Chapter 58 : I am not dead because....

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.