Monthly Archives: May 2018

Heart Transplant  – A Shining Example of How We Should be Doing things in Practice

 Three years ago today I was sitting in a family room at the Golden Jubilee Hospital in Glasgow surrounded by my family waiting to hear if my dad’s heart transplant had been successful. The initial call had come from my Mum at 1.30am to say the team had found my Dad a potential heart and we had been on a rollercoaster of emotions over the last 12 hours. 

In reality this rollercoaster had started for us 6 weeks earlier when after accepting that my Dad wasn’t going to get better we were referred through to Glasgow for what we were told was a complete re-assessment of his case. Little did we know walking into what is affectionately called ‘the pod’ that we were on Scotland’s only specialist heart transplant unit. 

So how is this relevant to the veterinary industry and my blog? The medical profession has invested significant sums into human factors and their impact on errors and patient safety, on culture within the NHS, teamwork and leadership. This type of research is seriously lacking within the veterinary industry but I believe we can learn a lot from the NHS.  

There is a multi-disciplined approach to transplant assessment at the Golden Jubilee and each patient undergoes a full medical assessment from cardiologists, surgeons, renal consultants, psychologists, dieticians and physiotherapists. You name it my Dad had it, every test you can think of and more. The whole process takes about two weeks and then the team sit down together and make a decision based on every member of the team’s assessment. Everyone’s opinion is valued and considered. For the family it can feel like an eternity as you put your faith in their decision making process. 

It became obvious after the first 24 hours of being on the pod that there was a very clear system for the team to follow.  It started with a mere mention of transplant as the very last option, before they started gradually introducing the concept to the whole family. Looking back it is clear that they were drip-feeding us the information in small bite size pieces so that we could absorb what they were saying. What was impressive was that the whole team were involved in the process, they clearly understood each stage and were communicating as a team throughout.  Even the ward assistants knew what was happening and what to say when the word transplant was mentioned. Each nurse that started a new shift knew exactly where we were in the process and we were never once told that they would have to double check for us. How often do we fail to communicate and hand over cases in veterinary practice? 

I think it would be fair to say that during this process my Dad was in complete denial as to how ill he was! Feeling out of control he would try and argue his case but the team always had an answer and kept gently shoving him towards accepting that this was our only option. Their empathy was remarkable, and they knew when to sit and listen to my Dad’s seemingly well-reasoned argument that he should be allowed to go home, and when a more blunt approach was required. 

Acceptance of his situation finally came when 5 weeks after admission and now with a balloon pump trying to keep his heart going, my Dad had a cardiac arrest. Save for the fast and swift response from the nurses on duty he wouldn’t be here now. 

Incredibly one week on from this we got the call, one heart had already been assessed and ruled out as not suitable, and my Dad was now at the top of the urgent list. Teams were working in the background all over the UK to find a suitable donor. Given the extremely sensitive nature of organ donation there are strict protocols to adhere to.  Transplant co-ordinators are assigned to the donor family and to the recipient and they work tirelessly in the background at all times of day and night. 

Out of theatre and on ICU we spent two days watching as the team slowly woke my Dad up and got him off the ventilator. The team on ICU were outstanding but I remember it as a time of fear and panic, every time a machine beeped my heart skipped a beat. 

I can still remember walking back down the corridor to the pod after my Dad had been moved out of ICU and feeling relief that we were once again in an environment where I felt safe and secure. We were in the same hospital run by the same Trust but somehow the team in the pod had created this incredible, safe and secure place for the patients and their families. 

Culture within an organisation can be difficult to define.  The leadership from the head consultant was clear, and his team spoke incredibly highly of him. The whole team were involved in decision-making and had clear, defined and valued roles to play in each patient’s care. 

Compassion fatigue is a well-recognised factor in burnout and stress in both the medical and veterinary profession.  Every day the team on the pod are dealing with life and death, there is no in between grey area. Their patients either go on the list or go home to die. They either get their heart in time or they don’t and they either recover from their transplant or they don’t. That’s the reality of their job, day in day out, and yet the empathy and compassion that they showed us over many months was remarkable. 

There are so many veterinary practices who are doing an equally amazing job, building a culture around mutual trust, with systems and processes, and where their team feel valued and that their well-being is a priority.  I am also sure there are many examples of less positive experiences in the NHS. However I think we can still learn a huge amount from the medical profession and our experience of the team at the Golden Jubilee was a shining example of how we should all be doing things.

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My amazing Dad enjoying life three years on from his transplant all thanks to the wonderful team at the Golden Jubilee and an incredible act of bravery and kindness from a grieving family #organdonation