. Sure, we have worked hard to come away … to pay our mortgage and save for the holiday. We work hard, and I genuinely feel that we deserve the indulgence, but I must remind myself that what I take for granted in my indulgence is the product of other people’s brains, vision and hard graft.
We simply jump on a plane to Greece, take a taxi ride to our hotel, eat the food, drink the drinks, swim in the pool, sleep in the beds etc.
If I take just one part of that … jump on a plane. If we go back to the Wright Brothers and follow the timeline to now, how many people, how much thought and sweat has gone into making that possible?
From workers in the steel industry to structural engineers, from designers, computer experts and telecommunications wizards to space explorers, from electricians and plumbers to cleaners, chemical engineers, anti-terrorism professionals and customs staff, from security staff, scientists and lawyers to HR specialists etc. How many agreements and foreign treaties will have been drafted up between politicians and lawyers to allow safe and free passage? The list goes on and is far too vast for my tiny brain to comprehend, but it is a list we take wholeheartedly for granted. That is just a tiny part of my holiday, but it is a huge cog amongst many cogs, made possible by small people with acorns of ideas. made possible by people daring to live their dreams.
Every day, in our lives, we take seemingly small things for granted. The loaf of bread in the kitchen, the water from the tap, the light from the bulb or the laughter from the TV.
All of these things are made possible by little people, working together in an overall hugely impressive team effort.
It’s easy to look at the mainstream media and turn the headlines into fear. It is such fear that sells papers (or online advertising space). The media doesn’t make money by dealing in reassurance. They love to feed the nation a daily fix of worry, scandal and fear.
Social media internet trolls, it seems, also like to feed on this fear, in the search for self-validation, likes or furtherance of specific causes. It creates this uncertainty of false news, which seems to be an ever-permeating reality in our society nowadays. In fairness, I’m not convinced as to the truth behind the news historically either, but call me a cynic and all that.
If we believed the slant of the news, if the fear was indeed true, then there’d be a paedophile in every park, a gang of child abusers at every take away and a terrorist at every shopping centre. The truth, of course, is a million miles from this.
Of course, there are terrorists out there, there are child abusers and paedophiles and there are drugs on our streets. We can’t hide from this, but this fear should not define us. The real truth is that there are billions of little people, decent people, each doing their bit to make society work. There are hundreds of thousands of mini societies all interlinking with each other to make the world one place. Of course, some societies will clash, some will disagree, some will fight, but in the main, people work together.
Wildlife documentaries have screened fascinating shows detailing colonies of ants, building tunnels, carrying food, protecting each other and working together. Viewers watch in wonder. As humans, we don’t often observe ourselves in the same way and we tend have a habit of living in silos. If we were on the outside looking in, aboard an alien space craft for example, then perhaps we would see the huge team effort; the tiny individual contributions that each of us makes to form a whole; not perfect, but generally, in the main, effective.
It is for this reason I want to reflect on equality. Not the equality as we have come to recognise it in recent years. Not women’s rights, gay rights or black rights. These things are all vitally important and valid. I feel equality goes deeper than that. I personally feel the current trend of equality just scratches the surface.
I believe that today’s society gives too much credence to the “Big Man” (I use the term loosely and am not being gender specific). When I refer to the “Big Man”, what I really mean is the “Rich and privileged person”. Bosses of banks, giving themselves huge bonuses, CEOs of private companies buying out parts of the NHS for profit, the aristocracy (I’m not an anti-royalist by the way), professional soccer players, rock stars, TV personalities, ministers and music moguls to name but a few.
The point I am trying to make is that these are the people who are paid the most yet get the biggest discounts. These are the people who are already wealthy but get free entry into night clubs. These are the people who can afford their own personal chef yet get a Nando’s black card. These are the people who get VIP treatment at the airport or theme park.
The ants, the little people, are the ones who have to get by. They don’t get the breaks, the discounts or the VIP treatments, but these are the people keeping our hospital wards clean. These are the people who keep the shelves stacked so we can find a tin of beans. These are the people who put the beans in the tin in the first place.
