The Question: My father has been on a “wait and see” list for 36 hours, with an IV drip. Once they know surgery isn’t going to happen, why wouldn’t they feed him normal food?
The Answer: The “wait and see” surgical list is ubiquitous to Canadian hospitals. That’s because a hospital, with finite resources, must operate at or near occupancy to be efficient in the public health care system. This is in stark contrast to the United States, which has the ability to treat a paying patient more quickly in a private system where hospitals, in some cases, are only half full and are looking for business.
Since your father came through emergency department, he did not have a booked operation. He was deemed clinically stable, put on an intravenous fluid to keep him hydrated, then placed in a queue for the operating room. This is probably the most frustrating part for patients. He will wait for some time – hours, sometimes several days – to move up the queue, knowing that as a trauma hospital, a more injured person coming here will be jettisoned to the top of the list. Conversely, a booked surgery may be cancelled, and your father may quickly be seen.
Still, your point is a good one: you simply want to know why he wasn’t fed and when a surgeon makes “the call” to say your father can now eat, then try the next day to get into the operating room.
“On the acute units, we depend on the call from the surgical team for further information about the planned surgery,” said Smitha Casper-DeSouza, patient care manager. “As soon as we know, we inform the patients/families.”
Patients on the “wait and see list” include those with fractures, diverticulitis, gallbladder issues or bowel obstructions.
Your father is restricted from eating or drinking, to decrease the risk of vomiting during surgery so he is ready at a moment’s notice to go into the operating room.
Cynthia Holm, director of operations, OR and related services at Sunnybrook, said the physician decides how a patient will be booked. The patient could be booked into that surgeon’s elective schedule or it could be given a higher priority.
“All patients on an emergency list are further actively reviewed by the surgical team as to patient priority and patient flow,” she wrote in e-mail.
Still, it can be hectic in a hospital and they may not get back to you as soon as you would like. When that happens, ask the nurse looking after your father or the team leader for an update.
