Sometimes I get sick of hearing about the ‘good ol’ days’– when homes were affordable, people were friendlier, milk tasted like milk (as opposed to some whitish water)— and how life may have been a little bit better?
Certainly, I’m not one to bicker about they way things were and how tough everything is now, but I certainly have developed a respect for both traditions and learning how to do things fundamentally correctly– without the addition of all the new gizmo’s that alway’s promise to improve on the way things were done yesterday.
I began having a hankering for nostalgia after I read an article a colleague emailed me from England, “Why in the 21st century, are NHS patients dying in agony from bedsores?” The article readily references a new book on the British healthcare system, by Michael Mandelstam, “How We Treat The Sick: Neglect And Abuse In Our Health Services.”
Reading though the article and book references within the article, it appears that both authors blame modern developments in our healthcare system for the systematic increases in bedsores and other medical complications that are acquired by patients during their admissions to hospitals and nursing homes.
In particular, the writers cite the lack of continuity of care from all types of hospital staff, nurses, orderlies, and doctors as one of the main reasons we are seeing the modern day bedsore epidemic at many medical facilities.
In the good ol days, nurses and doctors were assigned particular patients whom they typically cared for during their entire admission or stay. While caring for the same patients day-in and day-out must have help ease patient nerves, it also encouraged the staff to care for patients with a sense of pride! After all, would anyone want their professionalism questioned when a patient developed a bedsore– due to their inattentive care?
As Dr. Matin Scurr sums up the current situation:
I’ve written before about the lack of continuity of care as a result of destroying the ‘firm’– a paitent used to be assisnged to one firm (or team) of medics. The firm comprised one or two house offices (recently graduated doctors), the senior house officers, registrars and, at the top of the hierarchy, the consultant.
This firm ensured continuty of patient care. But the firm is no more. No patient care has become like a high-risk version of pass-the-parcel — patients are simply handled from doctor to doctor with notes in a folder and no one following them through.
I couldn’t agree more with Dr. Scurr’s assessment! Particularly as evidenced by the development of bedsores during hospitalization or nursing home stay, it is important to remember their development is really a sign of systematic neglect— as opposed to the inadequate care of a few caregivers.
While we may indeed see the development of other types hospital-acquired complications (medication errors, dropped patients, ect.) derive from a situation involving an individuals poor judgment, bedsores are really emblematic of systematic neglect. Even in the most fragile patients, bedsores– particularly advanced wounds (stage 4 bedsores) develop over periods of days and weeks.
When evaluated as a progressive condition, it usually becomes apparent that not only was the staff not doing their job in terms of bedsore prevention— but perhaps equally importantly– staff may not have been implementing the necessary medical treatments as the wound progressed.
I can only imagine that forcing a personal accountability issue medical staff would lead to situations where patient care would inherently improve– both out of the staff’s personal pride and perhaps– fear over personal responsibility over their visibly inadequate care. Indeed, perhaps its time we take a page from the past and acknowledge seemingly improved efficiencies doesn’t translate to better patient care.