We are so grateful to be home in our cosy and comfortable Station House. Gem performed above and beyond the call of duty, looking after our animals with diligence and affection. An overnight stay in hospital is bad enough; that we didn't have to worry about the menagerie reduced that anxiety. They welcomed us home with animated delight yesterday afternoon and Gem left to rejoin her little tribe at Windward Retreat.
The Mount Hospital reception area is rather sumptuous and gives a not-altogether realistic introduction to the rest of the facility. And Monday morning, the cold wind also permeated the waiting room with the constant movement of the self opening doors.
Six thirty cattle call is not fun. There always seems to be a great deal of waiting as the morning surgery list all congregate in the same space at the same time. Formal admission, delivery of any insurance excess and signing of forms depends on one's position on the list. As Michael was first on Ben Kimberley's list, we were through admission and being escorted to Karri Ward by concierge Paul fairly promptly.
We had been allocated a large shared room. The view was of the opposite side of the building and the carpark. The air-conditioning was vicious. At first glance, the room seemed in pretty good nick. We were visited by Evelyn, director of nursing, with whom I'd corresponded and met in 2020. I purred with satisfaction in response to her as I really hadn't had a chance to check out the facilities.
Being first on the morning list definitely has is advantages. We zoomed through the familiar process on the ward and I was still filling out paperwork when the orderly came to take him to pre-op.
Why do I go with Michael to pre-op? Does he want me there? From experience, I know waiting in pre-op bays to be isolating, sometimes scary and often cold. And yes, he wants me there. Michael dislikes the whole hospital experience so much that he tries to be invisible. He would rather shiver than ask for a warm blanket. He would rather wait for me to help him than ask for a nurse to get him a piddling bottle. He will wait until his pain is high, his nausea to the point of no return, his position in bed vastly uncomfortable before he asks for help. So, I act as his conduit.
Anaethetists, operating theatres nurses and surgeons or their assistants scurry in and out in pre-op. Most of the waiting is extremely boring. Eventually, I kissed Michael goodbye at eight thirty and headed out to Hudson's, the hospital café for breakfast. Toast and coffee consumed, I returned to Karri Ward. The time had come for a really good inspection of both the ward and the room holding beds 272 and 273.
Nothing could be done about the less than inspiring view. I ticked that off my list. The room appeared to have received a lick of new paint, but the shelving was somewhat scarred and daggy. The wardrobes were unloved and not easy to open and close and the bathroom door's bottom was showing serious signs of sustained bashings by wheelchairs and walkers. A baseplate on the bottom of the door could be the answer to repeated damage.
Worse still was the toilet. I had complained about the issues of blokes having to hold the toilet seat up a year ago. In another bathroom. Obviously, the engineering department considered this a Bridge Too Far to find a solution. Not God's sake, a clip to hold the seat and lid against the toilet would have done the trick. This may seem a trivial whinge, but Michael was initially unable to have a piddle standing up without me helping. There was no way he would have asked for assistance from the staff. He tried sitting down as well, which with two bandaged hands, this alternative was not ideal either.
The central air-conditioning continued to have a mind of its own. I spent most of our stay cold, whilst Michael was hot. Individual reverse cycle air-conditioners would make far more sense in two-bed rooms.
Then there was the absence of cotton blankets or a blanket warmer on the ward. I had also raised this issue a year ago, as frankly, the thin coverlets weren't up to the job, unless one could wear thermal undies all the time. I asked for blankets for him in pre-op and he arrived back on the ward with them post-op, but not having the capacity to obtain fresh blankets on the ward was poor management.
The promised microwave in the patients and visitors pantry was another unresolved issue. There is no option for heating of meals for patients and visitors. The old and tired line of health consequences was churned out. So, I asked if there was a microwave in the staff kitchen. Of course there was. At no point in my memories of the Mount has a staff member ever offered to heat up food for either of us using the staff microwave. That is not a request that should have to be made. Staff should ask their patients automatically as part of their duty of care.
Finally, communication had not overly improved. From the time of Michael admittance, I had asked for a script for his beta-blockers as we had no more repeats. I was reassured, repeatedly, that this task had been attended to. Come our discharge, no beta-blocker script had materialised. I had a minor tanty and flounced off the ward to get a hot drink from the cafe. Whilst away, I arranged Michael's follow-up appointment with the surgeon and picked up the referral to the OT. Upon my return, the script had turned up and been filled...Apparently, the anaethetist had phoned through the script but nobody was any the wiser, until I performed an impromptu and cranky song and dance routine.
Lack of both communication and the ability to think outside the square appear to be blighting our hospitals. I have been following the case of the seven-year-old who died in the Children's Hospital Emergency Department with sadness and disbelief. Communication and forethought seem to have been missing that night and I believe were as responsible for her death as the sepsis raging in her body.
A very long time ago, I undertook a year of nursing training before a car accident ended that career. I believe that a sound mixture of hospital experience as well as the theory is vital to create compassionate nurses with initiative. I don't think that balance is right. We need nurses to be proactive and really care about their patients without fear of favour. Only Thalia, his night nurse asked if he was comfortable in his bedding and altered the position of his blankets. She was, by a wide margin, the nurse with the most initiative during our stay. The other nurses' care could not be faulted but seemed to be following a tight script with no room for maneuvering.
And if nurses are not performing what I would view as their core tasks in relation to patients, then we all need to create enough noise for this system to be altered. Bedmaking, showering, toileting, watching for fever, wound care and drug management were drilled into student nurses back in the day. These should still be primary objectives of a nurse. We had a definite hierachy. Note making should be concise, accurate, with attention paid to patients' mental and emotional as well as physical care. Action should be immediate if any of these markers causes concern for either the patient, their family or staff.
May the gods who run our hospitals recognise these important issues so fewer people die unnecessarily. May the powers that be recognise why nurses are so vital on the coalface. Doctors are also responsible for miracles as well, but the nurses are the lifeblood of our wards. May they be treated as such and encouraged towards excellence.
We need a system that is not a lottery, but offers common sense, integrity and a passion for service from every single staff member, from the tea attendants to the specialists, but particularly in our nurses.
Programme on display in room next to the patient's whiteboard
NOT DONE ONCE
Discharge Information -It is important to us that your discharge from Mount Hospital is as smooth as possible. The following information has been provided to assist you in planning your discharge with the nurse caring for you. Questions you may wish to ask when planning your discharge with your nurse: • What is my expected discharge date and time? • When can I make arrangements for collection/discharge? • What medications will I be taking home? • Do I need a medication list? • How do I care for my wound? • What do I do if the dressing gets wet? • Do I need to obtain extra dressings? • Do I need to make an appointment with my specialist? • When do I make an appointment to see the GP? • Do I need to take my nursing discharge summary with me? • Do I need any equipment to use at home? Discharge Time To help us to prepare rooms to the same standard that you enjoyed upon arrival, we kindly ask that you depart from your room by 10.00am on your day of discharge. If your transport home has not arrived by 10.00am, please discuss this with your nurse. If you require assistance with luggage or transferring to reception, please do not hesitate to ask your nurse or ward clerk. Should you have any queries or concerns after you have been discharged, you are welcome to contact us on (08) 9327 1100 and ask to be transferred to the ward you were on.
GIVEN VERY BASIC DISCHARGE SUMMARY. We have never been discharged by 10 am ever.
