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Op-ed column: Discomfort of hospital stay due to institutional system

Op-ed column: Discomfort of hospital stay due to institutional system

While some of my friends were in Cancun and others were in Florida for our senior version of what is

While some of my friends were in Cancun and others were in Florida for our senior version of what is called “Spring Break,” I spent mine in Ellis Hospital.

Not quite the vacation package that I had hoped for, even though it is somewhat all-inclusive. I would still rather have the “rum runner” than the IV cocktail.

I didn’t choose to spend three weeks in the hospital; it came up rather suddenly, as in the doctor saying, “you’re going to the hospital right now!” Having lived with a manageable form of leukemia called CLL for many years, I am used to being susceptible to infections; but this one was different, managing to sneak into my ear and settling into the right side of my face, neck and skull. It has stolen my balance, paralyzed the right side of my face and shackled me to my house.

And I can’t tell you the end of this story, as my treatments continue at home with no definitive prognosis. But I can tell you a couple of hospital stories.

In the three weeks that I was in Ellis, I was in six different rooms on three separate floors. I had two different roommates, spent some time in ICU and had a couple of private rooms. I got to know the hospital and some of the floor staff pretty well. My care was generally kind and thoughtful, but there were the occasional institutional difficulties.

Party time

My second roommate, wanting to be absolutely sure that he had enough “medication,” brought his own to take in addition to what the hospital had prescribed him. I had heard him on the phone putting in an order that afternoon. Around 2 a.m. he yanked back the curtain between our beds, walked over to my side and said, “Man, what time does the party start around here, anyway?” My party had already broken up as I looked at him through 103-degree feverish eyes and tried to understand what was happening. At 4 a.m. the party expanded to the lights and the TV going on and up to their maximum ferociousness. I rang for the nurse. I was saved! Well, saved in hospital time, which means I was moved the next afternoon.

Time, as we know it, doesn’t exist in hospitals. Nothing happens quickly.

It’s sort of like when you have a doctor’s appointment and the nurse puts you in a room and says, “The doctor will be right in.”

The door shuts behind her and your internal clock begins ticking. Just when you are absolutely certain that you have been forgotten and abandoned in the exam room, the door reopens and bright smiles ensue.

Hospitals are worse. Nothing happens on time and some things that you’re expecting don’t happen at all. The televisions make it worse. You know there is real time out there, you can almost touch it as you watch the Final Four or follow another mass killing, in Binghamton this time, on the 24-hour news channel, but you also know that you cannot drink the nectar from that glass.

Time has been stolen from you and, what’s worse, that’s all you have.

“You Have the Right to Proper Pain Management,” said the sign in my bathroom, followed by a little cartoon chart of what pain 0–10 might feel or look like on someone’s face. Your doctor has scripted pain relief at the patient’s request, so when it gets too bad you just ask. At first it seemed to take forever, and, in fact, once it took three hours to get a Tylenol 3.

Computer problem

Part of the problem is the computer. If the medication isn’t listed there, you don’t get it. It might just need to be renewed or re-entered, as meds have a sort of built-in renewal date. “Would you please call the doctor and check?” you ask. “I will put a call in,” is the reply, which is code for you won’t be getting that medication for a good long time. If you hear, “the pharmacy will have to be called,” then you might want to call a friend and see if they can bring you some Tylenol.

Once, toward the end of my stay, I had just been fitted with an internal catheter in my arm, through some veins in my chest toward the vicinity of my heart, where the IV antibiotic will have the most effect. When I returned to my room from the procedure, I was anxious for it to be used in the hospital, as the idea was to teach me how to do it myself at home and I didn’t want to be my own scientific experiment. When a nurse arrived for other procedures I asked her if she knew when the IV treatment would begin. She looked at my chart. “Oh, that antibiotic has been canceled, it is not on your chart.”

I looked at her, I’m sure with desperate eyes, and held up my arm showing her the PICC line as it dangled out of my bicep. “I just had this put in today,” I told her, “the purpose being to deliver that medication.”

She was insistent. If it wasn’t on the computer, then I wasn’t getting it. I beseeched her to talk to my doctor. He came up some hours later, knew all about it, and assured me it was a simple matter of ordering it up on the computer. Ah, yes, hospital reassurance . . . four hours later.

When you are sick, all you have is information and time. You count on those things to help you through. You try to learn as much as you can about your diagnosis, your treatment and your prognosis, and you frame everything together into neat packages of time that somehow, if organized correctly, can give you something to count on, to be reassured about, to provide some peace of mind.

I never felt that in my hospital stay.

And it’s not about the people. Of course there are always varying degrees of competency, caring and skill, but for the most part, the nurses and the techs at Ellis did a fine job and I take some favorite names and faces away with me.

It’s the system

And I don’t think it’s economic either. I tried to make some observations that could show me that budget shortages are the cause of what’s lacking in hospital care. But I wasn’t seeing that connection, at least not from my perspective (although I will tell you that there isn’t a cotton ball in all of Ellis Hospital).

What I’ve concluded is this: What I found wrong, or uncomfortable, or less than satisfactory in my hospital stay is systemic to the institution.

Something has taken a nurse’s good judgment away and has allowed a computer to trump it; has allowed her to look directly at a new IV line and conclude, beyond reason, that there is no IV medication prescribed. Something has forced doctors to have fewer firsthand conversations with their patients, for shorter periods of time, and to share less information.

When the institution itself begins to take on the task of dispensing health care over the good will and judgment of the professionals hired to do that, then a piece of humanity is lost from the system. And it is that very humanity that patients can’t afford to lose.

Anthony Frank lives in Schenectady and is a regular contributor to the Sunday Opinion section.

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