You may think I am alluding to a Socialist ideology. I’m not sure about that. I’m just trying to highlight the value of the little person. It’s right that the person at the top of a corporation, making huge decisions affecting people’s lives should get paid more. I get it (although I feel there should be checks and balances so that this isn’t at the expense of the little person). I also get how the big boss person may want to use that pay to buy certain privileges, such as a nice house or flash car. I really do get it. What I don’t get, however, is how someone’s bank balance or visible wealth should automatically give an enhanced standing in society. What I don’t get is how a person’s physical wealth gives them automatic prior importance over other people.
What I don’t get is how society colludes in keeping the little person down. There’s evidence of it every day. Payday loans, with ridiculously unaffordable interest rates, are advertised alongside TV programmes watched by people who are likely to be retired, unemployed or on low income.
Certain companies, selling widescreen televisions and other luxury items, open impressively tempting showrooms in places of higher social poverty and lure people on already stretched incomes, by seemingly affordable, never ending payment plans.
Utility companies charge much higher rates for gas and electricity customers who use pre-payment meters.
The shops where pre-payment cards are topped up often have cash machines which charge customers to withdraw their own money. These types of cash machines are often placed strategically in places of higher social deprivation.
The people targeted are already living hand to mouth, some barely managing on a day by day basis. These very people must run this gauntlet each time they venture outside to buy groceries. These very people are more likely to go to the shops every day to purchase what they need as they often can’t afford a weekly “big shop” and, due to financial constraints, will barely see beyond the next day. They aren’t the sort of people who can benefit from the luxury of a TESCO (or whichever) home delivery. In essence, these people are likely to face this temptation, to face these hurdles every day, maybe several times a day. It’s a perfect marketing strategy for “The Big Man” to make money from the little person.
Then, when the little person fails to make a payment, or a direct debit is returned, they are often hit twice. There is an extra “admin” charge from the loan company plus and extra charge from the bank. I know this from experience. I have been there. I was once a hospital porter on less than minimum wage (before minimum wage came in) and I worked as many hours as I could to make ends meet. I’ve been there and it’s ridiculously hard to see a way out. This sort of “punishment” for missing a payment (often a double punishment) simply reinforces the cycle, adds to the difficulty, and reiterates the message that you are just a little person of no relevance. Whilst I understand that a lot of these charges can be challenged or negotiated, it’s hard to fight when you’re already beat up. Even when you do have the energy to fight, a lot of the customer service telephone lines are premium rate numbers (they certainly used to be) and this adds to your woes.
It’s ripe pickings for the poorest to become poorer and the richest to become richer. It’s like the opposite of Robin Hood.
These are the inequalities in society that I feel systematically pervade almost everything we see.
I’m speaking from an ideological perspective. I know this. The human psyche, since time began, has been blighted by jealousy, envy, gluttony and greed. My words on a blog will do nothing to change that. Society needs to change from within, but I doubt that will ever fully happen. Changes have been made and some things are better (not as many premium rate lines, as an example) but we’re still a long way off true equality.
One thing I do recall from my time as a hospital porter, living in council accommodation, is that I had big dreams. Little people have dreams just as big as the “Big Man” but, sadly, their dreams are easier to quash. It’s important to keep your dream alive and work towards it, no matter where you sit on the ant pile.
Even when I left my job as a porter and started my dream job, I was still struggling financially. My wages were the best I had ever earned, but I was still climbing an uphill battle to get me out of my previous situation. Then came the break-up of my relationship, so I moved out, taking only what I could wear or carry. It was important to me that I left my little girl in a house with a sofa, washing machine, beds, TV etc. What this meant is that I was pretty much starting from scratch.
I bought an empty house but obviously needed my own furniture, TV, cooker and washing machine, amongst other white goods. These don’t come cheap but were needed. Finance was the only way. This set me back for years, despite being in a good job with a reasonable wage. I also had child maintenance to pay, so once again, I found myself living hand to mouth. It was a tough time but it’s important to remember that these things are never insurmountable. It’s so easy to find yourself in a dark place and giving up can feel like an option, but it’s not.
Fortunately, I have never found myself in such a dark place where I have contemplated suicide as a serious option, but I have been lucky. There are many people who do find themselves in that corner. There are people whom I personally know who have been there (one of whom sadly didn’t come out). No doubt you may have, or have had, similar concerns about individuals. Take heart, because you can help. You can literally help to save a life.
