Dear Hospital,

You were created as a place of healing.  You exist with a mandate to preserve life. Those who work within your walls are compassionate and desire to help others in the direst of circumstances.  They bring health, comfort, and relief to the suffering who have been brought to you for assistance. It is a noble cause.  An honorable calling.  Your foundations are strong.  All that is built upon them rises to a virtuous covering of the sick.

But, Hospital, your growth has compromised your purpose.  The needs outweigh your ability to meet them.  There are those within your walls who have given up compassion for efficiency.  They have left common sense for self-protection.  Consideration has taken a back seat to checking boxes. Some remember the pull that brought them to work here, but others have all but abandoned the call to heal the sick.   It is a sad day for you, Hospital. Do you cry for those who have lost their way within your walls? Do you weep for those who suffer while they wait for compassion?

I understand you have more than you can handle.  I know your walls can only hold so many, and they just keep coming.  Choices must be made.  Priorities set. Who gets care first?  Who falls lower on the list?  It is the way of things to categorize.  It is also why I am writing to you.

You see, Hospital, my mother has dementia.  She is one of the low ones on your list.  We spent two days within your walls and not all those inside understood my mom.  She cannot tell you where she hurts exactly. She doesn’t know her last name or her birthday, which is the first thing anyone asks her when they enter her cubicle.  She is on their long list of people to check off and her inability to move much or process questions slows them down, which they do not like.  Talking louder does not help her.  Insisting she answer quickly does not speed her up.

The ER is a busy place, Hospital.  There are all kinds of unfamiliar noises and lights.  People come and go loudly all night long.  Confusion lives in your ER even for those whose brains work normally.  Imagine how scary a place it is for those whose brains are compromised.  Add to that all the machines blinking and alarming, the poking with needles repeatedly, and wheeling to all kinds of rooms with big machines, and you have a recipe for confusion like no other.

Hospital, did you know people with dementia respond differently to medications that influence the mind?  Giving Mom pain killers will reduce her respiration, her blood pressure, and put her in a deep sleep from which it will take days to wake.  That causes issues for you since you cannot release a patient who is practically unconscious.  If those inside only understood this, it could save you days and open up beds more quickly, which has become your main goal.

Putting a dementia patient in a holding cubicle while you wait for a room, is another issue which should not happen for the sake of the patient.  However, when gridlock happens, it requires you to compromise the health of those you were created to serve, Hospital.  The coughs of pneumonia patients so close the thin curtains wave with their breath, puts all patients at risk, not just the ones with dementia. Knowing the stories of every patient within 4 bays doesn’t help.  It only creates fear of the diseases flying in the air my mother is breathing, while waiting for her brain to wake up from too much medicine.  Hours of this goes against everything you have built and say you believe, Hospital.

Communication is compromised for those with dementia, but it shouldn’t be for those working inside your walls. Yet, sometimes they do not seem capable of understanding one another, the technology, the patient, or the family.  In your quest for efficiency and speed, you have made the process arduous and archaic.  It is counter intuitive Hospital, but you have tied the hands of your workers so they cannot possibly do their jobs in an efficient way. It takes an act of congress to leave your confines. Compassion has all but left your walls in favor of doing only what is on the checklists in however many hours it takes.

I do feel for you, Hospital.  Really, I do.  I know you are not living your best life.  I know you are trying to rectify all that has gone wrong on your watch.  I see you attempting to improve things with your charts and graphs on the walls.  Your fall clock is measuring safety in a public way even while it shames your workers into compliance.  It seems to me, creating a fear of what surveys say is not helping your workers take more care of patients, but less.

I must tell you, you do have some exemplary employees, Hospital. They have not forgotten why they are with you.  They love their patients and try to soothe them when they are scared.  They work with families to make the best choices for their loved ones.  They use kind voices and speak slowly and clearly, even when their own list is long.  It is a beautiful thing to see them because it means they go against the tide.

They are the strong ones who do not compromise their calling for the convenient.  Those are the ones you should pay attention to.  They are the ones who make the outcomes of their patients better, not by surveys and charts, but by compassion.  You better protect them, Hospital.  They are worthy of your effort to guard their hearts and to shield them from the forces set on forcing them to go a different way.

As for my mom, we are grateful to you for what you did for her.  We know you did your best, it’s just that your best isn’t the best, not for dementia patients anyway.  Please consider helping those within your walls to understand those who are cognitively challenged.  It would do wonders for those who have learned to trust you for decades as the place to go for compassion.

I sincerely hope you can find the way back to your noble cause.  I believe in you.  I know you can remember your foundation and become the place of healing you were designed to be.

Sincerely,

Michelle Gunnin

(For those interested, I have a category where I write about our experiences with dementia and our elderly parents.  Just scroll down to the category window and select Our Dementia Journey.)