can you hear me?

Kim Woolnough challenges us to think creatively about how we can help our patients’ ‘voices’ to be heard

The NHS can be hard to navigate if you can’t speak or communicate in the mainstream way. Making an appointment, explaining symptoms, or communicating pain may be challenging. Sadly, some people have no one to help them access health services, meaning they ‘give up’ or fall through the gaps.

Proverbs 31:8 in the Common English Bible (CEB) says ‘Speak out on behalf of the voiceless, and for the rights of all who are vulnerable’,
which is a daily call and challenge to us as Christian nurses and midwives.

People in our care may have a speech impediment, speak another language, use communication technology aids, sign language, or pictures. Due to dementia or a significant learning disability, they may rely on gestures, sounds, or behavioural cues to make their needs known. Everyone can communicate, but it may not be through speech! We must take time to learn that person’s language and care for them well. Thankfully, we have the help of the Holy Spirit. We can whisper a prayer; ‘Holy Spirit, you know this person intimately, help me to know what they need.’

I reflect on caring for a man with a moderate learning disability, recovering from a knee injury following a fall, and whose physio progress was very slow. ‘Non-engagement’ had been mentioned in the ward round. His demeanour and behaviour changed whilst the therapy team attempted to mobilise him. He had limited language ability and struggled to articulate what was wrong. We suspected there was unmanaged pain that he could not express. A repeat X-ray revealed the culprit – a nasty hip fracture!

Taking time to listen and observe verbal and non-verbal cues can be invaluable, but it is indeed a challenge on a busy shift!

We desire to advocate for the voiceless but struggle with a lack of time, knowledge, confidence, or resources to do this well. There are some practical things to make our care more accessible, such as:

• Making a patient’s hospital passport and communication tools visible to all staff
• Making easy-to-read information leaflets or pictures readily available
• Using pain assessment scales designed for cognitive or communication impairment
• Ensuring telephone language interpretation access is readily available

Food for thought: What practical things might you be able to do in your area of work?

Kim Woolnough is a learning disability nurse working in Oxford