Please see the below link to some free online training which can show you how. It’s a really useful package and I urge anyone and everyone to go through this. It literally could make all the difference:
Suicide Prevention Training
Going back to my story, I had been in a terrible hole following my relationship break up, but a few years later I was married, had two wages coming in and things were improving. We were still struggling a little financially, but we were ok. I hadn’t been married two years when infidelity (not mine) came knocking so divorce soon followed.
Whilst I managed to keep the house, I was left pretty much broke and penniless … in fact I was very deeply in the red, so at 39 years old I found myself on the bones of my backside once more. I now had one wage coming in, but debts for two to pay off, plus child maintenance, mortgage and my bank screaming at me.
Despite having got a promotion at work I was financially as bad as I had ever been.
It’s important for anyone who finds themselves in such a hole to make strides to clamber out; to not give in; to keep your dreams alive. The next link i will share did not exist when i was having my woes, but is a really useful place to start for anyone who is struggling to find a way out:
Money Advice Service
Time has, of course, moved on. I am no longer in the place I was.With the help of an amazing woman (a bloody amazing woman, actually) I am now on my feet again. I married that amazing woman and she has supported me through some difficult times. I’ve now had a further promotion at work and we live in a bigger house in a better area, with no debts apart from a mortgage. We have had two holidays this year and finally things are coming together for us.
Of course, I’m still just an ant in the wide scheme of things, but I’m further up the pile than I’ve ever been. Some of my dreams have come to fruition and I am working on several others.
The point I am trying to make is that when I speak of inequality I speak from lived experience.
I also think that inequality has been concentrated of late with the onset of austerity. Once austerity waved its big flag over the country things changed even more. Private corporations seemed to jump on the band wagon to make savings, or hike prices, at the expense of the consumer. Look at the big energy companies for example, the utilities providers or some of the telecoms giants. Better service? Doubtful. More expensive? I think so.
But by far the hardest hit is the public sector and the little people who rely on the public sector. Small minded austerity policies have looked at each service individually to assess where savings can be gleaned and where efficiencies can be made. So, for example, the Home Secretary looked at the Police Service, the Education Minister looked at schools, the Prisons Minister looked at the Prison Service etc. The list goes on. They all looked at their respective areas of responsibility, but I’m not convinced as to the efficacy of cross communication. The other concerning thing is the amount of cabinet reshuffles. One day I might be the Minister for Arts and the next day I could be the Educations Minister. It seems to me that the people in charge of making the savings don’t fully understand their own areas, least of all have any grasp of other areas that may be interlinked with their area of business. Decisions in one area could have an impact on another and without this cross understanding, how can we truly be efficient?
A situation occurred in my personal life back in August 2016 which caused me to think about this in more detail. That situation was my wonderful mum becoming ill and going into hospital. This story is personal for many reasons, one of which being that my mum never came out of hospital alive and we lost her within a month.
Late August 2016 and I was at work one afternoon. I received a call from one of the carers at the sheltered accommodation complex where my mum was living. Staff were concerned about my mum, nothing too worrying, but she didn’t seem quite right. In herself she was predictably resistant to going to hospital, typically reluctant to make a fuss and in otherwise good spirits. They had an inkling, however, that something was amiss.
I immediately left work and picked my wife up on the way to the hospital. We beat the ambulance there and we waited in the A&E corridor alongside three patients on stretchers and six paramedics who were waiting to discharge the patients into the care of A&E staff.
We waited about ten to fifteen minutes and my mum arrived, in reasonable spirits … and we waited. This isn’t one of those horror stories about waiting for twelve days on a faeces stained stretcher in a corridor full of dead bodies with only grid water to drink. Far from it, but I did learn a lesson that day.
It wasn’t too long (maybe an hour or so) before my mum was taken into hospital care and assessed. It was discovered that she had a collapsed lung and without immediate treatment could possibly die.
The first thing that struck me about this is that, although ultimately it didn’t end well for my mum, she had been given every chance. I’ll touch on that more as I relay the story, but the first chance she was given was due to “the little person”; the carer who was earning not much more than minimum wage, but who was astute enough to spot the very subtle signs that my mum “wasn’t quite right”. My mum’s chances started with that person, near the bottom of the ant pile, who had enough pride in her job to do the right thing. The world is full of these unsung heroes. The world is littered with them, yet they have no real status in society. That, I feel, is an injustice, but I digress.
Back in A&E, my mum was taken into resus where a chest drain was fitted. I waited outside on the corridor with my wife and what struck us was the number of patients still waiting to be admitted. With every patient stood two paramedics, who couldn’t leave their patient until they were admitted.
