Presented without pithy title...

There was an article in the Winnipeg Sun on Wednesday this past week, and I don't know a single person that's read it that didn't finish it with a fairly strong opinion.  It was written by Floyd Perras, the director of Siloam Mission here in Winnipeg.  In it he refers to a situation that took place at the Health Sciences Centre in 2008, where a homeless, double amputee named Brian Sinclair died waiting for longer than 30 hours in the Emergency department.  Mr. Sinclair was sent alone by taxi from a community health centre to present himself at HSC concerning a blocked catheter that required changing.  On arrival he may or may not have presented himself to triage, as he was never registered as a patient waiting for medical attention.  After more than a day, unable to void his bladder, he died in his wheelchair in the ER waiting room of a bladder infection that spread to his bloodstream.  The resulting furor has been going on nearly 4 years.  His family has brought legal action against the Health Sciences Centre, the Winnipeg Regional Health Authority, and the province of Manitoba, going so far as attempting to have the HSC ER declared a "public nuisance" and suggesting in their lawsuit it should be shut down (a move I felt stole an enormous amount of credibility from their grievance).  No final legal decisions have been made, but the province in now seeking to dismiss the lawsuit after paying Sinclair's family approximately $110,000 for "loss of care, guidance and companionship for his wrongful death."  They are still seeking $1.6 million.

There is no question that this incident warranted investigation and corrective measures.  As the only hospital in the core area of Winnipeg, HSC is presented with unique challenges and opportunities in its delivery of care, and must remain vigilant and consistent in providing it.  I am given to understand in the wake of Mr. Sinclair's death that the ER has taken measures to ensure this kind of oversight doesn't occur again, and has improved their triage process to ensure all who are waiting for care are accounted for. 

Many including myself, have found it somewhat baffling that his family have appeared to be such tireless champions for Mr. Sinclair and his cause following his death, given that he was homeless in life, and spent over a day in ER all alone.  Where were any of them when he was alive and really needed an advocate?  There's no way I would allow any of my loved ones to sit in an emergency room alone, and certainly not for anywhere near that length of time without exploring other options.  His family suggests that he had a speech impediment that made communication difficult.  Why was he put in a taxi alone from the community health centre then?  If they suspected he was incapable of triaging himself, they had no business sending him alone, without at least a telephoned report to the ER prior to his arrival.  The ball was dropped by many people in Mr. Sinclair's life it would seem, far before he turned up at the hospital.  Mr. Sinclair's family claim they persist in their legal efforts to "find out the truth about what happened to him" and that "he's going to leave something behind to this city, and that's a better health system".  I would ask how them getting a substantial pay day provides them with any further details about Mr. Sinclair's death than were provided to them by the medical examiner, or improves the health system by taking money out of it.  How does shutting down the only ER in the core area make for a "better health system"?  With many accessing ER for routine medical care, where does the family expect people to go instead?  Do they plan to donate the proceeds of the lawsuit (should they be awarded them) to aboriginal or homeless causes that would improve the health of these demographics?  If they do, they certainly haven't mentioned it publicly.  If changes have been made and processes improved, what more are they really hoping for in terms of "ensuring this never happens again"?

The article written by Mr. Perras was an incredibly glib, underinformed, and self-satisfied interpretation of these complex events, and attempts to lay blame solely at the feet of racism and discrimination.  While this would be an easy explanation, it in no way represents the truth.  Mr. Perras claims that "ER staff prioritize homeless people to the bottom of the list.  If they are aboriginal, they can be put even lower on the list.  They've learned that if you make a person wait and wait, they will eventually go away." Firstly, anyone who has so much as walked past the ER waiting room at HSC would find it easy to see that the majority of the people being served there are aboriginal, and many would appear to be homeless, or at least from less than ideal living situations.  It's a fair assumption that HSC provides care to more people of these demographics than any other hospital in Winnipeg.  Mr. Perras also takes issue with wait times. "A simple data base could remind intake staff of how long people have waited for help.  Perhaps after 6-8 hours, they automatically go to the front of the line."  Well Mr. Perras, HSC is designated as the trauma centre for Manitoba, northwestern Ontario and Nunavut.  This means that ER staff there deal with life-threatening injuries on a daily basis and prioritize their slate based on the seriousness of cases, not race or socioeconomic status.  This means that if you utilize the ER as a family doctor or walk-in clinic, you can expect to wait behind those who have been hit by cars, who've been stabbed, shot, assulted, or who have suffered major burns.  This is how it should be.  Imagine the hospital trying to explain to a family that their loved one bled to death while the staff tended to a headache simply because that headache waited longer.  Staff know how long people have been waiting, and they don't like it any better than the patients. The goal of ER staff is to see an empty waiting room, and patients receiving timely attention, not just outwaiting sick people in the hopes they'll "go away".  This is not why those who take on the massively stressful task of ER work do what they do.  They aren't in the back room drinking coffee and watching daytime TV thinking "20 more minutes and I'm sure they'll all give up."  They are on their feet for hours and hours, saving lives, and dealing with untenable situations every day that the rest of us couldn't even begin to imagine.

