Open Writing

The headlines in the newspaper entreat us to contact the government
urgently, articles and letters appear daily and, yes, we have written to the
Minister of Health. Why? Moves are afoot to cut back on government
spending and they are targeting health, education and pensions.

Dunedin is the Edinburgh of the south. Our medical school is the best in
the country and ranks highly with others in the rest of the world and we
have a first rate teaching hospital attached to the medical school. Yet the
government wants to close neurosurgery in Dunedin and centralize
everything in Christchurch which doesn’t have a medical school and is
hours away, (remember the “golden hour.”)

We are situated close to the main ski areas, climbing routes and tramping
tracks, the sorts of places where accidents happen and neurosurgeons are
needed. My husband owes his life to the neurosurgery department in
Dunedin, after a climbing accident many years ago. The helicopter on the
pad on top of the hospital is manned by paramedics, well trained to
operate in hazardous conditions, capable of being winched down to the
most inaccessible places. Twenty minutes can see you back at the hospital
where the highly trained neurosurgeons and nurses will be waiting for you
in the operating theatre. So we rant and rave at the government and the
hospital board goes ahead on its own initiative and appoints two new
neurosurgeons to replace the two who are retiring. Yes it is a well
equipped hospital with highly qualified staff.

A little while ago the paramedics arrived to cart me off to hospital in a
great rush. They were excellent. Hooked me up to this and that and
wheeled me into the ambulance. As we left the motorway to enter
Dunedin, traffic control echoed on the radio, “lights all at green through to
the hospital,” this was an emergency. I was wheeled by my friendly
paramedics through to triage, passing the rows of waiting patients, waiting
time could be hours for non-urgent cases. The doctors and nurses rallied
round, doing what they had to do to stabilize me and collect their samples.

Then I was left in a room all alone to await the arrival of the surgical team.
No-one could be admitted to the wards without the hierarchy’s permission.
So I lay there watching the screen I was hooked up to blinking away and
waiting for my husband to arrive.

I looked around and saw a very dirty ceiling, a dirty hand basin, no soap
dispenser or paper towels and overflowing litter bins and a general air of
neglect and uncleanliness. This was our “State of the Art” hospital, the
pride of the south when it was opened. Hubby arrived and went to the
washroom and said, “Don’t go there it is filthy.” I couldn’t go anywhere,
hooked up as I was to this and that. Granted it was Sunday and Saturday
nights are notorious for dealing with the results of drink driving accidents
and the mayhem of parties which get out of hand through alcohol and
drugs. Sunday was not a good day for staff who had probably been on
duty for most of the night and the contract cleaners don’t work at
weekends. But the state of the place had not been created in one weekend,
this was the result of months of neglect and slipshod, lazy cleaning.
Somebody was not doing a good job and what is more no one was
complaining about standards. Not good enough.

My mind wandered back to the first time I had been admitted to Dunedin
hospital, nearly thirty years ago. I was to undergo some major surgery.
The new hospital had not yet been completed so I was in the old part. In
those days nurses were not trained at Polytech, emerging with their
degrees and diplomas to be let loose on the wards, they were trained on
the ward floor, under Sister’s eagle eye. The trainees kept everything spic
and span, the smell of disinfectant lingered in the air and the
old-fashioned bathroom was spotless.

Nurses reassured you and chatted to you as they checked your temperature
and blood pressure and adjusted your drips etc. The lockers were wiped
down regularly, your water carafe was kept full and litter bag changed. As
you came out of theatre the curtained off area, under Sister’s observation,
gave you the extra care you needed and, as you improved, you moved
further down the ward and chatted to others who were in the same boat as
you, they had this or that symptom, so had you, so all was well with the
world. The consultant with his army of registrars and students made his
rounds at a set time each day. Visiting time was for two hours in the
afternoon and two hours at night, giving sick people a chance to rest and
recover. The place may have been archaic and old but it was spotless, the
nurses were on their toes and every patient was under a watchful eye from
Sister’s office.

The new hospital opened with great celebrations, everything gleaming,
carpets in the foyers and corridors and four bed rooms, with ensuite, well
out of sight of the “Nurses’ station,” so the patients could not be seen.
Contract cleaners were employed as Polytech nurses didn’t clean, they had
by-passed that bit, and visiting hours and numbers went by the board,
hordes of folk, young children included, might crowd around one bed,
while in the next a very sick person might crave peace and quiet, and
gradually the dirt and germs crept in.

Superbug and Norovirus appeared. Armed guards were put on the doors to
keep out all but essential personnel and, surprise, surprise, the place was
cleaned from top to bottom and sterilizing solutions were placed by all
doors to be used when entering or leaving. Were we, or should I say they,
learning that Florence Nightingale had a point and cleanliness was next to
godliness. No, the panic is over and the old dirty, scruffy conditions return.

The doctors and nurses are hardworking, highly skilled and conscientious
but the nurses can’t see the patients and often don’t answer calls from
bells and visitors wander in and out, whenever they like.

Yes, we have a brilliant teaching hospital capable of the most intricate
surgery but the skill in saving lives could be undermined by the failure of
commonsense hygiene and more consideration for the patient’s post
operative need for rest and recuperation. Come back Florence Nightingale,
we need your iron hand.