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A mother’s plea
The article on page A12 of Sunday’s Guardian, “A Mother’s Plea for Human Compassion at Hospitals” should be read not only by mothers and grandmothers and aunties and all nurses who take care of children but by hospital administrators and senior health officials in the Ministry of Health.
The story is simple. A seriously ill 12-year-old child is brought back home to Trinidad, admitted to the Intensive Care Unit for Children at EWMSC and then left to die alone which she does within six hours of admission. The admission was planned. She was not transferred from Florida until a bed was available for her in the ICU so there is no question of surprise.
Her mother had spent the previous four months at her bedside in the ICU at the foreign hospital, not only entitled to be there but encouraged to participate in her care, to the extent of staying with the child and holding her hand whenever she “crashed”, ie stopped breathing and had to be resuscitated.
The staff there are described as being “kind, compassionate, friendly and understanding of a mother’s pain.”
On arrival at EWMSC the parents are immediately told that “no parents are allowed in the ICU” and it is only the arrival of a senior paediatrician that enables the child’s brothers to see their dying sister. The parents are then asked to leave the ward and denied permission to remain in the family room.
The paragraph in which the mother begs and pleads to be allowed to stay with her daughter, “I would stand quietly behind her bed—I didn’t need a chair”. No. “I asked if I could be allowed to stay in the family room and check in on her every now and then. I was refused. I asked if I could stay outside the unit and check in on her. I was refused”, surely makes a mockery of the revised Hippocratic Oath (1964) which states, “I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon’s knife or the chemist’s drug” and again, “I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person’s family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.”
Two hours later when the family return, the child has died. It is then that the family is given permission to be with their child.
I don’t want to be drawn into a discussion of the nurses’ attitude towards the parents although it is far too common to be told in our public institutions, “you went private?” And ostracised.
I also don’t want to get into the compassion business or the Hippocratic Oath now.
No, I want to concentrate on the medical issue. The fact is that in the foreign ICU the mother was not only entitled to stay 24 hours with her seriously ill child, she was encouraged and supported to do so. There was no special facility for that to happen. This mother slept in an armchair for four months and used the nurses’ bathroom when necessary. She did it willingly and with the support of the medical and nursing staff because that is how you get the best results in ICUs. The research is clear and has been known for over ten years.
It’s known as Patient-centered and Family-centered Care (PFCC) and was endorsed by the US Institute of Health in 2001. By the American College of Critical Care Medicine Task Force in 2007 and by the American Academy of Paediatrics (AAP) in 2012.
In ICUs, PFCC improves outcomes for patients, families and health care providers, decreases health care costs, and leads to more effective use of health care resources.
That’s the bottom line. Why are parents being asked to leave their
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