Four weeks in Nanaimo General and I wasn’t bored to death. I was sick but not usually too sick to talk, so I interviewed practically everyone who came into the room. Cleaners, student nurses, porters, the meal-tray deliverers (hi Denise!), nurses, doctors, physios, and nurses aids. Add in the technicians who did all the ultra-sounds, CAT scans, bone scans and x-rays and I probably talked with 100 people or more. With their individual and often personal stories came a picture of the world they work in.
I have had to stay in hospital only once, but I’ve had a lot to do with hospitals (and nursing homes) looking after family and close friends who’ve ended up there. To tell you the truth, my experiences have been overwhelmingly positive. Which isn’t to say our medical system is faultless, or anywhere near it, because it isn’t. But it does work in the main, especially in crises, and it works because of the front line human beings who make it work. We don’t often acknowledge this.
I could go further. The care I got was delivered with patience, accompanied by acts of generosity that went way beyond the job description. There was even a fair bit of rule bending. For example, the technician, who made a point of briefing me on a rather frightening test that had been ordered, explaining what it entailed, and promising to be there for it should it happen (it didn’t). And the nurse who got me a latte on her break from the café downstairs. And this is not to mention the unexpected hands-on care of my (count-em) two orthapedic surgeons. First there was Dr. C. who when I queried him about what he’d done so the incision in my calf was never painful answered that he’d gone in with his fingers, manipulating between the muscles to slip out the abscess. He found a way to fool my quivering flesh into believing it had not been traumatized. And then Dr. S who came in the first two mornings after the second operation, to check the wounds and change the dressings himself.
For weeks I watched these people trying to do their jobs, working around the dysfunctional parts which, so far as I could see, had mainly to do with counter-productive administrative decisions. Like closing the pharmacy at 6:30pm. A few days in and it became apparent I was allergic to the detergent used by the (contracted out) laundry service. So sterilized linen was ordered. This was delivered the next day in a huge package containing sheets, pillow cases, towels, and gowns but no bottom sheet. The second package didn’t have one either. Thing was this laundry service couldn’t or wouldn’t deliver the sheet singly. You could only get the complete package. The third time, we scored, but this took two whole days, a silly amount of the nurses’ time, and it left my room looking like a linen closet after a wind storm.
Then there was the poor doctor who had to get me into the out-outpatients program to support the portable IV system. The problem there was the absence of doctors on Gabriola Island with hospital privileges who could provide back-up. Dr. R came in on his day-off to start the campaign, and spent many hours on the phone over two days ’til he found someone in Nanaimo. Reporting this to me he wasn’t beaming, though he was visibly relieved. He left remarking he rather deal with a heart attack than have to deal with bureaucracy.
Hospital food is an overworked joke. Living the joke makes you think about it, though. Like why? Haven’t any of the good people running the show ever been here around mealtime? As with laundry, it becomes obvious right quick that out-sourcing the food service delivers profits to someone somewhere, and food trays that make the ill want to vomit. (Exactly what I overheard another patient saying on the public phone across the hall.) Admittedly, once a day the kitchen sends in something genuinely nutritious and enjoyable with no added salt and/or sugar whatsoever. That would be the oatmeal porridge at 6:30 am. Everything else is inexcusably unhealthy and often inedible. Ersatz egg dishes with enough salt to melt a glacier; tinned sugar syrup with a bit of mushy fruit in cubes; un-ripened pears that stay rock hard until the day they turn black.
Eventually the Dr. G got heavy with me about the food thing. What was I going to do for protein? We agreed on cheese and peanut butter. So the next day, the tray included 43g of processed cheddar encased in plastic, and a single-serving (one tablespoon) of Kraft peanut butter — along with a rice curry that doubled as a laxative. (And here I thought no one could ruin a curry.) In my case food supplies were a ferry ride and five hours away, yet Laurie, Lindsay, Isabel, George and Kit managed to keep me in yogurt, cheese, fruit, nuts and sliced meat for sandwiches. Patients, I learned, are actually allowed to keep perishables in a fridge in the kitchen, an arrangement that I took as something of an admission. Expecting sick people to make do on crap food requires an escape hatch somewhere if only for those determined enough, and with friends and family on the outside. Personally, I’d prefer an up-front notice. Patients are advised to bring their own food.
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There’s one notice I did see. Everywhere. The was one about foul language and abusive behaviour not being acceptable, about verbal threats and acts of violence possibly leading to removal or prosecution. There you have the other side of the story. Angry, and demanding patients. People out of control with pain, or fear. I spent two days on the geriatric ward when I was first admitted, and got a load of what happens when a stressed-out elder, no longer able to cope, ends up in hospital. One had nurses on the floor searching for shoes under her bed, and fishing aids hearings out of the sink, fetching food and fixing the phone. The angst was palpable through the curtains. Upstairs on the orthopedic floor, I listened to the old man across the hall banging the railings of his bed, yelling for his wife and threatening to get out of bed. Eventually a nurse sailed in to calm him; explaining, again, where he was and why.
So I come back to basics. What makes our health system work are the people working there. The majority who love what they do, and are willing (and somehow able) to put up with the stress of administrative support systems that don’t actually support them.