Chapter 60 : the Royal Hobart Hospital.

Dear patient of the Royal Hobart Hospital.

I  love you.  I want you to get better and get out of the Royal.  The best way is take control of your illness. Accept responsibility for your illness. You are the cause and also the reason you will get better. The majority of illnesses are associated with lifestyle. In your case it may not be true but the moment you accept ownership of your illness you enter a wonderful place.

I have based my opinion on my experience in the hospital. Which kinda went like this.

A consultation with one doctor.  Whenever I mentioned a symptom he said he had seen it more often than me and one case ten times worse.

Consultation with a support group who wanted my email address. So they could send me weekly newsletters, dates of support group meetings and other ways they could give me information and support me over the next few years. I said I wanted to get better and my aim was to work towards not needing their support and they said, “Have a nice day. Goodbye.”

Consultation with a doctor. I pulled out a list of questions I wanted answered. The doctor was stunned. I was there to listen to him, not ask questions.

I asked for a copy of my notes and was told I had to fill out a form and apply through at a different part of the hospital and they would explain to me how to get there.  Elsewhere in the hospital I encountered staff who photocopied pathology results and gave me a copy and said,” don’t tell anyone”.

After a few weeks lying on my back I decided I wanted to get out and not return and that it was up to me. The system was not interested in promoting health or preventing patients returning.  The system was biased towards ED.  The Royal was 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.

There is nothing especially good or bad about the Royal Hobart Hospital. It is typical of a western hospital in the way it is staffed, managed and run. The only exception is morale which is probably worse than average. Which is probably because we are a small stable, prosperous island state with very distant neighbours and little news apart from the Royal.

In my seven weeks in the Royal I never heard a member of staff say, “I love working at The Royal. We do good work.” They used to they raised their eyebrows and shake their heads whenever they mentioned The Royal.

Does poor morale matter to you?   It does because a front page news’s story or politician on the evening news leads to a decrease in staff morale. Staff in bad moods affects you. You will suffer. A politician will celebrate getting their face on TV and the next day you will receive worse treatment. As a patient I used to watch the evening news. Just to make sure we never made it.

There is one thing you can do about staff morale. Thank the staff for their work. Whenever they do something for you, thank them. Tell them they are doing a good job. It’s probably true and means that in the future they will be happy to return and help you again.  It is a very easy task I am giving you. Because most of the staff are neat, tidy, punctual, compassionate and know their work.

In the ward one thing you will watch is the nurse complaining about the next ward, the doctor complaining about the registrar, the pathology staff complaining about administration. You could call them power struggles.  Everybody will get involved including the various wards, administration, the general practitioner, the lab, the nurses, the doctors and the registrars.

If you have worked in a big organization you may be used to these power struggles. If you are like me then it will be new to you. You have no choice. Get used to it. Go the same way as me. Assume that a power struggle means people have pride in their work?  Assume that there is nothing wrong with power struggles.  Everybody can argue about how to move forward if they are all moving in the same direction. 

Another thing you may see is the staff becoming confused about who the patient is. The staff would speak to my significant partner and then she would try and interpret. I would then ask her questions and she would say ,”We never discussed that” or “It never came up” or “Next time I will mention it”  or best of all, ”I was there. I know what happened better than you.” I saw this happen to other patients so it was a common habit and may happen to you. Please be careful.

What are you going to think about when lying in bed 24/7? Well I don’t know what you will think about. I can tell you what I thought about. I never thought, “How lucky I am, that I have been admitted. I am grateful and thankful for the services provided.”

I spent a lot of time feeling disappointed that I needed a bed, staff and services. I was never grateful that it was provided.   I thought about myself and my particular illness. I did not want to come back and I realised that the staff were not going to emotionally invest in my future. I had to take control. I had to find everything out about my illness. I had to get all this information from the staff.

Some staff were incredibly perceptive and would help me.  Others saw me as a threat to their control.  I eventually, by various mean, found out ways to manage myself. It is up to you to work out which staff will help you.

What I wanted was to get better and not return. What the staff wanted was to be neat and tidy, punctual and perform their procedures correct.   This is what they were expert at. They were sober, neat, tidy and polite.  They were kind, considerate and expert at following standard procedures. There was a standard procedure or standard form for every situation which was followed.  After discharge there was even a standard form for feedback.

Good luck to you and all the best with your recovery. Politicians will talk about bed numbers, staff numbers, number of services provided. Staff will concern themselves with standard procedures but it is you accepting responsibility for your illness which actually matters and will get you better.

Taking control of your management will not guarantee you eternal life but it might make what remains more enjoyable. Aim for a balanced life with physical, emotional, mental, social, spiritual health and a healthy diet free of excessive drug use. Good luck.

BIO: Alan Carlton is a retired Hobart dentist. He was admitted to The Royal in 2015 and 2017 (including ED and two weeks in ICU). He has now retired from work. He now spend his time running, playing tennis, gardening and visiting every cafe in Hobart.