Health - a daughter’s casebook
Some contacts are brief. Some are long. Some are hospital horror stories. Others are testaments to the compassion and skills of those who care for the sick and the dying. For some readers, their experience involves the trials and worries of life under stress at the bedside.
People like Ann Treadgold of Murrays Bay. Her letter, prompted by the column on %26quot;the secret sickness%26quot;, as it has been called, was one of a number of reactions. It was a very personal account which also summed up much of what was written by others.
Her experience was far from typical both in its medical complexity and in the time involved. And yet, at the same time, her memories involve patterns of hospital life and practice which many others will recognise %26ndash; for better or worse:
%26quot;On reading your column I thought back over hundreds of hours I spent in local hospitals over the last few years as support for my mother. Over eight years of ill-health, she spent the equivalent of about four years in Auckland and North Shore hospitals. After 70 years of near-perfect health her pancreas ruptured, causing the destruction of most of her pancreas, a third of her bowel and her gallbladder.
%26quot;We were told that she would die, however a senior surgeon at Auckland hospital set about a near-impossible mission to operate five times over two weeks to save her life.
%26quot;Her treatment involved seven major life-saving operations. The initial operation and complications caused a stay of 14 months in hospital during which she could neither eat nor drink and was fed intravenously.
%26quot;She had full access to intensive care facilities, x-ray, CAT scan, MRI, gastroscopy services, diabetes services, dietitians, rehabilitation services and district nurse services, I imagine amounting to hundreds of thousands of dollars.
%26quot;Staff were excellent on the whole. The senior surgeon made himself available by cellphone any time of the day or night in case of emergency. The senior surgeon treated our family as equals, thoroughly explaining and consulting with us about our mother%26rsquo;s condition.
%26quot;Mother%26rsquo;s case became very well-known and was used as a teaching tool. She made herself available for students to study her case.
She attended a lecture in front of hundreds of students while a patient in hospital. She answered their questions %26ndash; and the students gave her a standing ovation for her courage in the face of such extreme medical difficulties.
%26quot;Staff became very attached to mum %26ndash; as they do to many long-term patients %26ndash; and became like a family away from home. The surgeon and many of the staff from the ward at Auckland hospital attended her funeral.
%26quot;There were mistakes. One major operation was delayed when blood for a possible transfusion was not ordered.
%26quot;She was sent home too early while still suffering severe medical problems because the main surgeon handling her case was away and another registrar decided they needed mum%26rsquo;s bed. She was readmitted after two days and spent another eight months in hospital.
%26quot;During time when her main surgeon was overseas, she was left to sip liquids for about a week with no intravenous fluids given. Finally, she collapsed and almost died. Adhesions from previous operations had fused together, completely blocking the bowel. The appropriate tests had not been carried out quickly enough to pick up the problem.
%26quot;Unfortunately, she also broke her hip and needed a hip replacement. Necessary anti-diarrhoea medication was not given before the operation which had to be cancelled when diarrhoea occurred on the operating table.
%26quot;There was a tendency by some staff to treat mother as though she was suffering from senility instead of recognising that the pain and discomfort she was suffering was the cause of her confused state of mind. Some nurses were a bit too rough in their handling of her fragile body. Some did not give mum enough respect.
%26quot;Most of these problems were the result of extreme pressures on the hospital staff and resources and an inefficient system for communicating information.
%26quot;I spent hours at a time sitting in the ward with her or attending various procedures. Overall, she was given excellent medical care, but some things became glaringly clear.
%26quot;Shortage of staff meant that agency nurses were regularly brought in to cover the shortfall. Trainee doctors were obviously carrying an enormous case load and often appeared plain exhausted.
%26quot;Communication seemed to be a big problem. My mother%26rsquo;s case was extremely complicated.
The nurses and doctors did not have time to thoroughly read the notes %26ndash; in my mother%26rsquo;s case, several folders thick %26ndash; every time they visited her bedside, and they constantly asked her to explain her condition. My brothers and I had to be there almost every day as her spokespersons to make sure the staff were fully familiar with her condition.
%26quot;I also found myself advocating for other patients in small ways %26ndash; finding nurses when a patient was immobile or unsteady and desperate to go to the toilet, needed pain relief, or a container to be sick into, etc, and no one had responded to the bell.
%26quot;I often cut up food for stroke patients or helped someone change position in bed. Of course, there were always the patients who were lonely and afraid and needed a listening ear.
%26quot;I came up with the idea that it would be good for each ward to have a patient advocate working fulltime. They would visit each person on the ward every day, checking if they had any concerns that were not being met and reporting back to the charge nurse.
%26quot;I guess this would be unacceptable because of cost, but people in hospital are at their most vulnerable and need a strong advocate to ensure their needs are met. They have social workers, but I am not sure how often they are able to visit individual patients.
%26quot;Summing up the care my mother received %26ndash; and some of the mistakes %26ndash; I want to make clear that I have nothing but respect for the medical teams that cared for her. Their job is extraordinarily difficult. Every day doctors and nurses make decisions that are potentially a matter of life or death. They deserve the utmost support.
%26quot;I agree with you %26ndash; it%26rsquo;s time politicians stopped fighting about whose fault it is that our hospitals are not operating perfectly.%26quot;
- Very true, Ann. Then, perhaps the health system would be healthier and so would the people it is there to serve. Thanks for other readers%26rsquo; letters received which are filed for reference.
