We've had our fair share of contact with doctors the past few years. I certainly feel that what with pregnancies and birth and the care of our children once born, we're quids in when it comes to tax, and that's before we've even accessed the education system. It has led me to think however about what makes a good doctor. And it's rarely their actual medical skills. I was comparing two Consultants the other day, and why it was that I think one is brilliant and the other riles me. Then I realised, the latter one never introduced himself - it fell to me to ask him his name before he poked and prodded my child. Nor did he once use my child's name.
So here is my charter for doctors when dealing with child patients and their parents, for GPs and hospital doctors.
1) Names matter. Introduce yourself and ask what you should call the child. My daughter is never called by her full first name, I am not even sure she knows it. If a doctor wants to make her feel comfortable they need to used the diminutive we all use and they will only find this out by asking, not by glancing at her file. Similarly, my name matters. As I have written before, stop calling me mum.
2) Keep things private. Remember that just because a child is a child doesn't mean they don't also have a right to confidentiality and privacy. Don't start talking to me about their medical history in the corridor or waiting room.
3) Explain. It is easy to assume that just because a young child doesn't understand you there is no point explaining things to them. I believe children understand way more than we often give them credit for, and pick up an awful lot from body language and tone.
4) Be honest. Don't say something won't hurt if it will.
5) Keep listening. Just because I'm neurotic doesn't mean some of my concerns aren't justified. You know when you stop listening to me at my sixth point - well how do you know the seventh point isn't going to be the important one?
6) Ask parents what their worries are. I didn't know how to phrase my questions at one appointment, but the doctor finally managed to get it out of me. What specifically was I worried about, she asked. No one had asked me that before. It freed me to say what was on my mind, in the case the impact of radiation on fertility and cancer, and to be reassured.
7) Remember probability is meaningless to a parent. When you say something has a one in a hundred probability, we hear the one, not the hundred.
8) Talk information. There is no point telling us to steer clear of Google or avoid online forums - we won't. Far better to point us in the direction of the best sources of information.
9) Be human. I have one doctor I have seen a few times who always empathises and tells me his sons had something similar, whatever that may be, I have a hunch, based solely on the fact there is a picture in his office of him and a young girl but none of him and young boys, that his sons are made up wholly for empathetic purposes. Nonetheless I am choosing to believe him. It helps, knowing about your doctor's family, and who it is that they care about.
10) Be nice. My absolute favourite doctor always runs late. And she always apologises profusely. Which makes it okay.
Showing posts with label NHS. Show all posts
Showing posts with label NHS. Show all posts
Wednesday, 20 March 2013
Monday, 18 February 2013
The formula for life
Parents (that's right, parents, not just mothers, not that you'd believe it from reading the press around this that fathers are also involved in decisions about caring for their children), choose to formula feed their babies for many reasons, none of which are anyone else's business. And I just don't believe that any of those people do it because they don't want the best for their children.
What such a recommendation does is make parents feel guilty for decisions they have made when trying to do this best. That's why the breast is best slogan is wrong. Best in what way? Better than a mother so exhausted she has a breakdown? Better than infected cracked nipples? Better than slow decline into malnourishment? Better than being able to leave your baby and go out and earn a living? Sod it, who has the right to say it's even better than being able to wear an outfit with the confidence you won't leak all over it? We make decisions as individuals to suit our specific circumstances, and I just don't believe most people make decisions for anything other than the greater good of their family.
What's more, the recommendation is ridiculous. Once you have decided, or realised, that formula will be part, or whole, of your baby's diet, there is only a small window in which you can change your mind. Milk supply is difficult enough to establish in the first place, but almost impossible to re-establish. Do Save the Children really want people who stopped breastfeeding a week ago, a month ago, six months ago, to feel shit every time they give their child food?
I owe many people in the National Health Service a debt of gratitude for the care they have given me and my children. Midwives, surgeons, radiologists, fetal medicine experts, cleaners and so on. But one that sticks in my mind is the paediatrician who told me kindly when my daughter was (literally) slowly starving, that we don't actually have an obligation to breastfeed our children, but we do have an obligation to feed them. What did we do in the end? You can find the answer elsewhere on the blog. For the purposes of this post it's irrelevent. Not that you'd believe it from the headlines, or the parenting forums, but it's not us v them when it comes to breastfeeders and formula feeders. We're all parents, all muddling through, all trying our best, all hoping to keep our children safe. And fed.
