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Apr 03

“Safe” care and crumbs of kindness: NOT NEARLY GOOD ENOUGH

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The other day a colleague told me how grateful she was for the “positive” experience her family had in the acute care sector. I quote: “my husband didn’t get an infection in hospital, and the nurses were mostly kind to us”. I ask you: how did things get to the point where this bare minimum (and some would say sub) standard became something to be “grateful” for? In the days of surgeon/obstetrician Ignaz Semmelweis (1818-1865), people were terrified of staying in the hospital because most developed infections after procedures, and most died as a result. No one expected good things out of a hospital stay. Now we have the thin (and growing thinner) line of antibiotics, and the knowledge of asepsis standing between us and the same fate as hospital patients in Semmelweis’s era. Yet, I still read in the literature how the simplest of procedures–proper handwashing–eludes many of the health care professionals of today! We are in trouble. Big time. And no one expects good things out of a hospital stay.

Now for the other bit. “…the nurses were mostly kind to us.” When did the public learn that they had to settle for crumbs of kindness, and even worse, be grateful for them? Probably about the time that we decided that we were much too busy in acute care (or health care in general) to bother with kindness or good communication, or family-centred care. Evidence-based care?? What evidence are we attending to? Have we truly lost our way ? When did “safety” become the gold standard, (a standard that we are not so good at meeting BTW) when it should be the absolute minimum level of care? At the CNA biennium in 2006, I heard the that eloquent Newfoundlander, Rex Murphy, say something so profound. It has stuck with me ever since. I may not have the wording quite right, but it was something like:  “Those of you in health care better get the quality thing figured out, because the public has, quite rightly, precious little patience with paying billions of dollars for health care that has no care in it.” Believe me: many politicians think they have the answer–privatize health care and treat the patient like a customer–that’s how you work out the service problem. I don’t think they’re right–I think high quality, compassionate and caring health care is more than possible in a publicly funded, universally accessible health care system. But that’s not where we are, not right now, not from my vantage point.

Now, if you are reading this and you work in an environment where there is no “quality chasm” and all is as it should be, forgive this rant and please comment IMMEDIATELY and tell the rest of us the secret.  But, if you work in an enviroment where you see families treated like intruders, patients treated like widgets and evidence used as a justification for forgetting we are in a human service–start asking yourself what YOU can do to change things in your corner of the health care world. Quality care starts with each of us. Challenge the status quo–ask questions–don’t settle.  The future of our health care system might very well depend on it.

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