"Second shift of my first placement"

About: St John's Hospital / General Medicine

(as a staff member),

Elderly lady very poorly with communication difficulties and very limited mobility and oral thrush, on bed rest, refusing to eat and drink, and therefore dehydrated with low urine output.

I was asked to assist the lady with breakfast and she was refusing outright, but as staff were so concerned I took the time to talk to her, asked her about her life and family, and I asked her why she didn’t want to eat. She spoke very quietly which was hard to hear, but she told me her throat was extremely sore to swallow anything at all. I empathised with her, and thought what could I do to help?

At lunch her tray had a bowl of soup and a pot of ice cream on it. I brought it over and we chatted, but she refused again. This time I persisted light-heartedly, and she smiled and said okay, I’ll try some. The soup didn’t go down well, the heat of it and lumpy bits were just too much for her sore throat, after a couple of spoons we left it, and we went for the ice cream, I said it would be nice for her sore throat. She had the whole tub.

From then on it was the same; the smooth and cold things went down easier such as milk, ice cream and yoghurt. She was eating and drinking more, still not a lot but there was improvement. I became responsible for her fluid chart and food chart. This then lead to me meeting her family and discussing her improvements in appetite, and the improving urine output.

It was so rewarding because she gave me huge smiles whenever I was around in the bay, and she gave me a lot of chat because she knew I would make the effort to listen and understand what she was saying. Her relatives said she had taken a shine to me and seemed happier because of the care she had been receiving on the ward and thanked us.

I learned from this experience that giving time to listen and build rapport was essential for getting to know patients and understand their preferences, situation and life. By gaining trust I was able to build an effective relationship conducive to improving health and wellbeing.

This patient really put her trust in me and shared with me how she was feeling, and even though she couldn’t communicate easily, she liked the social interaction when we chatted at mealtimes.

I really looked forward to those times getting to know her, giving what we had been discussing in class, an important concept we were just starting to grasp, real holistic person centred care. I was so happy and proud that I had been involved in the team providing her care whilst in the ward.

From this experience I took forward the skills I had learned and developed further over the summer, I was in the same ward again and met a host of patients with similar problems, and there was the added heat of July weather and I really made the effort to ensure everyone was hydrated and adequately nourished and learned more about nutritional assessment and documentation, because I was keen to be able to spot when patients were at risk of malnutrition.

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Response from Customer Relations and Feedback Team, NHS Lothian

Dear Fionm6

Thank you very much for your positive comments and I am so pleased you found your time on the ward to be so rewarding. This is the kind of person centred culture we are trying to put in place in NHS Lothian.

Good luck with your future career.