There must have been four or five patients and they were stacking up.
I had a chat with a paramedic who told me he had been there for about two hours. He also said, “this is nothing” and alluded to a four hour wait not being out of the question.
If I’m being conservative and I say there were four patients and eight paramedics, stuck for just one hour, then this translates to four ambulances unable to attend emergencies for an hour. In reality it is much more than this and I am only speaking of one A&E department.
I dug a bit deeper and discovered that A&E were unable to clear beds as there were no spaces on hospital wards. This was causing a clog up in A&E, which in turn was preventing paramedics from saving lives. Not only were paramedics stuck waiting but there were more diversions of patients to A&E departments further away. This causes further delays for the ambulance staff but clearly causes delays in vulnerable people getting life saving hospital treatment.
Having had conversations with hospital bed managers, I know that to release a patient there must be adequate support in place, which often involves Social Services.
Austerity has hit Social Services hard also, so there are now inherent delays in assessments. Fewer staff with bigger workloads means that so called efficiency savings are having the opposite effect. The individuals performing patient assessments are under real pressure and strict scrutiny to release more patients into the care of family, despite the families’ ability to cope and despite the risk of falls etc.
I have seen this first hand with my own mum previously; that as soon as she can walk from the bed to the toilet the physio says she is fit. A “bed to bog” walk is hardly a realistic assessment, but these professionals are under increasing pressure to take more risks.
Going back to my previous point, however, these assessments take longer to get nowadays and when they are done they are less thorough and therefore fraught with risk.
In my opinion, many people are getting released when it is unsafe, due to bed blocking pressures … but those releases are taking longer.
It’s not just the assessments, but if certain things need to be put in place before a release, such as equipment for the home, then this takes longer also.
In the meantime, the population is growing. The population is getting older. People keep coming through the doors of A&E and backlogs continue.
On top of this, unsafe discharges result in re-admissions, putting more pressure on paramedics and A&E staff and the cycle deepens.
This blog was complete and ready to publish, when I read this tragic article on the BBC News website:
Tragic Death of a Child – Hospital Failings
I don’t claim to know the exact facts behind this awful story, and the news we read tends to report with certain bias. That said, there is no getting away from the fact that a beautiful child has lost his life.
A further article from the same news website shows a video of this little boy’s grandmother describing the pain that her grandson was in before he passed away:
News Article – Video – A Grandmother’s Description
Was this down to incompetence? Possibly. My view, however, is that hospitals are under so much pressure that mistakes are made every day. Individuals can only work under a limited amount of pressure and remain effective. When this pressure is too much and is present every day, what can we expect? There may have been mistakes made by individuals, but by individuals under great strain and with little support. In my opinion the blame for this tragedy, and many more similar tragedis, lies at Westminster.
It’s not just hospitals and the ambulance service who are affected, in my view. Taking this wider, because paramedics can’t attend everything, they naturally have to push risk elsewhere.
Calls involving, for example, a suicidal male, are now regularly passed to police to attend (just in case of violence). Upon police attendance the paramedics downgrade their response because the patient is with someone who can keep them safe. Police officers, who have already faced swingeing austerity and huge cuts to numbers, are now sat with this male. Those same officers can’t attend a violent domestic assault or robbery because they are sitting with someone whom they are neither qualified, nor trained, to deal with. Those officers could be tied up for hours awaiting paramedics. If the officers take the patient to hospital, then they too are stuck at A&E awaiting completion of a mental health assessment, so they can discharge the patient to the care of the hospital.
Unfortunately, mental health services have also been stripped back both in hospitals and in the community. Such assessments don’t come quickly.
If you then look at this deeper still … Social Services have been cut back. Mental Health Services have been cut back. Benefits have been cut. Mental health beds have been reduced hugely. Care in the community services are stretched. It’s no surprise that the most vulnerable in our society are having more breakdowns, with less support. This adds greater pressure on police, ambulance and the NHS.
Patients are released from hospital and mental health units before they are ready, and this creates more pressure on community services. These services are bursting with demand and individuals within these services are having to make tough decisions that are against their own personal values; decisions to exclude certain people from their service … but to where do the vulnerable people then go?
