I was urged by friends to tell my story as people should know, but wanted to wait until I was sure I no longer needed the care of Addington Hospital as I feared some kind of retribution.
MY STORY
I am fortunate that so far in my life I have been privileged enough to mostly experience private medical treatment and healthcare. I know that I am in a small minority compared to the vast majority of South Africans who have no choice but to go to Government clinics and hospitals.
I am blessed indeed and I know that the experience I have just undergone pales into insignificance next to what most people have to go through, but I am angry enough to want to share my experience...Angry not for myself but for others, the thousands of South Africans who firstly have no choice as I do most have and who also have no voice. Again, I do have a voice. Angry because I am a nurse myself and find no excuse for the poor quality of nursing I was exposed to, Angry at the fact that obviously the millions of rands of tax payer’s money that is poured into government hospitals every year is obviously not making its way to where it is needed.I am mostly angry at the total lack of caring and compassion which seems to follow all the way from top directors’ right down to the ward staff.
Eight weeks ago on Tuesday 16th July, I had a nasty fall at the Gateway shopping centre and having injured my right arm was rushed to Umhlanga Rocks Hospital. I received immediate care in the trauma unit, was put onto a drip for pain and had an x-ray taken where it was established that I had sustained a displaced fracture to my right upper arm (humerus). According to the doctor on duty I would require a surgical repair of the fracture.
This was when my bubble burst. I was unemployed waiting to move to the UK and thus on no medical aid. With limited funds available I would not have been able to afford the private hospital fees.
I am blessed that I “know” people, I do not want to say how or who, but someone phoned someone, who phoned someone, and the next morning (Wednesday) bright and early having been strapped up the night before as best they could by the team at Umhlanga, I was at the Addington Hospital orthopaedic outpatient clinic to see an orthopaedic surgeon who had apparently just returned from spending time working in the in the UK. I was told that I could not wish for a better surgeon and that proved to be the case. In fact, the orthopaedic medical team and the theatre team that attended to me were superb and I have no complaints. I was told that the break ( just above the elbow ) was a bad one and that I would need to have a humeral nail inserted down the shaft of the bone to hold the two fracture ends together as they would not align themselves. This nail is embedded in my humerus for life now.
I was put to the top of the following morning’s theatre list which I was warned might not endear me to some people, I was also told that as I was a nurse myself, and had a good support structure that I need not be admitted straight away but could report back for my op the next day and that if I handled the surgery well, I would only have to be in hospital overnight, as it was felt I would not thrive if I had to stay in the ward longer. I was myself also well aware that I would probably face some racial animosity as well so I was prepared for this.
I had to find my way myself around Addington to have a chest x-ray taken, bloods drawn and an ECG taken in preparation for theatre the next day. Nothing is in one place and no assistance was offered to help me make my way from one place to another. Thank goodness I was accompanied by my good friend who helped me as best she could.
The next morning (Thursday) bright and early, having spent 36 hours trying to manage the pain of my arm with the assistance of meds supplied to me by Umhlanga and by moving as little as I could, I reported to the orthopaedic theatre ward of Wentworth Hospital. Yes that’s right, Wentworth not Addington. The Addington theatres were apparently in such a bad shape that my surgeon refused to operate there fearing for the health of his patients.
At Wentworth we got lost as there is no adequate signposting and when we finally managed to find our way to the duty room of the orthopaedic ward, I was pointed to the ward and told to find a bed. My friend and I claimed the only bed in the ward that had a bench so that she could sit with me until I went to theatre. The bed was covered by a grubby torn fitted sheet and nothing else, no pillows, no covers, nothing.... so I opted to rather sit on the bench with my friend until they came to prep me for theatre.
