the saga of hallway health care


(This is part 1 of 2 about British Columbia’s hospital overcrowding problem).

Last month, my husband was discharged after six days as an inpatient in the hospital.  I’ve been reflecting on that entire experience from my vantage point as the wife of a patient.  What has struck me was the difference in the culture of the two inpatient units he was on (which I wrote about here) and the fact that my husband spent ten hours on a stretcher in the corridor of a nursing unit as the recipient of hallway health care.

My husband was lucky.  Although he was very sick, he had something that was easily fixed with a procedure and went home a few days after he was admitted.  The problem of patients lined up on stretchers in the hallways?  There is no procedure to easily fix this problem.

My husband started his hospital experience in Emergency and was moved around a number of times there as he waited to be admitted to a bed on the nursing unit.  He texted me early in the morning to say:  ‘I got moved to the nursing unit’  I responded:  ‘What room?’  His text back: ‘I’m not in a room.  I’m in the hallway.’  What?

I’ve come to expect to see patients in the hallways in Emergency.  In fact, in some busy Vancouver emergencies, people are lying all over the floor in the waiting room.  But admitting a patient to the corridor on an inpatient unit?  This was news to me.

Sure enough, I arrived at the hospital that morning and there was my husband, lying on a stretcher in the middle of a crowded surgical nursing unit.  By some act of mercy, he was hidden from public view by privacy screens on wheels.  But the hallway was so narrow and so busy, every time another stretcher or large piece of equipment went by, I had to push the privacy screens to the side so they could get past. There was my sick husband, just lying there on a stretcher in the middle of the hallway, exposed to all the world.

I’ll pause here to say that he tells me he didn’t care about lying in the hallway because he was on heavy-duty pain medication.  In fact, he didn’t really care about much of anything at that point.  But I cared.  I cared because I love him and wanted to spare him at least a shred of dignity.

There was absolutely no privacy afforded in this whole hallway set-up.  There was no peace either – this was a hopping inpatient unit, noisy with staff, physicians, families and patients.

Worse, there were other patients lined up in the hallways, too, most of them elderly.  I was reminded of my own beloved grandparents and thought:  All these years on this earth and this is the treatment these older people get from our health care system?  This is so shameful.

Maybe even worse:  There was absolutely no extra room for the nurses to administer their care to patients who were in the hallway.  My husband’s nurse was apologetic about the situation and I felt for her. I’m sure she dealt with angry hallway patients all the time and that nurses were the ones who bore the brunt of patient frustration.  She also had no space in which to work.  I cannot believe for a second that hallway medicine does not have negative effects on patient safety.

And the worst thing of all?  Patients in the hallways of nursing units is now such a common practice that it has been normalized.  These patients are called ‘flow patients’ and there are numbers up on the wall to indicate where they should be parked.  My husband was Flow Patient #5.

Someone asked me:  Why didn’t you advocate for your husband and demand he get a bed in a room?  Well, that would mean that he would force someone out of their bed and into the hallway, wouldn’t it?  That wouldn’t be ok.  Instead, I politely inquired if there was a chance he would get moved to an actual room and I was told they were working on it.  This information settled me down and sure enough, about ten hours later, my husband was moved to a four bed room.

This hallway business was but a blip in his stay, but I still don’t think that this practice reflects well on our health care system. I think to myself:  Would a senior bureaucrat with the ministry of health be relegated to be a flow patient?  I have no evidence of VIP treatment in the Canadian health system – I think all Canadians would get the same equitable – yet shoddy – hallway treatment.  But if someone with influence and power was parked in a nursing unit hallway, I wonder if this practice would be allowed to continue.

Sometimes I think: Why aren’t all of us patients and their families marching in the streets?  And then I remember that patients and families are too sick and exhausted to march in the streets.  So the hallway health care continues.

Please remember that health care is an issue when it comes time to vote in our upcoming federal election.  This is not a uniquely Canadian situation and it happens in other countries too.  Telling the truth about experiences in health care in Canada will not take away our medicare. It will not turn us into an American system.  Nor will telling the truth about Canada  prevent Americans from adopting a more universal health system.

Is the answer to hallway medicine to build new hospitals with more beds?  You might be surprised but I think that more hospital beds is not the answer.  The answer is much more complicated than simply building a new hospital, which to me, is a really expensive bandaid that costs over a billion dollars.  

To be continued in Part 2…




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