As Eastern North America prepares for the first major winter storm, we should consider how weather highlights a weakness in our health care system.
In weather conditions that close schools and government offices and cause the RCMP to issue warnings to stay off roads we expect medical workers to soldier on. Administrators, who stay home or have the benefit of foreign SUVs to drive them to work, expect front-line workers who have pulled 12-hour shifts to either cover for a coworker who can’t get to a hospital or to travel (either to or from work) under dangerous travel conditions. This is unfair to worker and patient.
Then there is the problem for those patients under home care. We expect the VON to travel in dangerous conditions. I’ve heard of nurses with night blindness whose days have stretched well beyond dusk, thereby creating a double hazard. In a storm if the VON nurse can make it to all those on their roster the travel time is such that care is delayed which can impact outcomes. That’s IF they can make it to all their patients. Roads and driveways may not be ploughed.
I knew a person who was recovering at home from knee surgery. The weather prevented the nurse from calling on her. The patient knew something was wrong and was able to email a photo of the incision to her doctor who diagnosed an infection and ordered antibiotics, which were delivered to the patient by a family member.
That is a shining example of how technology works. However, we can’t build a system reliant on the general population’s technical abilities, assets and coherency in recovery. The problems:
- not everyone has a smart phone or the technology to transmit images of injuries,
- not everyone has a doctor,
- in severe weather conditions doctors’ offices are likely to be closed and so the doctor is unreachable,
- there is no guarantee any images or communications would be dealt with in a timely, expedited manner,
- as we have experienced, severe weather conditions can knock out power and telephone connections for days and weeks, which can cause harm to those in weakened states,
- if the patient or care giver are able to reach a doctor, further treatment or medication may not accessible, thereby allowing the situation to worsen which increases patient suffering and potential cost to the system.
Nova Scotia health care has no Plan B for severe weather events. Other than clearing parking lots and throwing salt on ice there is no Plan B for either delivering home care to patients or helping front line workers travel.
We live in Canada. Bad weather shouldn’t be a surprise.