The theatre staff and anaesthetist were very nice to me and behaved much as they should, likewise the recovery room staff when I awoke after the op. I was vomiting from the anaesthetic so they gave me a kidney bowl before wheeling me back to the ward. In between bouts of nausea, I slept. I can remember my friend coming back to check on me, but I can remember no nursing contact at all, not until the ambulance came to transfer me back to Addington ( my actual hospital). The ambulance guys were friendly but they didn’t strap me into my stretcher, so I spent the very fast hellish trip between Wentworth and Addington alternating between holding on for dear life to the side of the ambulance and retching into my kidney bowl with only my left hand as my right arm was in a sling which was strapped very tightly against my body with bandages. Oh did I mention that my left hand also had a drip in it?
When we arrived in the orthopaedic ward, there were no nurses to help move me over from the stretcher to the ward bed (said bed with covers folded back at the very bottom of the bed, and with only one plastic covered pillow which had no pillow slip), so I had to try and manoeuvre myself onto the bed with the use of only the hand which contained the drip, so the position I landed on the bed in was the position in which I lay. The ambulance staff put my drip on the stand, pulled the bed sides up and left. Fortunately, I had taken my little pink donut aeroplane cushion as well as an oblong wheat pillow into hospital with me, so I managed to put the donut under my head and the wheat bag ( thin from being washed) over my eyes. (It’s how I manage to sleep)
I lay there as I was so sick, by this time with dry retching only for about an hour until a nurse appeared and gave me an injection for the nausea. Nobody did observations when I arrived in the ward, no nursing staff had prior to the injection checked up on me at all.
About half an hour after the injection, a nurse came into the ward to do observations. She wanted to take my blood pressure but seemed confused as to how to do this as I only had the one arm available and this contained the drip. I took this opportunity to tell her that my drip had tissued. (Was no longer in the veins but was leaking into the surround cells). She argued and said it hadn’t. She tried various methods to get the drip going and then just walked off. About 15 minutes later when the drip (needle still in my arm) began dripping fluid onto the bed sheet under my arm, I asked one of my fellow patients to call the nursing staff for me. The same nurse came and obviously annoyed, removed the drip from my arm very roughly, slapped a plaster on the site, stormed off and that was that! No conversation during this process I might add.
Soon after this, supper was served. Supper ... well what can I say about supper? Meals are served in polystyrene boxes like take away boxes. My supper box was slapped down on my over-bed trolley which was pushed towards me, where I was lying flat on my back, one single pillow beneath my hips where it had been since I had been moved over onto the bed from the ambulance stretcher. Supper was some kind of bloated large anaemic looking boiled sausage, much like an oversized Vienna on a bed of pink splodge. As I was still recovering from the post anaesthetic nausea I pushed it to one side. A ward assistant came around with the coffee / tea tray, but I was not offered any.
A little while later a group of people came in, they were a British family who were doing their 67 minutes for Nelson Mandela day (Ironic it seemed to me that these people were more caring than the nursing staff on this very special day). They were going to each patient, praying for them and offering each patient a little handful of soft toffees. I gratefully accepted the prayers and the toffees.
My throat was obviously sore from the theatre intubation and the vomiting as well as being excruciatingly dry. I had no water jug, so tried very gradually to produce some saliva by sucking on a small piece of toffee. Eventually this worked and I was able to swallow a teeny bit.
I was bursting to use the loo, so managed to pull myself up with my one very sore hand, and manoeuvre myself around the cot sides and off my bed. I grabbed my toilet bag and tottered off to the loo. I am not sure how I did not fall or hurt myself, but I managed the loo and also managed with my one hand to wet my flannel and give my face a bit of a wash which made me feel a little more human.
When I got back to my bed, I managed to unfold the covers from the bottom of the bed so that I could pull them up once I was in the bed. I also managed to pull the plastic covered pillow up so that I could use it if needed. I then clambered back onto my bed myself. During this whole process, I did not catch sight of one single solitary nurse.
My fellow patients seeing that I was a little bit more compos mentis asked me a bit about myself and what I had done, and the one lady even leant me her charger to charge my cell phone, which she warmed me I should not let out of my sight. What I then observed was patients helping other patients, not nurses helping patients and this seemed to be the pattern for the rest of my very brief stay. My fellow patients were mostly the victims of taxi accidents, some with really terrible injuries, but those who were less injured were helping the more seriously injured patients, even to the point of getting them into wheelchairs and to the toilets and bathrooms etc.
