In reply to TheDrunkenBakers:
Roy Lilley's take on this:
"Where does Alfie fit?
News and Comment from Roy Lilley
A couple of hours in a nice warm car did nothing to prepare me. No overcoat, no scarf, no gloves, November, no idea; I stepped into a wind that nearly cut me in two. I sprinted across the car park towards the hospital entrance.
To the left of the front door, invisible to the stream of visitors clutching plastic bags of fruit drinks and tissues, staff with their heads down, locked in conversation... in a shaft of watery light, between the wall and a drip stand, stood a man. A bag of something dangled from the stand's T-bar, draining into a tube that looped to and array of plastic taps and connectors taped to the back of his hand.
It turned out to be Alfie. Pyjama legs, a concertina piling up over once-white trainers, his top half wrapped in a towelling dressing gown. He was so thin it was difficult to decide what was stronger; the skin and bone or the drip stand. My money was on the stand. Black and grey tousled hair. Eyes sunk so far back it was impossible to see any light in them. In his free hand a roll-up cigarette. As he dragged on it his cheeks hollowed and his sunken face became a parchment skull.
'Blimey mate, you all right?'
'Yeh, I just nipped out for a fag...' he wheezed, coughed and wracked his body.
I walked back with him. We shuffled along. Alfie dragged the drip-stand. He was late-sixties and looked eighty. He had cancer. It was unspoken but it was obvious he didn't have long to go. I wondered if he would see Christmas. Cheerio's were made and as we turned into the ward a nurse said; 'Alfie, where have you been?' Like she didn't know.
It's a pretty unedifying sight; patients smoking by hospital entrance-ways. It happens, I've seen it often enough. NICE tells us it must stop. Smoking is bad for you. I think we get that. 'All hospitals should have on-site 'stop-smoking' services and staff should be instructed not to assist patients who want to smoke.' Compassion? Where's the CNO and her Six 'C's when you need her?
Professor Mike Kelly, director of the Centre for Public Health Excellence at NICE, described the guidance as a "culture shift" as opposed to creating a "penal culture"...I have no idea what that gobbledegook means.
I do know I hate smoking. It killed my Dad. He started before the health risks of tobacco were properly understood. Now we do and any sane adult who chooses to smoke is a burk. But, don't underestimate the power of nicotine. It is a lifelong lodger and you pay the fearful rent.
But, it is legal. Heaven knows why. It struck me that Alfie was a patient in a hospital. Not an inmate in a prison. He came to us for help. He is a fully paid up member of the NHS and is a guest in our hospital. We should behave like a host.
NICE say; Trusts should ensure "there are no designated smoking areas, no exceptions..." I wonder why they are called NICE? NASTY might be better; Not Allowed So Treat Yerself'. Shouldn't the NHS be like a Corinthian; patient, kind, modest, honourable, rejoicing in the truth and not easily angered? Draconian, heartless, unthoughtful and cold-blooded doesn't quite match-up.
I spent yesterday morning at the NHS Alliance' excellent 'Breaking Boundaries' conference. Earlier in the week I was at the RCN evening at the Chief Nursing Officer's conference in Birmingham, the ABMU Health Board conference in Swansea and the Hospital Directions Conference at London Excel. I don't think I have had a richer, back-to-back week of conferences, with top-drawer speakers and thoughtful presentations.
Everywhere; identical talk of patient involvement, patient directed care, patient pathways, patient budgets. Putting patients in charge, patient choice, patient focus, listening to patients, patient centred-ness.
I wonder... where does Alfie fit into all that?
Have a good weekend.
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