The story
“I neeeeed soommmee helllppp!” a scratchy-voiced elderly woman called down the hall.
“No, you don’t. Now shut up and go to sleep,” I thought to myself.
Did I think that I’d ever be the kind of person to be cruel to an old woman, an old woman who perhaps has dementia? Well, no, but that’s what the hospital did to me.
I’ve always hated hospitals, so I was kind of reluctant to go with my mom as she dragged my very ill self to our local centre of care. I could barely stand, my lymph nodes were the size of two small potatoes, and it felt like I had a cold, a flu, and something else all at once, but I still thought they were going to tell me to go home, drink lots of water, and sleep it off. So my slightly dazed self was very confused when that was not what happened.
The nurse took my vital signs, said, “Wow,” and then left. Then the doctor came in to look at me, said that I had the biggest glands he had ever seen, and told me to change into a hospital gown, which I was very confused about.
Then I got multiple vials of blood taken from both arms, and, after a failed attempt or two, I got an IV in my right hand on the inside of my wrist. After a few more tests and several minutes of explaining to the doctor that, yes, I was sure I wasn’t pregnant, I finally got my diagnosis.
It was explained to me kind of like this: “We’re going to have to keep you; you have mono, and hepatitis, and blah, blah, blah.” I tuned out the rest because he’d just used the words “keep you” and “hepatitis” in the same sentence.
After several minutes of conversation where my mom and I got nothing but vague answers, we deciphered that I had mono with a non-contagious swelling of the liver they call hepatitis, and a possible side of an infection or two. I was going to have to stay in the hospital. I was, understandably, extremely distressed.
So, there I was, lying in an emergency bed with a fever and the heart rate of an overweight asthmatic who’d just run a marathon, going through multiple boxes of tissue paper disguised as hospital Kleenex, with my very first IV in my arm and a very distressing diagnosis. And the nurse was telling me to pee in a cup.
I eventually managed to calm down enough to figure out how to wheel my IV into a washroom in my gown and gumboots and pee in said cup (which, by the way, is one of the most difficult things I’ve ever done in my life). I returned to my bed, where I stayed for what felt like a couple of hours while they arranged my room.
Eventually, all the admittance forms were filled out, I was feeling a bit better about my situation, and I got moved to what grew to be a temporary home.
I encountered my first experience with hospital food (mushroom soup, vegetables or something, and real cake!), and I was starting to think I could survive this night. I was learning how to manoeuvre an IV; they’d put my medicine into my IV so I didn’t have to swallow through my very swollen and sore throat, and I was going to survive.
It was a couple hours later when I first heard an elderly woman, who would end up calling loudly at all hours of the day for somebody to help her. Finally, I managed to tune her out and get a bit of sleep, but when a nurse woke me up to check my vital signs I felt nauseous.
Halfway through my blood-pressure check I managed to choke out an “I’m going to throw up” and vomited in the hospital bathroom for the first time.
Skip forward five or six hours: I’ve gotten barely any sleep, I’m puking for the third or fourth time, and all I can hear is “I neeeedd soooommeee heeelllpp!” It was, unsurprisingly, not the best sleep of my life.
Still, the night ended, the sun rose, and a new day started. The puking had stopped and I was feeling a little better about life; I figured I would probably be home by tonight and everything would be fine.
Somebody from the kitchen came to ask me what my food preferences were, which I thought was nice, but ultimately unnecessary due to my being unable to swallow… and also because I was definitely convinced I was going home tonight.
Until the afternoon, the only health-care personnel I saw were the people that came to take my blood three times a day. Eventually, the doctor came to check on me. He asked me how I was and I laughed. He didn’t laugh; he was serious. We briefly discussed how my medication had made me ill and he promised to change it for that night.
“So I’m staying another night, then?” I inquired. He didn’t answer, although he may have been trying to communicate telepathically through intense eye contact; apparently communication wasn’t his strong point.
I napped through the afternoon until the nurse came to give me my meds before bed. She had the same IV antibiotics from the night before.
“Oh, those made me sick last night; he said he’d change them,” I politely informed her.
“He didn’t,” she rudely responded.
“Can you double check?” I asked.
“Fine,” she replied. It turned out he didn’t change it, so she gave me the same drugs as I shed a tear and looked forward to night two.
It was exactly the same as night one.
I awoke on the morning of day three much less optimistic and much more haggard. That day my family doctor visited me. She didn’t ask me how I was, which I appreciated. I talked to her about the meds and she promised to change them. I trusted her because I taught her son improv; I had leverage. I slept through most of the day since I hadn’t slept at night.
When evening came around, a nurse came to check on me. I had noticed that the area around my IV (which hadn’t been changed since I was admitted) was getting quite red. I later asked my former-nurse grandmother about this, and she gasped and told me that was an infection and should never have happened, especially in a hospital.
