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Waiting at the hospital... My perspective

Tuesday, January 15, 2008

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Written by Bob Przybyla

Right now, I am typing up this editorial with the use of 2 thumbs and only 7 fingers. No, I didn't lose one, I merely cut my index finger while cooking and required some stitches. This is the first time I'd been to the ER for myself in Guelph. Since it was a new experience, I figured it would be a good study between my experiences at Guelph General and the things I had seen in the 'States.

First, I should get out of the way the things that pissed me off but were not the fault of the hospital. When you go to the ER at Guelph General, or any ER for that matter, you have to be triaged. My partner and I were waiting in the seats assigned for incoming cases to be triaged waiting our turn with my finger wrapped in bloody toilet paper. ( Bloody as in I bled all over it, not the British slang) A woman asked if we were in line for triage, we answered yes and then she slyly made her way towards the triage desk and when the desk became free, she stepped up and cut in front of us and had the triage worker look at her son. We didn't want to make a scene so we just moved up closer to the desk and gave her dirty looks until it was our turn.

Then when I was being triaged the nurse rattled off the questions that everyone is asked. When he saw I didn't have an Ontario health card because I'm an international student he said "we don't handle international people here." At which point my heart started beating so fast that I'm surprised the blood didn't obliterate the toilet paper around my finger and squirt all over the guy's face. After revealing that he was joking, he asked to see my wound and I took off the toilet paper. He then asked if I was trying to kill myself when it happened. I'm not sure where he learned his bed-side manner, but he is truly a master of comedy and care. (Does sarcasm translate over the internet?)

Those item aside, the experience was exactly what I expected. I got to the ER at 8:30pm and didn't get out of the waiting room until midnight and wasn't treated until 12:30am. Now this may seem ridiculous and outlandish enough to make Sean Hannity scoff and exclaim "See! That's what happens when you socialize medicine! GAAHHHH! I like yelling things!" But it's not a shock to me. I went in on Sunday night, when there is virtually no other option of where to go when something goes wrong. Admittedly, I wouldn't have sat there if I didn't have to but I needed stitches and where else was I going to go? I was low priority, I wasn't bleeding out, I wasn't passing out, I wasn't writhing in pain, I should have been low on the list and I was.

It seems to me that these American pundits, talking heads and Republican presidential candidates overall have never likely been to a real hospital and if they were their name power and/or available cash swept away any line for them. If you have enough money, you don't have to go to the ER, you can have the ER come to you. With all the talk from the 'States about how movies like Sicko and similar criticism improperly show the state of medicine in Canada, the 'States and elsewhere. However, the ER here seems to be largely the same as those I've seen in the 'States.

While I waited 3 and a half hours to get past those glorious metal doors, I waited with a child from my camp at the ER in the 'States once. One of my campers split his head open at the pool about 5 years ago when I was a counselor at the park district. He had t0 be taken to the hospital via ambulance, he was put in a neck brace, and had to remain still lying down because he might have done spinal injury, they didn't know. So we got to the hospital and he was immediately put on a gurney and wheeled down to the hallway and left in a soaking wet bathing suit, in an overly air conditioned hospital for 5 hours. I waited 3.5 hours for stitches on my hand in the relative comfort of the waiting room while this child with possible spinal and head injuries was left to shiver in a hallway for 5 hours.

Now, that might not be the best example. The hospital had a trauma centre so any major calamities were routed to their ER and who knows, maybe there was an 87 car pile up after two planes hit each other in midair and fell onto the highway at the same time that I missed hearing about... BUT that wouldn't explain all the stories.

According to Producer Tracey Lyons, writing for MSNBC Nightly News, the average wait in an American ER is, you guessed it, over 3 hours like my wait at Guelph General. Despite claims otherwise, the instances of waiting in the 'States are obviously serious according to an article attached to the above linked post. In Joliet, Illinois, (famous for it's prison that housed Joliet Jake Blues in the Blues Brothers) the hospital has pagers that you would usually find in a cheap-ish chain restaurant. In 2005 a Waukegan, Illinois, woman died from the heart attack she was having after waiting 2 hours and 10 minutes at the ER.

The blame for wait seems to be similar to the reasons in Canada. Since moving to Guelph about 8 months ago, my partner has yet to find a GP that is even taking new wait-list patients. Since there are too few GPs clinics and ER rooms get the spill over of non-emergency cases that have nowhere else to turn. In the 'States, there may be enough GPs for those that can afford them or have sufficient insurance but those that don't fit that mold are left to the ERs. And while there are more non-emergncy cases going to US ERs there are also real emergency cases and they are all going to fewer ERs. Between '93 and '03 425 of the 4000 or so US ERs closed their doors. Meaning wait times in the 'States are also the rule, not the exception.

