2 Hospital Days

In the two weeks since I last communicated with you, I have had an unwanted but unique insight into one patient’s experience of the health care system. The patient was my husband. On December 28, he was admitted to the Civic site of the Ottawa Hospital, his respiratory infection having developed into lobar pneumonia.

I am not certain I could have convinced him to go to the Emergency Room for an assessment had the presentation not included left-sided chest pain – the one warning sign most men his age will not ignore. Fear of a heart attack in older men is more compelling than laboured breathing, sweating and shaking chills, nausea and vomiting and the respiratory tract infection that he had been experiencing. The assessment in the Emergency Room was straightforward and thorough but, in due course, my husband was admitted to hospital for intravenous antibiotics and fluids since dehydration had become a complicating factor.

Having been admitted to hospital just as the first snowstorm of the year hit, the course of Andrew’s treatment was uncomplicated and his symptoms resolved within one day. In fact, I had expected him to be discharged after twenty-four hours but the schedule of ward rounds was thrown off both by the holiday and by the weather.

When I visited him on the first day, while he was much improved, he was also clearly shaken by his experience of how unwell others around him were. He had been kept awake by patients shouting and screaming, their suffering so severe that my husband wondered how the nurses and other ward staff actually endured the stress of these situations, day after day and night after night. He marveled at their cheeriness with him and their professionalism and care for the woman in the next bed who was unresponsive to her caregivers’ ministrations.

The unit where he was cared for is one of the hospital’s Clinical Teaching Units in Internal Medicine. He was impressed on the one hand by the care he received but shocked by the crumbling infrastructure around him. Again, his thought was for how difficult this must be for the people who worked there every day.

My husband is a lawyer, an intelligent man with an eerie capacity for intuition. To cope with situations that are emotional, he seeks to understand them. What he observed were professionals who did not allow difficult working situations to interfere with the care they provided. Each time I visited him, he told me how much he admired me for the work that I did. It was clear that he had not completely realized the degree to which deteriorating health care equipment and decreased staffing are a factor in health professionals’ work lives. I suspect that no patient does realize this until they experience firsthand the degree to which our hospitals do not look like the facilities in General Hospital or Grey’s Anatomy.

What is perhaps more important from my perspective is that my own descriptions of the conditions and circumstances have not truly communicated the degree of concern that I have about how much health care support systems have deteriorated in the years that I have been practicing medicine. Staffing has been systematically decreased, equipment has not been replaced appropriately, buildings have been left to crumble and food and cleaning have been outsourced to the point that these do not meet the standards for nourishment and cleanliness that most health care professionals would want for themselves.

For the first day after he returned home, Andrew spoke to all those who enquired after his health about the state of the hospital and the stress the staff experienced at work. Several times, he was overcome with emotion when describing his experience. He had clearly been traumatized by the realization of what being in a hospital was like for a patient.

It has taken me fully a week to process my own thoughts about Andrew’s experience. I have always believed that the only reason Canada’s health care system continues to provide good care has to do with the people who provide that care. As funding decreases, they do the best they can to remain cheerful with patients and to overcome deteriorating conditions. In fact, we have gotten so good at doing this that it is possible that we are not expressing sufficiently well how urgent the need for change is. In my view, I have regularly spoken at home about my concerns about dwindling resources but it took an actual hospitalization for my husband to realize how dire the situation is.

I am hoping that my husband’s story will serve as a cautionary tale that it is only the health care professionals holding our system together. I was not at all surprised by the conditions he described, which is only another indication that I have learned to adapt. It is time for those of us devoted to health care to stop adapting to situations that traumatize the people we are caring for. They are clearly also traumatizing for us.

(Note: I dedicate this to the health care professionals at The Ottawa Hospital who cared for my husband – especially his doctors and nurses.)

29 thoughts on “2 Hospital Days

  1. Thank you for your interesting post. I retired from nursing after 43 years of working in various positions. Always the threat of cutbacks, and job loss. Fighting for shifts as I put three children and myself through university at the same time, afraid that I would loose my job. Not enough staff on the floor to leave on our meal break. Always expected to do more, not enough equipment. Sent to units I did not know to “help” , and no one turning up at shift end to relieve me because no one knew I was there. Being told I have to stay to work the 12 hour night shift, when I am finishing my 12 hour day shift. Doctors who do not know what nurses really do (actually had a doctor patient post-delivery who asked if I really did all those checks on every mother and baby). So I appreciate that as a physician you could see that staff just keep on going, no matter how difficult the situation, no matter how tired, no matter what the expectations of patients and families. There were days I held it together, then went home to cry at some of the heartbreaking situations. But I always had a smile and a pat on the shoulder for the patient and co-workers.That is what nurses do.

