Dr Max says people have become increasingly wary of human contact due to concerns of being accused of assault
London, UK (BBN) - The news is bad, I’m afraid, I said to Mrs Reynolds, as she lay in her hospital bed.
She looked up and smiled at me warmly. I closed the door and sat on her bed. ‘Would you like anyone else to be here?’ I asked, reports Daily Mail.
‘No, it’s all right. Do I have long left?’ she asked calmly.
Mrs Reynolds already knew she had cancer. She had battled against breast cancer on and off for ten years, but it had now spread. She had been brought in after collapsing in the supermarket and scans showed the disease was now so widespread there was little that could be done.
I spent the next ten minutes having what was probably the most important and difficult conversation of her life. Several days later, Mrs Reynolds developed pneumonia, and again I sat on her bed, held her hand and reassured her as the nurse gave her pain relief. Later that evening, with her children around her, she died.
I was working in surgery at the time, and would often sit with patients if they were distressed, or scared, or alone, to try to reassure them. Yet, this is precisely the part of the story that would now get me in trouble: I sat on Mrs Reynolds’ bed. And no doubt eyebrows would be raised that I held her hand.
Over the years we’ve become increasingly wary of human contact, not least medical professionals. Partly, this is due to concerns around being accused of assault for simply touching someone, so preciously do we now guard our ‘personal space’.
But it’s also down to the buzz phrase of Health and Safety apparatchiks: ‘infection control’. This concept emerged from the public’s rightful indignation around rates of hospital-acquired infections.
Following ministerial pressure, hospital trusts are desperate to be seen to be doing something, and this has led to a number of policies being imposed, which have gone largely unchallenged because doing so implies, in some way, a laissez-faire attitude to infections and patient welfare. Flowers are banned, as are doctor’s ties. So is sitting on a patient’s bed.
But why? Is sitting on a patient’s bed and touching them really that dangerous? And what are we missing out on as a result?
A study published this week from University College London found that hugging and touching someone — even a stranger — can have dramatic effects on their wellbeing, helping them cope better with experiences such as pain. The fact is, there is no substitute for real human contact.
Naturally, there are times when it’s important to remain detached in a clinical situation: you don’t want a doctor getting touchy-feely when you’re having a heart attack, you just want to be resuscitated.
Yet much of medicine is about simple human interactions — it’s about listening to someone, trying to understand what their fears are, offering reassurance and sympathy. It’s about being human.
But how can we do this with any authenticity if we don’t ever touch patients? How can we do it if we’re prohibited from even sitting on their beds and being on the same eye level? I believe things should only be prohibited when there is robust evidence to suggest they are harmful. Yet this is absolutely, categorically, not the case with touching or sitting on beds.
On the other hand, there is considerable evidence to support such things being actively encouraged. I hate seeing doctors looming over patients as they lie in bed, craning their heads to hear what the doctor is saying. It’s not humane.
And in fact research also shows that patients report feeling that the doctor has taken more time with them when sitting compared to standing.
Hospitals can be scary, lonely places and anything that reduces this can only be a good thing. Of course, doctors need to act in a professional manner and, of course, it’s a judgment call about when to touch a patient.
But over the years I’ve come to realise that what matters to many of my patients, including Mrs Reynolds, is the warmth of human contact; this is often more important to them than anything I might prescribe.
SEXUALITY IS A PRIVATE MATTER
Thank goodness, some sanity after the madness earlier this week when it was suggested that doctors would have to quiz all patients about their sexuality.
The College of Medicine has warned that doctors will simply refuse to ask patients due to fears it will damage the doctor-patient relationship.
The NHS has claimed that it won’t affect treatment in any way, in which case, why ask?
It’s intrusive and another example of the insidious invasion by the State into our private lives.
We already give away vast amounts of information about ourselves to both the government and private companies, and it astonishes me how compliant we are when, in living memory, some states have used this kind of information against their citizens.
Have we learned nothing from history? Most importantly it risks alienating patients and forcing them to give false information.
These sorts of plans are cooked up by a metropolitan elite who can’t get it into their heads that not every gay person is draped in a rainbow flag dancing to Kylie.
Some people live in deeply homophobic communities and asking them if they’re gay before they’re ready to give up that information will damage the doctor-patient relationship.
I am gay and I know that coming out is a personal decision people make when they feel comfortable: you can’t force this.
It’s also insulting to doctors —credit us with the ability to judge the situation ourselves about asking for such information without issuing diktats.
I’m not going to change my practice: if you want to tell me you’re gay or straight that’s fine but I’m not going to ask you simply to tick a box on an equality form.
Language tests for nurses who trained abroad are to be watered down, as they’ve complained the tests are a ‘challenge’. Of course they are, that’s the point of exams. Nurses who’ve trained overseas make an incredible contribution to the NHS; without them it would collapse. But it’s only right that patients know nurses can understand and communicate with them and other members of staff. Rather than listening to applicants’ complaints, what about listening to patients whose health is put on the line because nurses can’t communicate properly in the language of the country where they work?
WHY OBESITY IS THE NEW ELEPHANT IN THE ROOM!
When it comes to big complex social problems, it’s tempting to find a bad guy to blame.
We see this time and again with obesity, where everything from genes to a lack of green spaces has been held responsible for the country’s bulging waistline.
In the firing line this week is advertising, with a coalition of the Royal Colleges and health charities calling for adverts for junk food to be banned during peak viewing times. Is this the answer? I don’t think so. Obesity is a relatively new problem; for the majority of our time on the planet, our problem was getting enough food to survive. But with the end of rationing after World War II, we’ve had increasing access to calorie-dense foods.
The rate of people considered clinically obese has risen from just 1 to 2 per cent in the Sixties to more than 25 per cent now. What’s going on? I think the answer lies in a study conducted a few years ago by the Department of Health that compared data from 1967 and 2010. Differences in lifestyle are clearly a factor: for instance, while 75 per cent of us walked for at least half an hour a day in the Sixties, now it’s just 40 per cent.
But what really stands out is the sharp contrast in attitudes. In 1967 nine out of ten people had attempted to lose weight in the past year compared with 57 per cent of adults in 2010. Most tellingly, 40 years ago only 7 per cent of people who considered themselves overweight had not done anything about it, compared with nearly half now.
So we just aren’t bothering to lose weight any more. And it’s no use banning adverts for foods that make you fat, if people don’t actually care if they’re fat.
Where has this complacency come from? It may be partly down to the fact that as more people are overweight, it’s viewed as increasingly normal — helped by the ‘big is beautiful’ mantra.
Meanwhile, doctors are wary of saying patients are ‘fat’ for fear of causing offence, too scared to confront the elephant in the room (excuse the pun). But let’s be honest, it’s also hard to listen to a doctor or nurse lecture you about obesity when so many are overweight themselves.
We need a social shift in how we view obesity so it’s less socially acceptable — and the place to start is surely in the ranks of the NHS itself.
BBN/MMI/ANS