Saturday, 1 March 2008

Large flakes of fluffy snow are falling outside my window. The sky is bright, however, and the temperature is mild. If this is the March lion, it is a fairly tame one. One of my neighbours has declared that this snow presages an early spring. I do hope she is right, as we are all heartily sick of winter in eastern Ontario. It came early and it has dumped close to a record fall of snow on us since November. I can't wait to put the shovels away.

I am also feeling springlike, joyful in fact, because N of just making it up as I go is awake and aware, off the ventilator and talking. Such good news! She still has a source of infection that the medical team has not found yet, and is catastrophically weak, but she's fighting hard. Here's part of what her husband had to say:

In order to prepare to remove N from the ventilator, they needed to give her two units of blood. This is in addition to the unit she received last week and the blood products that she received in the early days in ICU in order to keep her alive. A very small percentage of people donate blood on a regular basis. But I can attest first hand how important it is to the people who need it. I am a regular blood donor and I promise you that it is an extremely easy mitzvah (good deed).

In more medical news, JG is up on two canes and doing his road work, including stairs. If things go as planned, he will be home on Monday. The YD is on shift today at the hospital, making sure he is doing his exercises and generally behaving himself. Had she not chosen another career, the YG would have made an excellent drill sergeant; I, for instance, have been ordered home to rest today, in no uncertain terms. I do love her, a lot!

I've been reading, with great interest, some of the Hump Day Hmm postings on assertiveness. It certainly is something you need in the hospital. As I chased down nurses to get JG's overdue painkillers, watched residents who are incapable of listening, waited for physiotherapists who did not arrive and inspected meals that were less than inspiring, I really wished I had more of it. The surgical ward where JG has spent the week is horribly noisy, the rooms are so cramped that there is no place to put anything down except on the bed or on the windowsills on top of the heating vents, there is little continuity in the nursing care and the staff is stretched to capacity. Although a couple of his nurses were excellent, some of his physiotherapists were careless and out of their depth. There does not seem to be any system -- the hospital is at capacity and beds are not available where and when they ought to be. A patient without an advocate may fall into the cracks.

This is really a sad state of affairs. I am pretty sure most of the blame rests with hospital management and the scarcity of beds, which is a provincial responsibility. Our provincial government has lately set up a new level of medical management, called a Local Health Integration Network, which divides the province into compartments in which all levels of care are supposed to be managed efficiently. Our Community Health Centre out here in the hinterland has already encountered problems with these LHIN's, as we straddle the boundary between two of them. The LHIN we are not in has been trying to put all of its Mental Health Support Projects into one management, which would make the chart look really efficient, but which would also tear the MHSP that we manage in half. It's a pity they aren't tackling some of the hospital problems instead of trying to look good.

I would love to make each and every LHIN Board member spend a week on a surgical floor with their leg tied to the bed. And the Hospital Board members, ditto. Things might change for the better after they were let out.

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