There are so many other services to have been hit too; services that aren’t as appetising, such as drug and alcohol services. Without these services, people who are alcohol dependant or drug abusers are getting less support. There is then the knock-on effect of crime but without the police resilience to deal with it.
Prison places are fewer, so the criminal deterrent isn’t as robust. When prisoners are released the support in place isn’t as effective, potentially leading to recidivism. Dangerous prisoners are moved to open prisons earlier than they should be, and violent or predatory offenders are released earlier, or not jailed at all. This leaves the public at greater risk from crime.
Of course, the education system hasn’t escaped austerity and interference. I have several close friends who are teachers and I am a school governor, so I can speak with some (albeit limited) knowledge.
It’s true to say that the perception is that the staff working in education, from teachers to assistants, from welfare officers to administrative staff feel that ministers do not listen to their views. They feel that there is an agenda which is being forced through regardless and not necessarily in the best interests of the children.
One friend works in a special needs school. She is forced to teach the national curriculum when it is wholly inappropriate for some of her class. Some of her children do not have the cognitive ability to appreciate what happened yesterday, yet she must teach them about Victorians. Some children can’t hold a pen and would be best served by teaching them real basics, rather than expecting them to get a grasp of multiplication. She feels that she is fighting a losing battle and is letting down her children, due to internal confines and external interference.
Head teachers are under real pressure to balance the books and whilst the government say that education funding has not been cut, when you offset against inflation in real terms there have been huge cuts.
A lot of inner city schools are also catering for unprecedented influxes of pupils with English as a second language, so this affects attainment and results. The extra time needed for these pupils isn’t reflected in the funding so there is a knock-on impact on other pupils. Certain non-academic subjects may get put aside as a consequence, in favour of conventional subjects and, as such, many of the practical, but not particularly academic children are falling by the wayside. A system has been created where a student’s worth is measured by their exam results and this creates further division and injustice for children who aren’t as bright in a conventional sense.
A quote which has (rightly or wrongly) been attributed to Albert Einstein is as follows:
“Everyone is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid.”
I agree with this statement in that I believe that everyone is good at something. Everyone, in my opinion, has a gift. It is up to us, as adults and parents and it is up to our education system to find out what that gift is in each child and help them to hone it. It is up to us to shun the perception of conventional knowledge and help each child identify their talent.
Unfortunately, austerity and policy are working against schools and not making this an easy task. If we fail to identify our talent, we risk isolating a whole bunch of geniuses, who will feel excluded and potentially feel worthless. This social exclusion and injustice is one of the causes of crime. Society simply doesn’t have the resources to continue putting sticking plasters on crime so more radical thinking is needed, in my humble opinion.
I hope to have in some way illustrated how cuts to one service affect another.
Austerity has hit virtually every service from bin collections to education and from drug and alcohol services to fire stations.
The pressures on the “little people” to give a cursory service are higher than ever and the people suffering are the public. The very people who need a police officer to come are not getting one. The vulnerable people who need an ambulance might end up getting a police officer instead, if anyone at all. A person desperate to be discharged from hospital to home might be stuck, blocking a bed for a week whilst those who really need hospital care are sometimes discharged unsafely. People who need support with housing or mental health are going without and at a lower level, motorists are finding their cars damaged from unrepaired pot holes. Geniuses are not being recognised and those in need of urgent surgery are waiting longer for it.
I’m sure anyone reading this can come up with personal examples of how austerity has bit and created further social exclusion and further inequality.
Before I continue with the story of my mum’s final hospital admission, I will share another example that highlights my point.
A previous incident involving the hospitalisation of my mum saw an appalling level of care. She was unable to get herself to the toilet, she had sickness and diarrhoea but was not incontinent. When she needed to go she needed to go and she needed to go quite often, through no fault of her own. She had, quite rightly, been placed in a side ward (to avoid cross infection) so she had to use her buzzer to summon help.
I arrived one afternoon with my wife to visit her to find my mum confused, semi-conscious and her eyes rolling. I genuinely thought she was dying. She was also wearing a nappy.
I discovered, to my absolute disgust, that she had been drugged up and put in a nappy to stop her soiling the bed and to reduce the demand that she created. The decision was a direct result of low staffing. Whilst I understood the pressures, this was far from acceptable and I made a robust complaint. As a result, I met with the matron who was extremely apologetic and begged for a chance to get it right. Things improved, although not to a fantastic extent, but our hands were tied. My mum was unwell and needed to be there. Eventually she recovered but not without anger, frustration and tears at the way she was treated.