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  6. The comment about nursing homes You better open your eyes.They look great cheerful etc. but my mother in law was in a great one in St.Albert ab.canada.I was shocked how a older lady could be beaten up by a new client & the home was more worried about a law suite then care.Prior if she got a nose bleed from really picking they would send her by ambulance but when she had broken ribs arm leg nothing was done until my wife happen to stop in.
    She never recovered having to be sent to full time care but they tried raising her rent from 3500.00 a month to 5250.00 & had her sleep in a tv room on a cot as they rented out her apartment when she was sent to the hospital.We did not sue what for really but what brother me is no info would be given to her daughter who had total power of attorney.
    Beware people looks does not mean anything .The new person they know he was violent but money talks.Perhaps we should have sued & given the mobney away to charity as who wants to make money from such a event.To this day we know nothing the RCMP said what can we do.
    I am getting older & worry when we must rely on care in a better than average spot.
    How can we check when nothing has been recorded &the RCMP even say we can jail the man he is too old yet fine enough to beat a old women.People like him what do you do.He has the money to pay but right away making excuses that everyone bought into.The real problem was the home sending her off for a nose bleed but gets beaten on their watch nothing was done for her care.
    That was the last time she really spoke & could no longer be a person she was until that terrible day.
    Beware is all I can say as these things are covered up.I now wish I had him charged as took my wife mom away for every.She did get placed in a great government home on the south side called
    I cannot recall the name but was a good samaritan home.Great people that cared for her until her passing.I briefly read the comments & thought I better share our story as most would never think this would happen.I never did much fighting as a kid but not into fighting anyone much less a women in her late 70`s OMG.I am sure we will all end up their but I have a plan set up when my mind is going or gone.
    I do not wish to cost anyone the money nor being able to give back scares me so hope I sleep & never wake when this does happen,but know that just a wish.

    .

  7. The same can be said about teachers holding the education system together. Nothing will ever change because one of the main problems in both sysyems is too much money is going to administrators.

  8. Reblogged this on Patti Kellar and commented:
    Those who read my blog may believe my only interest is in sharing information on the harm caused by Industrial Wind Turbines. The truth is I have been passionate about health which is the main driver of my concerns. Given the continuing deteriorating state of healthcare in Ontario Canada, Doctors and Nurses have had to begun advocating for themselves. Similarily, they are doing what victims of Industrial Wind Turbines have had to do – at a time when they are ill equipped to do it. Our healthcare infrastructure continues to crumble while those we pay who in positions of power continue to pat themselves on the back, telling themselves they do a fine job. Enough already.

  9. Things are only going to get worse..our local hospital and I have heard that other hospitals are now hiring PSW’s an unregulated body to care for patients…I truly believe we are headed for a 3rd world health care, where if you do not have family to advocate for you, to help care for you in hospital , and to on occasion bring you ” edible ” food you are on your own!…Hospitals are being required to do so much more with so much less, they lay off RN’s , asking RPN’s to pick up the slack, now we will see RPN’s layed off and PSW’s to do the care which they are not trained to do, and again I go back to the fact they are unregulated in Ontario !..God help us all, the government has their head in the sand our health care is in crisis !

    • We are not headed there Sheila. WE ARE THERE. The government has not only reduced funding to bare bones but the funding is used for CEO, management salaries. There are more managers than nurses and doctors. Our Ontario health ministers since Harris are to blame. But nobody holds them accountable.
      We only get what we deserve. We teach people how to treat us and time after time our ambivalence has cost us dearly. Now I worry to death about nursing home care should I need it. Please God, make assisted suicide available to all Canadians. I want an option to long term care facility placement.

