Dear Editor
I have had some experience with the emergency department at the Battlefords Union Hospital. I found the service and the outcome of treatment I received to be fair. In those cases it was evident I either needed stitches or that my hand, hanging off at an unnatural degree, required surgery. I had no reason to question treatment quality. Others have voiced dissatisfaction with the treatment they received, saying health had been jeopardized, but since these reports were secondhand I felt that I was in no position to judge.
Over the last couple of months though, I have come face to face with a situation where the system failed the patient badly. My father-in-law, who lives with us, started to show worrisome symptoms. His doctor was not available, so we took him to BUH. My wife went with him and stayed with him throughout his time there. She explained to the nurse practitioner we had noticed he was somewhat confused and he told her he suddenly was unable to control his writing and had no strength in his arms or his whole right side. He also had trouble formulating what he wanted to say. He was also showing signs of lung congestion.
My research indicated a sudden inability to write is a definite sign of neurological problems. It is true infection can cause some confusion, but the inability to write does not fit with that type of confusion.
My wife was told his blood tests were expected any moment that might provide some answers. My wife explained her father told her no blood had been taken. This also showed his confusion. At one point a nurse told him and my wife that from tests on a urine sample, they were diagnosing a bladder infection. The urine sample he had provided was still in the room and no one had as yet done anything with it. This causes us to wonder about systems and procedures at BUH emergency.
He was prescribed a course of antibiotics to treat pneumonia and sent home. After five days he showed no improvement and we took him to the doctor where another, stronger course of medicine was prescribed. Again he did not feel he was getting better. The doctor's unavailability sent us back to BUH where we explained he was showing greater confusion than before. When the nurse was asked what was wrong he just stated he felt like shit (excuse me but that was his word). When asked what he meant he really couldn't explain himself. We now realize he was unable to do so due to the problem eventually identified.
He was then given a series of puffers as they seemed to want to concentrate on his lungs, which are not great, but did not want to seem to tackle the confusion problem. They asked him a few simple questions that checked long term memory like how old he was and where he was at that moment and that apparently ruled out any confusion. We explained he was now unable to operate the remotes for the television that have given him no problem before and he was unable to comprehend things we would try to explain to him.
On a third trip to the emergency department the nurse practitioner outright asked him why he was there again, as if he was wasting her time, even though we again stressed the confusion had advanced to where he would be unable to finish a sentence.
This man is 80 years old, but up until this started he was quite sharp and quick witted, bantering back and forth. By this time though, he was no longer that man and we were extremely worried.
Things came to a head a few days later when we had to call the ambulance when he fell and then was unable to control his one leg and arm to walk without assistance. The ambulance attendants asked the same simple questions to see if he was confused and he was able to answer those. At the same time he was ready to sit down to use the toilet without first lowering his pants, which definitely shows he did not know what he was doing. There were other signs of confusion we described.
He was admitted to the hospital. Within a few hours the ward nurses were saying how confused he was and commenting on his inability to finish a sentence and his inability to communicate. They administered a cognitive test on which he scored extremely poorly. This proved the inadequacy of the judgment by the emergency staff and maybe even their reticence to pay attention to what we were telling them.
He deteriorated noticeably as he waited a few days for the CT scan to be repaired. The scan results moved things along rapidly. A build up of blood in his skull was putting pressure on his brain. The condition is called a subdural hematoma and the neurosurgeon in Saskatoon Royal University Hospital and his family doctor have told us this is dangerous. This may have been caused by a fall a number of weeks before any symptoms showed.
The neurosurgeon was put out that something had not been done to get him to Saskatoon earlier and was open in saying this. He went so far as to say the man had received substandard treatment - an unusual pronouncement for a physician.
If the medical staff had listened to us and given us any credence he would have been treated properly much sooner. I feel the medical staff were insensitive to what was going on, were being a little prejudiced in their view of symptoms and were just assuming he was old. We who live with him were telling them this was not normal.
We feel BUH staff ignored us, assuming we did not know what we were talking about, and did not seem to believe how badly he said he felt. We feel that they were just making a judgment about his age. We were proven right.
The lack of action definitely put this man in danger and this is unacceptable. I am no longer willing to give them the benefit of the doubt. I have lost faith. I feel what we have experienced demonstrates a problem with the whole system not just with individuals on the front line.
This experience is evidence there is reason for the significant public distrust in the abilities of this hospital's emergency department. Something needs to be done.
Bob Zurowski
Meota
