Behind the Scenes at Dartmouth Hospital

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Dartmouth Hospital

There’s been a hospital in Dartmouth since 1887 when the town’s first cottage hospital opened in Bayard’s Cove - a permanent memorial to the Jubilee of Queen Victoria.

Until then patients needing longer term care had been looked after in a private room built by a doctor in the garden of his home at Mount Boone. The new hospital, in the building now known as Morocco House, swiftly earned a reputation for a high standard of care, a reputation that has stayed with the hospital through its move to the South Embankment, and is still true today.

Already this year the regular audits of hygiene, cleanliness and care have placed Dartmouth at the top of the tree for Devon’s hospitals, a fact met with pride, but not surprise, by interim Matron Philippa Ellis.

“We are really lucky to have a hard working and dedicated team here at Dartmouth. We’re like a family. Everyone is committed and does their bit.

“Audits and inspections happen all the time. Some we are told about in advance, some are spot checks where inspectors just turn up, and they are checking everything from the way we train and treat the staff to the cleanliness of the leaflet rack! We have to be ready for anything.

“We are cleaning all the time of course, but there is an annual programme of deep cleaning where each community hospital completely closes and radiators come off, light covers come off and everything is cleaned, from the drains upwards. The whole team is in, sleeves rolled up, steam cleaning under the beds, and then assessors inspect what we have done and decide whether or not we can reopen. We did so well last time that at that point we were the cleanest hospital in the area, which was absolutely brilliant – but I wasn’t surprised. Our standards are high all the time!”

Mum-of-three Philippa lives in Dartmouth and has been at Dartmouth Hospital for 20 years, since coming through the doors as a newly-trained staff nurse. She’s not quite the longest serving member of staff – her ward sister from those early days, Sue Pound, is still there, now working on reception. It’s unusual for nurses to stay in one place so long, but Philippa said: “We are like a family and we look after each other. We came into this because we care, and we are all committed to the idea of a community hospital. In a busy town like Dartmouth, particularly in the summer, we need somewhere where people can come and know they will get help, where there is a minor injuries unit.

“If it walks through the door – it’s ours. We’re ready for anything!”

The role of Matron has been reintroduced by the health service. At the moment Philippa is in the role as an interim measure. She praised her five senior staff nurses, each with their own specialism, who she said had stepped up to the mark to allow her to fill the Matron position.

“Having a Matron releases the paperwork burden from the team and allows them to nurse – you can’t expect nurses to be clinical if they have too many demands from paperwork. We are very good here at releasing their time so that they can provide hands on care.”

Taking an overview has allowed Philippa to see simple changes that once made have achieved great results. Even moving a linen store saved nurses’ time and kept them closer to the patients. Chat and company provided by the nurses as they go about their work is essential to good patient care and morale, Philippa insisted.

“The view also helps recovery,” she smiled, pointing to the wide ward windows which offer an unrivalled view of Kingswear, the Dart and the sea.

Paperwork and organisation is a vital role, but Philippa remains a nurse first and foremost, adding: “When I have the chance to be clinical, I am in my element. That is why I became a nurse, and I would rather explain myself having missed one form than not sit with a patient who needs my time and care. That is what is important, and I believe we have our priorities right here.”

With its 16 beds in three wards and two side rooms, Dartmouth’s remit is to care for patients who are 18 or over, who have rehabilitation potential. The hospital is regularly called on to take patients from overflowing hospital wards in Plymouth, Torbay and Exeter. Variety is an understatement!

Philippa explained: “We do some first line assessments here but others transfer straight to Torbay because that’s where the appropriate care is – we are part of providing the right care in the right place.

“We have a lot of orthopaedic patients – broken bones, after care from hip replacements. We have patients recovering from surgery. We look after people recovering from heart attacks, or from conditions like chest infections or urinary tract infections.

“Our priority is to help people get well and go home. That is what everyone wants. No-one really wants to be in hospital. A lot come here so that they don’t have to go to Torbay. They’re closer to home, which is nicer for the patients and for their relatives.

“Some treatments and intravenous therapies are carried out at Dartmouth, which means patients can be admitted, treated and sent home within an hour rather than having to go all the way to Torbay, which can be a whole day out. We carry out minor ops – lumps and bumps! The GPs do those and provide ear, nose and throat and cardiac expertise, for example.

“I have nurses here who are experts in everything from resuscitation and life support to tissue viability (the healing of wounds), end of life care, moving and handling, health care training and continence management. None of us can say we know everything and we are all learning and increasing our knowledge all the time, teaching and learning from each other, responding to change.”

Other services include working with Dartmouth Caring to manage discharge from hospital, physiotherapy, occupational therapy, and Philippa would like to develop further the hospital’s day services. She hopes that NHS changes which mean GPs will manage local health provision will strengthen the work of the hospital and allow change to develop, saying that the already positive relationship between Dartmouth’s hospital and GP practice put the town in a strong position.

Dartmouth Hospital has occupied its current home on the South Embankment since 1894. Fascinating old photographs of the Nightingale wards and young TB patients still adorn the walls, alongside artwork supplied by school children and patients. Philippa has seen a lot of changes; numbers of beds reduced to give the wards a more airy feel and the patients more privacy, long term conditions treated in the home with the hospital liaising with Social Services and families to make that possible.

Philippa said: “Sometimes I play a mediator role between the patient and their family. When someone is unwell it is an emotional time. But we are part of their community and they trust us. The community supports the hospital – the strength of our fantastic League of Friends is evidence of that.

“The specialisms of our nurses and our local GPs make us very autonomous – we are successful at a multitude of tasks which makes us different from the wards of the big hospitals. We are everything a community hospital needs to be.”

First Published April 2011 By The Dart