There are two major differences I see between here and home. First, the woman that stitched my finger closed told me she was a nurse-practitioner. I have never heard that told to anyone in the 'States. I think it's because self-involved Americans would buck against the thought of waiting three hours to see a nurse and would start yelling until they saw a doctor even if it meant waiting another 2 hours of screaming.

Second, I was never referred to a billing department!

To sum up, there is nothing wrong with the Canadian Emergency care system that isn't wrong with the American version. True, everyone has their horror story but that is the tale of the tape on both sides of the border. I have had enough of my fellow Americans criticizing a system they have not actually compared to the US system. Yes, if you live 7 hours north of the arctic circle, you're gonna have trouble getting medical care but in Guelph it's apples and apples with the 'States except here the apple doesn't cost $7,000.

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  1. Posted by: mika on Jan 16, 2008 @ 4:39pm

    i had sprung my knee and wanted to get an xray. i happened to be hopping by the xray room and no one was in the room for any of the diagnostic machines. the nurse at the triage insisted it would take me 8 hours just to get admitted and registered! i really dont like this system...if no one is using the equipment, cant they just ship me over to tht departmnt? Ive been to other hospitals where they do put you there right away and then you wait with other injured people waiting for an xray. im just wondering why its not like tht here? not to mention it only took 3 hrs at this other hospital and it was really busy!
    also, before i left (i didnt want to wait) i had a chat with this 90yr old lady. her dr had just died and now she didnt have a new one. she had severe back pain and needs narcotics to basically survive/function. she told me she has to wait 8 hours every two weeks or so just to get another prescription! (the drugs she was taking couldnt be refilled and couldnt be done by a walk-in)its this kind of situation that really breaks my heart. she said she was passing out in pain once and they told her she just had to wait and all she needed was 5 min and a signature... it was just, for a lack of a better word, sad :(

  2. Posted by: T on Jan 16, 2008 @ 5:12pm

    Thank you for your article. It's refreshing to hear someone recognize that their low priority on the triage list was the reason why the had to wait. All too often I hear people complain about waiting for a really long time and blaming the "system" for not working. While I readily admit the system isn't perfect I think a significant part of the problem is simply the patients erroneous perception of how serious their stubbed toe is.

    As for mika's situation, depending on what time it was there may have been no one to use the system for you (ie. Tech). This plays into the shortage crisis that our system is experiencing across the country.
    ...and prescribing narcotics isn't always straightforward as you can probably appreciate.

  3. Posted by: HA on Jan 17, 2008 @ 1:10am

    Guelph General is a self-prescribed prison for your pains. I would suggest dieing at home would be a lot better option than getting new germs at the hospital. A larger part of the problem is that the doctors and staff are not efficient enough. I have noticed they waste a lot of time.

    While everyone is blaming the ER no one is suggesting any solution.I strongly encourage people to come forward with a definite solution for the non- Emergency patients.

    Do we have a system where a non-ER patient can go? The answer is NO?

    We simply need another department for non-ER patients where they can go after hours. Another solution will be to increase the number of after hours clinics and extending the clinic hours to at least 9:00 pm. As far the shortage of doctors is concerned,the govt needs to do something serious to put the large number of Taxi-driving Doctors in Toronto and elsewhere into their real job.

  4. Posted by: on Jan 17, 2008 @ 8:20pm

    "Do we have a system where a non-ER patient can go? The answer is NO?"

    There are places actually, they're called "Urgent Care Centre". It's like a notch above a walk-in clinic but not as equiped as an emergency room. They're quite good, I had an unexplained fever for 4 days, the whole process took 2 hours (from walk in to walk out) which included 3 various blood tests.

    Suffice to say, the 'general' consensus is that Guelph General blows...hard. I've heard most people who live in Guelph actually just trek it out to Kitchener/Waterloo for any hospital care. I've have both good and bad experiences at Guelph General so it's hard to say where I stand with Guelph and it's health care.

    As for the taxi driving doctors, it's hard to believe but Canadian doctors are often better trained than those abroad. Knowing some international students/immigrants, it's kinda concerning how easy it is to get into med school is for some countries.

