Today we were able to go to the Children’s Hospital with BCU. Upon our arrival we went into the teaching seminar room and met multiple lead nurses for teaching. In the beginning we went over hospital protocol which included making sure to wash your hands, being mindful of patients, and having ringers on silent. After our introduction we split up into two separate groups and started to tour around the hospital. My group and I toured the oncology and hematology units. We were greeted by the nurse, Becca, and she gave us the rundown. I noticed that the units in their hospital compared to ones in the United States are brighter and move inviting. They have units full of around 8 beds or cubicles and nursing staff to care for the patients. At the nursing stations I noticed that they have a white board for all their patients with a coordinating nurse’s name next to it. I liked this detail and realized that we have a similar way of setting up our nurses station in the United States. I also noticed that the whole hospital is still running off of paper medical records and giving medication and in the United States we use the electronic version. When asking the nursing staff about this aspect of their job they said that it was more paperwork then they would like and said that supposedly they will be getting computerized records within the next year. Another thing I noticed when touring was the resources that provide for their patients and parents. At each unit they have play rooms and games for the patients and have kitchen and lounges for the parents. I thought this was really interesting because it shows the care they have for both sides of the bed.
After we toured these units we moved to the learning school that is within the hospital walls. We were given a tour of this center and got a brief overview of the goals of the school. The provider told us that patients are encouraged to go through school while in the hospital for educational reasons and for social reasons. Obviously children should stay up to date on their schooling but when they are learning they are also taking away the thought of being hospitalized for a little while. A patient can either come down to their care center or the teacher can accommodate to them by going to their specific room. Teachers can also do online lessons for sicker patients if needed. From a nursing perspective, the provider also told us how we can be helpful. She talked a lot about trying to let the patient advocate for themself rather then trying to speak for them. The patients want a sense of freedom or to be able to speak for themselves rather then always having to be advocated for.
After our tour of the learning school, we made our way back to the seminar room where we asked more questions to the nurses who were with us throughout the day. I took the information I learned about the National Health System from the previous day and asked about how patients have to pay for care after leaving the hospital. The nurse began to tell me that the patients don’t have to pay for any treatment that they receive medically or medications. If the patient needs surgery then they can either stay with the NHS or go private. The nurses said that there isn’t much of a difference in the treatment received whether its public or private funded and most of the time doctors who perform public services are also providing the private services. We also learned that the NHS has dramatically changed in the sense that general practitioners are up to standards which means that many patients end up going to the emergency department anyway. The increased need for general practitioners, even for minor problems that will eventually settle, leave the emergency department very full. These United Kingdom hospitals receive patients not from just within the country but worldwide. Many patients want the benefits of the NHS and travel for their medical services. These patients also know that the NHS doesn’t turn away patients regardless of their situations.
After our discussion of the NHS we moved onto asking questions about the mental health side of the hospital, not just for patients but also nurses. We learned that suicide rates are higher in patients in May and June because its exam season. Because these hospitals are so specialized, if a mental health crisis were to come in through the doors as an emergency, the staff would keep this situation within the emergency department. The patient is often given a one to one ratio of nurse when the situation is higher intensity. If the patient reaches the level of a T4 bed, they are institutionalized. The mental health crisis within the United Kingdom is also increasing just like the United States. We learned about the mental health support for long term patients and their parents. For the patients, they have the magnolia house, trips to the sea life center, school work, and the salvation army. The magnolia house is a house not far from the hospital where families can go to relax and get away from the hospital. Sometimes patients can go to the spa here or a private company will come in. The patients have to be screened before any activity for health reasons. Another option is going to the sea life center, which is provided by the nurses. If the patient is under critical care and can’t be immunocompromised, they are put into a double cubical. Because this cubical is socially isolating, the patients are allowed to decorate and make it feel like home. As for the parents well being, they are given offices within the hospital so they can show support for their children while also getting work done. Most parents can’t take time off from work for as long as their child needs to stay in the hospital.
From the nursing perspective, mental health resources are also offered within the hospital. There is a well-being hub which is a room where staff go to relax and decompress. There are also staff ambassador being teams and professional nurse advocacy teams. These advocacy teams can have one on one sessions or group sessions with the nurses within the units and offload whatever has been bothering them. There is also a well being Wednesday where nurses can exercise together as a group and participate in activities. Most units also have psychologists that can support patients and parents but mainly are there for staff well being.
After the mental health section was over we got a quick talk from the PACE team by Jessica Palmer. PACE stands for pediatric assessment and clinical evaluation. From hearing Ms. Palmer speak about her job, I gathered that it is very similar to a respiratory therapist in the United States. This team works closely with the intensive care team, sometimes working with the cardiac unit. Most of the nurses can prescribe medications to patients but just have to take a course for this. That is different then the jobs that nurses can carry out in the United States.
In the hospital today I learned a lot and loved comparing the two systems between these countries. I think that NHS is the major difference that is greatly talked about and is controversial. Sometimes the NHS sounds very beneficial and then when talking to the nurses who work for the NHS, it has its downsides. I can’t wait to hear more about the nursing industry tomorrow !
