This is from ICCU !

It’s very cold , lot of electronics around , it looks high tech , linear displays with some regular spikes , some beeping some stuttering TikTok. People in bed are differently challenged. The para medical looks responsive and trying to cope with multitude of nursing challenges. This is where , intensive care is extended.

I am writing this to relate and share the importance of wholistic and systemic perspective. Some thing that applies to every aspect and situation , including hospitals, my recent reflection!

My 91 year old father suddenly stopped using his left leg and hand . Doctor suggested MRI and the report was disturbing. There was a big size clot on the right side leading to the left side being paralysed.?

Our physician prescribed immediate hospitalisation for an immediate surgery. We were skeptical?, brain intervention that too at the age of 91 . The house was divided , some completely against surgery and I had to take a call. Leaving him on mercy of the time , or go by the doctor’s advise and take risk and go ahead with operation. I decided to follow my heart and decided in favour of surgery. He was hospitalised in the morning and was operated the same day in the evening. Operation successful and he is back in to the ICU , where I experienced the reflection.

Check?, multitude of elements , integrated and in a network , each?impacting other,?a system emerged out of a situation and is live.The patient , the physician , the surgeon , a hospital owned by some one else and most importantly ‘para medical’ team and intense pool of relatives. Can you imagine the complexity and the criticality of the delivery as the system is dealing with life of the human beings. A terrific challenge in terms of keeping all involved aware and updated , appreciating the mutual collective responsibility of the system to ensure seamless execution.?

What is to be recorded is recorded and captured ? What is critical is shared ? What needs to be avoided is highlighted ? What is mutual is agreed and the overall objective is spelled clearly to all involved agencies in the system.?A timely clear communication , stating the each one in the team , the role each one has to play , can go a long way. Basics buried in a beautiful tomb , remembrance relegated to rituals burning the invisible spirit of the existence.?

Physician briefed surgeon , he?also briefed the hospital authorities , authorities shared with the paramedical. The patient and the relatives briefed the?doctor and the doctor briefed the relatives. A spiral loop feeding and getting fed by another element.?

Doctor arrived to operate and discovered that the patient is 91 year old , pls note ‘discovered’ . He came with a mindset to simply operate for removing the clot , unaware of the age of the patient. He briefed me and my wife on the process and procedure that he shall be following and also introduced us with the consequences,?taking support of the stale statistics . Physician , could not brief clearly on an important issue of medication on this patient as the patient had a long history that was known to the physician only. Surgeon operated and stated operation to be ‘successful’. He prescribed some pain killers that could damage his renal functions. Past history of nephrological issues, being?missed and not read completely. Fortunately the Physician discovered during the evening round and suggested changing medicines immediately.?

The night two in ICU , father restless trying the get out of bed and the staff?found it easy to administer a sedation injection , phenargun which is generally given but very seldomly to an old recently operated patient , specially in this case when the patient is 91 years. My father continued sleeping for next 24 hours ,making staff to suggest , food through Rice Tube. Feeding through tube and reversal to normal feeding has low success rate and hence we were apprehensive. We objected to the idea and agreed to wait for him to come closer to complete consciousness and have food in a natural way.?

Day three he was to be taken to the CT scan Center , hospital called an ambulance which had no suspension and was making sound from every corner and was without AC . 91 year , brain operated patient being made to travel in a shock absorber less OMNI. Patient to be lifted from one stretcher trolly to a hand held stretcher in the Van and the same process to be done four times , complete absence of sensitivity and responsibility.?

Common sense is commonly missing sense , years of experience , work force without?values and direction , a good ICU and an impressive building , all is useless , if the purpose is defeated by the very owners of the purpose. Interesting , this all happens tacitly and the system remains unaware leading to annihilation.?

Is it happening in your organisation ? Does the experience above matched with yours , listening even the junior most in the team is valuable and the bosses who do not have time to listen kill the organisation ? Hospitals handle sickness while we think they create health and mismanagement allows the sickness to continue and we become systematically and perennially sick.?

Stay aware and stay mindful. Don’t let the hedge eat the garden!

Jai Ho !?