Anitta Thomas from Imperial College Hospital speaks about her experiences with a shared care patient.
I would like to share my experience about Mr Parduman Matharu. I have been given permission from his family to use his story to help others understand the impact shared care can have on patients and their loved ones.
Mr Matharu was a 67 year old man attending the renal dialysis unit three times a week for the past three years. The concept of shared care was known about however it was only in September 2020 that our programme actively started and I took up the opportunity to be the shared care lead in my unit. As part of my role, I performed the shared care audit which an provided opportunity to talk to the patients and generate interest in them towards shared care.
Mr Matharu refused to participate in the shared care program initially as he was quite anxious about dialysis and all the procedures in the unit. A few months later, he showed willingness to participate after observing other shared care patients. I was not entirely convinced about his ability to be involved because of his anxiety and earlier reluctance to participate.
Mr Matharu asked to speak to me and expressed his interest in shared care. I informed him that he could come in 15 minutes early for his dialysis every session so that I could teach him. I was surprised to find him presenting himself at the door, at the agreed time for his next session. I was delighted to see the interest he had in learning. First, I showed him the handwash technique, however he was more interested in getting himself a full set of PPE, "because the nurses are wearing them". This was becoming more intense than I ever expected it to be.
He learned the basics very quickly and progressed to preparing the table with aseptic technique and before long, was setting up the table himself for lining the machine. He was getting more comfortable in seeking my help related to dialysis which was a huge contrast from how he behaved before starting shared care. I explained the functions of kidney, dialyser, dialysate etc. and he was well on his way to becoming a professional. In exchange for my lessons, he would talk about how he was telling his kids and grand kids that he was now training to become a dialysis nurse. He was very keen to learn how to line and prime the machine, which after repeated requests, I started with him.
Unfortunately, Covid was beginning to show its full fury around London at the time. This limited the opportunity to progress further with training. I allowed the patients to continue with the level of shared care they had achieved so far but was not actively teaching new techniques to further their learning. I aimed to return to teaching once Covid related problems settled down. Unfortunately, things did not play out as I intended. Mr.Matharu went on to become Covid-19 positive and passed away a short while after that.
My perspective of shared care was given a positive boost when I was later contacted by the family of Mr Matharu and they told me how much he used to enjoy the new things that he was learning at the dialysis centre. They were very pleased that he found the last few months of his life more productive because of his interest in shared care. Apparently, his conversations at home included a lot about the interactions that I had with him. He had enjoyed the new opportunity to learn about dialysis and be more involved in his own health care.
In the 'Thank you' card sent to me, Mr Matharu's family told me that his anxiety was much relieved due to him being allowed to take part in shared care.
I hope this story will enable more nurses to realise that the impact of their actions is much more than what is visible. You have the power to change someone's life around.
Contributed by Anitta Thomas, Shared Care Link at Hayes Units, Imperial College Hospital, London (April 2021)