Hazel McHaffie

A Matter of Life and Death

It’s curious how, right now, so many books are taking me back to my own recent experience in hospital fighting for my sister’s best interests to be respected. One such is  A Matter of Life and Death, written by a palliative care nurse, Kelly Critcher, who elected to take a turn working  in a High Dependency Unit during the Covid-19 pandemic. But it’s been a useful exercise. Listening to  the perspective of the staff dealing with the fallout, gives a more rounded picture, which helps to keep our own personal frustrations in proportion.

Nursing is in Kelly Critcher’s blood; both her mother and grandmother were nurses, but she initially took a different route, first gaining a degree in Business Management, and then going into office life. However, she found no fulfilment in any of the avenues she tried – they were just a job to be done. Her heart lay elsewhere.

From the outset, nursing suited her perfectly, and she loved the energy and drive of a busy general hospital in Greater London, Northwick Park. However, increasingly she found herself drawn to a less high-powered speciality, one that provided holistic care with the patient’s needs centre-stage: palliative care, an area where she could make a real difference to the lived experience of dying.
… to look death in the eye – to save a patient while the fight can still be won, and confront life’s end with grace and kindness when it can’t.

Her book is divided into two parts, the first of which deals with her professional life up to early 2020, and includes so many incidences that resonate with me. On one level it’s confirming; on another it’s disturbing. I so want to defend those patients whose care fell below the standard they had a right to expect, and I commend this brave nurse who has shined a light on the deficiencies, and championed the cause of the terminally ill. There should be no room for entrenched attitudes, arrogant consultants, dictatorial regimes, old-school ways, that ride rough shod over gentle dignified management.
… there are no second chances when someone is dying. No going back to do it differently next time …

When Covid-19 hit the hospitals, the London Borough of Brent, which has some of the most deprived and diverse communities in the UK, became the epicentre of the pandemic. Northwick Park had the worst death rate of any local authority in England and Wales, and was the first hospital to declare a critical incident, when they ran out of bed space and were about to be overwhelmed. Stringent restrictions had to be implemented, including banning visitors. These measures were particularly hard for staff like Kelly, trained in enabling patients and their families to experience good deaths.
All nurses see the value of a friendly visit to a patient, and in palliative care we recognise family involvement and support as integral to what we do. Covid robbed patients of this basic right ...

It’s hard, knowing what we now know, to be reminded vividly about the failures that characterised the early days of the crisis, when the priority was to clear hospital beds to make way for the tidal wave of patients suffering from this new killer coronavirus about which so little was known. Protection was minimal; risks high.

As we know, staff at the coalface were much more aware of what was unravelling than the Government appeared to be. How vulnerable and badly protected they were. How much they suffered having to implement draconian measures, denying families access to their loved ones, even to say a final goodbye.
People were dying alone, and to us that was an abomination.

This book is no literary masterpiece, and in some places the detail is rather too gruesome for a lay readership (IMO), but it does give some useful insights into life on the NHS frontline. It’s sobering to read …
For years we’ve battled against underfunding, working in old, decrepit hospitals with constant bed and equipment shortages. We have faced complaints from patients, families, managers, politicians, the press and the public on a daily basis. Yet, we still pull ourselves out of bed each day and go to work, knowing that at least some of what we are doing was helping to save lives. Then, in those first few weeks (of the pandemic) that seemed like an eternity, we were national heroes, every one of us.
Were we really so ungrateful?

But alongside the negative experiences, it’s heart-warming to be reminded of the courage and kindness and self-sacrifice the crisis brought out in people. I salute them all. And I thank all those NHS staff who have gone to print and shared their side of the story. Time to move on, methinks!

 

 

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