David Hill: It's time for hospitals to enhance client viability

I had a melanoma excised the other day in the day ward of our local public hospital. I went in at 8am and was out by 11am. I was treated with courtesy, efficiency and skill. I felt isolated and dislocated nearly all the time.

My feelings are no reflection on the hospital staff. They could not have been more thoughtful. (Though they could speak a bit more quietly; not everyone in a day ward is deaf and/or sedated.)

At each stage in the procedure, people checked certain things, explained what they were doing, chatted to me about Holmes last night.

The trouble was that at every stage they checked almost exactly the same things: Was I allergic to ... ? Had I ever ... ? When had I last ... ?

It happened at admission, it happened in the day ward, in pre-op and in the theatre. I began to fret a bit. Were they actually listening to my replies? Were they listening to one another?

Yes, I would have been more concerned if they hadn't asked me any questions. And, yes, I do understand why each stage of a hospital procedure has its own separate team and checklist.

But I suggest that many patients passing through these stages are nervous, vulnerable, not in a state to appreciate such points. And I know that the feelings which grew on me were those of dislocation and isolation.

Dislocation because of the inevitable jolt as each team passed me on to a different team. I kept facing the shock of the new, which in my apprehensive state was not comfortable.

Isolation because I felt an increasing sense of being a tiny minority. It was just me and three professionals. Then two more, different professionals. Then another, separate four.

If anything had worried me, it would have taken a major effort to question this succession of unfamiliar faces.

Moving parallel to me through part of the procedure was another, elderly patient, and I believe she felt a similar lack of contact and continuity.

So, is there a solution to such patient anxieties? I wonder if hospitals could use some sort of patient's friend.

I picture a layman (or woman) who would accompany the patient through each stage of surgical procedure. They could explain to him or her why questions are repeated. They could help to clear up any misunderstandings by getting to know the patient's voice and concerns.

They could introduce each new set of professionals, keep the reassuring chat going rather than having it cut abruptly short as the time comes to move on, focus on the patient as a person.

Would a patient's friend need medical skills? Not really. They would need people skills, an understanding of the hospital's system and personnel, ability to communicate, ability also to keep quiet when appropriate. They probably couldn't go into the theatre but they could be there just before and after, to reassure.

They might be retired or semi-retired people. They might be paid, although I imagine the work itself would be hugely rewarding. I do not believe they would usurp the positions of medical professionals. More likely they would free those professionals to concentrate on the medicine.

Patients' friends could help to provide that contact with the outside world that so easily disappears when you enter a hospital. The loss of this contact is one factor that makes many patients - me included - feel so isolated and potentially dislocated.

Or, to use the market jargon more familiar to those who administer our health system, patients' friends might be a useful way to enhance client viability.

* David Hill is a New Plymouth writer.