Because that's the thing about formula - it feeds children safely. Contrary to popular belief, there were no halycon days in the past when all women contentedly breastfed their happy chubby babies. No, the past is littered with dead or malnourished children who may have survived had formula been on offer. Lack of milk, inability to breastfeed or circumstances that make breastfeeding difficult are not another kind of yuppy flu that only exist in modern times. They have always existed, but the outcomes were far worse than today. Cigarette style warnings Save the Children? Don't be ridiculous - bottlefeeding doesn't kill, it actually does the opposite. Sure, put large public health messages on boxes of formula, but make them accurate. 'Formula saves lives', that's what they should say.
Related post: The great unsaids - bottle feeding
Wednesday, 14 November 2012
How to make a fuss
At an antenatal appointment this week I was ushered into a room before my main appointment so my urine and blood pressure could be tested. The room, a side room off the waiting room, would be private if only they'd shut the door. And, of course, if they hadn't tried to do my tests in the same room at the same time as they were testing someone else. I made a fuss of course, I am good at that. "It's not our normal practice" they told me. "Then why are you doing it now?" I asked. So they waited, not, I think, because they thought I was being reasonable, but because I was making a
fuss. Or as I think of it, making a fuss. The reason? As I explained to them, it's no good for patient confidentiality, mine or the other patient's, if they discover something wrong with one of our tests.
But I have a particular interest in/chip on my shoulder about this issue that stems back to the early weeks of my daughter's life. In the area in which we live, due to high density housing, a large number of immigrants and poverty, all newborns are offered a BCG injection to protect against turberculosis. I was in two minds whether to have this for my daughter, largely because of the associated swelling and scarring and not wanting my beautiful newborn's perfect skin to be sullied in this way, but a belief in herd immunity won out and we duly went to our appointment.
If you are not the kind of person who believes that environment affects behaviour you have probably never been to this particular health centre in Tottenham, North London, where the TB jabs in our area are offered, I used to be a patient at the GP practice there but found it so demoralising I left very quickly. Once I rang over fifty times before getting through to a receptionist. Upon telling the GP I finally saw about this he agreed,saying he'd had the same problem one day when trying to call in sick. Unlike my current GP where you get what you want by being nice to the receptionists, there I found you only got acknowledged by being as arsey as possible.
Anyway the appointment started badly when everyone there for this injection was asked to fill out a form about their baby including whether they are HIV positive. I understand of course that medical professionals need to know the answer to this, but the forms were being collated on the counter where any other patient walking by could see them. This would not only impinge on my daughter's confidentiality if the answer were yes, but on my own too. On principle I objected.
We were then escorted into a room with another parent and baby. "Are you intending to do both of these children in this room one after the other?" I asked. They said yes. What did I do? That's right, I made a fuss. It wasn't going to happen, I explained, for two reasons. First, I did not want my child, or the other child, to get upset by the post injection screams of the child who went first. But also because it was possible that I, or the other mother, might have medical questions or issues to ask that should be kept confidential. Not just HIV which was clearly on the agenda as a question, but anything else too. "You'll have to wait here in the corridor then," they told me. Which I did. But I was fuming. What they were trying to do as a time saving measure ignored some of the basic tenets of healthcare that we expect our modern health service to offer.
It reminded me, in those early days, that I was not only my own health advocate, but my daughter's, and that just because she was a baby did not mean she didn't also have the right to respect, dignity and privacy as a patient. What's more, that there are times when she will only get that by making a fuss, something I am proving very adept at teaching her.
But I have a particular interest in/chip on my shoulder about this issue that stems back to the early weeks of my daughter's life. In the area in which we live, due to high density housing, a large number of immigrants and poverty, all newborns are offered a BCG injection to protect against turberculosis. I was in two minds whether to have this for my daughter, largely because of the associated swelling and scarring and not wanting my beautiful newborn's perfect skin to be sullied in this way, but a belief in herd immunity won out and we duly went to our appointment.
If you are not the kind of person who believes that environment affects behaviour you have probably never been to this particular health centre in Tottenham, North London, where the TB jabs in our area are offered, I used to be a patient at the GP practice there but found it so demoralising I left very quickly. Once I rang over fifty times before getting through to a receptionist. Upon telling the GP I finally saw about this he agreed,saying he'd had the same problem one day when trying to call in sick. Unlike my current GP where you get what you want by being nice to the receptionists, there I found you only got acknowledged by being as arsey as possible.
Anyway the appointment started badly when everyone there for this injection was asked to fill out a form about their baby including whether they are HIV positive. I understand of course that medical professionals need to know the answer to this, but the forms were being collated on the counter where any other patient walking by could see them. This would not only impinge on my daughter's confidentiality if the answer were yes, but on my own too. On principle I objected.
