Wednesday, December 17, 2008

‘Make it up as you go along’ works

“Life is what happens while we are busy making other plans” – John Lennon

6.30 pm, January 10th 1977 and the wind was gale force. The rain was torrential. I was the manager 'on-call' for my local hospital – a 140 bed unit mainly for older people and some younger people recovering from surgery.

I had just sat down for my evening meal at home when the phone rang. It was Ken - one of the porters at the hospital just ringing me to tell me, for information, there was a problem with the drains in the car park. It seems the manhole covers were lifting through water pressure and Ken understood the tidal river that ran through the town had flooded as the high winds coincided with unusually high spring tides. I asked if there was anything I could do but Ken told me things were ok and all seemed calm despite rumours of chaos in the town.

No sooner had I put the phone down when a neighbour came round in a panic to tell me the river had indeed flooded and the town was under water in places. Emergency vehicle sirens could soon be heard all over the town and I felt it may be a good idea for me to go in and check things were in fact ok at the hospital. I was concerned because the hospital was only about 200 yards ‘as the crow flies’ from the river so if there was a problem it is likely that the hospital may be affected.

As I reached the hospital car park in my car I was amazed at the sight that met me. The entire car park and the drive leading to the hospital was flooded to a depth of at least two feet and I had to leave my car and try to walk to the main entrance to establish quite what was going on. Why hadn’t I had a follow up call from Ken?

The scene was total chaos and I decided to walk to the main entrance in the clothes I was wearing. As I passed one of the new buildings in the grounds on my way to the main entrance I was by now up to my waist in freezing water and couldn’t help noticing the new furniture floating in our pride and joy building – the new Day Hospital that had been opened just a month or so previously.

When I finally got into the hospital Ken greeted me with the news that all power had been lost including telephones and as this was of course before the days of mobile phones the hospital was completely isolated and yet in the middle of the town!

So there I was at age 24 – still ‘green around the ears,’ still learning my trade and suddenly faced with a major incident.

It was now 9 pm and the only people at work on the premises were the night nursing staff the porter and me. This was a total of about 10 people. There were well over 100 patients whose welfare was of course our greatest concern.

I wandered around the hospital to speak to the people on the six wards to make sure things were ok. Obviously the one ward on the ground floor was our biggest concern and that ward had about six inches of dirty water covering the floor.

We decided to use one office as our base and those who could be spared came to the office for a quick meeting to plan what we could do for the rest of the night.

The truth is we were making this up as we went along. Yes there were polices and procedures that had been written in

the warmth of a comfortable office, probably in the middle of summer. Here we were in the middle of winter in a violent storm with no power and over 100 vulnerable patients. And we could not communicate with the outside world.

We developed some plans on the hoof and gradually three or four more people battled their way to the hospital main entrance as the depth of the water in the drive continued to rise. Eventually we managed to set up a primitive form of communication. The local Sea Scouts organisers came up to the hospital entrance in a boat! They delivered a loud haler which meant we could communicate with people wanting to offer help as word got around the town that the hospital was in effect cut off. We were overwhelmed with offers of help and we had to make priorities about what we needed.

After a few hours the telephones were re-connected but we had no power until the following day. The ten of us kept in touch by constant walking round the hospital bringing folks up to date with any news we could find out.

As daylight broke the water finally began to subside and at last the hospital became reachable. In the meantime we had moved the most vulnerable and ill patients from the ground floor to higher levels to escape possible infection from the dirty water. All the patients were given extra blankets – remember we had no heating!

During the following day we evacuated 120 or so patients to various hospitals all over the region and it was just incredible to find myself at my tender years to be in charge- by default - of such a major incident. Amazing learning.

The miracle is that no patients lost their lives overnight although sadly a couple of patients died a day or two later in the hospital we managed to evacuate them to. It was felt by the nurses that the trauma of the event itself contributed to the patients’ demise.

I have many vivid memories of that night. The overwhelming learning is about how, at times of great adversity, ‘unconnected’ people can work together as a wonderful team and ‘deliver’ effectively even though there is no precedent, no plan and no experience of dealing with such a major incident. A wonderful experience and I was so proud to be a member of that team.

Leadership Lesson

‘Make it up as you go along’ works as a strategy sometimes. Policies help and act as a guide but sometimes you just have to get on and ‘do it.’


J.KANNAN said...

An amazing presentation of, recalling over three decades of real life experience. You have made a most apt beginning with the quote of John Lennon.

Yes life is created by “The Supreme Power”- We can only keep ourselves busy making plans, the end result is undoubtedly decided by that “Supreme Power”-hope you will agree with me, Trevor.

I think of Kenn’s action of informing you of the situation over phone should be described as “Impromptu to action”, a good action on the part of Kenn, a very good part of a great “leading Team” of the hospital.

Similar is the initiative,drive and action on your part also to be mentioned as “Impromptu action” to reach the hospital, a great idea conceived at a very younger age, that’s why you are very powerful in leadership even at this age (‘I don’t really mean you are old pl)-It needs lot of will power and firm determination to get into action quickly and swiftly, you did made it and entered the hospital in adversity conditions. According to me you have been blessed with managing and bring to control the “Crisis Situation”-i.e. Crisis Management one of the qualities of Leadership. Just I was imagining you have about 120 lives inside the hospital on bed recovering from post surgery- Any panicky situation can only complicate matters and only swift and quick action can bring in the desired results and you did with your small team. The quantity of the team does not matter, but the quality of the team do matter, that you had with you and I would put it this way-You were not only Manager “On-Call” but also a Manager on “Crisis Management”.

To add to the agony, the power cut and disruption of communication was yet another grave situation and the way the communication part was managed with primitive form of communication is indeed a sensible and innovative idea under the circumstances, to enable you to bring the situation under control faster.

An incident of such a grave magnitude is not only an amazing learning but a great experience too, that would probably have helped you in your succeeding years of association with NHS.

I do agree with you at the time of crisis, calamity, danger etc just make it up and “Go Ahead” with actions as a strategy, leaving aside the policies and rules in the book. For Ex-Post-Facto sanctions.

A great posting and I liked it very much.


Trevor Gay said...

Hi JK – this was one of the greatest learning experiences in my entire career and I’m sure it helped me later in life. One thing I discovered in that overnight experience is how many people are leaders – even if they are not ‘senior’ in the pecking order. Cyril, the engineer was brilliant as was Ken, the porter and the junior nursing staff - a great team I was proud to be a part of!

Trodos :0) said...

Having diffulty with supreem powers are they real or imagianery