Wednesday, 2 April
2008, 7:00 am | 1,627 views
Andrew
Loh
“In
Singapore,
within half-an-hour, you would be in SGH
(Singapore
General
Hospital),
TTSH (Tan
Tock
Seng
Hospital)
and within one-and-a-half to two hours flat, you’d know what went
wrong.”
- Lee Kuan Yew, TODAY, November,
2003
Recently a friend of mine
(we’ll call her ‘Esther’) was admitted to the Accident and
Emergency (A&E) department of the Singapore
General
Hospital
(SGH).
Esther had earlier seen
her GP who recommended that she consulted doctors at SGH to
determine the cause of her illness.
Day
One
Registration
– 8.40pm
The registration at the
triage section of the A&E’s Isolation Ward (IW) was smooth and
swift and went without a hitch. The triage nurse was courteous,
friendly and apparently highly efficient. We thanked her and took
our seats at the waiting area for Esther’s number to be called by
the doctor on duty that night.
It was about
8.40pm.
The consultation with the
doctor eventually took place at around 10pm – after some 1 hour 20
mins later. Esther was told that she had to be admitted for
overnight observation so that more tests could be done to ascertain
the cause of her illness.
So, we returned to the
waiting area and waited for Esther to be assigned a ward and a bed.
In the meantime, a nurse told us that they would find a bed in the
IW for Esther to rest temporarily, instead of sitting on the chairs
in the waiting area, which was an exercise in endurance for someone
who is ill.
It turned out to be a
frustrating, excruciating and a very long wait indeed.
At 12.20am, some 3 hours and 40 mins
after Esther had registered at the A&E, I approached the triage
nurse and asked if they were aware that Esther was waiting for a
bed in the IW. (In all those 3 hours 40 mins, we were not informed
or updated about when a bed might be available.)
The nurse was very
understanding and explained that there were no beds available and
that there was nothing they could do. And so the wait
continued.
12.50am
–
4 hours 10 mins
At 12.50am
– 4 hours and
10mins after registration – we were finally informed that a bed was
available in the IW’s Fever Zone. The relief – and exhaustion – on
Esther’s face was evident. She would be able to rest her tired self
finally.
The “Fever Zone”, where
the temporary beds were, is a small section within the Isolation
Ward. It has two rooms – one for male patients and one for female
patients. Each room could hold about 6 to 7 beds. The Fever Zone is
the place where patients who have to be warded are temporarily
placed while waiting to be admitted to the wards of their
choice.
Esther had opted for a
B2-plus ward (5 patients in an air-conditioned room).
We were hopeful that we
wouldn’t have to wait just as long for Esther to be assigned a bed
in the B2-plus ward. The IW ward has its television and lights on
24-hours and patients are wheeled out to the wards and new ones
wheeled in, a situation which doesn’t really allow one to rest
properly amidst the noise and the comings and goings.
Our hope was
misplaced.
The long wait was to last
till the next day.
Day
Two
9pm
–
24 hours 20 mins
At about
9pm
on Day Two –
24 hours 20 minutes after registration – Esther was informed that a
B2 bed was available and the nurse asked if she wanted it. As a B2
ward is non-air conditioned, as opposed to a B2-plus ward, Esther
declined. (See
here)
The reason why she
declined is because we suspected that Esther might have to stay
quite a while in the hospital (as she already had 2 previous
unsuccessful blood tests, one at a private hospital and the other
with her GP) and because of her constitutional sensitivity to warm
temperatures we decided to wait for a B2-plus bed.
Thus, we waited a further
3 hours.
12.50am
–
28 hours 10 mins
At about
12
midnight, a nurse informed us that
a B2-plus bed was available. Preparation was then made to transfer
us to the ward. Esther was put on a wheelchair and wheeled to the
corridor of the IW. We were so tired from all the hours of waiting.
It was only 15 minutes later that we heard the nurse informing the
ward, through a phone call, that Esther was ready to be
transferred. A further 12 minutes later, a male nurse arrived to
wheel Esther to the B2-plus area of the hospital. Esther had waited
for about 30 minutes in the corridor.
It was 12.50am
on Day Two
before Esther finally managed to put her head down on a bed in a
B2-plus ward.
All in all, from
registration to being admitted to a B2-plus ward, it took
28 hours and 10 minutes.
Nurses were patient,
courteous and professional
Now, before you think that
my frustration is directed at the nurses on duty that night, let me
say that they were very patient, courteous and professional in
their duties.
Although they could have
done better in some areas – such as keeping us informed of the
situation with the availability of the bed – it is understandable
as the A&E is a very busy place to work in. The nurses also had
to tend to many patients.
I would like to mention,
particularly, the nurses at the IW’s Fever Zone. They were
compassionate and understanding. This is especially commendable
when one considers that most of the patients in the IW that night
were elderly and weak.
One of the nurses
explained to Esther that the situation has been such since the
Chinese New Year. She also said that the wards in
Tan
Tock
Seng
Hospital
were fully
occupied and patients were being directed to SGH. Hence the
shortfall of beds there.
A serious
problem
Esther was not the only
one who had to wait so many hours for a bed. But perhaps she is
luckier than others who had had to wait in wheelchairs in the
waiting area for hours and hours on end that night we were there –
for even the number of beds in the IW is limited.
While MM Lee may be right
that “within one-and-a-half to two hours flat, you’d know what went
wrong” (even though in Esher’s case the cause of her illness is
still unknown 5 days after admission to SGH), the other important
thing is the availability, or the squeeze, on the number of
hospital beds.
According to the nurses
there, this is not a sudden or a temporary hiccup. It has been like
this since the Chinese New Year, as earlier mentioned.
While we trumpet the
excellence of our clinical healthcare service (and I don’t disagree
with this), it is what happens on the ground to each patient that
needs to be looked at.
Waiting for more than 28
hours for a bed is simply unacceptable.
I hope that the Minister
for Health, Mr Khaw Boon Wan, will put some effort into solving
this problem – especially now that he has been called “the best
Health Minister Singapore has ever had” by none other than SM Goh
himself. (Straits
Times)
When you are sick and
weak, you shouldn’t be made to endure a frustrating and
excruciating 28 hours just for a bed.
And I am sure that Esther
is not the only one who has had this experience.
Perhaps the new
Khoo Teck Puat hospital in
Yishun, scheduled to open in 2010, will help to alleviate the
situation. But that is left to be seen.
One can only hope that
Singapore’s healthcare system will not become what MM Lee said of
the system in the UK, where he experienced “restlessness and
unhappiness” when waiting for 45 minutes for an
ambulance:
“There’s no connection
between those in the system and the patients..”
- MM Lee, (TODAY)
From Esther’s experience,
one could say the same for Singapore’s
system as well.
