Saturday 16 July 2011

What's all the fuss about?

When I had a meeting with the head of my year in the medical school this year, he kept saying things like "I think you're being over-cautious, you won't run in to any problems" or "doctors deal with patients with disabilities so they're good at dealing with colleagues with disabilities". I couldn't get through to him that it wasn't that I was worried in case their would be problems at some point in the future, I was there because these problems were part of my daily experience.

So I decided to keep a list of all of the accessibility issues I encountered during one day of placement this week. Obviously things change between hospitals, but this is a fairly average representation.

1) There are 3 steps up from the front door to the entrance hall. There is a level entrance door, but it's not right at the front where I can get dropped off, and it's the other end of the hospital from the paeds ward.

2) The lift buttons are incredibly stiff, so I either sublux my fingers or don't manage to register that I've pressed them every time. I eventually ask a stranger for help.

3) The ward has a keypad entry system, and push button to exit system. If I have one hand on the stick, and one on the keypad, then there's no hands for the door. And the period the door is open is very short so I keep missing it. A nurse takes pity on me and comes to open the door.

4) Once inside the ward, the doors are big, old, fire doors. I can only open the push ones, because when I try to pull them open, my joints give before they do. Again, a nurse helps me out. I would not manage at all in a chair. I'd tip over.

5) The doctors room is not on the ward, but is as often happens, at the other end of the building. This means longer walks backwards and forwards, which add up really quickly to increase pain and fatigue. It also means getting through a tonne of the above heavy doors of evil.

6) The ward has very small cubicles. Each has a bed / cot in for the patient, and an armchair bed for a parent to stay. When there are two doctors, a nurse, and a parent in, there is barely room for me, let alone for me to bring a chair in. By the end of ward round at the start of the week, my seated heart rate was 150.

7) There are very rarely (if ever) staff disabled toilets in hospitals, and this is no exception. I use disabled loos because it saves me getting stuck not able to stand up (as nearly happened in the cinema yesterday). This is an infection control and privacy issue, and often means having to leave the ward and going to the ground floor to find the only appropriate one, especially in a small old building.

8) The toilet door is heavy. The lock is stiff. I nearly can't get out, and there is no alarm cord with which to summon help (not that they're generally heeded anyway).

9) The shortcut from the ward to the dining room involves going down 2 flights of stairs and back up 1, then the same in reverse. This is how the others go to lunch, but I have to go to the lift, and people ask why, and it ends up being a really obvious difference. Consultants also tend to not think before run down 5 flights with a teaching group, too quickly for me to ask where it is they're heading.

10) The canteen is self-service. I asked if someone could carry my tray to the table, because my wrists are prone to giving way, even when one of them isn't taken up with stick. The staff refuse, because it's busy and they "don't do that". The consultant comes over and takes my tray for me, and goes off into a reel of "you're so brave to deal with this" nonsense. I'm not brave. I just get up in the morning and live my life.

11) The consultant was late for clinic, so I had to stand around and wait for him, because the few chairs in the waiting room were full. There aren't enough chairs in the world in general, I've decided.

12) Spent the whole afternoon in clinic during which the consultant took no rest breaks, so as a consequence I didn't either. 4 hours of near constant sitting in a chair without arms means that I have a wicked headache / neck spasm by the end from trying to hold my head up. It's increasingly hard to concentrate.

13) In the clinic, the examination couches were fixed height, so it was not possible to sit down to examine the patients.

14) At the end of clinic we were taking a pile of case notes up to the secretaries. Case files are heavy, even in paeds, and the fastening are stiff and awkward to use, causing more hand trouble. (The delay in getting paper letters out really disadvantages coordinated care, especially for kids with complex conditions. They're currently typing up letters from January clinics). Junior doctors spend a lot of time acting as postmen for Xray requests, and case files.

14) I get a lift home, as I got a lift in, for which I'm very grateful. The bus stop isn't within my walking capacity from the house, and the bus stop outside the hospital is at the bottom of a steep hill leading up to the entrance (as seems to often be the case).

15) In the middle of this I am trying to keep to a good routine for my meds, and food, because my tummy's been so sad recently. This is really hard when you're not in control of your own timetable.

This is one day of placement, not including what happened before or after at home. It gets very tiring.

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