Canadian Health Care, Health crisis, lean health care, Living life, musing, registered nurse retired, Saskatchewan health, Women,s issues

Health care – imperfect yet necessary

stethHealth Care and Medicine make mistakes.

That is a hard pill for me to swallow some days.  I feel a need to defend. I feel a need to complain. I feel a need to have compassion. I feel conflicted.

The sad facts: Some of Medical care’s long-held beliefs may be (or are) just incorrect.

  • So many things I have done in my 40+ years of nursing, with the knowledge we had at that time, have been proven ineffective and incorrect.
    • We believed that testing the urine of a diabetic patient would give us a good indication of how much insulin he needed – not knowing about renal thresholds of sugar, HBAIC and fancy glucose meters.  Many of our patients died prematurely , or have long-lasting complications from our poor control measures. This saddens me but gives me hope for the future of medicine.
    • We thought days of hospitalization and bedrest made for better outcomes for surgeries, cataracts, heart attacks, childbirth and medical conditions. We needed a lot of hospital beds for these long stays and families were interrupted.
    • We cleansed, enema’d, and  shaved from knees to nipples prior to most surgery, – We cut people wide open and gave them awful naso-gastric tubes for gallbladder surgery. We “opened people up” for a look see because of lack of good imaging.
    • We made hip surgery patients stay in bed and non weight bearing for weeks. Children with fractured femurs, or needing IV antibiotics stayed  in hospital for months.

I am sure we can think of more and my point is not that we did wrong, but that thankfully we were open to new ideas and changes. There are still things stuck in the dark ages – things we need to let go of and make way for change.

