A family is grateful for world-class care for a mother and her new-born twins at Auckland City Hospital.
Opinion
THREE KEY FACTS
Auckland City Hospital is the country’s largest public hospital and the largest clinical research facility.
It has approximately 1 million patient contacts each year, including hospital and outpatient services.
Auckland City is one of two major trauma centres in the region. Its department of critical care is one of the largest and busiest critical care units in NZ.
Rae Lamb is a former Deputy Health and Disability Commissioner and chairs the board of Te Tahu Hauora Health Quality and Safety Commission, which advocates for improving the health of communities.
OPINION
There’s an old adage that when the chips are down, people step up. In our case recently it was the public health system.
Every day we hear about the multitude of problems confronting Health New Zealand Te Whatu Ora. Workforce shortages, ageing infrastructure, and significant financial challenges to name just a few. We know there are long waiting lists and that access to services can be difficult.
But when you are in the midst of a major health crisis - as our family was very recently - you don’t see this.
What we saw in 20 days living across two wards at Auckland City Hospital in June/July and dealing with multiple medical teams, was world-class care delivered almost without exception by dedicated, highly skilled, hard-working staff who did it with empathy, care and kindness.
There was the hospital orderly who added panache and humour during transfers. The healthcare assistants and nursing staff dealing with high-need surgical patients who were as expert and kind at the end of their 12-hour shifts as at the beginning.
The anaesthetist who rang during the emergency surgery to report on progress. The surgeon who gives his cellphone number to all his patients, public and private, says “ring any time” and genuinely means it.
And there were the many doctors and nurses from other teams who came to visit and follow up progress on the ward even after care was transferred to another team. It was so comforting to see their familiar faces.
When infection set in, state-of-the-art wound care was delivered by a specialist wound nurse, later backed up after discharge by an outpatient wound clinic and a dedicated team of district nurses. Communication was good across the teams despite the many opportunities for it to fail.
There were midwives who crept in and took our tiny twins out for feeds in the small hours to let their exhausted father or grannies sleep as we juggled 24/7 baby care on one ward and long days on the surgical ward in another part of the hospital with the twins’ critically-ill mum.
On the surgical ward, we were told by the medical team they would be more flexible than we might imagine. And they were. We could take the babies to spend time with their mum as she improved, undoubtedly enhancing their early development and her recovery.
We saw waste and inefficiency. So much plastic, used once and discarded. There was the phlebotomist who turned up daily to take blood that had already been taken by nurses earlier. Specialist immunology and nutritional products from the blood bank that had to be ordered and signed off were not received and administered until late at night two days in a row when both deliveries could have been arranged earlier and at the same time.
And the notable exception in the empathy stakes was the surgeon from Europe who came a couple of times on morning rounds with junior doctors in tow and no bedside manner. Ignoring the presence of babies and others in room, and failing to introduce himself, he asked how the patient was.
When she said she was feeling very low, his only response was to ask if there was any swelling. He subsequently talked over the patient, abruptly asked if there were any questions, then left. This stood out in sharp contrast with everyone else.
We also saw differences in the approach to recognising the trauma of the events. The general surgical response was “you have family support so you will be fine”. Women’s health was much more attuned to the need for follow-up professional support.
On the board of Te Tahu Hauora, the Health Quality and Safety Commission, we regularly see the results of patient experience surveys.
I am often struck by how positive these results are when we see such concerning and negative headlines about the system. Now I understand.
Yes, there are serious issues around accessing care and waiting times.
Yes, there are things that go wrong.
I know this from my time as a former Deputy Health and Disability Commissioner and the complaints that I saw. Like others, I have had previous personal experience of mistakes in care. Nonetheless, our most recent experience has been a timely reminder of the overall quality of our system and the expertise of the people it’s comprised of.
As a family, we were very lucky. Our babies and their mother were in the right place when we needed it. But judging by the many thank-you cards displayed on notice boards in the kitchens on both wards, we aren’t the only ones.
Despite everything our public health system delivers extraordinary care every day.