New Brunswick

Patient describes stress and tension among nursing staff during Saint John hospital stay

Jody Kennedy has been hospitalized several times for a neuromuscular disease, but her latest stay at the Saint John Regional Hospital was unlike others, with nursing staff showing heightened levels of stress and anxiety on the job.

Jody Kennedy says patients are restricted from getting family help while nurses are run off their feet

Jody Kennedy has been admitted to the Saint John Regional Hospital at least 16 times over the past decade for a neuromuscular illness. (Submitted by Jody Kennedy)

At 43, Jody Kennedy estimates she's been hospitalized about 16 times for a neuromuscular disease that put an end to her nursing career.

Every one of those visits to the Saint John Regional Hospital has deepened her respect and empathy for the nursing staff who work there.

That's why she's speaking out about seeing the system stressed and strained like she's never seen before.

She was also struck by the words that she heard — nurses speaking quietly, one to another, conveying an overall feeling that morale has never been so low. 

"One nurse told me that she goes into the bathroom at times and cries and has little panic attacks," said Kennedy.

"Then she pulls herself together and comes back out."

From the time she arrived at the emergency department on Nov. 25 to the time she was released on Dec. 17, Kennedy said, she saw nurses run off their feet. 

She described them as exasperated, exhausted and drained.

Kennedy says she's never seen nurses at the Saint John Regional Hospital appear as stressed and strained as she did during her stay as a patient from Nov. 25 to Dec. 17. (Wikipedia)

"I overheard two of them talking and one of them say, 'We're on a sinking ship'."

"And yeah," said Kennedy, "I think a lot of them feel that way."

She said one nurse kept apologizing for not being able to provide the care she felt her patients deserved.

"And I just kept saying, 'You don't need to say sorry. I know it's not your fault..'"

Afraid to ask for water

Kennedy said there were days and nights when the nurses seemed so overburdened, she didn't want to ask for help.

That was especially true when her unit was locked down due to a possible COVID-19 exposure.

That meant nurses had to don a full set of fresh PPE and clean their equipment in between every patient.

Kennedy felt guilty then, even asking for water, and so she'd go without.

"You felt ashamed to ring your bell," she said.

About a week in, Kennedy developed an infection from a central venous catheter inserted in her neck.

Kennedy says she couldn't see family, even after developing a serious infection from a central line that was inserted into her neck to deliver fluids and medication. (Submitted by Jody Kennedy)

Central lines are used to provide patients with doses of fluid and medications.

Her body reacted with shivers, shaking and sweat.

"I would wake up, soaking ... but for whatever reason, they had no shirt to give me. The linen didn't come."

Some of the meals she was served were the worst she'd ever had in hospital.

"One day I got a grilled cheese and I couldn't even cut it, it was like rubber."

"Eventually, I just asked for broth all the time."

No help from family

While in and out of hospital for 21 surgeries, Kennedy said she could always count on her parents to provide bedside care and support.  

But this time, she was alone.

Due to pandemic restrictions, her father was told he would have to leave the hospital as soon as she got a bed.  

Kennedy said she waited all night, some of it in a wheelchair, some of it in a family room while in respiratory distress. 

"They had nowhere to put me and I just thought 'I can't stay here trying to breathe by myself and not panic'. So eventually, they kind of ignored my dad and let him stay."

But at five o'clock in the morning, Kennedy was admitted and her father had to go.

She then spent 14 days trying to manage her own emotions, including her fear of succumbing to sepsis and dying alone.

She heard other patients acting out and berating staff. 

"Almost every day, they called a code white," she said. 

Code white is a hospital response to a patient who is acting violent or combative.

It was a sad, difficult, scary experience, said Kennedy — about the worst she'd ever known. 

"You have nobody even to hold your hand, nobody just to sit with you," she said.

"Sometimes it got so overwhelming, I would just lay there and sob."

Being alone in hospital puts patients at risk

Patient advocates say family members can and do play a crucial role in a patient's care and recovery.

"It can literally be the difference between life and death," said Kathleen Finlay, the founder of the Centre for Patient Protection.

Kathleen Finlay, CEO of the Center for Patient Protection, says family members play a critical role in a patient's healing and recovery. (Submitted by Kathleen Finlay)

She says sometimes it's a family member who detects a small but significant change in their loved one's condition and makes the call for help.  

They may notice a medication is wrong or help a patient with mobility and save them from a fall.

They also provide emotional support and bolster a patient's desire to get better.  

"And keep in mind, we have many more tools at our disposal than we did in the early days of the pandemic," said Finlay.

"Rapid testing, it seems to me, would be one of the most important things that would allow us to continue to have loved ones in the hospital setting."

Restrictive policies cause unintended harm

Healthcare Excellence Canada, a non-profit funded by Health Canada, is urging institutions to support the presence of loved ones in hospitals and long-term care homes even during COVID-19 and even during lockdowns.

The organization says blanket visitor restrictions, such as those applied early in the pandemic, caused unintended harm to patients and moral distress to health-care staff.

Healthcare Excellence acknowledges that hospitals and nursing homes must also manage the risk of COVID infection, including emerging variants such as Omicron.

"This is the dilemma that everybody is wrestling with," said Dr. Jennifer Zelmer, the president of the organization.

"This is a global question."

Dr. Jennifer Zelmer, president and CEO at Healthcare Excellence Canada, says hospitals around the world are wrestling with the dilemma of how to provide patients with important family support while managing the risk of COVID-19. (Submitted by Healthcare Excellence Canada)

No family visitors for 14 days, Horizon says

CBC News asked for interviews with Horizon interim CEO Dr. John Dornan and Margaret Melanson, vice-president of quality and patient-centred care, to answer questions about the current strain on the hospital system.

Neither was available.

In an emailed statement, Melanson said details of the hospital's designated support person program could be found on Horizon's website.

It applies to certain patients who have been in hospital 14 days or longer, as well as patients in palliative care, intensive care, obstetrics, pediatrics, and patients who have cognitive or communication impairments.

Designated support persons must be 18 years or older, show proof of vaccination, pass COVID screening, and complete a 30-minute online course about infection prevention and control.

Those who qualify can be at a patient's beside when they are needed. They don't have to maintain distance and they don't have to keep to visitor hours.

"Horizon is working hard to ensure patients in our hospitals are receiving safe and quality care, while balancing this with our desire to protect patients, physicians and staff from COVID-19," wrote Melanson.

"While there are currently no social visitors allowed in our facilities, we do recognize the importance of family presence to our patients as an integral part of their healing process."

ABOUT THE AUTHOR

Rachel Cave is a CBC reporter based in Saint John, New Brunswick.

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