I genuinely don’t think that anyone goes into the nursing profession, the paramedics, teaching, the police service or social services to give a poor level of service. I’m sure that when the vast majority of these dedicated individuals take up their roles they do so with the best intentions.
Unfortunately, pressures due to austerity and efficiency policies, coupled with higher demand are causing perverse thinking and behaviour.
Who would ever think that putting an adult, who is not incontinent, into a nappy and drugging them up unnecessarily is a good idea? Who would ever think that is acceptable?
On the flip side, however, it might be the only option when, as a qualified nurse, you are dealing with 15 to 20 patients (maybe more), all with complex needs and persistent demands; you are also having to document every interaction, double check medications and fit multiple catheters; you have to show compassion with each patient and understand their individual needs; you have to accurately conduct hourly observations including blood pressure and temperature checks and document the same; you have to act on each observation whenever there are any concerns; you have to answer buzzer after buzzer from patients who may simply want a cup of tea or a chat, to patients who can’t breathe or have defecated the bed; you have to liaise with the doctor and double check their notes to ensure you are following instructions; you have to ensure that no medications are missed; you have to answer questions and challenges from concerned families; you have to fit all this in and more whilst working on your feet for twelve hours, barely getting your own toilet break and probably eating on the move. Under such pressure, in order to allow you to do all that and more, calming someone with drugs and putting them in a nappy might seem like a sensible way of managing one of the many competing demands during the day.
In my opinion, it is not the little person who is wrong. Of course, there are members of the caring profession who shouldn’t be paid in washers, but thankfully these are few and far between. In the main, the little person is doing their level best, but they are breaking. The system, battered by austerity, is responsible for breaking these people and broken people can’t fix broken people in the way they would like to do. Sadly, day in and day out, working within a broken system alongside broken colleagues becomes the new normal, and this can’t be right.
The little people suffer; the workers and the service users.
I do take real heart, however, in that the politicians who have overseen years of cuts and pay freezes, who have presided over a system that sees war veterans going to food banks, tell us that we are all in it together. I take real comfort from this when in the midst of all this, those very same politicians have received offensive pay rises on the back of the expenses scandal. I am warmed and comforted that we’re all in it together.
The inequality is staggeringly blatant and frighteningly shameless.
I have colleagues who are financially worse off now than they were eight years ago. I am fortunate, in that I’ve worked hard and been successful at promotion. Consequently, I am financially better off but promotion isn’t for everyone. There’s a lot to be said for job satisfaction and it would also be unsustainable to promote everyone. Job satisfaction, for the reasons stated, is not as prevalent as it once was and not as obviously present as it should be.
Anyway … true to form, I have hugely digressed. Let me take you back to late August 2016.
My mum was admitted to a hospital ward, complete with a nice, new shiny chest drain. The plan was to ensure that her lung was re-inflated and repaired so she could be “unsafely” discharged. (I joke, of course. Any discharge at this point would, I suspect, have been quite safe as she lived in sheltered accommodation with carers on site).
Over a period of about four weeks she remained, bed bound, attached to a chest drain. It was a pretty grim time for her, but she was an inspirational woman, who kept her spirits up pretty much the whole time.
As I stated before, she was given every chance. Whilst there, staff spotted an infection by careful observations of her temperature and blood samples and hit her with antibiotics at the right time. At one point she was exceptionally weak, and we were warned that we would be likely to lose her. We discussed it with her, we all had a good cry and came to terms with it. The staff didn’t give up, however, and continued to make efforts to save her. I went home, fully expecting a call through the night, but the call never came. Instead, a combination of the hospital staffs’ efforts and my mum’s resilience resulted in a remarkable recovery, which baffled the doctors. Again, she was afforded a chance, thanks to the little people.
My mum was a real fighter and lasted another two weeks. Unfortunately, her lung just wasn’t re-inflating and the consultant couldn’t understand why. He was confident, however, that my mum would recover, and he assured us of this. My mum looked otherwise well, and she was in good spirits (as usual). As I left her I had a bad feeling and I told my wife that I didn’t think we’d see my mum alive again. There was nothing to suggest it; nothing but my gut instinct.
