“Stop all the clocks…”

What could a stopped clock tell us about the culture of your hospital, your ward or the state of your health service?

In the harrowing Patients’ Association report of the neglect and shameful care of older people in some NHS hospitals, one family member wrote to say that she wondered why something as simple as providing a ‘working clock’ seemed to be beyond the ability of such a multi-million pound organisation.

The daughter wrote:
“There were other simple issues. There was no clock in the bay my mother stayed in. Another elderly lady staying the bay frequently voiced that she was confused about what time it was. When I mentioned this as a minor side issue to a nurse I found their explanation baffling. The nurse said clocks aren’t put onto the wards as it is more confusing for patients if they show the wrong time. Why is it not possible to ensure something as simple as the maintenance of clocks in a hospital?” (p.23) ‘Patients not Numbers, People, not Statistics’, August 2009

I regularly ask groups of nurses to explain why it could be so difficult to do something so simple. Their answers speak volumes about the stultifying nature of the bureaucracies that they work in and the sense of powerlessness that they often experience.

Here are the top 5 reasons:
1. Even if there was a clock and it stopped, so what, no-one would care.
2. It would not be anyone’s job to fix it
3. Even if a nurse brought in a new battery for the clock, the OH&S police wouldn’t let her replace the old one. Multiply that by a factor of 10 if she would have to stand on a chair to replace it.
4. If someone did notice, did care and bought a new battery for the clock, they might expect a reimbursement of the cost. Have you any idea how many forms, signatures, permissions and ‘person hours’ of work that would take for a $2 battery?
5. The person replacing the battery would need to be specially ‘accredited’ as a battery changer.

We can forget about nurses and health care staff being ‘agents of change’ and dynamic, thrusting ‘service transformers’ if they are barely ’empowered’ to keep a clock going.
It seems that the only things ‘ticking over nicely’ in some hospitals and health services are the systems and processes that paralyse them.


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