Editorial Comment

Last week, the subject of the hospital magazine was discussed at a meeting of the Communications Sub-Committee. The following recommendations were made by that Committee:

1. "The Standard`' should continue to be published on a weekly basis, in order that the newsy aspect of the magazine is not lost;
2. the magazine is fulfilling the purpose for which it was intended relative to Winwick Hospital, and should therefore continue in its present format;
3. the concept of a Group newsletter or Magazine is desirable and would be supported by the Sub-Committee.

We would like to think that these recommendations are in keeping with the wishes of our readers. However, not having received a single letter of guidance, we can only assure you that those associated with 'The Standard' are fully satisfied with the results of the meeting.

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Chairs for Warrington General

Councillor B. Eaves, Chairman of the H.M.C., received two special chairs from the League of Friends of Warrington Hospital at a presentation on Monday, 2nd October.

The £350 chairs, which are designed to prevent pressure sores, were bought with cash raised by the League of Friends, intended for use at Warrington General.

Publications Committee

Social Therapy Review

A week last Thursday, 28th September, the final match of the rounders season was played at Lancaster Moor. As is the custom, each hospital sends their team, two of whom represent them in the final match. After the players are given a tea whilst the other team members who have not participated eat a packed lunch alongside their own friends. This is the reason we sent only two representatives. We feel it is unfair to single out two people when the whole team is present and indeed when these two receive token medals. After all, as a team they are on equal standing, so why not on this day, which to our way of thinking, is the most important of the season. Anyway, with the help of our catering staff we proved it not impossible to provide a meal for everyone.

Last Thursday the fixture with Cranage Hall had to be cancelled due to the illness of their P.T.I. Mr. Allen.

If anyone hasn't already noticed we have three new full-time staff. Rose Young, who was evening staff, Terry Allen and Jackie Worrell, late of female 5 down.

K. Appleton.

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Every day we look at the paper or go to the shops, and something has gone up in price. Do we grumble? You bet we do!

What about the ladies and gentlemen who are patients here? They work in the wards or on the gardens, delivering laundry and stores - you name it and a lot of them do it.

When did they last have a rise? Their cigarettes, sweets etc. are the same price as ours. Isn't it time something was done for them?

J. Mee.

Patients Bank

I don't think that we can let the occasion of a new bank pass without some comments even if only to say 'Thank you' to all the people responsible.. The engineers, sewing room, domestics and everyone else who has made possible another, very important aspect of therapy. From the staff point of view, we have plenty of room to work and it's very clean and very well designed. Thank you again.

M. Milner

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The Society of Radiographers (N.W. Branch) held the first meeting of the 1972-73 season at Winwick on Saturday last, October 7th. The Members were welcomed by the Group Secretary, Mr. E. Fox, and a talk given by Dr. R.E. Wild, F.F.R., Consultant Radiologist on "Lymphangiography"

The staff of the X-Ray department would like to thank all concerned in the success of this occasion.

The Members, many of whom come from as far afield as Lancaster, North Wales and the Lancashire-Yorkshire borders, went away, from Winwick greatly impressed.

M.E. Weilding.

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Psychiatric Concept

In hospital part of the patient's illness nay be difficulty in coping with people both friends, relations or acquaintances, and also any problems that may or may not really exist and also the inability to understand them or maybe even himself.

Nursing staff may lack the ability to cope with each other as people vis. patient/staff or even staff/staff. This comes under the heading of Interpersonal relationships.

Nurses have to endeavour to become as good as possible in understanding these problems to enable then to see the patient as another human being and so alleviate the term "them and Us".

Patients may see the nurse in different roles i.e. loving, possessive, father-mother figure. Often a nurse or doctor will say "my patients" this I think is open to criticism, the other well known comments often said are: "my ward," "old grans", "old dads", "a load of kids`' This type of relationship may serve as a defensive distance between staff-patient or the patient may come to rely more and more on the nursing staff, because of their over-protective attitudes towards them. This in turn destroys part of the patient's individuality and the first grim step towards instutionalisation has been taken.

A good rapport between nurse/patient is an essential part of treatment, to bridge the gap of being with the patient and observing him.

The nurse observes the patients behaviour, but should not get too emotionally involved, this is alright but it is only through involvement that the nurse may attain insight into peoples' lives, although negative involvement can be valuable.