I worked nights that night and at 12 noon the following day I was awoken by my wife. The hospital had called, and we needed to get there. My mum had rapidly deteriorated and was unlikely to survive.
The journey to the hospital was frustrating as we hit every red light, but we got there in good time. My mum was still alive but was barely conscious. She had become very weak and had no reserves left to fight. We were told it was a matter of hours. They moved my mum into a side ward to give us privacy and told us we could stay as long as necessary.
We were paid a visit by the palliative care team to talk through my mum’s imminent departure from this world. They explained that towards the end my mum would probably get anxious, but they would write up and prescribe drugs now to be administered to calm her as soon as it was necessary. A doctor would not be required to sign them off and the drugs could therefore be administered without delay to ease my mum’s passing. We were promised that the ward staff were on high alert for my mum’s buzzer and would come the second we needed them. This was certainly reassuring.
We stayed with my mum for several hours and throughout most of that time she was unconscious. There were odd moments of lucidity, but in the main she was sleeping.
During my mum’s hospital stay, as a result of the chest drain, she had developed subcutaneous emphysema. This is trapped air under the skin, which causes swelling. It’s usually nothing to worry about and temporary. It started at her chest and we joked that she looked like Jordan (without the false lips). Eventually it started to spread and by the day she passed away it had spread to her arms, neck, face and eyes. It was exceptionally unpleasant and not what anyone would want to see a loved one go through.
We watched, and my mum’s breathing became more laboured. We watched as she gradually started to swell. The journey was a rollercoaster of extreme emotions, but I promised I would hold it together and remain strong for my mum; to be there for her as a familiar and reassuring face should she wake with any anxiety. I was desperate for love to fill the room, so that in my mum’s final moments she would have no doubts and could slip away in peace.
As expected, my mum awoke, and she was anxious. She was more anxious than I have ever seen her. She was scared, and her fear was painfully obvious. It was also immediate; from 0 to 10 in a heartbeat. I pressed the buzzer, confident that staff would attend immediately with drugs as promised. As soon as I pressed the buzzer an alarm went off on the ward and staff went running to this alarm. Seemingly someone had gone into cardiac arrest at the very moment that I pressed the buzzer, so it was all hands to the deck to save this person’s life. The sound of my mum’s buzzer fell into obscurity and no one came.
Whilst I understood the situation outside my mum’s room, the situation in my mum’s room was excruciatingly real. She was trying to sit up, panicking, trying to get out of bed and shouting with no punctuation: “Oh my God help me Darren help me help me oh my God Darren help me Darren help me!”
And I was helpless to help her. Both my wife and I were helpless. Despite our loving reassurances and calm words, the only help that could come was outside of the room and it wasn’t coming.
We both tried our best to calm my mum; to assure her the nurse was coming, but we were utterly helpless. My efforts to fill the room with calm serenity and love were failing.
I knew the staff were trying to save someone’s life, so I did not want to interrupt them, but I was failing my mum. I was failing a beautiful person who had never failed me, and I was failing her at her greatest hour of need.
I started to break. I felt myself starting to break and I couldn’t let my mum see this, so I went to the en-suite toilet room, leaving my stricken mum in the care of my amazing wife.
I closed the door and broke. I sobbed like I have never sobbed before. It was an uncontrollable sob; the sort of sob where your bottom lip curls without choice; where you can’t breathe and the sort of sob that hurts your ribs. I was a mess. I was swearing at God, demanding that he intervene. I hated God and everything that God stood for. I cursed him. After a few minutes, I gained some strength and managed to pull myself together. Now, however, I was angry.
I walked back into my mum’s room feeling stronger and more capable, but the room started to fill with anger, not love. By now about ten very long minutes had passed and my mum was still in a horrendous state of panic. I decided to go out and confront the staff.
A young doctor was sitting behind the nursing station and there were no nurses to be seen. He was writing and looked almost offended to see me standing there. I suspect it was an unwelcome surprise to see a visitor outside of visiting hours.
“Yes?” he questioned, in an accusatory manner.
It was obvious to me that he didn’t even know we were in the side ward, least of all what the situation was.
I responded in a sharp manner, but still, I feel remarkably restrained, given my anger.
“I’m here with my mum, Norma Whitehead. She’s in the side ward because she’s dying”.
His manner immediately changed, but to one of annoying platitude.
“Oh, Mrs. Whitehead. I’ve treated her. She’s a lovely lady.”
