By B. Kelly Murphy
Thankful for American
in the industry
I recently returned from a mission trip
to Romania. My five member team was
working with a local ministry there called
Livada Orphan Care ( www.livada.org).
Livada Orphan Care hosts week long
camps for Romanian orphans throughout the summer. It’s similar to vacation
bible school in the United States and is
the highlight of a Romanian orphan’s
year. After the interns and volunteers
leave, Livada provides follow up care to
the orphans the rest of the year.
On my third day of camp, I suffered
an injury while playing a game—seven
broken ribs and a collapsed lung, to be
exact. The game wasn’t supposed to be
dangerous, but I guess that’s what happens when you match an overly competitive 45 year old man against a young
healthy 17 year old boy (who also happened to outweigh me by about 35 lbs).
I soon discovered that Romanian
healthcare is vastly different than healthcare in the US. In fact, it is even significantly different between the public and
private hospitals in Romania. I spent my
first two days in a government run facility and the next eight days in a private
hospital. There are no Joint Commission
standards, HIPAA privacy and security
laws, CLIA licenses, CAP inspections,
time out procedures, two patient identifiers, no communicating with the patient
in their “preferred” language, or patient
satisfaction surveys. While in the hospital, I never had an ID arm band. I never
saw a medication in a labeled syringe and
most of the nurses did not wear gloves.
The technology was dated and infection
control efforts were lacking.
The hospital staff were generally nice
and seemed apologetic for the conditions, as if they knew it would be considered substandard compared to America.
Of course, not speaking Romanian made
communication challenging. Most of the
time, I did not have a translator and many
of the non-physician staff did not speak
English. My first day in the government
hospital, a nurse (or nurse aid) brought
in a basin full of digital thermometers.
Without explanation, she handed each
patient a thermometer and left the room.
When she returned five minutes later to
collect them she stared at my chest for a
few seconds and when she finally looked
at my face she rolled her eyes and motioned that the thermometer belonged
under my arm and not in my mouth. She
documented my temperature, collected
the thermometers, and placed them back
into the basin. I wondered if they were
cleaned between uses.
Around midnight the first day a nurse
entered the room with a tray carrying a
number of 10cc syringes. They all con-
tained a clear liquid, but none of them
were labeled. The nurse took one of the
syringes and injected my IV. Then she
took the other syringes and injected a few
other patients (the rooms at the govern-
ment hospital held eight patients each).
Since I never had a patient ID arm band
at either hospital, I don’t know exactly
how they knew whose medication be-
longed to whom.
There was one men’s restroom and
one women’s restroom on the wing of
the government hospital. The men’s
restroom had two stalls, one of which
was out of service and the light bulb was
burned out. At 2:00 AM I got up to go to
the restroom and walked unassisted with
my glass chest tube bottle down the hallway. My nurse was walking toward me
and I assumed she was coming to assist
me since I was a little wobbly due to the
medication. Instead, when she looked
up and saw me, she suddenly turned and
walked the other direction. So I proceeded to the restroom, left the door open so
I could have some light from the hallway,
placed my bottle on the floor, and stood
in someone else’s urine. The next day I
was transferred to a private hospital and
a private room with wifi, which was a big
deal for me since I had very little contact with my wife since the accident two
days prior. The connection was spotty
and sometimes I would have to carry my
chest tube bottle into the hallway to talk.
But I was thankful.
I was surprised that neither hospital
monitored my hydration. I had to manage
Not one of the x-rays taken at either facility
would have passed QC in my hospital.