Just before lights out, the nursing staff came to do another round of observations and to hand out medicines. I was given a pain injection, lights were put out and off we went to sleep.
Halfway during the night the air-conditioning tripped and was off until the next morning, it was swelteringly hot and I was lying on a plastic covered pillow with no pillowslip. In the early hours of the morning, they brought in an old lady, I think from the streets, and she woke the whole ward with her blood curdling screams and her attempts to run away as in her drunken state she thought the staff were trying to kill her. This strangely enough was the one highlight for me and very funny as it brought back memories of when I was a nurse and had to deal with similar patients, never an easy task I assure you.
The next morning when the day staff came on duty, the sisters all moved as a group from one end of the ward to the other singing gospel songs in their very beautiful Zulu voices. This was an absolute joy to behold. Such a pity it was the only time I saw the sisters in the wards before I left.
I got up again to go to the loo, when I got back the nurses were straightening the beds and I asked them if the could put a pillowslip on my pillow. They didn’t have any so they wrapped it in a bunny sheet and then they left. What they had omitted to do was raise my bed again, and with my sore arm strapped to my body I was loathe to lie down flat so I tried to ring my bell ... it wasn’t working needless to say. So I sat for a while on the edge of my bed, but eventually I got up, walked to the duty room, where all the sisters seemed to be congregated chatting to each other. I asked them if someone could please come and raise the back of my bed as I could not do this myself. One of them got up very reluctantly, walked into the passage, yelled something in Zulu and then went and sat down again. I walked back to my bed and soon afterwards a nurse came and raised my bed for me.
Then breakfast arrived..... During the course of the night, I had eked out the toffees that had been given to me, but I was starving and eager for my breakfast as I had not eaten for almost 36 hours. This time I got given two polystyrene containers, one with a similar sort of sausage and splodge as the night before, and the other a tub containing pre-mixed soggy cornflakes and milk. I decided that I would have to eat something and the cornflakes seemed the better option. It was only then that I realised something... there was no cutlery. I asked the lady in the bed next to me and she laughed. Apparently cutlery is not supplied, and if you don’t supply your own you have to use your fingers. A few of my fellow patients were sharing a plastic spoon but I was not about to go there, so I ate my soggy cornflakes by using my fingers to squeeze the milk out of them and fork them into my mouth.
When the lady with the tea trolley came around, I asked her for water and she brought me a jug and a glass, which were most welcome.
Nobody had come to me since the night before to ask how either my nausea or pain were doing, so when the staff nurse did her rounds with the medicine trolley I asked her for something for pain and was given two panado.
A short while after observations, and assistant nurse came to take me to x-rays for a follow up. I asked her how we were to go to x-rays (four floors down and along a long passage) and she said we were to walk. I put my foot down and refused point blank as I felt I was far too weak to make it all the way, so I asked for a wheelchair. Off the nurse went and came back with one of the sisters who asked me what my problem was. I explained to her and she looked me up and down and said “funny you had no problem walking to the duty room just now to ask for your bed to be raised”. I said nothing but just looked at her. She barked something at the assistant who went off and came back with a squonky squeaky wheelchair that only had one foot support, but it was better than nothing.
Shortly after I arrived back in the ward, the attending doctors did their rounds and I was discharged.... told I could go after I had received my TTO’s ( to take outs – your take home medicines) which consisted of a bottle of panado and my appointment card for my next visit to the outpatients. I phoned my friend who was there as soon as possible and I left, very grateful I might add to be out of there. I was told I had to report back in two weeks time to have my stitches removed, but my doctor told me that if my dressings became too messy I could have those changed a week after the op. ( I had four incisions down the length of my arm)
A week later I went to my own GP to have my dressings changed, and he asked me what pain medication I had been given and when I said only panado and that I had been trying to eke out the pain tablets given to me at Umhlanga, he gave me a script for an anti-inflammatory and something mild to help me sleep if needed.
