Thursday, April 15, 2010

Hospital hygiene – it's in the details

It started with a chair.

But unlike the movie Juno, that’s where the gynecological similarities between this and that story end.

I had been admitted to Centrallasarettet (Västerås County Hospital) for a hysterectomy. A small armchair stood in the corner of the room. It was not an unattractive chair and it added a little warmth to the room. The evening before my operation I sat on it and noticed the back was broken. This is a little dangerous, I thought. If someone leans back too far they could get hurt; now I know why the chair is propped in the corner.

A day or two after the operation, my husband came to visit. He pulled the chair forward and it flopped back. Look out, I called, the chair is broken. Another time, a nurse came into the room and the chair was looking floppy. She nonchalantly propped it back into the corner. No one took it upon themselves to have it removed before someone got hurt.

(When you're stuck in a hospital bed for a week, there’s not much to do except observe - like the picture of a sweet child on the wall of a room in a ward for women facing reproductive issues such as difficult pregnancies, miscarriages, hysterectomies, and gynecological cancer. Bad choice.)

Due to challenging surgery and a complication, there were two drains and a catheter protruding from me the first couple days. Each time a nurse came into the room to check me, she’d (all my nurses were female) pick up the drains, which had fallen on the floor, saying “These shouldn’t be on the floor.” Inevitably, since hospital beds are narrow and, at first, I wasn’t even aware I had drains in me, they’d fall on the floor again and another nurse would come in and say “These shouldn’t be on the floor.” (I couldn't pick them up myself.) One nurse did pause and look to see if there was a way to fasten the drains to the bed but nothing came of it.

Soon the drains were removed, but I still had the catheter. As I began to get up and move around, I noticed dried spots of urine on the floor, where the drains had lain, and where nurses emptied the catheter. The spots were sticky-looking and dirty because each day a custodian came in and dry-mopped the floor, thereby smearing the semi-dry urine.

I felt ready for a shower. I went into the bathroom, which was shared by four patients, two per room, and their visitors. I noticed a sign above the toilet and large bottles of anti-bacterial disinfectant next to the sink. The sign said that patients, for their own safety, should clean the toilet, I assume the seat, before using. I took a quick look in the bowl. Not disgusting, but not the cleanest toilet I had ever seen. (After abdominal surgery, patients’ bodily functions are not quite what they should be.) It stayed like that for days.

As my own body recovered and I started using the toilet. At least once I slopped excess disinfectant on the sink and the floor as I was wiping the seat. I thought about the effect of this on the worldwide overuse of anti-bacterial agents, but never mind.

One afternoon there was a problem with my catheter. As I lay in bed and the staff attended me, they put used tubing and instruments on my bedside table. When they were done, they took everything away, but no one wiped down the table, which was also used for food and medication. When they had left, I got up and did a little cleaning. Thank goodness for that disinfectant in the bathroom!

At meal time, staff would bang on a pot lid - like farmers summoning pigs to the trough or, more kindly, troop leaders rounding up kids at scout camp - to let patients know the food cart had arrived. There was also a coffee cart in the corridor where patients could get a light snack and something to drink during the day. When I was able to walk, I got up for coffee. The floor in front of the cart was splattered with coffee and juice.

One day as I sat in the patient lounge, I smelled something - it was the custodian’s mop as she casually made her way down the corridor.

I’m sure the chair is still there.

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