Are There Any Real Changes?
I walk down hospital
hallways narrowed by the clutter of computers on wheels, food and linen carts
and staff standing in clusters talking amongst themselves. A loud machine waxes
the floors as a man pushes it down the hallway and people barely move out of
his way.
I’m visiting a patient who
has been diagnosed with cancer, and his family. The prognosis is not good. I
was there when he received the diagnosis from a physician eager to start
chemotherapy that another physician later said surely would have killed him. Information
is constantly being thrown at the patient’s loved ones, who are scared and lost
in a cloud of emotions arising from fear, confusion and lack of sleep. Words
are often unheard, instructions are a blur.
I remember the doctor
telling this recently-married man the bad news — stage four cancer with
“nothing” to do but palliative care — and recommending treatment. I asked the
doctor, “What do you think he heard after you said he has stage four cancer?”
The doctor continued to tell the patient what the treatment options were even
though he had strict orders not to share this devastating news without the patient’s
wife present. “I need you to sign a consent form,” the doctor told him.
Now the patient is in a
third hospital and being treated for breathing difficulties. The medical staff kept
telling the patient and family there is nothing that can be done for his
cancer. Exhausted from lack of sleep, his wife constantly reminds staff that he
is not there for cancer treatment. They had a plan. He is there to be treated
for his difficulty breathing.
On each of my visits I notice
the standard of care he receives. The only sink is in a bathroom near the window,
yet no one ever walks past me to wash their hands. The gloves, closer to the
door, were easier for staff to reach. They didn’t wash before grabbing them.
I suggest the family goes
for dinner when I arrive. I do not need to be entertained. They go to dinner
and I notice that the compression stockings are not connected. One of the
visitors who stayed behind with me said that if they needed to be connected,
they would be. I knew better. When asked, the nurse says someone “forgot” to
hook them up. In the times that I visit, no one ever shifts him. He gets
bedsores that the family explains, “can’t be helped.”
The patient is critical and
might die soon, but for now, he wants to live. Still, in the 2½ hours I was there
one evening, no one washed their hands, no one shifted him, a hose from his
breathing treatment dropped on the floor and before I could stop the nurse she
reconnected it.
I saw that the antibacterial gel container was taped over. I asked the patient’s family why. “Because he had c-diff,” his wife explained, and the antibacterial gel won’t work on c-diff. I asked if anyone ever washed their hands and the family said “sometimes.” Never while I was there. But I wasn’t there the 24 hours a day that his wife was there. Maybe they just didn’t wash while I was there.
Maybe everyone gets
infections in the hospital. Maybe all hospitals “forget” to plug in the
compression stockings. Maybe all hospital staff don’t wash. Maybe in all
hospitals bedsores are acceptable. Maybe in all hospitals the patient doesn’t
need an oximeter on their finger, or staff don’t shift the patient? Maybe all
hospitals have cockroaches and the nurses argue over who will be the one to
kill it late at night, like this one did. The list is so long.
But the family was happy
because the nurses were “nice.” Families of sick patients don’t know what to
look for. Hand washing becomes trivial. Families have no idea that the policies
and requirements are not being followed: the patient and the family are happy
if everyone is nice.
The family probably knows
that the patient would have died anyway. I will always wonder what he died from.
Rest in Peace.
Rest in Peace.
