Poor old folks

Ugh. I’m booking into dignitas.

*Books non return flight to Switzerland for Jan 1st, 2050

Having worked in the HSE as a management consultant I can tell you that it's an absolutely money pit where nothing runs efficiently and never will. It was set up to fail and it will continue to fail in epic fashion. I now think that throwing money at the problem actually makes it worse. There is no value and it sends the wrong message. I don't ever see a day where a government is brave enough to sort it out. Too many vested interests that will block all reform and accept the status quo - Unions, bloated Management layers, Consultants, bloated Admin layers etc etc.

It needs to be abolished and re-created correctly next time with 1000s of non front line compulsory redundancies. Never happen of course.

What I never understood is why what amounts to “hostel like” accommodation in multi bed rooms is deemed to be acceptable for the old and the sick here.

I would absolutely hate to have to share space with a bunch of strangers and go from having my own home, dignity and privacy to living in some kind of weird Victorian hospital 5 to a room with bad and depressing facilities.

How is this ever acceptable?!

My mum died recently (and quite young) in a big, relatively modern public hospital and what shocked me was the lack of privacy. It was a multibed neurology ward and at one stage I was at the bedside and a man across the room was clearly being given use of a bed pan. I nearly got sick with the smell. The only ventilation was the open windows.

That and there were people who were clearly likely to die (my mum for example) sitting in beds opposite people who were very likely to recover.

When my mum died we didn’t really know what to do.
I went for a bite to eat and when I walked in and found she was dead and went rushing out to the nurse who nurse who already seemed to be vaguely aware of it.

Then a priest came in and did some kind of blessing thing.

Then we were just left there and had no idea what to do next.
Do you just stand there?

Nobody took us anywhere. There was no space to bring her. We had no idea where her body was going. We ended up kinda sitting in a corridor hugging and crying until we went home and the was still nowhere to go with the body.

You'd kind of expect maybe they'd wheel her out into a quiet space where the family could get their heads around what just happened, but no such place seemed to exist.

I had to ask staff what to do next and nobody seemed to know.

She went from totally normal breakfast to dead in 24 hours.

I have no idea what you're supposed to do. My dad was in actual shock and I was on autopilot and we ended up just going home. It felt awful as there was such a weird lack of respect to the whole thing. The hospital just went on as a big acute hospital and we felt like we were in the way.

The whole system here is a mess.

I can't pin blame on individual staff. they were all nice and friendly but there were no systems.

I’m still in shock about it tbh a few weeks later. I still get nightmares.

It’s not the staff. Individually they were doing their best and were extremely busy doing medical things. It’s an extremely busy neurological ward and people were arriving with head injuries, strokes, seizures and they were dealing with people recovering from brain surgery in other areas of the same floor.

The consultant did their absolute best to be there and talk to us when she was being treated but when she died it was like there was just nobody.

You literally need bereavement counselors on site who can immediately just step in and make sure the whole sad exit from hospital is done with dignity. It’s not even a religious thing. It’s just you need someone to be able to take you and your recently departed loved one to a calm, quiet room and coordinate making arrangements.

The undertaker was actually far, far, far more helpful than the hospital.

What I always feel in Irish hospitals is that there’s nobody coordinating anything. I’ve found this even in expensive private Irish hospitals and public hospitals. You arrive in and you’re assigned to a consultant and the hospital is just sort of working around you without anyone as a point of contact. You’d think each specialty would have a team of hospital doctors and that every patient would be assigned a GP-like person who can interface between the hospital and the patient and manage and facilitate their care, but nope - instead you’re basically left to your own devices in semi organized chaos.

It’s almost as if instead of it being a hospital, it’s one of those coworking spaces where a whole load of self employed people use facilities to work on totally independent projects. There’s never anyone to interface between the patient and the hospital. You often can’t seem to get information or find your consultant or have to resort to ringing their office on your mobile to get information.

The other big issue is the patchy nature of quality of facilities. Brand new wards are usually “ok” but anything from older eras is usually diabolical. How the hell we are still building expensive new facilities with multibed wards, over hot radiators, no HVAC systems and so on is beyond me.

There’s something very wrong with the specifications of these facilities.

EdgeCase wrote: »

.....

When my mum died we didn’t really know what to do.
I went for a bite to eat and when I walked in and found she was dead and went rushing out to the nurse who nurse who already seemed to be vaguely aware of it.

Then a priest came in and did some kind of blessing thing.

Then we were just left there and had no idea what to do next.
Do you just stand there?

Nobody took us anywhere. There was no space to bring her. We had no idea where her body was going. We ended up kinda sitting in a corridor hugging and crying until we went home and the was still nowhere to go with the body.

You'd kind of expect maybe they'd wheel her out into a quiet space where the family could get their heads around what just happened, but no such place seemed to exist.

I had to ask staff what to do next and nobody seemed to know.

She went from totally normal breakfast to dead in 24 hours.

I have no idea what you're supposed to do. My dad was in actual shock and I was on autopilot and we ended up just going home. It felt awful as there was such a weird lack of respect to the whole thing. The hospital just went on as a big acutely hospital and we felt like we were in the way.

The whole system here is a mess.

I can't pin blame on individual staff. they were all nice and friendly but there were no systems.

I’m still in shock about it tbh a few weeks later. I still get nightmares.

I am very sorry for what you and your family went through.

We had a similar experience. And while most of the staff in the ICU were very nice to our family, we were treated with contempt by the head nurse and the doctor doing the rounds. As our elderly father lay dying and had hours to live, we had to deal with confrontational staff, as more of my siblings arrived from far flung areas of the world. We were extremely respectful of the environment and the requirements of the ICU unit, but there was a complete lack of respect and dignity for my father's last hours on this earth. I have to point out again though that many of the ICU unit nurses were truly inspirational and understanding.

The HSE is a mess; it needs to be torn down and re-built again, but this time from the bottom up.

EdgeCase wrote: »

The other big issue is the patchy nature of quality of facilities. Brand new wards are usually “ok” but anything from older eras is usually diabolical. How the hell we are still building expensive new facilities with multibed wards, over hot radiators, no HVAC systems and so on is beyond me.

Have you ever heard the story of the 5 monkeys?

Start with a cage containing five monkeys. Inside the cage, hang a banana on a string and place a set of stairs under the banana. Before long, a monkey will go to the stairs and climb toward the banana.

As soon as he touches the stairs, researchers spray all the other monkeys with cold water.

After a while, another monkey makes an attempt with the same result... all the other monkeys are sprayed with cold water. Pretty soon, when another monkey tries to climb the stairs, the other monkeys will try to prevent it.

Now, put the cold water away.

Remove one monkey from the cage and replace it with a new one.

The new monkey sees the banana and attempts to climb the stairs. To his shock, all the other monkeys assault him. After another attempt and attack, he knows that if he tries to climb the stairs he will be assaulted.

Next, remove another of the original five monkeys and replace it with a new one.

The newcomer goes to the stairs and is attacked. The previous newcomer takes part in the punishment with enthusiasm, because he is now part of the "team" and has learned the rules.

Now, the monkeys that are beating him up have no idea why they were not permitted to climb the stairs. Neither do they know why they are participating in the beating of the newest monkey.

Finally, having replaced all of the original monkeys, none of the remaining monkeys will have ever been sprayed with cold water. Nevertheless, not one of the monkeys will try to climb the stairs for the banana. If they could talk, they would simply say, “We’ve always done it that way.”

So realistically, in the case of the HSE (and many others) we should just start with all new monkeys