I replied with a touch of venom in my voice.
“I’m not bothered about whether you think she’s a lovely lady. She’s dying right now and she’s scared. We pressed the buzzer ten minutes ago because we need somebody, and no one has been. We were promised this wouldn’t happen”.
The doctor was speechless, but fortunately for him a nurse emerged from the office. My attentions were turned to her.
“We’re just checking the medication now”, she said. “We’ll be with you in a few minutes”.
“You wouldn’t treat a dog like this”, I snapped.
I went on. “This is a really important time for me and my mum. She’s dying. We’ll never get this time back. I didn’t want to spend this time angry, but I’m angry right now”.
I realised, however, that the more I went on, the longer I would delay my mum’s drugs, so I shut up and returned to be with my mum.
Very soon after the nurse came in and was confronted by my equally upset and angry wife. She reiterated “we were promised that this wouldn’t happen”.
It was a devastating time for us both, to see my beautiful mum go through this.
The nurse injected my mum with a drug to calm her down. It would normally work immediately, but because my mum was so swollen it had to be given subcutaneously, which takes longer to work. After about ten more long minutes my mum drifted to sleep and started to rest.
The nurse explained that even though the drugs were written up by the doctor they still must be double checked by two nurses. Due to the emergency, a second nurse wasn’t available to double check, hence the delay. It didn’t make me feel better, but at least I could understand. In essence, there weren’t enough staff to deal with more than one emergency.
About an hour or so later my mum awoke one final time and again was anxious, but this time the response was quicker, this time by a different nurse from the night team. She commented that she would give the full prescribed dose this time, not half the prescribed dose that the previous nurse gave. This was annoying also and raised a question that I will venture into later.
My mum was soon asleep and a short time later she passed away as I held her delicate, little hand.
The relief was immense, but the loss was devastating. My wife, as always, was an absolute rock. We held each other and sobbed a while as my dearest mum grew cold.
I think this must have been the most traumatic thing to ever happen in my life and for a while both my wife and I thought we may need counselling. We haven’t had counselling and we’re doing ok, but this awful situation highlighted to me another cost to austerity. Again, due to low staffing, hospital staff were unable to deal with two emergencies at once and my mum was disgustingly failed.
One thing struck me, even in the midst of my angst. It related to the half dose of medication that my mum had been given first time around. First of all, had she been given the full dose, as prescribed in advance by the doctor, then perhaps she wouldn’t have had to endure the second trauma when she awoke. Perhaps she would have just slipped away. So that annoyed me. But it also made me think.
I feel that because we live in a blatant blame culture, professionals are scared in case they do the wrong thing. They are second guessing themselves all the time for fear of civil litigation. This has the perverse consequence of actually making them less efficient.
In this situation, my mum was dying, and not dying well. Why, under these circumstances, would you second guess a doctor’s decision and give less dosage than prescribed? Was the nurse so much in fear of being accused of euthanasia? I don’t know, as I never got the chance to ask, but why else? You can see that this person is going to die within hours, if not minutes. You can see that they are suffering and having an awful death. You have the option to give a full dose of medication, backed up by written authorisation from a senior, qualified staff member. Why then, would you do different? I don’t get it. I can only assume it is fear of civil litigation.
So, in my opinion, such public servants are not only held back by austerity, their hands are also tied by fear.
Not only is austerity letting down the living, it is also responsible for creating a system where hospitals are so short staffed that even the dying are being let down.
This concludes what has been a long blog, with multiple diversions and various topics. I’ve tried to cover some experiences of my own which have led me to the conclusions and my beliefs about social inequality.
As I said earlier, this has been written piecemeal and what started out being written by our private pool, midway through our holiday, has been partly finished off on the flight home, but completed fully back in Blighty.
I’m not sure if I’ve achieved what I set out to achieve, but if anyone takes anything from the blog then please take the following:
Value the small person. The small person’s genius is as big as yours and their dreams are just as vivid.
Don’t look down on the small person, unless you are giving them a hand up.
Try to see the genius in everyone and try to help people recognise their own.
Don’t assess your wealth on the value of your car, house or bank balance.
Value yourself and your personal contribution to society.
Trust the opinions of those who value you. Discard the opinions of those who show you no value.
Be satisfied with where you are and what you have but keep your big dreams alive.
That’s it for now. Until next time …