Catheter Life Charts and Other Dispatches

I never fail to be surprised by the bureaucracy within the NHS which then gets thrown in my direction. This week I was scheduled for a routine catheter change, something that has been part of my life every six weeks for almost a decade. The change itself is relatively simple; a short but not necessarily sweet procedure and, until last year, I thought beyond the imposition of NHS paperwork.

It seems I really tempted fate because some well meaning healthcare operative introduced the ‘Catheter Life Chart’. This is a multipage booklet that looks at the process of, need for and alternatives to a urinary catheter. This form was introduced with the aim of reducing ‘unnecessary’ use of catheters and thereby their complications such as the infections having a catheter in situ can cause. I bet you’re thinking great, sounds really positive, what is there to whinge about?

The problem is that the form is not designed for us long-termers, who are managed in the community by a health care team. It is so clearly meant for the hospital ward. Questions include: reason for insertion, removal, change; does the patient understand why they have a catheter; does the patient know and understand how to manage and care for it. I have watched a fifteen minute treatment appointment creep up to almost an hour, just because of this form. I complain fiercely at every appointment, the nurse always tells me orders from on high say it just has to be done! To be fair she did add in the box for additional comments that, “The patient thinks this chart is a complete waste of time and resources”. A small victory for all the prodded, poked, relentlessly scrutinised and documented disabled populace. Two weeks ago I was reading The Times journalist, Melanie Reid’s “The Spinal Column”. She talked about the relentless questions and repetitive documentation that she has also experienced. When you are in clinic or being admitted into hospital, you are suddenly bombarded with these questions about your day to day care needs, ironic really as I often think as I am answering, “Yes, and when I was struggling to get my jeans on without falling out of my wheelchair this morning, nobody cared. And they won’t care tomorrow when I’m home once again either.”

If these questions were asked with a view to your needs being met and your life changing for the better, which of us would argue? But to be constantly asked the same questions with no expectation of improvement and to do it at every appointment you have, becomes ridiculous. Just look back through the notes, my answers have not changed, because my disability hasn’t!

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