Anyway, the nurse told me she was going to take my IV out and let me have a shower. This was great news, since by that point I smelled somewhat like a mix between a wet Chewbacca and Oscar the Grouch. I was given a towel and soap and told that she would be back later to put a new IV in. I showered and waited… and waited.
It had been several hours, and I was worried she’d forgotten. I was feeling chipper after my shower, so I walked to the nurse’s desk. The nurse looked annoyed that I had moved. I told her the other nurse was supposed to give me a new IV; she said the other nurse had gone home, but she could do it.
She came to my room and tried to get the IV in. Four times. She said she needed better light and we went to another room where she tried again. Four times. She then got the head nurse, who, after three tries, put the IV in my hand. Brilliant. My arms were a little sore, but thankfully the meds got switched and I spent the night barf-free.
And on the fourth day of mono, the doctor gave to me three blood tests and the all-clear to go free… kind of. I still had to go back for daily blood tests for two weeks, where I was occasionally threatened with further hospitalization if I didn’t get my potassium up, or my fever down. By the end of it all, I looked like an emancipated drug addict with the track marks to prove it.
When asked what arm I wanted blood taken from, I would just hold them both out in their bruised, scarred glory and ask, “Which one looks better?” Eventually, after a month of bed rest, three weeks of blood tests, and one echocardiogram (essentially an ultrasound for your heart), I was cleared free to leave my life again.
The issues
I may sound a bit bitter, and I am a little, but I know I’m lucky. In Canada, we have some of the best health care in the world for free. I didn’t go into debt from my hospital stay, my mom wasn’t afraid to bring me in case we couldn’t afford it, and I am extremely privileged to be living in a place where that’s possible.
But that doesn’t mean there aren’t issues.
In my stay in the hospital, there were multiple miscommunications between staff and mistakes in my treatment. Am I blaming the nurses and doctors for this? Absolutely not.
Let’s start with nurses. In the 1990s, most provinces weren’t hiring nurses. This led to many qualified candidates entering other fields or leaving the country. Over time, this caused a nursing shortage.
Nursing, to begin with, is a difficult job. Most of us likely can’t imagine doing a lot of the things nurses do every day. It’s stressful and strenuous work. It’s work that’s difficult to do in any capacity, but because of the shortage, nurses are working double shifts and overtime. When pushed to their maximum capacity, nurses are unable to perform to the best of their ability.
According to the Canadian Health Services Research Foundation (CHSRF), “Hospital nurses working more than 12.5 hours at a time are three times more likely to make mistakes, including medication errors. In fact, errors increase significantly when nurses work overtime or when they work more than 40 hours a week.”
As well, working at such a high-stress job puts the nurse at risk for injury and illness.
“Research shows that job stress increases the risk of musculoskeletal injury, accidents, physical and mental illness, substance abuse, and smoking,” says the CHSRF.
Short-staffing can also increase the risk to the nurse when they must do things like lift patients by themselves.
There’s also always the danger of violence as a nurse, whether from coworkers or unwell patients, and “over-worked nurses (those working more than 40 hours a week or working overtime) are most likely to report incidences of violence,” says the CHSRF.
All of these factors combined lead to higher absenteeism among nurses; in 2002, absenteeism for full-time registered nurses was 83 percent higher than for the rest of the labour force. Increased absenteeism only increases the strain on nurses, creating a vicious cycle.
There are issues with doctors, too. A problem easy to understand if you’ve ever tried to find a doctor in Victoria is the inability for patients to find the care they need in a timely manner. If you’re lucky enough to have a family doctor (and 15 percent of Canadians don’t) it may take longer than usual to be able to see them: in a report by the Health Council of Canada, it was found that Canada had the longest wait times of countries surveyed to see their family doctor.
That study also found that 47 percent of Canadians had recently gone to the emergency room for something a family doctor could have treated, even though our wait times were the longest of all countries surveyed, with 26 percent waiting more than four hours for treatment.
This is troubling, since if emergency care isn’t being used for emergencies, it’s unlikely that the best care possible is being given. Wait times for surgeries are also high in Canada. In a study by the Fraser Institute, the median wait time in 2013 from referral to procedure was 18.2 weeks.
As a patient, it’s difficult to wait so long for surgery, and as a doctor, it’s difficult to be overworked and keep up with higher demand than availability.
The solutions?
These are only some of the issues affecting doctors, nurses, and patients, and there are many more. It’s evident that the system isn’t working to the best of its ability. So this brings the question of how do we fix it?
It seems that many of the problems could be fixed by simply having more health-care workers. However, many say that by only hiring more workers we could create a boom-and-bust cycle, where we have too many doctors, and then not enough again.
Other than that, it gets more complicated. A solution to our health-care problems requires analysis and funding on provincial and global levels.
But I’m not a policy analyst; I’m not an expert in health care; I’m simply a patient. And I’m a patient that sees flaws in a system that could be way better.
We’re lucky to have a health-care system in Canada that allows everyone to access the help they need, but until some problems are addressed, it will fail to live up to the potential it’s capable of.