The status barriers which exist i.e. staff-patient, doctor-patient can be broken down through continuous contact with each other and talking about your interests and feelings and avoid a professional front. The way of asking questions in a clinical manner will do little to encourage a relationship and may even be resented. Once the relationship has been established on the lines of 'two people' instead of the traditional staff-patient then information will be given freely instead of having to be asked for.

After using the phrase 'two people' may I hasten to add that I do not mean 'two' literally, because of the psychotherapeutic groups where everyone can express themselves freely and members of the group e.g. nurse, doctor, social worker, etc. helps the patient by using their own specialised knowledge not only does the group work in this way but it should also be realised that the patient must learn to become an active participant in his own treatment instead of relying wholly on the nursing staff. In this way, the patient becomes to some degree a therapist. In this situation the word patient probably is as misleading as the term nurse.

The first two words used in this article are 'In hospital' now let us take it a step further, into the community.

The term community care is terminologically misleading as it implies involvement by the Local Authorities in the community which is quite right but also implies the hospital is apart from the community, which is not right, as the hospital is an integral part of any community.

This misnomer, I hope is now being rectified by certain changes taking place e.g. the reorganisation of the Social Services and by certain hospitals starting their own Community Nursing Services and ex-patients clubs etc.

This article was written not to criticise any person or persons but under the guise of clarification. I hope that it may stimulate some interest and invoke some discussion in the role in which we all have a part, in the rehabilitation off the psychiatrically ill.

J. Beck.

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Are our Present Hospital Evacuation Techniques Out of Date?

Re-printed from "Fire"

Methods of patient evacuation in hospitals have remained the same for many years, not necessarily because we consider them to be adequate but rather because we have failed to keep pace with the advancement of medical science and technology and the introduction of complex equipment to which the patient is attached.

In the age of transplants and extensive surgery we should be taking a long hard look at the state of the patient, the attendant equipment, and ask ourselves, "Are we doing enough to ensure patient safety?"

The exchange of information between the medical profession and the fire authority appears to be non-existent. Changing techniques in patient care produce situations that would prevent rapid movement, and it may be true to say that careless movement would result in grave deterioration in the condition of the patient, or even death.

The first thought of the fire prevention officer is the life risk. Has he then been denied the information or access to areas that would cause them to think twice about patient evacuation? On the other hand, do medical staff feel they're bound by some Hippocratic oath or are they ignorant of the need for the exchange of information? It would seem the latter is more to the point.

The present methods of patient evacuation consist of mattress and line, blanket removal and hand carries; the last method for semi-ambulant patients is simple and very effective; the other two are slow, cumbersome and in many cases impossible to use.

We must remember that during night hours the demands of the patient are reduced and therefore nursing staff are reduced accordingly, very often leaving one or two nurses to attend to 20 or 30 patients. This, of course, is not true in areas of special care.

Allowing two nurses per patient, 10 to 12 stone is the maximum weight that can be moved. Beyond this weight, it becomes physically impossible for most nurses to lift patients off the bed. What hospital authority can say that the individual patients weigh no more than 12 stone? It is my considered opinion that, while better than nothing, this type of evacuation procedure is of little use. Certainly in the areas of intensive care and special equipment the methods could not be used at all.

Other areas that warrant special attention are wards containing paraplegics, spastics, renal units, geriatrics, accident fractures and so on - all of which point to the need for bed movement and the use of lifts in the event of fire.

Protected lifts are provided for the fire authority - why not for patient evacuation? Surely, the extra cost is not so great? Design of future hospitals could incorporate protected lifts which would ensure speedy movement to lower floors. Accepting that beds could be moved, let us continue the exercise to lateral movement of beds away from fire to adjacent ward areas.

Doors obviously must be of sufficient height and width to allow free passage, The ideal shape of the building would be square, with an inner quadrangle.

Needless to say, the building would have to conform to usual fire protection requirements and building laws. Agreed, the idea is very basic and would need greater deliberation, but if I can cause some serious thought upon the matter, then I will have achieved what I set out to do.

Regrettably, the Department of Health and Social Security cannot find money overnight to build ideal hospitals. Many of our present buildings would require many thousands of pounds to raise then to the ideal standard. We are, therefore, left with the problem of evacuation from wards which are far from ideal.

Individuals in the hospital service have recognised the problem and made attempts to provide slings, chairs, canvas blankets, etc., all of which are equal to, but no better than, the mattress line.

If we agree that these methods are unacceptable, do we continue to teach them to unsuspecting nursing staff, or do we do something about them? The Department of Health and Social Security are certainly an interested party, but they are not the experts. The medical profession could certainly provide expert advice on patient movement. The fire authorities would surely like to know more about the problem.

