Fighting cynicism in an under-resourced health care system


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7 comments

  1. Camilla

    Loved this piece. Evidence-based common sense.

    Practising in remote, under-resourced environments keeps us tertiary academic physicians humble and reminds us of the paramount responsibility in advocating to better the social determinants of health.

  2. Ali

    Here is the ugly truth, if there is no family actively caring of the individual and helping out we will never have enough staff to take care of individuals. It is pragmatically impossible.

    People are trying to outsource basic care like back rubs and social interaction to someone else. This is a deeper issue here that is plaguing the mindsets here in the west.

    We are trying to force staff to act like family and friends. That is impossible or unsustainable and unfair.

    We can’t keep expecting providers to be superheroes or miracle workers. I know many of them who are and then they burnout. It’s unfair and oppressive.

    • Connie Francis

      Ali, thank you, you nailed it! I used to be a practical nurse in nursing homes, working 12 hours shifts back-to-back for over 5 years, when my health started to fail me. The TRUTH is, indeed, people are “outsource” onto a system half the number of patients, and growing smaller, without so much as a question: “what can the family do to help?”. There is only the expectation for the system (There is the thinking aloud that sais: they are paid for it, after all) to “manage or fix” their problem, without family involvement. Which of course, is totally insensitive but mostly totally unreasonable.
      The second truth is, … many of the patients have … no family, at all. I will probably be one of these statistics!? Then, the “system’s” expectation for shared involvement becomes … redundant!
      It’s sad, and quite complicated. The reality is, if the government doesn’t create a comprehensive & STRATEGIC (based on country’s logistic needs) open doors policy to immigration, Canada’s over 50s today’s population is going to be in great trouble in another 20 years, maybe sooner. No amount of feelings, compassion, can cope with overwhelming numbers of people that will effectively “innundate” homes with no one to care for them. This is not “looking at the glass half-empty”, but a call to action, as the facts have already started to show up, for the past 10 years.

  3. Karen Fruetel

    You have articulated the issue beautifully! I will share with my colleagues and team members in geriatrics in Calgary as I think what you have written will resonate with them.

  4. Cynthia

    This is beautifully written to describe a problem so true in long term care. It is easier to prescribe a pill than to implement any non drug measure. As a pharmacist, I have work with various long term care facilities to reduce use of antipsychotics. I found it most effective to engage the PSW who know the residents at a personal level. It’s a lot of talking and discussion to realize pill isn’t the answer but scarce resource also prevent giving each resident individual attention for back rub, talking or social interaction. It is even more work to deprescribe.

  5. Beth Nimmo

    The family involvement is a good idea, giving a back rub, keeping the family member/patient more active during the day ie. walking or being more engaged. I like the behavioural management of insomnia Would the patient then be more appropriately ready for sleep? ( not napping during the day) Offering more fluids during the day might get away from recurrent bladder infections.

  6. Adam smith

    An excellent article. This isn’t about under-resourcing, more about bringing together the caregivers to think and discuss what’s going on with the patient and what happens in the care setting.

    I take issue with the headline that assumes we are under-resourced. We know our system is actually well financed. We spend lots of money but there are problems with how it is spent, where it is spent etc. Spending more money in a system that doesn’t address those challenges simply means we spend more money and get the same results.

    Your article shows how some thinking, coordination and compassion can make improvements without raising the fight about money. Well done.

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