BLACK BOOK | A woman with a femoral neck fracture lies in pain in her excretions, desperately waiting for the operation. A baby falls to the floor of the delivery room during birth. Everyday life in German clinics – because there is a lack of staff.
In order to show that care in German hospitals has reached its limits across the board, the project Black Book Hospital brought to life. On the Website the initiators write: “We, workers in the healthcare system, report on overload and patient endangerment in everyday work. The following testimonials show what healthcare really is like in Germany.”
We reproduce part of the stories in a slightly abbreviated form on DocCheck. You come to the original texts and all other reports here.
No time for humanity
a caretaker writes in his report: “The emergency room is full again. We, the nursing staff, are permanently in a state of emergency. None of us take a break, some of us can’t even go to the bathroom or drink. The latter even helps to avoid having to go to the toilet. But it’s not good for your own health.”
He treats one patient among many in the overcrowded emergency room. “I constantly prioritize how urgent a task is. The patient has a femoral neck fracture. Otherwise, her circulation and state of health are stable. She’s lying on the stretcher in the hallway waiting for her surgery. She is sober for the surgery, hasn’t eaten in hours.”
30 minutes ago she would have asked him and his colleagues for painkillers. “No one had time.”
“After 1 ½ hours she asks again in tears. No one has time. After 2 hours she finally gets painkillers, but now she has to go to the toilet. But of course she can’t go to the toilet by herself because of the femoral neck fracture. The emergency room is bursting at the seams. Many of the patients are critical and need our full attention. No one from the nursing team has the time and capacity to accompany the patient when she goes to the toilet. No one has time!”
When dignity is surrendered at the clinic door
“After three hours, the patient wet her pants. She begs for help. No one has time. After four hours, one of which is spent in her own urine, the patient has to have a bowel movement. In addition, she is in pain again.”
Even after four hours, the situation in the emergency room is still extremely tense. The nursing team rotates. There was simply no capacity in this service for a patient in pain and lying in her own urine.
“No one has time! The patient now burst into tears. She continues to lie in her own urine and stool. She is lying on the floor in pain and begging for help. It’s not up to us. We would like to help her. But other patients continue to need our full strength and attention because their conditions are more critical. After five hours, the patient is wheeled to the surgical area, lying in her own urine and stool. How undignified can a hospital be please!”
The Sugar Trap
A midwife reported from her first year of training: “When I started my morning shift, a harried midwife came towards me. She alone had looked after five women that night, all of whom had given birth to their children that night. After handing over the service, my midwife assigned to me said that I should have a quick look at the newborn in delivery room 1. The newborn would have been born at 3 a.m. and since then the midwife on night duty has not had time to check on him.”
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She went into the delivery room and checked on the newborn. “I saw that the child looked greyish and lethargic. The muscle tone was reduced and it was immediately clear to me that this newborn was not doing well.” She picked up the child to seek help and met a young resident in the hallway, who immediately recognized the seriousness of the situation. “She called the pediatricians and they treated the child. It turned out that the child had a blood sugar of 13mg/dl. The minimum value for a newborn should not fall below 45mg/dl, because then the child will require treatment. Hypoglycaemia in a newborn leads to reduced bodily functions (adjustment problems, body temperature instability) and quickly attacks the newborn’s brain. In the worst case, irreversible brain damage occurs.”
The child was transferred to the intensive care unit. “I can’t say how the child was doing. I only remember that the parents thanked us because they thought we had saved their child. I didn’t tell the parents at this point that the first symptoms of hypoglycaemia are easy to recognize (tremor, reduction in body temperature, greyish skin color) and therefore also easy to treat. If the midwife had been able to observe the newborn closely – which is part of a midwife’s job – the child would never have gotten into this state.”
fall into life
“Unfortunately, when I was a fully qualified midwife, these experiences continued. I can remember a night shift when I looked after five women as a midwife, three of them actively giving birth. I was solely responsible for five women and five children. Sometimes I didn’t even notice who was newly admitted to the delivery room (the doctor had to go to the delivery room door more often), because I was caring for a first-time mother quite intensively. The doctor on duty had canceled the delivery room, but the fire brigade brought two women with the statement: ‚Yes, the other delivery rooms are also closed.‘Suddenly she heard the doctor on duty yell her name and although the woman giving birth was about to give birth – her head was already visible – she rushed into the delivery room, where the scream came from.
“I saw a woman standing by the delivery room bed, a newborn lying on the floor, and a torn umbilical cord. The doctor tried to put the woman to bed. I took the child – it was alive and screaming – put it quickly on the mother’s chest, clamped the umbilical cord and just said quickly to the doctor: “Remember the warm towels for the child, I have to go back to the other woman.” This other child was born a little later. The child, who fell on the ground, had to be transferred to another hospital for observation by the paediatricians. Imagine this: a child falls to the ground because nobody is there.”
“The other woman is left alone shortly before giving birth – not to mention the other women, who unfortunately I could hardly look after due to the lack of staff. The women entrust themselves to us, they are convinced that we can take care of them, look after them.”
Furthermore, the midwife writes: “I would like to emphasize at this point that the current writing of this night service does not come close to reflecting the psychological and physical stress I was exposed to, not to mention how endangered the women and children were that night. There are countless case studies in which patients are acutely endangered – simply because not enough midwives are deployed.”
If you also want to report abuses in your clinic, you can here Contact Black Book Hospital.
Image source: Brandon Holmes, Unsplash