  5. Posted by: Josh Dehaas on Jan 17, 2008 @ 8:38pm

    Bob. Cool article.

    Alex, the doctors who are allowed to practice in Canada are poached almost entirely from Africa, which is clearly no better at training doctors than we are.

    The real problem with the number of doctors is that socialized medicine prevents them from being trained since if the government were to allow for more doctors, they would have to find money to pay them. That's why the number in medical schools is half what it should be to meet the demand.

  6. Posted by: on Jan 17, 2008 @ 9:29pm

    Really? From what I'm finding it's Iran, then India, then Pakistan.

  7. Posted by: AAD on Jan 26, 2008 @ 10:16am

    My mom had knee replacement surgery in Guelph General and her care was excellent. And the idea of people treking to K/W seems kind of bizarre to me given Grand River Hospital has had much bigger problems with staffing than GG. I think a lot of good points have been made here, but we still have a long way to go. Curing our healthcare ills (pun intended) will require a multi-level solution, not a single, quick cure all. Still, I wish blowhards like Giuliani and McCain and Hannity et al would limit themselves to only talking about things they know about, which aren't many anyway.

  8. Posted by: Jonathon on Jan 26, 2008 @ 12:26pm

    Think your situation is bad? My father has terminal heart desiese, last time he was in the hospital he waited, untreated, in the ER with a heart rate of "Out of range high" (his heat was beating faster then the equipment could register) for 48 hours. I know this because I sat with him. Then when he got in the care in the hospital was so bad that he had to have a family member sitting with him 24/7 to ensure he had anything approaching decent care.

    Mind you, not like our goverment actually wants to spend the money to fix the system, ya I'm bitter.

  9. Posted by: on Jan 27, 2008 @ 3:01am

    two tier, two tier, two tier...

    thats all i gotta say.

    oh and check out this book.
    http://www.amazon.com/Code-Blue-Reviving-Canadas-Health/dp/1550223933

  10. Posted by: Kevin on Feb 7, 2008 @ 2:15am

    When I shattered my knee, I was taken to hospital in an ambulance and with the exception of the x-ray tech being a bitch (no I can't roll over, it's broken) everyone was really good. I think they had me out of my remaining hockey equipment, x-rayed and in bed in about an hour.

    Within 12 hours of the accident, I was under the knife for reconstructive surgery. Not too shabby.

    Honestly, the worst part was the shoddy work and care of the Guelph First Response team. Never, ever call them if you have a medical problem, call 911 directly. They resisted telling me my actual injuries and never got in touch with my family or housemates though they promised they would. I had to call them myself 2 hours before surgery with a double dose of morphine in me.

  11. Posted by: Linda on Feb 13, 2008 @ 2:28pm

    My Family Physician suddenly passed away Jan 02/08. The last time I was there I was told by a certain dr. in the Emerg. Dept. that the dr.'s will no longer give out prescriptions to the late doctors chronic pain patients. We rely on this meds. for our chronic pain. I mentioned no dr's are taking on new patients, I have no vehicle to go out of town at present. The dr. said that it was not their problem & that I should have found a doctor by now. Maybe some of these doctors should re-read the Canadian Medical Association's "Code of Ethics." I realize I need to find a dr. but the dr.'s could have given us a little more time, under the circumstances. Other past issues I've dealt at that hospital are being mis-diagnosed, rudeness, abuse, just to name a few. A hospital is for caring for people. In my opinion their are few people in that hospital that know the meaning of the word. If nothing changes nothing changes. We need to have more people come forward & make more noise. I know that there are cut backs in the health system, but that does not justify on how patients are mis-treated and abused. If nothing changes, nothing changes & something definitely needs to change.

  12. Posted by: Maggie Robertson on Jul 31, 2008 @ 8:38pm

    As I completely understand your woes, I do also sympathise with the hospital's staff. I have had serious and not-so-serious ailments that I've had to wait for long amounts of time for treatment. I understand the problems, but see no real solutions. We have a deficit of doctors and nurses, a lack of funding, and no government that cares enough about the problem. I think that we are better off than the United States, though, because we've had the mind to create programs such as OHIP. This has been able to allieviate some of the funding problems because there aren't diliquent payments.

    In order for all of the problems to be allieviated, we need more General Practioners that can take the common colds and flus. This will, in turn, lessen the line-up at triage.

    All in all, it is not the fault of the individual hospital, it is the fault of the government itself. More steps need to be taken to ensure that General Practioners are available to everyone.

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