A nurse friend is starting up a new patient advocate service in Australia. It is her first job after having been sacked by her hospital for asking questions about the safety of the covid vaccine, as part of her role as occupational health and safety officer. She was sacked with the label ‘incompetent’.
Four years later she is still bitter.
So why start a service for lost patients?
The line between Doctors and patients, nurses and patients is a very fine one. The hospital bed is. Only a thin line between the suddenly sick and powerless and the currently well and in control.
Both sides realize that this could easily happen to either of them.
Why do people in hospital need an advocate service?
Hospitals are like a cross between a boarding school and a prison.
There are strict times, regimented routine, rotating rosters of staff who come and go and an institutional model of care.
Yes you get three meals a day, a bed to sleep in at night and some degree of care. But that’s about it.
You lose all your personal control, autonomy and rights.
The entire bureaucracy of hospitals is about patients as nameless, powerless lumps that get pulled and pushed around.
Many individuals are kind and decent. Some are not.
But the structure of hospitals is designed for centralized top down control, strict medical protocols (tick box treatments) , the care package funding models and avoiding DHS fines.
The high rates of errors that have always plagued big socialist run hospitals makes the people who work there immune to the pain that patients feel when things go wrong. There are virtually no repetitions for staff if they make errors. Side effects are easily brushed over. Fear of legal action makes everyone minimize or cover up actions and treatments that went wrong.
Many relatives and patients try other reach out for help. The stories would suprise you.
Family member told he is on palliative care and can’t drink, and given continuous morphine. He begs for food and drink, family gives it, he recovers and wants to go home. Doctors say no, he’s dying. His family reach out to a patient advocate, hear about a second medical opinion, get one, the patient is allowed fluids. He drinks, recovers, goes home and is still alive years later.
Elderly relative is given a CT with contrast to investigate a lump, possibly cancer. The junior doctor charts a drug to protect his kidneys from the dye which damages kidneys already damaged. The nurse doesn’t see the drug order on the chart. The patient doesn’t have cancer, but goes into immediate kidney failure. No dialysis beds are available for his age. A month later he dies.
A man has a large heart attack damaging part of his heart wall. The hospital tries to insert a stent. The tip of the stent inadvertently leaves the vessel and pierces the damaged heart wall. The catheter lab can’t remove it. The man goes to theatre, has an open heart procedure, the tip of the catheter is removed and his heart wall patched. He goes to ICU post op. Staff are trying to keep his blood pressure stable. They inadvertently push morphine into an IV line, not realizing it is full of adrenaline from the ambulance. His blood pressure spikes, he blows the patch, and bleeds to death.
Hospitals as Dr Marty Makary an expert in hospital errors and the need for better safety are dangerous places. We could do a lot better.
So yes, patients do need a patient advice. And who better than an experienced nurse who herself has been on the wrong side of autocratic bureaucratic hospitals?
