Ooh, better not mention that

So there I am in a pre-op assessment session at a local hospital.
I have filled in the purple pages of the thick pathway booklet.
All my personal details and conditions and medications.
I included, of course, dementia.

And I meet the very nice and lively HCA to be clerked and have a few tests and measurements.
Height, weight… I saw OBESE show up on the screen.
I’ve lost nearly a stone in two months, but still it’s there, I thought.
Slightly irritating.
Anyway, he confirmed my loss of weight since my last operation, but declined to repeat the screen message.
Perhaps I was pleased by that, but I saw it.
So job done, NHS. I am duly reminded I am fat.

(Any real suggestions for how to support me – not anyone else – me, to lose weight?
Nah. Nor from my GP, or practice nurse.)

Back to the HCA.
He read through the purple pages, noted things, asked things, wrote things…
Ah, you’ve got diabetes…
So let’s go through your medications.

Is my dementia irrelevant?
Does the hospital
let alone the clinical staff who will care for me
Know how dementia affects me?
Can they rely on my information?
Can I remember what they say?

…And so on to the nurse practitioner.
Lovely lady, on the ball, excellent in all respects.
Great patient interaction.

Reads through the purple pages.
Gets to dementia
Let’s find out which type of sticking plaster you are allergic to.

And we did, which is the first time anyone has bothered, though I tell them all.
She stuck me with three types and checked 15 minutes later.
One was inflamed.
So well done her.

Eventually she tells me some stuff about which medication I should stop before the op.
So I get out my iPad to write notes, and say
If I don’t do this I’ll forget what you said.

Dementia gets a mention.

And then on and out to the next person.

The registrar.
Who in his own way is fine and polite.
Asks me to explain what I am having done.
And I did.
Then consent…
No mention of dementia and capacity.
Ok, I have capacity, and it’s pretty obvious, but dementia, memory, understanding…?

And no information about possible problems, infection, etc, and probabilities…

So I asked him and extracted these.

And I consented.

All done.

What do you think?

Today I was doing some really great training in values based recruitment (VBR) at our acute trust.
They involve us patients on some of their band 5 nurse recruitment, and I really enjoy this work. Did a lot in my paid work.
This values based recruitment is part of the Trust’s determination to ensure the core values
agreed by staff last year
are embedded in the staff and organisation.

Today was the second day of training and we were practising interviews.
Lot of multi tasking and thinking needed during the questioning and recording stages.
I was pretty much up to this, especially as I find the principles and approach of VBR are in part what I have been doing for years.
(It is hard though.)
This evidence based model is however much much better than I have been doing.

After my interview question and answer session the trainer turned to me and asked
And how did that go for you?
I could not get my mind in gear, or rather access that bit I needed.
Couldn’t remember much of the interview. So consulted my notes.

And I noticed as the day went on, and the excellent nurses and facilities staff became more familiar and relaxed with the model,
I could not think anywhere near as fast as they can.
I probably used to be able to, but not now.
What I know I can well articulate.
What I do not expect I cannot process.
And I did wonder,
Should I be doing this at all?

Well, at the moment I think I can do good interviews, but as I have said before,
Please tell me when you see that I cannot!

Oh and thanks to all for being so forgiving about my inability to remember your names even for five seconds

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