The Not To Hidden Message of Dirt

FTLComm - Swift Current - April 28, 2000

For over a year, articles in Ensign have discussed the continuing concern we all have over our health care system. Government ministers of health and health care administrators across the country complain that the Federal government is not providing enough funds for the system to function properly. While there is no denying that they Federal government is making a smaller contribution then was formerly the case, we at Ensign have over and over pointed out numerous instances where there are huge problems with waste and mismanagement. This story is not a financial one, but what can be simply observed and is documented here in pictures taken on Tuesday of this week. Part of the Saskatchewan government's over haul of the health care system was to establish district health administrations throughout the province. These opertions replaced local hospital boards and took over some responsibilities from the provincial government. Almost all of them are in financial trouble and this past year filed their budgets for the year to be approved on the day the budget year ended. They consist mostly of appointed officials and through out the province have housed themselves in outstanding buildings.

Sitting side by side in Swift Current is the Union Hospital which provides care for a city of fifteen thousand and its surrounding area. Beside it is the District health office. The contrast between the two facilities is truly remarkable and the physical nature and upkeep of the two suggest the emphasis and importance placed on what goes on in these facilities.

Swift Current's hospital is like so many similar facilities one of those buildings that has been modified and added to as the years have moved along. The picture above shows the structure from a distance and you can see the various wings that have become part of the building and the newest portion is the lighter coloured section that is now the front of the building. About a year ago we had occassion to visit a patient in this portion of the building and though it was modern and has the look of a present day facility it was not particularly well maintained. On Tuesday of this week we visited a patient in the older portion of the building and it is simply run down and poorly looked after. Perhaps the underlying message in this sign, which is posted by all the elevator doors, says best the intent of this facility.

Mission Statement Vision Our long-range vision is in a Healthier Community     Mission - - - - - - - In pursuit of that vision, Swift Current Health District's mission is that there will be: The best quality of life possible for those with continuing health needs Healthy lifestyles Recovery from illness or injury to optimal health in a timely manner Healthy environment Dignity and comfort for the terminally ill     Values - - - - - - - - - - - - - We believe in: -------Public Responsibility ----------• Accountability and responsiveness to the needs of patient/clients, ------------the community, and to our environment. -------Integrity ----------• A shared vision built on honesty, trust, mutual respect, fairness, ------------and open communications. -------Teamwork ----------• Consumers, health workers, medical staff, the public, -administrators, ------------and the Board; we're all in this together. -------A Healthy Workforce ----------• Commitment to the safety, security, satisfaction, and quality of the ------------workplace, with due consideration for the contribution of all ------------employees.     Motto - - - - We will work together guided by these principles: -------To listen with a desire to learn; -------To learn with a heart that cares; -------To care with actions that respond; -------To respond with compassion, respect, and dignity for all. At the main entrance to the brightly lit and spotlessly clean Health District office their mission statement is posted on their directory sign. Though the content of both of these messages seems consistent, the tone and underlying attitude seems so radically different that the District mission statement when we see it in action pushes the credibility panic button. The main entrance to the hospital is not supervised by a reception or information desk. A desk and wicket is there but the single person on duty does double duty handling the doctors' office patients which occupy a large adjacent waiting room. A list of the patients in the hospital is posted on a bullitin board with their room numbers. The health district office is an attractive lounge with a reception desk. It was several minute wait at the hospital information desk before the overworked clerk had time to respond to my question. At the district office I was greeted immediately and when I asked for a paper version of the mission statement a second lady came to find it and make me a copy.

Below on the right is a look down a gleaming hallway toward what appears to be the District board room while on the right is the main hallway leading from the hospital's main entrance back to its elevators. Though the light does reflect off of the floor in this picture, those floors are dirty. As a school principal for three decades, I have never seen a school with floors as poorly kept and my work took me through all four Western provinces and the Yukon territory. Dirt on the floor of any building is bad stuff, it dries to dust which floats in the air to settle on everything, providing a nutrient medium for organisms. A dirty floor means the whole building is dirty.

As you look down the hallway (above right) you can see a pile of boxes that have accumulated in the hallway. They were photographed there in the morning and shortly after lunch hour they were picked up but replaced with more around two in the afternoon. Apparently it is the practice to use the hallway as a place to store waste temporarily. Having had the experience of outbreaks of bacterial infections in elementary schools, one learns about the need to keep things clean. The picture below is of the two elevators that serve to transport staff, visitors and patients on stretchers about the building. The condition of these two elevators would be considered a disgrace in a warehouse or construction site, let alone a working functioning hospital. Not only are these really dirty places, but they are seriously worn and in need of general upkeep. It was unpleasant to stand in these and there was a pressing need to go wash ones hands after touching the buttons or hand rail, these are dangerous places.

This picture was taken with a flash inside one of the elevators looking at the accumulation of filth along the walls and in the corners. From the top of the picture in the corner you can see evidence of some fluid having run down the corner. Essentially, bacteria thrives in environments like these and what's on the floor gets in the air onto things and the people who move about in such an environment. The mission statement reference to a safe working environment clearly does not apply to the building next door. The pictures below show the hallway in the older portion of the hospital. This view looking South and to the North you would be looking toward the intensive care unit. The size of this hallway is typical of older facilities and the cleaning cart on the right remained in that location for a good part of the day only to be moved by a housekeeping person just before noon hour. The cart in the centre of the hallway is the food tray as the noon meal was being served by a busy and very compitent individual. On the right below is the way almost all the doorways in this portion of the building appear. Damaged and suffering from low maintenance.

The nursing station picture here serves both the eight or so patients in this wing and the intensive care unit which by afternoon must have had its patient moved because it was darkened. Four people worked on and off at this station all wearing coloured outfits so that there is no way to identify their work status. Some could be nurses, nurses aids or lab techs. Through out the entire day one worker spent the entire time on the telephone making call after call. She appeared to be extremely busy making notes referring to charts and only occassionally rising to get another file. Two doctors wandered in at one point, looked at a chart and strolled into the ICU then left on the dirty elevator a few minutes later. It is believed that they practice in the offices that are part of the hospital buiding. Notice the holes in the ceiling, these ceiling tile are relatively inexpensive yet the ones nearest the corner are seriously mutilated but have not be replaced. The hospital staff I saw going about their work seemed considerate and professional in every way, some looked a little tired as the twelve hour shifts reduce the alertness one sees in people fresh to a task. When a patient in extreme discomfort turned on a signal light it was more then five minutes before anyone came to attend to the person. That same person while trying to get to the bathroom the night before had fallen twice and though a fellow patient turned on the signal light it was a long time before someone came to help the eighty-six year old woman off the floor. (Once again bringing into question the veracity of the mission statement)

This pleasant sitting room with a television is at the end of the hallway and offered a nice environment to otherwise an abysmal place. The furniture in the room reflects the evolution of the facility. Some of the chairs in the room are more then half a century old but the over all environment seemed clean and inviting. It is hard to tell what all of this means. The low to no upkeep around the building suggests that health care is not what this place is about and the many signs around the building announcing the rapid expulsion of patients suggests that there is a feeling of urgency and tension about dealing with what would seem like the primary function of such a facility. Interestingly enough it was the signs that seemed to have an ongoing message all of its own. Some administrator was developing these poison pen messages and having them erected. One outside proclaimed that skate boarding was not allowed on the property, others warned of AIDS some of other terrifying diseases and conditions. All pointed to a kind of alarmism. My favourite was this one shown here on the right. This one was on the outside of the building overlooking two empty parking spaces. There was also a startling one on a car parked in front of the building that had a harmonious chill to it "Time flies, when you are in a coma."

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