  • Physicians can be wrong, uncaring, overworked, behind the times and stuck with tradition.
    • you have the right to change physicians if it is not working for you. The best way is to tell the previous one you are changing.  Although I have advised many people on how to change physicians, this is probably one of the hardest things I have ever done. Sometimes physicians can be lovely but not progressive enough for me. Sometimes my need for facts/results/options can offend the  physician. Sometimes the personalities are just not right. The good news is there are many good ones !
    • you have a right to a second opinion
    • you have the right to say “No – that is not my belief or wish”  ( I did this just recently when the common canned supplement was recommended for hubby – I said, “you know I really don’t like all the preservatives in that and prefer to make my own” )
    • You have the right to say – “can I go to a specialist anyways”  – even if your GP says you probably are “all right”.  Let the specialist decide if your concern is valid.
    • you have the right to combine natural remedies and traditional medicine. You should inform your health care team what you are doing, but don’t always expect them to approve. This is a field that still lacks approval from many physicians.
    • you should check for references from friends or other health care professionals for physicians and specialists – you want someone you can relate to.
    • You have the right to research – but try to research the reputable sites ( Mayo clinic, Registered nurses of Ontario,  Pub Med)   rather than relying on Doctor Google.  You have a right to package inserts or written information.
  • Physicians and nurses may avoid telling you the truth if a mistake has been made – This is a practice  that is going away quickly, and far from the norm now, but as I said – some are stuck with tradition. The traditional  system used to believe “what they don’t know doesn’t hurt them”.. yes I am ashamed to admit that but I belonged then too.  My most meaningful episode of this was when as a student nurse a surgeon called tying of the ureters instead of the fallopian tubes ” something that just happens”. The patient nearly ended up in renal failure and had a second surgery.  I wanted to squeal so bad, but that would have been the end of my career. I do believe that these days  major errors are told to patients and families – but some minor still go unknown. If you see something you don’t think was right – speak up.
  • Wrong medication is the most common error that happens in hospitals and pharmacies. Double checks are put in, but the best check is you!  Check the medications you or your family get and say something if you get the wrong coloured one or a new one. Double check your discharge medications for dosage and drugs and ask about ones that seem to be missing. Ask the why’s about any new ones – they may be the same as the ones you have. A pharmacist can be your best source.
  • Nursing staff can be wrong, uncaring, overworked, behind the times and stuck with tradition.
    • Sad to say this, but I almost quit nursing because of how I was treated after loss of my premature infants. I ended up making motions to change a system, and the nursing classes… not by myself – but through Compassionate Friends and others.
    • I firmly believe if you have an issue there are very important first steps to take. First talk to the nurse in question – Sometimes, we as nurses need to check ourselves. Busyness, home problems and unthinking can cause us to ignore something or appear unkind.  Then contact the supervisor in charge and wait for them to get back to you. Then the Quality Care Coordinator for the hospital. Calls to MLA’s and ministry can follow if those people don’t hear your concern.  As a former manager, it was very disconcerting to find out a problem had occurred and nobody had advised me before going to the ministry. It causes a lot of people to be involved and maybe some press, but it ties the hand of the manager to get the problem solved. It is hard to reconstruct an episode that happened weeks ago, but easy when the staff is still present.
    • If you are a health care worker, ask your coworkers to intervene if you mess up or sound sharp – to take you away from the bedside and offer you a break. When you do intervene, as a patient, advocate or coworker  do it gently, if you cannot do that at the moment, take some space and time and then go back. Vulnerability is a sign of maturity. As a former nurse, I appreciated when someone called me out – even if it did hurt at the time.
    • Beware of the viral Facebook post – it is so tempting to share them and to get caught in the ” ain’t it awful” comments.  Ask the question first – did the person follow the above steps? Will this post hurt someone who has no control over the situation ? Will it help ?  If not.. read and move on.
    • Find an advocate who can look at situations from the outside or who can help from a medical standpoint. This can be very helpful to understand the why’s of situations.
  • Hospital beds are at a premium.  This is somewhat from the old belief of patients staying in hospital weeks and months for things they no longer stay in for. Bed numbers are based on “average ideal length of stay”. It is in part due to lack of funding for beds that are closed. It is sometimes because physicians listen to us when it is inconvenient to take our loved one home today as we are working, or he/she would need some extra help. It is because we think it impossible for our loved one to a nursing home that his not our preference, or even out-of-town to free up a bed for someone very ill.  It is sometimes because physicians still think that hospital is the best place and keep their patients too long.
    • Hubby has stayed in Emergency for a couple of nights, been without a bed following elective surgery, and moved several times. The cubby hole  in Emergency was small and cramped with little space for me. He has shared rooms with women ( now common) and none of this was easy.
    • There are ” bed managers ” working at full tilt trying to find beds that aren’t in hallways and making sure people are safe.  Hubby once had an alcove bed with a little  ding bell that would probably not be heard in the next room let alone down the hall, but he was fortunate, that time,  that he could call out and walk to the desk. It was crowded – but it worked.
    • Talking about closing the Plains or too few beds at FH Wigmore Hospital  is not helpful. It is too late for that planning to change but not too late to look at solutions with the beds that are there.
    • The nursing home that you don’t prefer is tough, but a hospital where someone is kept in bed, not dressed and not socializing in a dining room is the worst place for our elderly patients.  Infections, pneumonia, incontinence and confusion are side effects of this. Ideally everyone should live where they want, but life today is less than ideal for our elderly.

I had a lot to say – and said a lot.  I hope this helps your navigation through ” the system” and helps you understand.

Everyone makes mistakes, everyone fails to be kind, everyone says the wrong things. Only you can decide whether it needs forgiveness or fixing.

5 thoughts on “Health care – imperfect yet necessary”

  1. How true this is Terry, have spent time as a child and more recently as an adult- generally the nursing staff are kind and compassionate and everyone is doing the best they can. I had a challenge with the renal specialist when i chose to go an alternative route from prednisolone, along with telling them when they told me my choice was life- 25% , death or dialysis and I said i was going to meditate and use my law of attraction tools and i was going home xx Thanks for sharing

  2. I’m feeling kind of depressed now. We’ve all heard horror stories about the long hours and challenging conditions many medical personnel must endure. For six months many years ago I worked as a volunteer at L.A. County General Hospital and I had to quit because I started having nightmares and feeling depressed all the time, and I was only there a couple of days a week! Thanks for sharing your advice and inspiration.

    1. Sorry about that. This was meant to empower not to depress!! Our Canadian system is very different than yours. It is difficult to get rid of the “Yes docotor, yes nurse” mentality. Gone should be that God complex. It saddens me that without an advocate it is hard to move through the system, but inspires me when I see strong advocates.

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