      • Suzanne, as a retired RN who has worked in the Ottawa Hospital systems for 30 years and just recently returned from a 3 years posting in the Caribbean; I would have to disagree! We are not there, believe me!
        Healthcare and many other organizations with top heavy administrations are filled with professional bodies all striving within their own professions to do what is right for patient care. Note, I did not say client care as that was one of the indicators that highlighted the fall of healthcare. The involvement of everything to make healthcare about business (money) and not people! Program management. Everyone is competing for their own piece of the pie instead of working together. Too much lip service and ongoing complexities surrounding administrative politics. In the Caribbean they are struggling to catch up to first world with such conflicting contrasts that are mind blowing. Hospitals with poor infrastructures and leadership but a surgical speciality area with all the latest equipment. Certain facilities for those who can pay but totally out of reach for those who can’t pay. Re-using equipment that shouldn’t , sharing of drugs, RN’s mixing drugs ( like chemotherapy) with no fume hoods, using hangers as surgical tools; there are many examples.
        Yes, there has been deterioration in our system but what needs to happen here is getting back to the principles of care givers and patients. People who know the system and who also know the business . Instead healthcare and some people working in healthcare, not those delivering healthcare, need to advisors and auditors giving recommendations not directly driving the organization from the purses of politicians and big financial donors. It has become so multilayered the top has forgotten what is going on beneath those layers. The day to day. The foundation can’t continue to support and unhealthy structure if it isn’t maintained and cared for!

  10. Eleven years ago this past October I was diagnosed with Esophageal Cancer. I had my surgery in Hamilton and then after a six week recovery I went to Kingston General’s Cancer Centre for chemotherapy and radiation. When the radiation was over I returned closer to home to Belleville Hospital for my last 2 rounds of chemo.
    In all the time I spent in an around hospitals, Dr’s and nurses and the other assorted medical professionals I cannot think of any situations where I was concerned about my care or the care of those around me.
    Without our Healthcare System I would be dead.
    It makes me both sad and furious to see what has become of our healthcare system. Last summer my best friends husband was in Intensive Care on life support for 10 days. His care was phenomenal however when he was well enough to go to a regular room I was appalled by where he was sent. The entire floor of the hospital seemed to be a drop off point for those who didn’t require specialized care or were too sick to go home yet but too well to worry about. The surroundings structurally were horrendous and the real kicker – the hospital has a brand spanking new wing that many of us can not figure out what it is being used for if the old building is where they send patients.
    I don’t think we can blame one government in power over one that used to be in power. Its not something that happened overnight. It has been a long slow process that is now presenting itself. I always knew we were luckier than those in the US because of our superior healthcare. It is becoming painfully evident that even though we still have relatively “free” services, those services have been eroded.

  11. I have a friend, who is a union rep. Every year he has to deal with hospital administrators who are under pressure to reduce the budget, and the staff for the coming year. I have seen ER nurses when a critically ill patient comes into the system, along with the usual fractures, and sprains and cuts and bruises,,, and of course children with the sniffles and coughs etc. So then I try to count the staff on board… which is difficult because they are on the run most of the time. At those times the wonder is that they don’t all collapse from exhaustion on a regular basis. If the province demands more cuts… the system could be compared to an anorexic…

    • We do collapse from exhaustion on a regular basis. Burn out among nurses is so common we don’t even talk about it anymore. We always have one or more people off on stress leave and no one is surprised at all.

  12. I started looking after severely ill patients at a very early age of 17 just out of high school. That was back in the seventies. Over the years I have worked for mental health and back to long term care. What I find perplexing as a care giver I cannot find a competent family GP to supervise my husbands care effectively and competently since the retire of my GP in 2013… The medical infascructue is collapsing as a whole.. I come from a small town Brockville Ont, Can.. And if it was not for a cardiologist taking on my husbands claim after he was found to be suffering From advanced Parkinsons disease from short, long term, to CP disability We would be at witts end if relying upon my former GP .. Because I derousted myself from this uncaring and abusive practise, I can not find a GP to take myself and my family on… I would love to continue to work in long term care until retirement, but I suffer from multiple health issues as well and do not need to banned from the medical community because of a uncaring, abusive, GP in Brockville, Ont…. After the diagnosis of advanced Parkinsons this Doctor had the gall to tell my husband go back to work there is nothing wrong with you. He did the same to others afraid to speak up for themselves in fear of what is happening to our family. Thank you so much Dr. Hynde for taking his case on if it was up to the GP in Question we would have lost our home and would be homeless. His staff and himself has a line of put down to ill people we do not have time to do the paperwork for your heath benefit claim, draw unemployment instead , Dr. X, I wonder who you are working for…… My hats off to all nurses ,Psw’S, Health care Aides who endure poor working conditions in a medical collapsing system caused by cold and uncaring MPs and otherwise… My question is ? Who will take care of the caregivers when they become ill…. Suffer on my dear Sisters ad Brothers who work I Health Care ad try to at least make a differance…