If Mr. Perras would like to take issue with how he believes aboriginals and homeless people are discriminated against by the health system, I say people in glass houses shouldn't throw stones.  His own organization categorically refuses shelter to those who appear intoxicated or who may be under the influence of drugs.  As substance abuse and addiction are understood to be a prevalent issue amongst homeless and/or aboriginal people, and addiction undoubtedly makes them even more vulnerable, I would ask Mr. Perras who's really deprioritizing the homeless?  And according to the Siloam Mission website, every single one of their beliefs and values centres heavily on the Christian faith and emphasizes that "without a faith commitment to Jesus Christ, the future is one of eternal separation from God and all that is good", which I am given to understand is not a philosophy in line with traditional aboriginal spirituality.  If Siloam Mission disapproves of how one of the resources utilized by the aboriginal homeless is treating them, perhaps they as a resource should be making greater efforts to pick up the perceived slack and be more inclusive.  I certainly respect Siloam Mission's right to operate their organization as they see fit, but in doing so, they are alienating or outrightly barring a large percentage of those that need help, while criticizing HSC for allegedly the same thing.  Perhaps a little self-reflection and fact checking would have done Mr. Perras some good prior to writing his article, as it certainly wasn't a good vehicle for organizational promotion published as it was.

Thank you for reading and have a well-informed week :)

*none of the preceding represents the views or opinions of HSC, the WRHA or the province of Manitoba*

Ch-ch-ch-ch-changes

WCCNEP graduation was Friday, and I am pleased to report, lasted only an hour!  I spent most of the day with a strange, disbelieve-y feeling, like I couldn't believe it was finally over.  Sometimes at the end of a journey, people look back and talk about how the time flew by.  I will not be doing that.  This was the longest, unhappiest, most difficult 6 months of my life.  It caused me more self-doubt and anxiety than anything I've ever experienced in my life.  And it's over.  I made it.  And no one is more surprised about that than me.  I think it's easy (and nice!) for other people to say "Oh, I always knew you could do it", but from the inside, and as the person trying to do it, I wasn't so sure.  I had weeks where I was scheduled for 6 shifts, or 72 hours.  I had a stretch of 12 days where I only got 2 (non-consecutive) days off.  I just kept slagging through and eventually came out the other side.  I have truly no idea how.  I want to take a moment to recognize a few people, without whom I wouldn't have been able to make it.  Firstly to my parents, your faith in me and your willingness to listen through hours and hours of whining and crying....I couldn't have done without it.  Amber, your sympathy and attempts to share in my outrage in what was required to finish this monstrosity were a constant source of comfort.  Mike, your realism and listening skills will never be forgotten.  And for showing up for another of my graduations :)  Jaime, your constant positive reinforcement and enthusiasm got me through several hard days and weeks.  And my preceptors, Jill and Kevin.  Jill, your pragmatism, thoroughness and oodles of experience are things I will take with me the rest of my career.  And Kevin, you really fostered my independence and built my confidence when I needed that most.  I really appreciated that during the grad speeches that one of the speakers acknowledged our friends and families.  I can't imagine I (or any of us really) would have made it without them.

Needless to say, after this past week was over, and a celebratory dinner was had, I was thoroughly exhausted.  I spent the entirety of Saturday and Sunday at home, cleaning, crafting (I know right?!) and watching the Westminster Kennel Club Dog Show.  I can't explain it outside of the fact that I'm a dog person, but I LOVE watching it every year.  I love that it's still this spectacle of good manners and refinement and that they haven't resorted to putting sunglasses on the dogs and having them trotted out by Hooters girls to improve ratings or some such hot nonsense.  It always leaves me feeling like I want another dog, we were always dog people growing up, and while I have a cat, I am in no way a "cat person".   Anyways, here are the ones that this year's show made me feel like I want:

And most of all......

I don't care what anyone says, I'm beyond excited we are in an Olympic year again :)  The Olympics are like my Christmas, or Super Bowl, or March Madness.  If I had enough seniority to take my holidays around the Olympics (summer or winter) that's what I'd do.  I'd so not wild about the logo they chose though, it looks kind of 80's.  Like if Jem and the Holograms were asked to commission a logo....