Whose ball? Whose court? The linesmen and public are ready, we are waiting for someone to call "play".

C.P. Evans.

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I would like to thank all those who worked so hard in helping with the move from F.l Up to M.2 A, i.e. Nursing Staff, Mr. Stewarts' and Mr. Woods' staff, domestic staff, and the two porters who hung the curtains, not forgetting Mrs. Collier (Sewing Room) who was very helpful.

Our hospital artisan staff who are often the back room boys, (and whose good work seldom receives a mention) are to be complimented on the excellent job they have done in M.2 A, both from a structural point of view and the general decor.

Any member of the staff who wishes to see this transformation from the old to the new, may visit the ward by arrangement with Sister C. Gleeson or myself.

My apologies to anyone who helped and I have not thanked.

Sister Gleeson
A. Critchley

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Ward Changes

On Thursday, 5th October, the re-arranging of the wards continued when ward F.1 Up moved to ward M.2 A.

Publications Committee

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Work Study

What is Productivity?

It may be defined as the ratio between output and input, or put in simpler terms, productivity is nothing more than the arithmetical ratio between the amount produced and the amount of any resources used in the course of production.

The resources may be - land - materials - plant machines and tools - the services of men - or as is generally the case a combination of all four.

We may find that the productivity of labour, land, materials or machines has increased but the bare fact does not in itself tell us anything about the reasons why it has increased. An increase in the productivity of labour, for example, may be due to better planning of the work on the part of the management or to the installation of new machinery. An increase in the productivity of materials may be due to greater skills on the part of workers, to improved designs and. so on.

The following examples of each type of productivity may make its meaning clearer.

Productivity of land:- If by using better seed, better cultivation methods and more fertilizer the yield of corn from a particular hectare of land can be increased from 2 quintals to 3 quintals, then the productivity of that land in the agricultural sense, has been increased by 50%. The productivity of land used for industrial purposes may he said to have been increased if the output of goods or service within that area of land is increased by whatever means.

Productivity of Materials:- If a skillful tailor is able to cut 11 suits from a bale of cloth from which an unskilled tailor can only cut 10 the skillful tailor may be said to obtain 10% greater productivity from the bale.

Productivity of Machines:- If a machine has been producing 100 pieces per working day, and, through the use of improved cutting tools its output in the same time can be increased to 120, productivity has been increased by 20%.

Productivity of Men:- If a bricklayer has been laying 600 bricks per day and improved methods of work enable him to lay 800 bricks per day, the productivity of that man has increased by 33 1/3%.

In short, higher productivity means that more is produced with the same expenditure of resources, i.e. at the same cost in terms of land, materials, machine time or labour used up, thus releasing some of these resources for the production of other things.

It can now be seen how higher productivity can contribute to a higher standard of living, if more is produced at the same cost, or the same amount is produced at less cost, there is a gain to the community as a whole which may take various forms.

Higher productivity provides opportunities for larger supplies of both consumer and capital goods at lower costs and lower prices, higher real earnings, improvements in working and living conditions, including shorter hours of work and in general, a strengthening of the economic foundations of human well-being.

To achieve the greatest increases in productivity; action must be taken by all sections of the community, governments, employers and workers.

Governments can create conditions favourable to the efforts of employers and workers to raise productivity. For these it is necessary, among other things, to have balanced programmes of economic development; to take steps necessary to maintain employment and to try to make opportunities for employment for those who are unemployed or underemployed and for any who may become redundant as a result of productivity improvements in individual plants. This is especially important in development areas where unemployment is a big problem.

Employers and workers also have vital parts to play. The main responsibility for raising productivity in an individual enterprise rests with the management. Only the management can carry out a productivity programme in each company, only the management can create good human relations and so obtain the co-operation of the workers, which is essential for real success, though this requires the good will of the workers too. Trade Unions can actively encourage their members to give such co-operation when they are satisfied that the programme is in the interests of the workers.

J. Shaw.

Welcome to:

I. Miller - Student Nurse
R. Carooppennen - Student Nurse

Visits

18 students and Tutor from Royal Albert Edward Infirmary, Wigan, will be visiting the hospital on Friday, 20th October.

Nota Bene:

As New Years Eve falls upon a Sunday this year it is felt that the true spirit of the event could not be captured on the Friday or Saturday preceding, therefore this function will not take place this year.

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