Mary Wakefield

Why wouldn’t our NHS saints help a dying man?

Too concerned with their own safety, nurses refuse to lift patients

Why wouldn’t our NHS saints help a dying man?
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We all think pretty highly of ourselves these days, free from old-fashioned ideas about sin. We’re good people. And yet… I read in a letter in a local newspaper recently a description of an event in the writer’s own home which shows that we might also be becoming monsters.

The letter-writer, Jane, was a lady in her late fifties who cared at home for a husband, Fred, with terminal brain cancer. As Jane’s letter explained, Fred had fallen recently on to the bathroom floor, and as she was unable to lift him, she telephoned for help. Seven medics arrived and rushed to the scene. All seven then stalled. Though Fred was not obese, though there were seven of them, they told Jane that they were not allowed to help him up.

Jane wrote: ‘I had two Marie Curie nurses, three district nurses, two paramedics and myself, all standing in a circle while they told Fred that he would have to try to get himself up from the floor… . Is this right, that in this day and age, a terminally ill man in great mental and physical distress, unable to comprehend why nobody would help him back to bed, is allowed to remain in terrible discomfort because the professionals involved are all too concerned about their own safety?’

Her letter ends: ‘I’m so tired of being told I need to look after myself, asked what my feelings and emotions are… and yet the patient, the person requiring practical assistance, my husband of 27 years, was just being talked over while he lay helpless on the floor for two hours.’

I’ve been haunted by the scene in Jane’s bathroom, by the thought that to bewildered Fred this must have seemed like simple inhumanity.

And wasn’t it? We bicker about religion but mostly we agree about what constitutes a good deed. For Christians, Muslims, atheists, a good person is one who helps someone suffering in front of them. To turn away is to forfeit your right to be good. Those people surrounding Fred were the best of us: NHS workers, the saints of secular Britain. So what on earth were they thinking?

I tracked Jane down and called her to make sure I had the story straight. Yes, she said, the district nurses had told her they never pick up patients. Baptists don’t dance, district nurses don’t lift. The paramedics had said that they too ‘weren’t really supposed to lift’ unless it was a cardiac patient. After two hours of argy-bargy over poor Fred’s head, one of the paramedics did relent and help Fred back to bed, said Jane, which is why she did not complain to her NHS trust. It’s also why Jane is a pseudonym: she doesn’t want to cause further fuss.

The helpful paramedic gave Jane the number of the county council’s care-in-the-community outfit, which does lift, and as it happens, sadly, she had to call them out soon afterwards when Fred fell again. They lifted very nicely, said Jane, but they had no medical training. So picture this: if Jane had called the medics and the lifters on that first occasion, there would have been nine professionals in that bathroom with Fred. The NHS is short-staffed and cash-strapped, but there are clearly other things wrong as well.

Why don’t nurses lift? After a pry into nursing forums, the short and often-repeated answer is that ‘a nurse only has one back’.

Well, I do see. Rolling and propping fatties all day without hoists or mechanical help would scupper even the sturdiest spine. But hoists are routine these days. Surely, in exceptional circumstances, it’s the patient who should take priority, not the back? And why does it seem to anger some nurses even to be asked to lift a patient?

There should be a word for the process by which guidance issued by the government calcifies into the hard law as it drips down through senior management.

In this case the actual advice of the Health and Safety Executive is pretty mild. Avoid risky lifting ‘where reasonably practicable’, says the HSE. The Royal College of Nursing takes this and firms it up quite considerably: ‘No one should routinely manually lift patients. Hoists, sliding aids, electric profiling beds and other specialised equipment are substitutes for manual lifting.’

Now imagine the lawyers and the HR departments embedded in the various NHS trusts, all wringing their anxious hands. What if a nurse is injured lifting? Could it be argued we were negligent? Let’s just ban it!

It’s no especial disrespect to nurses to say their minds provide the perfect environment for turning a suggestion into an inalienable right. It’s true of all of us. Once it’s suggested a person is entitled to something, woe betide the ninny who tries to make an exception.

Then there are the paramedics. Why don’t paramedics lift? Well, they do, of course they do. Their job requires all sorts of lifting: the fallen like Fred, comatose drunks, the victims of road accidents. I called Jane’s local ambulance service to check on the ‘no lifting except cardiac patients’ rule, and they said that it was nonsense. Jane wasn’t lying, and I don’t think the paramedics were either. What could be up? I smell panic in middle management. The Spectator has reported before on the awful state of our ambulance service. Paramedics are leaving the service in droves: the worse the job gets, the more paramedics fall sick or leave, the worse the job gets.

From what I’ve heard, requiring medics to lay off lifting is just the sort of wheeze a target-driven area manager would come up with in a desperate attempt to retain staff, and that hero paramedic would not have been commended, when he returned to base, for putting Fred’s needs first.

When I next spoke to Jane, to tell her what the ambulance service had said, she told me that Fred had died. After those falls and those hours on the floor, he’d ended up in the local hospice, where he’d passed away. Jane said again that she didn’t want to make trouble for anyone. ‘Fred always said it wasn’t the people that were the problem, but the job,’ she said. ‘He was a much kinder person than I am.’

Written byMary Wakefield

Mary Wakefield is commissioning editor of The Spectator.

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