Sault Ste. Marie Healthcare Narratives: Seven Shattering Voices of Silence

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Seven short e-mails sit in my inbox, dredging up my conscience, nudging me out of a long state of inertia. Seven one-ounce e-mails that feel like some sort of ten ton leaden anchor from which I have been trying to disconnect. Trust me, I did everything. I hit the delete button hundreds of times but the next morning the seven e-mails reappeared thousands of times, growing in intensity, taking up so many megabytes I only had mini-bytes left. A much dreaded dreadful virus had taken hold of my computer, bigger than any I have ever known. Not to be daunted, I ran to the store and purchased anti-virus software capable of obliterating the hardest computer virus. All computer glitches were easily erased, but the software remained ineffectual against the effectiveness of a human conscience. It is always this way, the logic of the human mind more or less equivalent to computer hardware, but not the softness of the human heart. Consciences have a way of beating us down when we toss important matters into the recycle bin. Even knowing this, I kept hitting the delete button, wanting out of this healthcare quagmire.

After all, I only intended to write one article, share one look at what was transpiring in our home and in the lives of home-health care workers. I tossed the ball and expected someone else to pick it up, expected someone else to play catch and fix everything. No-one caught the ball in the way anticipated or expected. Games are like that, always tricky and full of surprises. A few people caught the ball then threw it back like a steel boomerang I tried to dodge and avoid. It was worse than the seven e-mails sitting in my inbox when I was trying to find the outbox. Problems were multiplying. Problems are like games in that way, tricky and full of surprises, not going away if they remain unresolved.

It is those anchors that never let go, never let us have a sense of inner freedom and peace until they are addressed that become unwieldy and weighty. Bringing to light an issue full of grey left me standing in a room devoid of light, pulverizing any sense of inner peace. Until a moment of illumination. It was not my story that was important, rather the seven told stories laying untold in my inbox. The spoken words, the unspoken words, the stories of those enduring unendurable care, the seven silent anonymous voices that chiselled the soul. Finally, the loudness of the echoes pushed and propelled me to say something, anything at all. But it is challenging and difficult to speak one’s truth let alone give voice to the truth of others as the sheer force of the sound waves bashed against my mind.

With each echoing bash, I wondered about the people behind the e-mails, the faces I could not see, cloaked in anonymity. I wondered about the well-being of the people who came forward only to withdraw, rallying me to continue a journey I had no intention of taking. Seven simple e-mails with not-so-simple stories. Seven lines avalanching into seven thousand issues begging and bargaining to be heard. Today I speak with them and for them. Today we are joined together even though we remain unknown to each other, having never met. Today I carry their stories within me, carry these stories to you.

Voice One: “I’m not going to listen to those workers. No-one listens anyway. There is nothing more to say, nothing more to do. Nothing changes except the dents in my head from banging it against the healthcare wall. Positive care is positively impossible because workers don’t work, don’t do the things they are supposed to do. Imagine, walking into the bedroom and the wheelchair was being raised to the ceiling by a mechanical lift with my son in it. They forgot to unbuckle the belt and I nearly buckled over from the shock. What are they learning in College?” – Anonymous recipient of home health-care.

Voice Two: “Workers have 8 minutes to get residents bathed, brushed and ready for breakfast. Now there is talk of trimming it down to 2 minutes. Workers are operating on a bare bones minimum and the higher ups want to strip the bones of health care further. I’d like to elaborate, but I don’t have time to talk. If I don’t hurry, I may lose my job. We have no MPP in the Soo to hear us so I am looking for a pharmacy to purchase a bottle of hope.  There seems to be a shortage of hope like everything else these days. Cut-backs I imagine”. – Anonymous Personal Support Worker

Voice Three: “This isn’t what I signed up for. I used to love my job. There used to be time to give quality care to quality people. Things are different now. I have witnessed patients fall through the cracks. The system has lost the patient in patient care, setting us up to fail”.  – Anonymous Nurse

Voice Four:“Last year I took care of my mother. There are so many cherished memories, so many terrible memories I must pull out of my mind and throw away like an abscessed tooth. Like the time six supervisors or superiors sat in our living room outlining all the excellent care available. After an hour, I didn’t know who was who or what was what, but I did know nothing much was accomplished, wasting my time talking about services instead of providing them. Top-heavy plans and haphazard services hazardous for the health. It is true–small things make such big differences. If only agencies sent the same workers. Continuity of care rarely happened and it was like my mother had strangers bathing her. What bothers me even more than the chaotic care was having the choice of death stolen from my mother.”  – Anonymous recipient of home-health care  

Voice Five:“We are privileged, Canada one of the safest havens in the world.  So a healthcare system where care is sometimes unsafe or questionable remains a most important question. An A+ country with a B rating is incongruent with this great nation, incongruent with the great workers who dedicate their lives to healing, to bringing hope to the ill. ” – Anonymous

