A tale of two hospitals

During my recent fun* time with pancreatitis, I spent an extended period in Armidale and Tamworth hospitals. And while I write about hospitals and health all the time, there’s something really educational about spending an extended period in the wards.

This was actually this first time I’d ever been admitted to Armidale or Tamworth. While I am a frequent flyer to emergency, and have had many long stays in hospital, in the dark days of my migraine journey I was in Sydney because I needed access to specialist neurologists. So I’ve done long stays in Prince of Wales, Royal North Shore, and Level 7 of St Vincent’s in Darlinghurst was like a second home for years… but here, I’d never gotten past emergency as a patient.

I started collecting and cataloging all kinds of potential stories during my stay. The airconditioning that was turning half the surgical ward into an oven was the first one, replete with management and Hunter New England Health’s media unit denying there was an issue while their staff stood there with sweat dripping down their face, apologising and offering small desk fans as some relief for sweltering patients.

The second story begging to be told was the insane hours staff in Armidale were doing. Multiple nurses and doctors doing double shifts, not having days off, and doing it all with a smile despite the obvious fatigue. It’s a story I can’t tell without getting good people into trouble, because of course they aren’t really allowed to talk to media.

The third I’ve already had a vent on – the delay and frustration of having to wait days for a simple MRI scan. I’m not done with that.

More striking (once I’d gotten over the initial outrage fuelled by my own health fears and out of the sauna-like heat of the broken aircon situation) was the resignation of the incredibly dedicated and capable staff in Armidale that this was what they did.

They just coped.

I watched RN’s scrub toilets, doctors making friendly conversation to distract worried patients, AINs and medical students step up to do anything they could to help. Never complaining, never making a fuss, despite every bed being full and the pressure being enormous. They didn’t have the resources, the equipment, or the staff, but they made up for it with an abundance of care and professionalism. They just got on with it.

Even when the snow hit and so many staff couldn’t get in, they made do. Every patient was cared for.

The reason that was most striking was the contrast with Tamworth.

I think we have a ‘grass is greener’ thing with bigger hospitals, and there is no doubt that Tamworth gets a lot of bells and whistles in terms of facilities and equipment, while the rest of us are just expected to schlepp to Tamworth should we need more than a couple of stitches.

But in a total flip from the amazing staff in Armidale doing the best with what they had, it was clear the staff in Tamworth did not appreciate their nice new facilities and equipment, nor each other.

From the moment I was installed in a bed in emergency at Tamworth, the toxicity in the Tamworth Hospital was obvious. It started with listening to staff bitch about how I shouldn’t be there but surgery wouldn’t take me because it was too late, and then continue to complain non-stop about other staff, management, policy, paperwork, or this or that not being good enough all through the night.

When I did get taken up to the ward in the morning, there was a really obvious lack of care in the very new building. Scuff marks and other damage to the walls and floors, staff dropping (and in one case throwing) equipment, stacks of equipment cluttering halls, through to the cleaners who couldn’t really be stuffed cleaning.

Some of the nurses were ok, but there was none of the friendly banter and reassuring confidence of Armidale. Like their colleagues in emergency, there was quite a bit of grumbling – one spent quite some time complaining about having to work a whole 40 hours in a week, while another pair complained to each other about a hospital policy they didn’t like. And while one does not want to mention the R word without significant evidence, there was a really unusual grouping of nurses by ethnicities that I noted a couple of times.

It was almost a relief that I was largely ignored and forgotten about. It probably went a bit far when I didn’t get fed for a day and a half because of some system issue… although I didn’t mind because the food in Tamworth was awful. Except for the salads and sandwiches I nicked from the leftovers (which were fine once I picked off the bits I couldn’t eat – allergies suck), literally everything cooked was microwaved, inedible bleugh. Compare the pair, if you dare – I was served a pork meal without ordering it (I don’t eat pork) in both locations, Armidale was restaurant quality right down to the parsley garnish, Tamworth’s frozen budget special was… well I’m not really sure what that was.

I will say the lady from the kitchen who came to sort out why I wasn’t getting my meals in Tamworth was great, and clearly not appreciated. But my lack of food was not the only obvious, glaring issue in basic standards of care. I had to ask for two days for a clean set of sheets. I had to go hunting for bottles of water. I basically looked after myself.

I didn’t meet the surgeon until just before going in to surgery while talking to the anaesthetist, and I was given no post-op instructions. Most confronting, mere hours after surgery, I was told I was being discharged and would need to make my own way back to Armidale. When I said that wasn’t really feasible, so sorry I don’t have a husband to summon to come get me, I was told “the best we can do is assist you to the train station”.

Couldn’t. Care. Less. Well, except about getting me out of there, they cared about that.

After I protested for a couple of days I was clearly still not well and not keen on trying my luck on the train given I couldn’t sit up for any length of time without significant pain, I got bumped to a crowded, noisy, overflow ward, full of people from anywhere but Tamworth. Most of them distressed, most without the support of loved ones. And the staff in this ward also didn’t care and also clearly didn’t like each other.

I finally got a patient transfer back to Armidale. Back up the rickety tiny lift that is desperately due for replacement, and installed back in the bed behind old cloth curtains that don’t actually provide full privacy, I was again greeted by the warm and wonderful staff – a couple of them just sticking their head in my room on hearing I was back to see if I was still the wonderful shade of yellow that I was when I left. And they weren’t discharging me until they ran another set of bloods, checked a few more things, walked me through my discharge paperwork, gave me scripts for painkillers and nausea medication, and gave me clear instructions on what to do next.

Weeks later, I’m still not well. I’m not sure why, but I am pretty sure that the week long delay before surgery, the transfers between hospitals, and the stress of it all – particularly the stress of trying to figure out how to safely get myself back to Armidale – might have something to do with it.

It was definitely an educational couple of weeks – and a reminder that pretty buildings don’t guarantee good care, but centralising health resources does guarantee an increase in bad health outcomes.

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