Canada’s healthcare? Fine as long as you never get sick or injured or never grow old. Part 1.

There’s been a bit of banter lately (again) about the pros and cons of healthcare in Canada vs. the United States. First, a disclaimer: I am a Canadian by birth and an American by choice. My first nursing credential was a diploma from a Canadian school of nursing. My BSN is from Seattle Pacific University in the States. My first nursing job was in Canada in 1994, right after I graduated with my diploma from Kelsey Institute of Applied Arts and Sciences in Saskatoon. Shortly thereafter, I emigrated to the States and worked as an RN for several years in Texas. I’ve been working in healthcare informatics since 2003; and for several years as a healthcare IT consultant. (Some would argue, therefore, that I am no longer a RN i.e. a “Real Nurse”).

I’ve worked in Canada on and off during my career, most recently in Edmonton with the Capital Health Region (2007). It is in Edmonton where my story begins.

During my engagement in Edmonton, a close friend and colleague who is diabetic had a diabetic reaction and I had to take him to an emergency room. I had heard of the legendary wait times in Canadian ERs and I that was what I was expecting when we walked into the ER of one of Edmonton’s busiest hospitals. Contrary to what I had heard, the service in the ER was quick and efficient. I had my friend in an exam room inside of a few minutes. A doctor saw him a few minutes after that, ordered some tests, arrived at a diagnosis and treatment plan, and had us out the door inside of a couple hours.

Flash forward to 2011, Saskatoon. My mom was hit be a car on January 6, about one o’clock in the afternoon, in front of her house. She suffered a fractured hip, fractured clavicle and skull fracture. She was taken to Royal University Hospital, Saskatoon’s only full-service hospital. She waited in the hallway of the RUH ED the entire night, while a surgical team was assembled to take care of her hip. That was considered to be the worst of her injuries. She was in the ED for several hours before anyone considered taking a serious look at  her skull fracture. A CT scan revealed that she had a subdural hematoma. The treatment team was still preoccupied with the broken hip, however, and the middle of the next day–over twenty-four hours after the accident, my mom had surgery on her broken hip. The only care planning out of surgery, again, focused on her hip with barely any attention paid to the skull fracture and subdural hematoma.

Mom’s post-surgical recovery continued uneventfully, and inside a week it was determined that she could be transfered to a step-down unit in  Saskatoon City Hospital to start physiotherapy. She had been at City Hospital for less than three days, when she experienced a dramatic decrease in her cognitive abilities and level of consciousness. Another CT scan, only the second since the accident, revealed that the subdural hematoma had extended, that the increase intracranial pressure was causing a problem, and that an urgent intervention was required. Mom was transfered back to RUH. She was once again taken to the O.R., this time for an urgent craniotomy (a small hole drilled in the skull) to releave the the pressure on her brain. This procedure was followed by a long convalescence in RUH. During this time, the medical staff discovered that somewhere in all of this Mom had also suffered a couple of small strokes. All the while, my brother Mike and I (Mike is also a nurse) had to remind nursing about the basics of nursing care, remind them to keep up with there assessments, and not to over-drug her. After the craniotomy it was over a week before Mom got a follow up CT scan. That only happened because Mike and I hounded the neuro staff (mostly residents) that follow up imaging was a prudent and sensible think to do (especially considering the almost lackadaisical approach to the head injury in the first place). The follow up CT indicated that now instead of fluid in the space caused by the subdural injury, there was air–technically a pneumocephali. A series of interventions–bed positioning, hyperoxygenation, and others–eventually resolved the pneumocephalus problem; but not before Mom lost weight, declined further, developed anemia, and problems because of the hyperoxygenation.

Stay tuned for Part 2.