Patient safety on the frontline – 5 minutes with Anaesthetic Nurse, Richie Chibisa

Q. What drew you to a career as an Anaesthetic Nurse? 

A. I initially trained as a nurse in 2003, but three years later, I decided to work towards being an Anaesthetic Nurse because it’s more hands on and highly skilled. It’s also a specialist area, so you get to work closely with the Anaesthetists. It’s great because you can always see the difference you’ve made at the end of every day. You see patients coming in for surgical intervention, and then going home after surgery with no more issues.  

Q. I know you have a young daughter. How do you describe your job to her in a way she would understand?  

A. I tell her that we put people to sleep and make them comfortable so they can have surgery. Generally, my daughter understands that my job is to make people better. 

Q. That’s very sweet. What’s something you wish everyone knew about being an Anaesthetic Nurse? 

A. The central role we play in making patients feel at ease and our contribution to the surgical process. It’s not always about the anaesthetic that the patient receives, but making sure they feel safe. For example, you might have a patient going into surgery for cancer treatment and you don’t want them to feel scared, so Anaesthetic Nurses have to find ways to take the patient’s mind off things by being a good listener or conversationalist.  

“Over the years we’ve been trying to figure out how we can communicate with patients who don’t speak English as a first language. I’ve been in situations where no one speaks the same language as the patient and you have to find a translator or someone else”

Q. I wonder if the average person going in for surgery thinks more about the surgeon and may not consider the fact that before you get to that stage, that’s where the Anaesthetic Nurse comes in and helps make you comfortable.  

A. Of course, without a doubt. Many people used to say the doctor will make them feel better, but once they get to the hospital and see the work nurses are also doing, or even the tea lady or the porter, they will remember those people as much as the doctor who performed the surgery. It’s important for people in other roles to be just as recognised as the doctor because our work contributes to the overall patient experience.  

Q. Working in healthcare right now must be so hectic and unpredictable. What does an average weekday and weekend look like for you? 

A. I work four days a week at the Royal Surrey, so I wake up around 06:00. Because I’ve been assigned more specialist cases like the head and neck which are cancer centres, I’m usually in emergency theatre where I work from 07:45 until 20:45. It’s highly skilled so it can be intense and but it’s quite rewarding when you see the impact of your job, so I like it.  

At the weekends, I play quite a lot of sports, especially golf and cricket. I recently became a member of the Marylebone Cricket Club in London. My youngest daughter wants to learn how to play golf, so I’ve just started teaching her. I’m a big sports fan. At work, they joke and say “don’t talk about sports with Richard or you’ll be there all day.” 

Q. You mentioned earlier that a large part of your job is making patients feel comfortable and at ease. Many healthcare workers have faced challenges communicating with patients with additional needs, i.e., being blind or autistic. Have you felt the same? 

A. Oh yes. Over the years we’ve been trying to figure out how we can communicate with patients who don’t speak English as a first language. I’ve been in situations where no one speaks the same language as the patient and you have to find a translator or someone else. Even if you find someone who speaks the language, they may not understand the medical terminology we want to get across to the patient and the next steps we’re going to take. 

All patients know we will provide proper care for them, but it’s good to explain our actions in more detail so they won’t feel scared or feel like they have to be compliant and do whatever we want just because they’re a patient. Small changes like saying “okay, now we’re going to put a mask on” makes the patient feel like they’re following the process and they understand how we’re going to treat them. 

“Sometimes we can’t find an interpreter, then we might have to delay the surgery, which then affects the patient and everyone else”

Q. That’s a very interesting point. Would you say the biggest challenge with communication has been language barriers?  

A. Every day we come across at least one or two patients who don’t speak English as a first language, so language is a big barrier. It’s also challenging for patients who are deaf or hard of hearing. Many of the people coming into hospital right now are older, so they may be losing their hearing capacity. Under normal circumstances they could get by with non-verbal cues such as lip reading, but now that we’re all wearing masks and PPE (Personal protective equipment), they can’t understand us at all.  

Q. Yes, that’s definitely been a big issue since the pandemic started. Besides searching for interpreters, how do you currently deal with communication barriers?  

A. Usually finding a nurse or another member of staff in the hospital who speaks the language, if you’re lucky. Some the patients have had to speak to their family on video calls. I’ve also seen Google Translate used in one or two situations but I don’t think that’s the best approach.  

Q. Have you ever had a situation where you couldn’t find an interpreter or someone else who could speak the language?  

A. Oh yes. Sometimes we can’t find an interpreter, then we might have to delay the surgery, which then affects the patient and everyone else.  

There was a time my colleagues had a patient who couldn’t speak English. They thought he was Indian, so they went around looking for someone of Indian origin to communicate with him. I was passing by, making a phone call and the patient overheard me speaking Shona, a language he understood, so he called me over. Everyone had assumed that because he was Asian, he spoke an Indian language. But in fact, he grew up in Zimbabwe where they speak Shona just like I do. On that day I had to act as a translator for the patient.  

I don’t know how many languages the translators can speak or if anyone else in the hospital speaks Shona like me, so that just goes to show the limitations.  

Q. Why do you think nothing has changed? And why aren’t we getting where we need to be?  

It’s possible that many people don’t see it as a big priority and so they don’t care as much as they should. Personally, I think ignoring access to good communication for all patients can have legal implications. There can be huge mistakes made if patients don’t understand what’s happening to them or if information is translated incorrectly. 

If we’re going to do things properly in the healthcare industry, then we have to make sure we’re using the right tools rather than cutting corners. We can’t keep asking the cleaner who speaks the language but doesn’t understand the medical terminology or the process that is required to put the patient to sleep. That’s like giving someone a role and responsibility they’re not trained to take on. But when you have CardMedic, it makes a huge difference. Fair play to you all because I don’t know anyone else who has thought of creating something like this.  

Q. What do you think of CardMedic as a communication tool and how do you see it changing healthcare?  

I’ve worked as a nurse since 2003 and I’ve not seen anything like CardMedic. I think it will go a long way in elevating the level of care we provide in hospitals and operating theatres. It’s very daunting for a patient to not understand what’s happening. I wouldn’t want to be on the receiving end of that. It’s a terrifying experience and it has been going on for far too long. We see it every day, and everybody has a story to tell, so I think CardMedic can really change things. 

Q. What advice would you give to an NHS Trust or hospital struggling to find interpreters and translators?  

A. This is a chance for them to trial another way of communicating. They need to give modern technologies a chance and CardMedic is one of them. It can be downloaded by the patient as well, so I think more NHS Trusts need to give CardMedic a go, without a doubt.  

Not offering proper care can massively impact patient safety, so if you have a record of what has been communicated to the patient and what has been done to them, like with CardMedic, then it makes things easier and safer for everyone. I think it’s the way forward. 

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