Tuesday, September 19, 2017

First Hospital Experience

I survived my first hospital experience here in Czechland.  Nothing major, it was just a tonsillectomy.  Everything went well and the staff in the ORL (ENT - Ear, Nose, Throat) department at University Hospital Bohunice were great.  My biggest problem was not knowing what to expect in regards to the differences between a hospital stay in the USA and here.

Bohunice ORL ward waiting area
As a patient you need to bring your own pyjamas and robe.  No American style hospital gowns that tie in the back and never quite fit right.  The good thing about this is that you get to be comfortable wearing your own pj's.  You also need to bring your house shoes.  All of the doctors and nurses wear white sandals with their hospital whites.

Generic hospital TP
You also need to bring your own toiletries - a bar of soap, shampoo, a tooth brush, toothpaste, etc., plus a towel.  I was advised by friends to also bring my own toilet paper.  The hospital does provide it but it is the standard, cheap "Eastern European" variety.  I also brought an extra pillow as a creature comfort as I was going to be in hospital for a week.

One of the first things that struck me was the lack of paperwork.  So much less paperwork.  When checking in, I just had to show my health insurance card.  I had to speak to the anaesthesiologist who did have me sign a form that I was made aware of the risks of general anaesthesia.  I was even given the document in English.  The only form I had to complete with the nurse was for any valuables I may have brought such as a mobile phone, tablet, or laptop.

Standard private room
I've heard stories of having to share a hospital room with up to four or five other people.  For the ORL ward, each room had a maximum of up to three patients with a shared in-room shower and toilet.  There was Wi-Fi and I think that there was a TV in each room.

            Deluxe private room
Each hospital ward has a limited number of private rooms.  The fee for a private room is not covered by health insurance so you pay this for yourself if one is available.  The basic private room cost 500 Kč ($23) per night and the deluxe private room was 1000 Kč per night.  The basic room had a TV and a private shower and toilet.  The deluxe room looked a bit more like a hotel room with art on the walls, a TV, a kettle, a small in-room safe, and a private shower and toilet.  With the private rooms, the nurses are less concerned about the strictness of visiting hours because you're the only patient in the room.

Dinner when I was still allowed solid food.
A friend called the hospital and reserved a private room for me.  I really didn't want to have my tonsils removed and need to make daily small talk, in Czech, with any roomies.  For peace and quiet, a private room was definitely the way to go.

Some people may have outdated misconceptions about post-communist medical care.  Compared to medical facilities in the USA, those here in Czechland may seem a bit worn and outdated.  For example, the food trays and meal containers look like something from the 60s or 70s.  While somethings may seem old, everything is spotless.  However, when you go in to the operating room everything is shiny, new and very high-tech.  They are definitely spending the money where it really counts.

My first visitors
All of the doctors spoke English but the nurses spoke Czech.  The nurses were all pretty patient with my poor Czech.  One of the nurses spoke German with me so when she was around all of the other nurses deferred to her.  There was one nurse who would speak loudly to me in Italian whenever we couldn't understand each other.  What's funny is that I don't speak Italian; just what I can piece together from my Spanish.  I found out that a few of the nurses actually spoke some English but just weren't comfortable trying to use it at work with a patient.  Even the Italian speaking nurse could speak enough English that's way better than my Czech.  Oh well.  In a worst case scenario you can also grab one of the student doctors because they all speak English.

A day on the ward was pretty regimented.  It began at 6 am with the nurses bringing morning meds and taking your temperature.  Breakfast was from 7-7:30.  From 7:30-8:15, every patient had a morning check up with the doctor.  Lunch was from 12-12:30 and then it was time for afternoon meds.  Visiting hours were 2 - 6 pm.  At 2:30-3 pm an afternoon snack of coffee and a rohlik.  Dinner was from 5:30-6 pm with evening rounds from 7-8 pm.  Quiet hours were from 10 pm to 6:30 am.

Having a tonsillectomy means no solid food.  This meant that lunch was always a bowl of potato puree and two soups.  Dinner was, again, a bowl of potato puree and another soup.  The only solid food I was sometimes given were vanilla wafers that came with a custard and flavoured kefirové mléko (basically either strawberry or apricot flavoured acidophilus milk).

In American hospitals, your meals are brought to you.  Here, the nurses announce over the intercom that it is meal time and you go pick up your tray.  You can eat in the common area or take the tray back to your room.  You return your tray when you are finished eating.  The Czech system makes more sense to me because it forces patients to get up and move.  Of course, if you can't move around then they will bring the tray to you.

The speaker was also used to tell people when it was time to go visit the doctor for your morning check up.  Bohunice is a teaching hospital so every day a group of students would come by with a senior doctor to perform rounds.  It felt like a scene from a Czech episode of Grey's Anatomy.

Another difference is that when I left the hospital I got to walk out.  In the USA, hospitals make you leave in a wheelchair even if you can walk.  Basically, the hospitals are afraid of someone falling as they leave and that the hospital will be liable.  Americans love lawsuits.  Here's a scene from the 1994 movie Guarding Tess that I found on YouTube.

When I was discharged from the hospital the only bill I received was for the cost of the private room which I paid at the cashier on my way out.  That's it.  Even with health insurance who knows what I would have had to pay in the USA?  The Czech healthcare system is excellent!  I just don't get why people back home freak out about socialised health care.  Here I pay taxes and my healthcare is covered.  Very simple.   

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