Editorial

Citation

Downey-Ennis, K. (2009), "Editorial", International Journal of Health Care Quality Assurance, Vol. 22 No. 1. https://doi.org/10.1108/ijhcqa.2009.06222aaa.001

Editorial

Article Type: Editorial From: International Journal of Health Care Quality Assurance, Volume 22, Issue 1

My writing in this issue is to inform the readers of this journal of my own personal experience of being a “hospital patient” in Ireland. First, I wish to give the context of my admission without revealing too much – safe to say my “ailment” is a result of being in the tropics – however it is proving hard for the medics to find out what it is as my visit to the tropics was not in recent times. In the Irish context there is a two-tier system: a public system where there are accusations of major inefficiencies and financial overruns; and a private insurance-based system where one would not read about such as the public system. It is the latter one that I find myself to be the recipient of.

The hospital is renowned within the Irish republic as probably one of the finest “private” hospitals to be established and I must say the surroundings are pretty good, even for my standards! However despite the good surrounding I was glad to have a “private” room, as I would not like to share within a hospital environment, precious person one may say but heck that is the way I feel. Truthfully I am not what you would call “sick” at the moment and if I was perhaps I would not care whom I shared with!

My reason for writing this is to inform readers of what it is really like from many perspectives of being “the patient”. The staff of the hospital do not know I am writing this editorial, it would not be fair to put them under the pressure. However it is fair to inform readers of how it really felt. First, I have been a clinical nurse for many years, now in management and trying desperately to make things better for “patients” and to put the patient at the centre of everything healthcare organisations do.

Prior to admission the hospital confirmed my admission date and asked me to present for admission on a Sunday between 1 p.m. to 3 p.m. When I questioned why so early I was informed that this was the rule but, being me, I did not present for admission until 6 p.m., obviously being a compliant patient I did inform the admission office of this. On admission I was met by what I could only describe as a pretty stern faced administrative secretary, there was not a hint of a smile. She took my details and appeared to be somewhat perplexed when some of my personal details had changed, anyway she decided she better update her records as it had been a long time since I had a consultation within this particular hospital. I was produced with a “form” and instructed to complete. When I questioned her on the details required as I did not have the information with me she “politely” informed me that “it was my insurance company who wanted this information” so of course I said to myself “just comply”.

The admission to the ward was quite uneventful and painless. I was met by a very “smiley” nurse who again took my details, but I am not complaining of this as there has to be safety mechanisms. After all I would not like to be transported to theatre for an amputation or something the next morning. My room had all I needed and I soon settled down for the night following some light reading. My doctor had all the necessary numerous tests ordered and had arranged consultations with different specialties.

Next morning a very nice porter entered my room prior to which he knocked and informed me that he would take me to radiology for tests. This member of staff was polite, courteous and very personable and we trotted off to the radiology department where I was met by an equally nice radiology assistant. Following this I had some tests by a consultant radiologist whom i can say without any fear was most helpful, informative and made me feel at ease right throughout the procedure. He also informed me of his findings and his “not findings” which assured me. After this test I was to have another common radiological examination and again the radiographer was very pleasant. However during the examination the door opened, there was no knock and a person entered and did not say one word or asked to be excused by me. So I thought “So much for privacy and dignity!”, but more to come on this. Following this I made my own way back to my room as I was fully capable of this which gave me a sense of “empowerment”.

Next came the phlebotomy and what they described as a “rake” of bloods were drawn. The phlebotomist, after getting her identification correct (cannot complain there either for safety reasons), proceeds to take my blood without any gloves and with two hands adorned with “diamonds”. I politely asked her if she had washed her hands and does she not wear gloves? With a little huff and puff said “of course I washed my hands with the Spirogel prior to coming into the room” but her reason for not wearing gloves was that “she finds it easier” without them!

Next in line were the cardiology tests and again another porter similar in manner to the first porter accompanied me to the cardiology department where I was met by a polite but somewhat austere cardiology technician who proceeded to complete the tests. Just like the radiology during this procedure another technician entered the room without “knocking” and proceeded to ignore me and speak to the technician about “taking her break” when she completed my tests. The technician completing the tests was as I said “polite but austere” and all I can say was she exuded an air of “paternalism”.

Back on the ward I was visited by my “own” consultant who was extremely nice and helpful and then by two other consultants for consultation. Both of these were helpful and did their own; of course I was known to both of these.

Now to the staff on the ward: both cleaning and household staff were polite with the exception of one who at no time had a hint of a smile on her face. The nurses (and remember I am a nurse) I guess were there if I needed them (but then I was in a private room) and perhaps would not see them as they go around the ward doing whatever it is that they do. From my perspective they took the mandatory temperature, pulse and blood pressure even though I did not have any signs or symptoms that these were out of “kilter”. I asked one of the nurses why these were performed and she said “we always do that” and “management” checked the charts. So nursing has not changed too much since my clinical days when tasks were done as routine things and nobody questioned why. I was somewhat disappointed that the nurses and especially the student nurse who was one of those who took the mandatory observations did not even try to find out from “the humble patient” what were my symptoms, etc. as a means of learning and perhaps expanding their skills. One other task they undertook was to “make” the famous bed and “change the linen” even though I was only there for two days at the most!

So to summarise my brief but enlightening stay in a “private” hospital which some may say is “privileged” – but I do pay for the insurance and will keep on paying for the best insurance so that I do not have to wait endlessly for treatment. However, it is fair to say if it was an emergency I would be seen in the public system, maybe not quickly but eventually would enter the public hospital.

The medical treatment I received was I felt one of excellence and state-of-the-art investigations. However despite this I was the recipient of a “near miss” through a miscalculation of a drug – thank you to the pharmacist who spotted this. The second was an actual “error” in my viewpoint – I was discharged from the hospital having had a test performed, but with no instructions of when to have it read.

While the medical treatment was as outlined all staff should remember that patients are human beings and should treat all patients as they would like to be treated themselves, knock prior to entering rooms where investigations are being held and at least acknowledge that there is a patient on the couch and not just a “thing”. So all in all I think clinically I have been overhauled but wonder if staff simply “do not think” anymore that it would be better if their interactions with patients were more humane and above all please nurses do take an interest in the patient, their symptoms, etc. instead of relying on records to find out about some “elusive” signs and symptoms.

While I may sound critical in this editorial I do not really mean to be but felt it would be a good way of relaying what a “patient” really feels upon hospitalisation. I would also like to compare what it would be like in a “public” hospital but will humbly leave that to somebody else! The issues that I have felt needed improvement within this hospital will not “take financial resources” but plain privacy, dignity, respect and personable staff. The manner in which the tests were aligned was perfect so I would think “process management” from that perspective is good but the other areas require addressing. The whole experience for me was efficient, as I just had to pencil out two days from my diary to complete the whole lot.

Kay Downey-EnnisCo-Editor