I can't help but notice that since Will Forte left SNL, he hasn't done a damn thing.  And SNL is worse off for him not being there.  If Bill Hader ever leaves, I might just give up on it altogether.

Sigh.

The longer I do the job that I do, and the longer I am around simply as a human being, the more I wonder how people can do such terrible things to each other.  I have not become desensitized to it like people assume you will be working in the medical field, and in some ways I find it harder to stomach now than I used to.  Maybe because I'm exposed to it more directly.  Maybe because I've been in ICU some weeks now, and I've seen people die from the brutality meted out to them by others, sometimes by their own flesh and blood. 

About 2 weeks ago, the 1st murder of the year in Winnipeg was committed.  Sadly, people were quite surprised it took til the 23rd of January for it to happen.  It happened 2 apartments directly below mine, when a man took it upon himself to beat and stab his wife to death.  They were new immigrants to Canada from Eritrea, and had only been here about 5 months.  The person this woman had been to hell and back with, who she had tried so long to build a new future with, who she should have been able to trust inherently, was the person that took everything from her.


Then last week, in Winnipeg's 2nd homicide of the year, a 29 year old man got into an argument with 3 other men at his residence.  2 of them left for a time, only to return with knives and stab him repeatedly, and ultimately, fatally.  According to news reports, the accused are only being charged with second-degree murder, not first.  While I've always been vaguely aware that first-degree murder entails an element of pre-meditation, I decided to find out the difference.  According to the Criminal Code of Canada, first-degree murder is "planned and deliberate" whereas second-degree is "more likely spur of the moment".  The 2 accused in this case left the home, giving themselves ample time to cool down and consider their course of action, and the course of action they chose was to return with knives.  In what way is this NOT "planned and deliberate"???  As someone pointed out to me today, perhaps the police feel their chance of getting a conviction on second-degree murder is better than taking their chances trying for first-degree.  If that is in fact the case, I guess some conviction is better than none at all, but it's unfortunate the legal system is so inefficient as to tie the police's hands this way.

Anyways, onto frothier things....

I love wearing scarves, and this girl is cute as a button.  Enjoy :)

My sister and I were discussing Paula Deen's announcing that she has type 2 diabetes a few weeks back, and how everyone seems to think she was obligated to announce this news sooner, and in some cases, that she should have completely overhauled her way of cooking the very minute she found out about her diagnosis.  She's also being criticized by many, (including a usual personal favorite of mine, Anthony Bourdain), for signing on with a drug company to represent an anti-diabetic medication.  Firstly, I think her health is her own damn business, and no one else's.  I don't think she has an obligation as a public figure to disclose what is very personal and life-changing information the moment she finds out.  If people who claim to be such huge fans of hers (who are now feeling SO betrayed that she kept this to herself) didn't realize the way she cooks isn't conducive to a long and healthy life, well perhaps they should have taken their heads out of their asses sooner.  Her high-fat, high-calorie cooking has been the butt of obvious jokes for years, and it's common knowledge it's not exactly good for you.  To the people who think she should change the cooking she presents on TV, in books and in magazines, I say B.S.  There are umpteen dozen food personalities out there who cook lighter, and make over high fat recipes, but Paula Deen built her brand on her particular style of cooking, and there are few others out there doing the same thing.  She's never come out and said her cooking is how people should be eating every meal of every day.  In terms of her representing a drug company, is anyone surprised in the least that a celebrity jumped at a timely opportunity to line their own pockets?  I think not.  At least it's a treatment she herself actually (allegedly) uses.  I doubt very much that Denis Leary actually drives a shitty Ford truck, or that Jennifer Lopez uses a drugstore razor.  As for Anthony Bourdain implying that she somehow is giving people diabetes and then profiting off of their requiring treatment for it, I call shenanigans on that too.  People should be accountable for their own decisions about what they feed themselves, and how they treat their bodies.  Paula Deen is not responsible for anyone else's health.  The American (and sadly frequently Canadian) mindset is to try to offload blame for any and all of life's ills onto someone/something/the government, claiming ignorance/naivety/etc.  This victimized way of thinking is underselling us as a free-thinking, free-willed people with open access to information.  We are all responsible for ourselves and our choices.

Now just to to finish off on a lighter note:

Oh and to those of you wondering, less than 2 weeks left in this 6 month nursing boot camp I voluntarily signed on for!!!  What was I thinking??!?!!  Hahahahahaha!!!

Thank you for reading, and have a wonderful and well-informed week :)


"In the midst of winter, I found there was, within myself, an invincible summer" - Albert Camus