We
arrived during a working day and were shown to a two-bed room with a good view
of an adjacent garden. An elderly woman
who had been in and out of the place a few times occupied the other bed. She had been in the wars with cardio-vascular
complications, but had her wits about her and an ‘organized’ presence. She and Carolie became friends, and for a
short time a mutual support team. I was
relieved as she had little engagement with the women in the high-dependency
wardroom. A friendly presence in the
next bed helps satisfy one of the basic healing needs - sympathetic
communication. The woman is an artist
and they quickly found areas of common interest.
Gym
work could not start immediately as various assessments were necessary to
establish capacities and therapy plans.
One by one, various therapists appeared to complete their initial
assessments. We were looking forward to
getting started with these, including physiotherapy, speech pathology and
occupational therapy. Carolie’s cranial
infection required ongoing treatment, which ultimately led to interventions by
infectious diseases physicians.*
The
introduction to the rehabilitation environment was initially encouraging. I want to stress at this point that my
criticism of the overall approach adopted here does not reflect on the
professionalism of the various therapists and specialists we encountered. It reflects on the ‘one size fits all’
operational culture. There was almost no
opportunity to shape an individual response to services on offer. It was all done by the numbers – regimented
and inflexible. It seemed as if decades
of cultural change in the area of patient care had passed this unit by.
Sadly,
the first discordant note sounded almost immediately. We had used the beautiful posters from school
classes to great effect as positive stimulation for Carolie. The ward had lovely white walls as a backdrop
for these. Our first engagement with the
senior nurse manager in charge of the ward dashed those plans. She advised it was new hospital policy to
disallow posters, paintings et al to
be stuck on the walls.
Obviously, this
edict had failed to reach the high dependency ward we had come from but strict
adherence was the order of the day in this corner of the labyrinth. I wondered at the bureaucratic mentality
behind restricting an opportunity to create a stimulating space for people recovering
from severe brain trauma.
Once
again, the differing cultures at work in the labyrinth were on display. I was frustrated to say the least and we
found a staunch ally in the next bed.
She had a relative bring in one of her paintings to put on the
wall. The protest was short-lived and
stymied by ‘she who must be obeyed’.
The
painting came down and I explored creative ways of propping up the posters
without resort to wall sticking. Most
were viewable but their extraordinary effect diminished. I imagined the ‘lady-in-charge’ as another
relative of the red queen, whose edicts were not for flouting - we were smack
in the middle of a croquet game whose rules were opaque, requiring careful
footwork to avoid ‘head lopping’.*
To be continued...
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