We have so many people who enter our lives, some a fleeting influence, some who inspire us to reach higher, do more, and remind us how precious is life.  I acknowledge and celebrate the memory of my friend and colleague Christine, who had demonstrated such strength and can do attitude as she coped and defeated a few times the disease of cancer.  The rounds of chemo, the outlook of hope this time it works, her dedication to nurses and the importance of our work at point of care.

Christine was our pragmatic, no nonsense (and balanced with humour, caring, and kindness) Executive member who reminded us “what can we do for the staff nurses….” and she would draw from her vast experience of mental health practice, management, leadership, teaching, public health, and joined our wine sessions as we brainstormed, drafted documents, and kept the wine supply steady as we reworked our first resolution to be presented at the Annual General Meeting of RNAO 2014.

We were thrilled when word came of her new status of grandmother, she regaled us on her joy of holding her grandson (so beautiful were the words she used), we collectively were concerned when we recognized her increased fragility at our Annual Think Tank.  Though it did not detract us from a delightful evening of free drinks when the restaurant turned into a set from the movie Noah, as we enjoyed the simple pleasures of eating together, sharing stories, and celebrating our recognition as Interest Group of the Year.  Though we had the feeling of dread at her physical appearance Christine still took the lead on our Nursing Week mail out–a care package for our staff nurses.

By the way Christine was born and raised in New York, she was very clear that it was her starting point and she was proud of her country Canada, and the strength of a publicly funded health system.  Namaste my friend you are missed, know we are grateful you touched our lives and inspired us that a cancer did not define you–it was your attitude, aptitude, and fortitude that needs to be remembered.  Below you will find Christine’s submission, it’s my privilege to share this space, her first and only blog.

Infection Control on TV and in Real Life

Recently I watched the series premiere of the Canadian medical show “Remedy”.    At one point the surgeon was admitting her patient into an in-patient room.  (A surgeon?  Admitting a patient??).   In the show, the surgeon becomes angry that the cleaner has not finished cleaning the room, and the surgeon commands the cleaner to leave the room so the patient can be admitted.  Later on in this same show, the hospital where the surgeon works is dealing with an outbreak of C. Diifficile.   Now how much of a stretch is it to attribute this outbreak to poorly cleaned rooms?   “Remedy” reflected poorly on both the surgeon and the hospital for allowing the patient to be admitted into a dirty room, neglecting the basic tenants of infection control.  But that was a TV show, I thought, and reality is much different.  Or is it?

Of course in real life, hospitals realize the importance of proper infection control procedures in order to protect patients and staff from illnesses, especially superbugs.  Much time is spent educating staff about hand washing to avoid the spread of pathogens.   Hospitals monitor superbug incidences and try to keep the numbers down.  Some hospitals even pre-screen for superbugs and isolate potential admissions with symptoms.  But do these precautions filter down to the actual patient experience?  Not always.

Two months ago, I slid on the ice and hurt my arm.  I went to the emergency room of a large teaching hospital in Toronto with an excellent reputation.  I spent 5 hours in the ER waiting, getting X-rays, waiting and getting a plaster cast put on.  Yes, it was broken.   When I arrived at the ER I used the designated unisex patient bathroom; a one toilet room.  It was obvious that some poor soul had recently had a bout of diarrhea as the bowl was completely filthy.  Flushing did not clean the bowl.  I daintily used the toilet without touching it, and using only my non-dominant hand.  I was in fear that e coli, C Difficile, or worse would infect me.  Five hours later when I was ready to leave, I again used the same toilet.  It was still filthy!  Five hours!

Around the same time, at this same hospital, I had a biopsy done at the same day surgical unit.  The locker they assigned to me had used tissues in it.  Obviously no one had checked on that locker between patients.  In the pre/post-surgical area there was one patient bathroom for all the 15 occupied beds to use.  When I first emptied my bladder there was a used K-basin with bodily fluids of some sort on the bathroom sink counter top.  Seven hours later when I was discharged, it was still there!!

I have nothing but praise for the professional at-the-bedside treatment I was given.  The nurses in the ER ensured that I had ice for my broken arm while I was waiting.  The nurses in the surgical day unit went out of their way to make me comfortable.  The medical care I received met standards and the physicians explained procedures.

Should I have said something?  Told the staff?  I have been giving serious though to this.  Both times I was preoccupied with own health issues and pain to be able to think critically.  I did tell the surgical porter about then used tissues in the locker, and he just shrugged.  I remember thinking that the dirty toilet areas were probably in-between scheduled cleaning times.  As a patient, I was vaguely aware of the power issues.  If I complained, would I continue to get good service?   It was not until I observed the soiled toilet rooms the second time that I realized that there were major cleaning issues.

Perhaps the ORs are scrubbed diligently.  Perhaps the in-patient units are cleaned regularly.  But the out-patient areas seem to be missed.  Patients in the ER or in procedure areas are vulnerable to infections also.  They are in the hospital because of some health problem and maybe vulnerable to lurking pathogens.  Staff have to be a responsible and check patient bathrooms and change areas to ensure that the high standards of infection control are maintained throughout an institution.   Hospital administrators may be penny wise in cutting back cleaning staff from out-patient areas, but it is pound foolish in the long run when sick patients return to the hospital with nosocomial illnesses.

I laughed at the “Remedy” show and the flagrant disregard for infection control standards.  But I have real concerns that in our real life in today’s large hospitals the standards are really not so very different.

Christine Kent, RN  2014

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Paula M

Registered Nurse Storyteller, Healer, Scribe, Transformational Leader