We were then escorted into a room with another parent and baby. "Are you intending to do both of these children in this room one after the other?" I asked. They said yes. What did I do? That's right, I made a fuss. It wasn't going to happen, I explained, for two reasons. First, I did not want my child, or the other child, to get upset by the post injection screams of the child who went first. But also because it was possible that I, or the other mother, might have medical questions or issues to ask that should be kept confidential. Not just HIV which was clearly on the agenda as a question, but anything else too. "You'll have to wait here in the corridor then," they told me. Which I did. But I was fuming. What they were trying to do as a time saving measure ignored some of the basic tenets of healthcare that we expect our modern health service to offer.
It reminded me, in those early days, that I was not only my own health advocate, but my daughter's, and that just because she was a baby did not mean she didn't also have the right to respect, dignity and privacy as a patient. What's more, that there are times when she will only get that by making a fuss, something I am proving very adept at teaching her.
Sunday, 9 October 2011
Why I love the NHS
I've been writing a series of posts (to be continued) on ways to improve postnatal care in order to make those difficult scary first days with your baby a bit easier, or at least not harder, but it has struck me that I should also write a positive post about the NHS and the care we received. Because most of it was excellent.
The antenatal appointments checked that the baby and I were safe. Blood tests were taken using clean equipment and results came back quickly. I had choices over pain relief. Pregnancy bleeding led to a trip to casualty and to the early pregnancy unit where both times we were seen quickly, scanned and reassured. My blood pressure was frequently checked. The baby's heartbeat was often listened to. Had I needed to get to hospital in an emergency I knew I would have been able to call an ambulance. We had scans to pick up and monitor any problems. I had my own room to give birth in and was constantly monitored by midwives determined to safely deliver me a healthy baby which they did, and to leave me as unbattered as possible, which they did. Doctors operated on me post birth in a clean operating theatre using strong drugs and great skill. Midwives and doctors looked after my baby when she was sick in the first few days, and looked after me too. The wards were clean. I was given food. The medicines were plentiful. The most up to date technology was used to diagnose my baby and to treat her. And in the days and weeks and months since the birth every time we have needed to see a GP, we have been able to, all
medicines needed have been free and all hospital appointments have been with experts. Wow.
I have complaints and suggestions for improvement but it's important, I think, not to lose sight that all of this was free at the point of use, available to anyone who needs it and delivered in a clean and safe environment by well trained staff.
So this is a post to balance out the ones about improving postnatal care and to say how grateful I am to the NHS and all who work for it. How lucky we are to have it.
Related posts:
Ways to improve postnatal care #1: Don't call me mum
Ways to improve postnatal care #2: Change the sheets
Ways to improve postnatal care #3: Help us buy the basics
Ways to improve postnatal care #4: Allow partners 24 hour access
The antenatal appointments checked that the baby and I were safe. Blood tests were taken using clean equipment and results came back quickly. I had choices over pain relief. Pregnancy bleeding led to a trip to casualty and to the early pregnancy unit where both times we were seen quickly, scanned and reassured. My blood pressure was frequently checked. The baby's heartbeat was often listened to. Had I needed to get to hospital in an emergency I knew I would have been able to call an ambulance. We had scans to pick up and monitor any problems. I had my own room to give birth in and was constantly monitored by midwives determined to safely deliver me a healthy baby which they did, and to leave me as unbattered as possible, which they did. Doctors operated on me post birth in a clean operating theatre using strong drugs and great skill. Midwives and doctors looked after my baby when she was sick in the first few days, and looked after me too. The wards were clean. I was given food. The medicines were plentiful. The most up to date technology was used to diagnose my baby and to treat her. And in the days and weeks and months since the birth every time we have needed to see a GP, we have been able to, all
medicines needed have been free and all hospital appointments have been with experts. Wow.
I have complaints and suggestions for improvement but it's important, I think, not to lose sight that all of this was free at the point of use, available to anyone who needs it and delivered in a clean and safe environment by well trained staff.
So this is a post to balance out the ones about improving postnatal care and to say how grateful I am to the NHS and all who work for it. How lucky we are to have it.
Related posts:
Ways to improve postnatal care #1: Don't call me mum
Ways to improve postnatal care #2: Change the sheets
Ways to improve postnatal care #3: Help us buy the basics
Ways to improve postnatal care #4: Allow partners 24 hour access
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