Mixed Sex

The following letter has been taken from the letters to the editor in this weeks New Zealand Doctor. 

“Over the past year there has been a debate raging in the UK about getting rid of mixed sex wards. The Government is considering a financial penalty for hospitals that continue with mixed sex wards. It is considered to be, at least, degrading for patients and, at worst, a danger for female patients in mental health wards.

“In New Zealand there is no debate. We have mixed wards and I have always found them an insult to human dignity. The process of admission, being left in corridors and then planted in mixed sex wards are all an affront to human dignity.

“Seeing people wandering through wards with drip stands infusing them and catheters relieving them is a grim sight. They wander round in back-closing shrouds revealing their buttocks and tubing systems to the world.

“I suppose patients should be grateful for the “free” treatment they receive. There is only one thing they have to pay for in exchange. They must lose their autonomy, identity and human dignity.

“The advantage of going private is you keep these very precious, very human things.

Jonathan Simon

GP, NorthShore City”

I, too, agree with Dr. Simon that mixed wards are a degrading experience. Women, especially, have told me many time that they feel very vulnerable in a mixed ward, even when the only male in the ward is elderly and immobile. But Dr. Simon is describing much more than the experience of mixed wards, he is describing the dehumanising experience of being in a hospital. Most of what we do in hospitals is inadvertently degrading and undignified. Some observations:

• Admission is often a long-drawn out process of being asked the same, sometimes very personal questions, again and again, in very public places.
• Staff are often more interested in completing their paperwork than attending to you. This is because their managers are much more interested in completed paperwork than good patient care (though they would never admit this)
• Your doctor will see you as a disease to fix, rather than a person. This is not because s/he is a bad or rude person, but because s/he has about twice as much work as s/he can safely handle.
• Your nurse will have strange ways. She will think nothing of wheeling you in a wheelchair when you are perfectly capable of walking, making you wear dreadful hospital garments, allowing your catheter to “dangle” and your drip to fill with blood. This is because she is a nurse and these things are normal to her. She will also call you by you first name if she is young and by your surname if she is old enough to be your mother. She will laugh at very odd things.
• Nobody will explain anything to you in English. The doctor will explain things in Medical, in a slightly bored tone. When you are thoroughly confused s/he may ask you if you have any questions. At this point your brain will be completely empty. The nurse may then explain the same thing to you in tones usually reserved for an infant. Always ask for written material. They will look annoyed for a second then go away and never come back.
• Under no circumstances ask what a test is for. You won’t like the answer, should you actually understand it.
• It’s probably better if you don’t ask about results either. If it’s bad the doctor will come and start using scary wards. If they are good the doctor will say “they were fine”. You are better off asking your GP after you are discharged – he knows how to speak human.
• Hospitals and boredom are synonymous terms. While most elective patients remember this, the emergency patient is often climbing the walls within hours. There are no books, games, magazines or TVs that work in a hospital. Your bedside radio gets static and national radio. Death is preferable.
• Hospitals have waiting rooms everywhere. Physio, OT, Xray, Laboratory, every ward – even theatre. Waiting is what you do in hospitals. This is why you are called a patient. Now you know.
• If you thought the admission process was bad – wait until you get to the discharge one.

Come to think of it, perhaps mixed wards are the least of a hospital patient’s problems.

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