Canadian Health Care

There is a concerted effort in the US to establish a health care system which combines private health care and publicly funded health care. In some ads, the Canadian public health system is villified with "facts" which are not accurate. I will be the first to admit that our system has its problems but patients in urgent need do get timely care and their families are not financially devastated by that care.

That being said, the real truth about health care in Canada is that a private system has always co-existed with the public one. There has always been an option to pay a fee for access to private clinics, private diagnostic facilities and private surgical services. It is a business which exists within its own world and much of the general public remains completely unaware that a dual system exists.

I have worked within both of these health care options in Canada. Each has its strengths and its weaknesses. The future of health care will be a blend of the two and it remains to be seen if the mix will create a better system or weaken the one that is already in place. Holding health care institutions and providers accountable will ensure that patients will not have to pay a high price along the way.

Personal Injury Lawyers Need to Consider This

A personal injury claim can be a complicated process. A client can present with injuries that seem to have been minor but turned much worse. Under the current conditions of an overloaded, budget-cutting health care system like the one we currently have in Canada, as an attorney, you need to consider the timeline of medical care provided to your client.

It is not unusual for me as a practising RN to hear of patients being delayed care that would have made receovery that much easier and faster. Only ten days ago, I heard from a friend who went to see a physician for a suspected broken ankle. The wait to see a doctor was five hours with no pain relief or comfort measures. He was given a requisition for an x-ray. A full week later, he receives a call to return for a cast... he really does have a broken ankle. The long term consequences of having a fracture in joint that will now not heal properly are immense. Surgeries, physiotherapy, degenerating joint health all that could have been prevented by an immediate diagnosis and treatment with a cast.

Is your client a pharmaceutical firm facing claims about side-effects and adverse reactions involving long-term injuries? Evaluate how quickly the client was seen by a doctor, how soon were they given treatment for the symptoms? Did they spend days in a hallway in a crowded emergency room?

Unfortunately, this is not an unknown story in hospitals and doctors' offices. Perhaps you have more than an injury claim... perhaps you also have a negligence claim against a hospital.

IV drug for nausea causing problems

It has been reported in the “Annals of Cardiac Anaesthesia” that ondansetron (also administered under the brand name Zofran) has caused severe cardiovascular complications for adults and children. The drug is given to prevent or treat nausea and vomiting. It has been rapidly replacing dimenhydrinate (also known as Gravol) in acute care settings in Canada.

Documented cases have revealed that even when properly administered there has been a drop in heart rate to as low as 16 beats per minute. There have also been reports of adverse events such as unusual heart rate patterns and fatal heart patterns.

Further study has been proposed for this drug and the present suggestion is for caution when using the drug at the current time.

If you have a case involving cardiac irregularities which resulted in an adverse outcome, consider checking the chart for the administration of ondansetron.

Ultrasound Gel—Moms and babies at risk

Two infectious pathogens have been found growing in bottles of ultrasound gel in Canadian health care facilities. The connection was discovered by tracing skin infections on moms and babies who had recently had ultrasounds.

Ultrasound gel is often kept in squeeze bottles left with the machines that require it. Ultrasound machines and fetal monitors are the most common places you would find the gel. It does not contain any anti-bacterial properties.

The theory is that the nozzle of the bottles are coming in contact with the patient’s skin thereby contaminating the tip and allowing the pathogens to then find a great place to grow within the bottle. Gel that is heated only speeds the process of bacterial growth. Then this gel is used on the next patient. Suggestions for preventing the spread are to ensure bottles do not have direct contact with the skin and cleaning the nozzles of the bottles with an anti-bacterial wipe after each use.

A concern which crosses the mind of a nurse is one of infections that were missed. How many new moms developed wound infections following delivery because of the ultrasound gel used on their abdomens throughout the labour or prior to their caesarean section? How many babies developed skin infections that were never traced back to the gel?

Technique is so important to the outcome of a patient's care. And more attention needs to be paid to the systems in place to prevent infection and how they are actually followed on the front line of health care.

Specialized training program too expensive?

In the North American world of obstetrics, there is a specialized program that is considered a “gold standard” of maternity care. It provides information and training sessions for the care of women during pregnancy and delivery. It is a valuable tool for teaching health care providers of all levels from obstetricians, family physicians, registered nurses, and midwives on the multitude of skills necessary for the modern practice of obstetrics. Lawyers who work on maternity cases will often ask if this program was in place to train the staff to an expected standard of care.

However, in the current environment of budget reviews and the “business” of health care that is an emerging trend in Canada, this program is about to disappear. Deemed “too expensive” by administrators, the program is expected to be gone by the end of 2009.

It takes at least two years of full-time work for a nurse new to the area to begin to feel comfortable with anything that can be thrown at her during labour and delivery. We don’t have that kind of time anymore and the training program helped fill that need of skill building because we are losing experienced care providers to retirement. They will not be there to provide the support and hands on training for a bevy of young nurses just starting to get their skills established in this very specialized area which relies very heavily on the expertise of the RN to identify and apply interventions necessary for the well-being of the mom and her baby.

Too expensive to train health care providers? How much are the two lives of mom and babe worth? How much value is there in traumatized staff who only wanted to provide the best care?

Can H1N1 be contained in hospitals?

The last few months have seen the outbreak of the H1N1 virus. It has been appearing all over the world and varies from mild to severe, sometimes resulting in death.

People present to the hospital for various reasons. Some are staff. Some are visitors. Some are injured. Some are booked surgeries and diagnostic tests. Some are very ill. When word of an outbreak occurs, everyone assumes that doctors, nurses and other hospital staff will take every precaution to protect themselves and others so that the infection cannot be spread within the hospital itself.

But is this true?

Sadly, it is not. The worst culprits are often doctors. Doctors who make dangerous assumptions. They discount the need for isolation precaution procedures already in place. They ignore nurses who tell them of the risk and precautions necessary before, during and after patient contact. They don't wash or sanitize their hands before and after seeing a patient. They contaminate the charts and the desk area where others work.

Often it is only after they receive as positive lab result (sometimes days later) that they acknowledge what they have done... and only to themselves.

Patients who develop complications after a hospital visit-- no matter what they were doing there-- need to have a thorough examination of the timeline. There is a very good chance it is a case of "white coat" contamination. Questions that need answers include: were isolation procedures implemented, reinforced and carried out at all times? Was any caregiver diagnosed with the same illness or treated with anti-flu drugs due to an unprotected exposure? Detective work by someone who knows how a hospital works behind the scenes can provide the answers.