Chagal4's Blog

Before I start this rant I want to say that I have enormous respect for health care workers. I know they have an increasingly difficult job to do in most places and I know too that hospital administrators face the difficult choices of where to allocate scarce resources. The population is aging and with that aging people find their bodies breaking down…making bigger demands for care strategies. Governments in Canada and the U.S. have insisted on cutting taxes to stimulate the economy and incidentally to buy the votes. In a lot of ways it couldn’t come at a worse time. The income gap between the incredibly wealthy and the working people is beyond huge…and the proportional taxation is practically criminal. Canada has what we call a universal health care system …meaning that practically anyone can get into a hospital for treatment and their costs are covered. It is becoming difficult to maintain but it is holding. Wait times for surgery are getting longer in spite of major efforts to reduce them. Emergency rooms are virtually never empty. There aren’t enough doctors and amazingly cost cutting choices in a hospital here has the administration cutting twenty five staff…not administrators…but nurses and care givers! A few days ago I found myself in Emergency at a local hospital with severe pain in my abdomen. I didn’t know what it was and I was spooked. I’ve spent enough time in hospitals in the past six months. It turned out to be a kidney stone and I’m not writing to whine about that. It hurts…it will be dealt with. When I got to Emergency with my own true love…we found that we would have to wait four to five hours to see a doctor. Doesn’t sound like much does it? Four to five hours. The waiting rooms (plural) were packed with people in varying stages of anxiety and agony along with concerned and frightened family or friends. I got some medication for my pain and settled in to wait…closer to seven hours. I looked around the waiting room…there was nothing much to do otherwise and it struck me that the whole design of these places was stupidly wrong. It seems to me that health care ought to begin in the waiting room. I don’t mean that doctors should be working on patients there but the space ought to contribute to improving the patient. I’ve been in dozens of waiting rooms over the years and every one of them was an architectural dead zone. Money and design time is spent on operating rooms, treatment spaces, board rooms, class-rooms, administrative offices, laboratories and specialty spaces. Waiting rooms are neutral spaces connected to an intake kiosk . The are stocked with cheap and durable furniture that gets more traffic than your average taxi. I’ve never seen a comfortable chair in any of them…in any event, spending four hours in pain on almost any thinly padded chair is likely to produce ass paralysis in the toughest people. We endure it because we have no choice.  I think waiting rooms need to be redesigned as part of the health care protocol. Furniture should be specifically designed for easing pain and easy cleaning. The rooms need to be brighter, cleaner, and designed to absorb and reduce noise and aggravation. There is clearly little chance that waiting times will improve dramatically over the next few years. If these hard minded right wing governments have their way…only those who can pay will have access…but there will be more than enough of them to fill waiting rooms. In the short term existing waiting rooms could and should be retrofitted …brighter lighting, better paint choices, some acoustic tiles  and a serious search for some furniture that belongs in a waiting room. This is a critical piece of the puzzle. You’re sick, or in pain, you’re scared, you don’t know what’s going to happen to you…you’re sitting in room full of sick people in a chair that has been continuously occupied by sick people who may have contagious illnesses. Nobody washed or sprayed that chair before you landed in it…and nobody wiped it when you left it. That doesn’t mean they’re never cleaned and it doesn’t mean that you’ll catch some virus or bacteria from being there. But the chances are better than they would be if you were walking in the park and it doesn’t inspire confidence as you’re sitting there watching a guy vomiting into a bowl in the corner chair. So chairs that are upholstered in some easily sanitised material and that have a design that can give some comfort to pained people for four hours or more.  But the key piece of the puzzle has to be the “active waiting” room. There needs to be waiting room staff. Maybe not fully trained nurses but aides with some training and they need to be there to provide information, let people know what’s going on…how long their wait will be…how close they are to the top of the list… to provide water or reading material…TO SHOW CONCERN for the patient and any family or friends…bring blankets. Act as intermediaries with intake nurses…alert them of increased pain in patients or emerging crises. These shouldn’t just be inspired volunteers (although anything is better than nothing) but trained and paid staff whose function is understood and integrated into the care strategy of the hospital. If this could be done…I believe that patients would be less anxious, more communicative and better able to assist in their own diagnosis when the finally see the doctor…and perhaps reducing the time and difficulty in dealing with upset patients. Moreover, providing some assurance and concern in the waiting room would enable family and friends to get past their own anxiety and act as more supportive strength for the patient. These are positive outcomes. Am I asking for a Cadillac version of hospitals? Hell yes…I’d like there to be Cadillac schools and Cadillac governments too…but everything is relative. I know that these aren’t choices that cash strapped hospitals will make…I just want to see some new thinking…some steps in the direction of overall care…I want want waiting spaces to be caring spaces. If you can’t reduce the wait times…at least try to make the waits more bearable.

This entry was posted on April 18, 2011 at 4:09 pm and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.