(A Doctor Critiques . . . )
In my years of working at Salem Memorial Hospital I came to value the medical staff secretary, Barbara Halsey. She is particularly special in helping the doctors do a good job caring for their patients. She is one of those wonderful hidden assets patients never get to hear about. After my hospitalization, I would occasionally stop by her office to shoot the breeze. I expressed to her some of the stuff contained in this article. She encouraged me to write down my ideas, offering to pass them on to the people in hospital administration who might be interested in them. I accepted this invitation and wrote my observations in the form of a letter to the hospital administration. She, in turn, passed them on. I never heard from anyone connected to the hospital. Although I was not surprised by this lack of response, Barbara said she was.
Speaking personally, I doubt if I can ever go into a hospital again, even if it means dying.
The Problem is . . . I am convinced, after hospitalizing thousands of patients and being hospitalized five times myself, that we hospital staff send the wrong message to our patients. By our actions, our words, our rules and our attitudes, we convince some very healthy people that they are sick. This is how we do that.
To begin with, we don’t know who our patients are. The patient is asked the same questions over and over again, first by the Admissions Officer, then by the Admissions Nurse, then by the Anesthesiologist, then by the Admitting House Officer, then by the Floor Nurse, then by the patient’s private doctor, and then by the radiologist, etc., etc. Not only does the patient get tired of this repetitive crap, but it soon becomes obvious to the patient that staff members almost never read what other staff have written. This looks, and is, unprofessional.
Next, the patient is put into a room that is aesthetically awful. Even cheap motels offer better accommodations. The beds are very uncomfortable and room furnishings non-existent. Lying neatly on the bed is a paper gown which, when worn, is not only embarrassing and undignified, but is downright dehumanizing. None of us would choose to wear these paper gowns since they expose our rear ends, demeaning our sense of dignity and modesty. No wonder everyone gets in bed and stays there as much as possible.
After the patient has managed to answer all the questions, undress, and now lies safely in bed, wrapped like a package in paper, he or she discovers the food menu. At first this looks like a pretty good deal. There are choices, and the descriptions of the food items are pretty appealing. However, on arrival, the selections are not always identifiable and are often covered with sauces best described as “stuff.” Further, if you happen to be one of those patients on a clear liquid diet, you will learn the joy of lemon Jell-O for breakfast. Personally, I love Jell-O but I can’t figure out what hospitals do to it that makes it so completely unappealing and inedible. Also, when the food arrives, we realize how profoundly alone we are. Eating alone is tough.
Isn’t it amazing that the patient who has been responsible for himself, and probably many others for many years, can no longer take his own medications now that he is hospitalized. He is brought his pills according to the orders of the doctor and given this medication by a nurse who has to keep track of everyone’s medication. I wonder who is more likely to make a mistake in meds, the patient who handles his own medication or the nurse who has to keep track of the meds for thirty patients? What is the message we give the patient when we tell him he can’t even take his own meds anymore? I wonder how often the nurse decides whether a patient needs a sleeping pill rather than the patient. Doesn’t the patient have a better idea how much and how often he needs pain pills?
And here’s another one. I never want to hear a nurse ever again use the word “we” when she means me. “Shouldn’t we get in bed now.” That is not the way respectful adults address each other.
Most patients who are hospitalized arrive mobile (capable of walking), remain mobile during most of the time they stay, and leave mobile. Despite their capable mobility they are not allowed to walk anywhere and have to be taken by wheel chair or on a gurney. Why?