  13. Excellent Article. I have copied it to the Facebook Group Site for the Carleton Place Hospital – Keeping It Local as the conditions of the hospital building are deteriorating as I write this, it is a 60 years old building and very outdated. The staff are super but the health system has to change and we are trying to let our Ontario Health Minister know of our current situation but he certainly doesn’t seem to care. He doesn’t even answer or acknowledge emails sent to him – that’s how much this present government cares about the people that pay their salaries and into their golden pensions.

    • Hi Norma,
      Thank you for forwarding this report on. As I read through the comments, I am stunned by how consistent the experience of hospitals is by patients around Ontario. I am use twitter and facebook to publicize how many are experiencing similar poor conditions. Even the hospitals cannot be entirely blamed for this, nor even one government, but it is time to reverse the funding deficit for health services in Ontario. In April, 2015, I wrote about how government is squeezing hospitals’ and doctors’ funding to the detriment of patient care. This is that article: https://drgailbeck.com/2015/04/19/getting-blood-from-a-stone/ We could all remind our Members of Provincial Parliament that the infrastructure of a hospital – the building, the cleanliness, the atmosphere, the food – can make us feel better or worse when we need care for a serious acute medical condition.

  14. I agree with Lynn about the uniforms. Frequently, I also find that the person’s nametag has been tucked in a pocket to keep it out of the way perhaps. Another hospital in a state of decay is Carleton Place Hospital. The staff there have huge challenges to overcome on their daily shifts. I wish that a member of the MOH had to be admitted to one of these hospitals .Maybe then, some cash would fall out of the pockets of that ministry for renovation, repairs or replacement of these structures instead of adding to high salaries of staff–union & non union.

    • If an MP or MOH was admitted to hospital, their room would be freshly painted, two nurses assigned to him and lobster for supper. He would not have any complaints about our health care system.

  15. Health care is our most precious possession and should be properly funded. Failure of the politicians to put proper funding into welfare is prejudicial and is not cost effective due to the long term consequences of inadequate medical care due to insufficient funding.

  16. Thanks Gail.maybe we should be asking those patients who have been hospitalized to share their stories more.I myself have been brushing off their concerns over the last few years as part of their angst at being admitted.however,now I think I will encourage them to complain to the local MPP

  17. It’s been suggested before, have our politicians get a taste of our system. Insist they not seek any private health care from anywhere, and park their “status/ego” at the door. Infact, make it clear to all staff it’s an offence to treat them anyway differently, and to report any bullying they might encounter.
    PS private is not the way to go, just look at private nursing homes, we have the money

  18. Awesome! As a former nurse at the good old Civic… We had an amazing bunch of people… My career is “winding down” now, and I’m hoping beyond hope, that our severely broken health care system improves… Don’t even know where to start!!

  19. The doctors and nurses would have known that you are a doctor and your husband a lawyer, and he would have received the best care the system can provide.

    • As a nurse working over 30 yrs at The Ottawa Hospital, all people/patients are treated with compassion , care & respect, regardless of their status…. That’s why I became a nurse, to care ….

    • I don’t agree with that sentiment, my wife is an RN, formerly QCH, now a nursing home closer to the town we moved to, and she would talk to me about her patients, no names of course, confidentiality was always maintained, and it never mattered to her what they did as a living. Her level of care was always the same.

  20. Gail, this is a very good introspection of what I have seen in some areas of some of the hospitals I have visited. Some places, especially if you have been sent to an older part of the hospital, are in very bad shape. It is depressing. Another point I would like to make, is how hard it is for a lay person to decided who is a person in authority or a nurse or a doctor, since multicoloured uniforms are worn everywhere. I once asked a man if it was okay to go in to visit someone and this person said to me, “It doesn’t matter to me, I am just the cleaner”. I really do think that most workers in hospitals work very diligently and try to do what they can with the resources they have, but to me there have been way too many cutbacks.

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