MARY CARR’S REACTION

LIKE most people who have been through our creaking health service, I can tick most boxes when it comes to its shortcomings. I can’t count the number of times I have sat in the ninth circle of hell, otherwise known as an overcrowded A&E, waiting with children or elderly relations for attention.

I remember as if it was yesterday: A sleepless night in the post-op ward at Temple Street hospital amid Dickensian conditions and an atmosphere of chaos and howling pain that could only be likened to a war zone.

During a week-long stay at the Rotunda, the lift was broken for part of the time, the showers ran with dirty suds and grime and the nursing station was so shortstaffed, that the teenage mother in the bed beside me, kindly offered to feed my squalling newborn.

Struggling

While visiting ill relatives in hospital, I carry out tasks that I would shrink from in the outside world: wiping blood and worse from furniture so that visitors have somewhere to sit, struggling with wheelchairs and carting IV drips along corridors so that frail patients can go to the bathroom.

There are a million ways that, in a climate of never-ending staff shortages, an obliging visitor can make themselves useful in the parallel universe of hospital life.

But for all the gaping faults and fissures in the health service, the staff are not the problem.

Indeed it often seems to me that the care and compassion of porters, orderlies, nurses and doctors is the mainstay of our health service and the only ray of light in a wasteland of poor planning and under-investment.

Now granted that is something of a generalisation. Not every HSE employee is blessed with a bedside manner, the common touch that can encourage the crankiest of patients to calm down and puts them at ease when they are at their most vulnerable.

We have all met the imperious consultant’s secretary who acts as if she’s the Gatekeeper to our Lord and Saviour. Or the arrogant consultant swollen with selfimportance and the nerdy science freak who can’t see the human being behind the disease.

And the nurse who is a total dragon, fussing over her ward as if it’s her private fiefdom, sticking her nose into people’s business.

But these are aberrations. When you think about it, it’s the personal connections with staff and, indeed, other patients we recall vividly, long after the memory of our illness has vanished. For instance I still remember, with gratitude, the cheerful porter who cracked jokes as he wheeled me to the operating theatre and gossiped outside the door, killing time until the surgical team was ready for me.

After all these years I still recall the name of my regular midwife in the Rotunda, who made a habit of popping into my room to say ‘Hello’ every day I was in hospital.

And the kind nurse who raced down the corridor after me and my father to ask how his routine check-up had gone, months after a serious operation.

I don’t doubt that over the course of these hospital visits, I have been called ‘dear’ or ‘how’s yourself’ by staff instead of my regular name.

Respectful

But it has never bothered me in the slightest. I have never felt patronised or reduced to a number or a trifling object on a factory conveyor belt. I’m not so attached to my Christian name that I have to hear it at every turn and so long as the tone is friendly and reasonably respectful, I’m not complaining.

Perhaps that’s why I find the HSE’s new communications programme, which is in place in 16 hospitals and due to be rolled out across the country, utterly bizarre, not to mention counter-productive.

Under its auspices, staff can no longer call patients ‘dear’, ‘love’, ‘boys’ or ‘lads’ and must always call patients by their first name.

It’s part of a drive to ‘raise awareness of how depersonalising some commonly used language can be’ and to stop the habit of referring to patients by their diagnosis or room number.

According to a report in this newspaper today, Mullingar Regional Hospital had a one-year bespoke programme to train ‘facilitators’ who can drive ‘person-centred cultural change’ in other hospitals.

Honestly, you couldn’t make it up. Is this really all the HSE has to worry about?

It appears that the recommendations are based on patient surveys where the feedback showed that communications between hospital staff and patients should be improved – as well as everything else, I might add, from hospital food to facilities and staffing levels.

Perhaps the HSE felt it could zone in on improving communications with minimum cost and disruption, but the upshot is a report called Listening, Responding and Improving, which includes the recommendation that staff take ‘environmental walkabouts’ in order to see hospitals through the eyes of their patients.

Endearments

Now while there is certainly an indisputable case for the HSE to improve patient care, there is no need for an environmental walkabout, let alone a wide ranging patient survey to show us where the problems lie – a three-year-old child could tell us that. Just give them a taste of a greasy chip or a piece of rubber chicken.

A three-year-old could also tell the HSE that protecting patients from perceived slights through the use of collective pronouns is the least of its worries.

Far from making the hospital experience more personal, a scheme that sounds suspiciously like a design to reduce staff to bland cookie-cutter prototypes, permanently watching their Ps and Qs and treating patients like the snowflake clients of faceless corporations will make it arguably more impersonal.

You don’t have to be a linguist to know that there is something about the caressing tone of the native Dublin accent that lends itself to endearments such as ‘love’ or ‘pet’ in a way that other accents don’t.

If a nurse or doctor with a cut-glass accent, for instance, called you ‘pet’, the effect would be to put you on your guard or perhaps make you feel that you have been condescended to.

The Cork accent allows for its own quirks of expression, such as ‘langer’ or ‘lasher’, which are terms of warmth and fondness.

Every region has its own phraseology which bonds people together with a shared identity and a sense of place.

It’s true that in any hospital, the patients can come from all over the country and many may be unfamiliar with the local slang or expressions used by staff. But so what?

Isn’t local language part of the rich tapestry of life, one of the things that gives places their unique charm and colour?

Surely it’s one of the things that prevents hospitals becoming too cold and clinical and embellishes the human spirit when we are at our most anxious and fragile.