It seems hospitals are hardly a risk-free zone. In fact, they can be downright scary, writes Dr Linda Calabresi
If I was in a major car accident, had chest pain or got severely burnt there would be no place I would rather be sent than our local tertiary hospital. Honestly, despite reports of miscarriages in toilets and the occasional missed diagnosis, I believe our public-hospital system does acute care really, really well.
However, I am a little more sceptical of what can happen during more long-term hospital stays. Courtesy of the witnessed experience of friends and relatives, and compounded by a range of horror stories from many patients, it seems hospitals are hardly a risk-free zone. In fact, they can be downright scary. Front of mind is a friend with axillary thrombosis whose IV leaked for hours despite staff being alerted to this, meaning that most of the urokinase wound up on the floor. Or another friend who was about to have blood taken from his jugular vein before the intern, who had had trouble with the cubital fossa, was stopped by the NUM!
And while these incidents might constitute near misses, or be the subject of a review of processes as proposed by Professor Liam Donaldson, it is often the subtle deficiencies in care that seem to make hospital stays a test of endurance.
Simple things like delays in pain medication, a lack of assistance with inaccessible food trays, slow response to help with toileting, a lack of privacy, and the patient’s perception that they are being thought of as difficult, demanding, or at the very least, annoying when they ask for help, create concern about what goes on in St Elsewhere’s.
Now I know the vast majority of doctors and nurses working in these institutions are not only professional, but kind and caring. But whether it be a lack of resources or an inordinate focus now on non-patient processes such as form-filling, there are vulnerable patients suffering out there.
The answer is unlikely to be simple – or for that matter, cheap. Perhaps tertiary care could learn from its less prestigious sister, general practice. It has been proven that health outcomes are better when one patient regularly sees one GP. Each inpatient could benefit from having a single person responsible for all their care within the system – an advocate for that patient as it were. But can you imagine the expense of that?
The trouble with these issues is they are anecdotal and, really, they are less about medicine and more about care. Nonetheless, they need to be given a voice, as much of a voice as ED waiting times and statistics on falls, surely.
Email: linda@medicalrepublic.com.au