“When . . . benchmarked against 16 other countries . . . Canada received a “B” grade and ranked 10th overall out of the 17 countries. As Canada’s population ages, there will be a greater need for high-quality care.” [1]

Voice Six:“My health is ruined. I worked over 25 years in a system full of shortcomings and short-givings which short-change us all. Overworked, underpaid, shortage of supplies, long hours, nerves frayed, all creating and contributing to fatigue, a fertile breeding ground for mistakes. Out-dated medical equipment despite how much we study and become up-dated. Thankfully fund-raising has allowed us to purchase newer equipment because better equipment equals better care. I sat on two huge fences in my life, working in the medical system and working at home caring for an ill loved one. I am still sitting on the home-care fence. Wish I could help more, wish I could say more, but as I said, my health is ruined from all this stress, from this healthcare mess. Improvements are essential.” – Anonymous nurse

Voice Seven:“It wasn’t a strike. It was a rally. We posted and picketed outside a long-term care facility to let the public know we are expected to do more with less. Patients fall through the cracks because health-care workers are falling through the cracks and the system is making the cracks larger not smaller. We need to add workers but the system subtracts workers. Top-notch care will be notched and eroded away if cut-backs keep coming. We work hard, caring for more residents than ever. People think night-shifts are easy so there is one worker for 32 residents. A floater flies in as needed. But last night, let me tell you about last night. All 32 residents rang the call bell at the same time, wanting a washroom break. Eerie. Probably a full moon.  Maybe they drank too many fluids at dinner. The floater called in sick, unable to float. Absolutely no-one to help me help them so I did the best I could. I felt constrained, unable to provide proper care.” – Anonymous Personal Support Worker

I thought about the costs of cutting costs, about the true savings. Less staff, less wages equals higher laundry costs. Less staff equals higher wound care costs as urine promotes skin breakdown. I thought about my own father who knew his call bell would not be answered, could not be answered and knocked himself out trying to stand on his faltering feet. I thought about the other residents, about myself, about how it would feel if I had to sit in my own urine for hours. I thought some more and thought some less because thinking about the cost of cutting costs was cutting me up.

“According to the World Health Organization’s ranking of the world’s health systems, neither Canada nor the USA ranks in the top 25. Canada ranks 30th”.[2]

I turned off the computer, turned off my mind, hoping neither would reboot. There was no escape, the virus unexpectedly erupting, spreading into the community. People approached me in the visible flesh, demanding written guarantees that their identity would be kept invisible. So I promised, folding my hands across my chest, vowing to endure torture before revealing the source as I imagined journalists would do, except I am not a journalist but I didn’t bother to tell them. The truth is funny like that.

No Voice: This spoken story can never spoken, not now, not by me.  The person retracted, regretted speaking.  Like a night wearing shiny armour, I offered every reassurance, suggested every last tiny teeny detail would be altered so the source could never be traced. But the person held up a red flagging, telling me to stop, conjecturing this or that may happen. The potential for harm started scaring me.

I didn’t like this one bit, didn’t like hiding the truth when I was trying to let it out. Erasing a story that started with these words “I never expected to have my safety jeopardized” froze my fingers to the keyboard every time I tried to delete the words. Bringing silent voices to life was intended to make things better, to promote optimal care, to confer more value not less value to health-care workers. The worker was afraid. I was afraid. So I tucked the words inside the attic of my heart. I can’t stand having my heart brimming to the max like some sort of trash can with pieces of litter that belong to someone else, but I will because I promised. Safety at all costs or all is lost.

Health-care workers, caregivers and those receiving care are saying the same things in different ways. “It isn’t fair. We want better care”.

Colleges and universities offer programs, many wait-listed because so many students are eager to enter the helping profession. Hire them. Hire more, not less. Cut-backs result in set-backs.  Cut-out cut-backs.

Final Voice: Seven e-mails sit in my inbox. I never expected any, not seven hundred, not seven thousand, not seven million, but it doesn’t take even seven voices to change the world. It takes one. Yours. The last voice is the most important voice. The last voice is your choice.

*****

[1] The Conference Board of Canada’s How Canada Performs Program (2015). How Canada ranks when it comes to universal health care. Retrieved from http://on.bluecross.ca/health-insurance/health-tips/408-how-canada-ranks-when-it-comes-to-universal-health-care

[2] The Patient Factor (2017). World Health Organization’s ranking of the world’s health systems. Retrieved from http://thepatientfactor.com/canadian-health-care-information/world-health-organizations-ranking-of-the-worlds-health-systems/

About the Author: I’m just a simple person who simply wants to give a voice to all those in need because I have listened and heard. Hopefully agencies and the government will hear and respond to the need. 

Dale Lutes can be reached at [email protected]

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