The following week I went back to the orthopaedic clinic to have my check up. This was another long process with me having to move from department to department in this vast hospital, first to pay my fee (admittedly a scant R20) then to retrieve my file, then to have a follow up x-ray and back to the OPD clinic to see the doctors. After I had seen the doctors and received strict instructions that although I was not in a cast because of my operation sites, and was in a broad arm sling, I should treat my arm as though it was in a cast and not move it at all for the next four weeks, giving the very fragile wound time to stabilize a bit. MY surgeon told me that the fracture was far worse than the x-ray had shown and that he had very little bone to work with and that I needed to take the utmost care.
After this I was directed to the dressing room to have my stitches removed. Only one nurse in the dressing room and she was exceptionally busy, so she kind of lined us up and had two or three patients in the room at any given time.
I had four sites with stitches, one on the top of my shoulder, one about five centimetres down, and two in the crook of my elbow. When it came to my turn, I cannot remember if she was or cleaned her hands beforehand, but she did not put gloves on. I remember she had these short stubby broken finger nails with chipped red nail varnish. She opened up a dressing pack, removed my dressings, swabbed my wounds with preptic swabs (the little alcohol swabs used when injections are given) and proceeded to remove my stitches with.... wait for it ... a scalpel blade and her own stubby short nailed fingers. No stitch scissors and no forceps. The two upper wounds went OK but the two in my elbow presented a problem as I could not straighten my arm ( which she tried to do ) so as she could barely get her fingers to grip the tiny stitches, she tried to hook them out with the scalpel blade, cutting my arm in the process and drawing blood. Eventually she said she had all the stitches out, swabbed my wounds again and applied Vaseline gauze and dressings. It was only a couple of days later when I re-dressed my wounds myself, that I realised she had left a couple of suture filaments in the wounds in my elbow. I was most definitely not going back to Addington, so I determined that I would keep an eye on these myself. Fortunately although I can see the filaments, no sores or abscesses have formed around them and they have healed over. Should a problem later present itself, I will go to a local doctor for a solution ... I will never willingly go back to Addington.
Soooooo... that is my story.
I need to add here that there are stories of excellence and dedication , individual people who care, individual clinics and hospitals who strive to provded excellent service under extremely trying conditions, they are to be applauded and there dedication should always be noted.
But for the rest......
As said in the beginning, I am not so much angry for myself as for the thousands of people who have no other recourse but to go to Addington hospital.
As a nurse, I am angry and ashamed that those people call themselves nurses. I do not care how dire the circumstances are in which you work, if you are true to your profession, you provide the best care you can anyway.
I am angry at the doctors, hospital directors, matron and senior staff who allow this to happen, who probably don’t know and don’t care enough that it is happening.
I am angry at the politicians and policy makers, who do not better control or know where the funds are going, because by gosh they are not going into basic ward and outpatient care.
No cutlery, broken wheelchairs, no linen, the chairs and tables that the doctors in the clinics work from are all broken!
This is hell, this is a world gone mad where no-one cares anymore and no-one keeps the statistics of people who die or who are permanently maimed and disabled from such atrocious lack of care when they could be healed if the environment was not so screwed up.
Mostly I am just so terribly sad for the people of my country, that nobody cares enough to change things and make sure things are working.
My experience I assure you is nothing and pales into insignificance compared to some of the horror stories I have heard about clinics, and hospitals and the treatment or lack thereof that the people of our country receive.
And onto this decaying rotting mess, they want to pin a national health system? My gosh people, one has to get the infrastructure up from the abysmal mess it is in and working first before you even consider national health... It won’t work; it has no good solid foundation on which to build!
Every policy maker in this country should be forced incognito with nobody knowing who they really are to spend a couple of days being put through the abomination that stands as our public health system. If this were done, I can assure you changes would be made.....
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