Lying in a hospital
bed I read articles in the local newspaper about the Tasmanian Health System. Articles
written by health experts or politicians or the unions. This disturbed me. None of these articles was
written by anybody who had done what I had done. Been a patient in The Royal.
Well you could say that
these people had my best interests at heart. They were just channeling my
thoughts. Well maybe but I will tell you what a patient actually thinks not
what other people say is best for me.
Politicians often,
without asking me, used me and my predicament to try and gain political
advantage. They focused on things they
could understand or things they thought were going to get them media coverage. Such
as bed numbers, staff numbers or obvious mistakes by the health system. Politicians
gave the impression they didn’t understand health, care about my fellow
patients, or want the portfolio. I also got the impression that politicians
were good people, who had been given an impossible job, and that both sides
were the same.
Some articles were
from the unions. The union had a standard response to everything. We need more
nurses. Sometimes they may have been right but they were always predictable and
when I was a patient I never thought the union was on my side.
As a patient I used
to think. How can I get out of here and not come back?
I used to spend
most of my time thinking about my particular illness. I did not want to come
back and I realised that I had to find everything out about my illness. I had
to take control. The staff were not going to emotionally invest in my
future. The staff knew everything and I
had to access this information. It was not a formality that this information
would automatically flow from them to me. It varied. Some staff were incredibly
perceptive and helpful. Others saw me as
a threat to their control.
The system as it
exists at present is not interested in promoting health or preventing patients
returning. The system is biased towards ED. The Royal is expert at picking people up from
the bottom of the cliff and resuscitating them and hopeless at preventing
people falling over the cliff. They found me at the bottom of the cliff and I
was expertly resuscitated and completely ignored when I wanted to prevent falling
in the future. I realise now that promotion of health has no political or news value.
I never lay in bed
thinking, “How lucky am I that I have been admitted.” I never felt grateful and
thankful for the services that I needed. I was never grateful to the staff that
helped me. I was never grateful to the Royal for providing a bed. I used to
spend my time feeling unhappy and being self-obsessed. I was disappointed that I needed a bed, staff
and services not grateful that it was provided.
Bed numbers and staff numbers were
never an issue. Never something I thought about.
As a patient I was
mesmerized by the behavior of staff.
There was nothing
else to do apart from watch the staff. The staff seemed to have a form for
everything. Everybody filled out the
same form. I began to see how a generic form could trigger the staff to think
of everything and cover every situation. I found this behavior strange but my
work history does not involve a big organization. Maybe standard procedures and
standard forms are needed in all big organizations.
The moment any
incident occurred the reaction would be, “We must write a report and make sure
this never happens again.” There was always something that prevented a good
outcome and a report that would fix the problem. Maybe not accepting responsibility is also
inevitable in big organizations
And I used to
observe power struggles between one member of staff and the next ward,
administration, the general practitioner, the lab, the next nurse, the other doctor
or the registrar. At times the power struggles deviated from humorous.
The other situation
I used to observe was the issue of focusing on the patient and ignored the
family. I witnessed it many times. A patient being successfully managed. And
coping well. And then the family would visit. They would not be coping. Often emotional wrecks. The family would need
some sort of support. They had to be part of the solution. They had to be
involved. They were either part of the
solution or needed help. At the very
least they needed a friendly chat.
As a patient I
noticed that staff morale was poor.
Whenever the staff
mentioned The Royal they raised their eyebrows and shock their heads.
This attitude is
understandable if you read or listen to the local media. Every story making the news will highlight
some failing, discrepancies or mistake.
At times the front
page news’s story or politician on the evening news leading to a decrease in
staff morale was palpable. A politician will celebrate getting their face on TV
and the next day the staff will treat you worse. When you are a patient you
dread The Royal making the evening news. It leads to grumpy staff who don’t
treat you as well.
In my seven weeks I
never heard a member of staff say, “I love working at The Royal. We do good
work.”
Which is sad
because a lot of the staff do a lot of good work and should be proud of their
work.
What else did I
think about when lying flat on my back?
I saw many procedures
performed. Sometimes they didn’t go as in the textbook. The equipment was not
in the drawer; the patient’s anatomy was unique. That pleased me. That tells me that The Royal
is full of unique humans (carers and patients).
I love this confirmation that The Royal is one part of our magnificent, imperfect
and ever-changing world.
Thanks to The Royal
I know how lucky I am. I did this by sharing a ward with people who were not as
lucky. I saw people who, unfortunately, had
not been given good cards. At the time my impotent reaction was to wish these
people all the best. To hope they got better and got out of that place.
Despite or because
of its idiosyncrasies I am not dead. The
Royal did the right thing at the right time. My trip to The Royal leaves me
feeling blessed and lucky. I encountered
staff who were sober, neat, tidy and polite.
They were kind, considerate and knew their subject.
BIO: Alan Carlton is a retired Hobart dentist. In 2015 he spent seven
weeks in The Royal (including ED and ICU). Since then he has retired. He now
spend his time running, playing tennis, gardening and visiting every cafe in
Hobart.
