He’s not my patient

Every time I turn around, it seems I’m reading stories about problems in our health care system – ranging from mistakes made in the interpretation of diagnostic test results to lack of proper hygiene for some very complicated medical gear through to sheer incompetence on the part of the people who are supposed to be the health care professionals.  One has to wonder in the wake of yet another news conference and more apologies – is anyone minding the store?

Case in point: a retired nursing professor in New Brunswick told the story of how she spent several months caring for her husband in a medium-sized hospital as he lay dying.  She spent every day with him in the hospital.  In only one incident of the many she wrote about, she went to the nursing station to ask the person on duty if they could help her turn her husband in bed.  The response?  “He’s not my patient”.

To me, that’s the root of the problem.  So many people who work in the health care system today see it as being a 9-5 job and please don’t ask them to do more than the contract stipulates.  I understand the problem of cut-backs and stress; it’s not unique to the health care system.  Everyone is being asked to do more with less. Think about people who work in private industry for whom the notion of overtime is a fantasy world.  It’s not going to get any better; as a matter of fact, every indicator is that it’s going to get worse.

But that doesn’t excuse anyone from saying “he’s not my patient” when the simple request is to help turn a patient in bed.

The attitude unfortunately is endemic throughout the system. 

Think about nursing education.  Once upon a time, Registered Nurses had to take a two year program that focused entirely on patient care in hospital and most often was based in the hospitals.  Then, the four-year Bachelor of Nursing programs were introduced into universities because it was felt the nurses weren’t getting enough “professional” training.  Now, the norm is moving back in the direction of a two calendar year course in university.  Veteran RNs will tell you that many of the students in the BN programs are there because they want to be nurse-managers and not bedside care givers.  What does that tell you about attitude?  It also speaks of skill level.

Think about cleanliness in hospitals.  You can walk into just about any hospital in this country and see the lack of attention paid to cleanliness.  Most hospitals (dare I say ALL?) wouldn’t come even close to passing a white glove test, but the people who do the job will tell you “it’s good enough”.  Unfortunately, that attitude seems to prevail from the custodian whose job it is to clean up a room after a patient leaves through to the sterilization of some very sophisticated equipment.  Think of how many times we hear about MRSA or other superbugs – often transmitted because the people working in health care don’t wash their hands properly.  Think of a urinal or bed pan being left on the tray-table where the patient’s meal will be placed.  Think of dirty (and I do mean DIRTY) bathrooms for patient use.

Think about the physicians.  So many of them see themselves as being unquestioned authorities and yet there’s as much incompetence there as in any other profession.  There are medical school graduates who score only the 51% required to pass some tests and that’s all.  So much of medicine is an educated guess.  Do you recall the psychiatrist at Her Majesty’s Penitentiary in St. John’s whose first move when a new prisoner was admitted was to suspend all of his medication?  It created chaos as prisoners who had long histories with specific medications were taken off them.  This was a psychiatrist, by the way, who was teaching at the medical school.  I seem to recall his reasoning was that he knew best.

The same thing happens in hospital where changes in medication are often predicated on the reasoning, “I wonder what will happen if we do this”.  When so many people today are on very complex pharmaceutical cocktails, messing around with one can create a domino effect in terms of reactions.  Most doctors are not pharmacologists.  Again, it’s a question of attitude.

There are very many good and caring people working in today’s health care system – as a matter of fact, the majority of health care workers fit that description but there is enough evidence out there to suggest that they’re struggling.  I can only imagine that Vickie Kaminski must feel enormous fatigue every time she has to host another news conference to explain another serious error in protocol.  Mainly because people were not doing their job.  Just like the dirty floors, it needs to be fixed.