General Hospital ep2: Apples and Oranges

People like to ask what being in a Korean hospital is like, if it's the same, and the easiest way to respond is saying "It's like apples and oranges".  We've all heard the saying (or idiom for the fancy folk) and we'll sometimes it's the best way to sum it all up.  They are both fruit, but they are quite different by comparison. 

I've had my fair share of hospital experiences over the years in the states as I'm accident prone and unfortunate in that way that I get to share the fun stories that always start with "When I was (enter age), I (enter illness, accident, surgery, or hospital visit).  It's built character and given me a pretty solid understanding of what emergency rooms and hospital life are like (at least in Texas).  And while my experience here is very much the experience and perspective of a foreigner, and not all hospitals here are the same as I am not in the really big university hospital (DFW think Baylor or Parkland). I am in the Lake Point, Doctor's Hospital, Medical City, or any other local hospital in a big city.  So don't rake me over the coals if someone reads this and it's not their experience home or abroad...get your own blog and make your own list!

I will assume most reading this have an understanding of hospitals elsewhere so I will rarely talk about the apples...because it's the oranges people want to know about.

1. Gloves.  They just don't wear them here.  Taking blood, putting in IV's, taking out a drainage tube from my knee...pick an activity and then take off the gloves.  The only gloves I have seen were in the operating room and even then only those operating on me had gloves on.  The nurse who put on my mask and monitors...no gloves. 

2. Appointments.  They don't exist.  Almost like the DMV, (but so much more efficient) you just show up, your name goes on a screen putting you in a virtual line, and then you wait.  But the waiting is short.  To see my orthopedic surgeon my wait was maybe 15 or 20 minutes.  So you get told come back and see me on Thursday for a check up, not Thursday at 10:15am (but don't expect to be seen before at least 11am).

3. Length of Stay.  I had complete reconstructive surgery on my ACL and MCL.  I believe at best I would be looking at maybe a 2 day hospital stay back home and I'm not even sure that I would be granted that much.  Here 10 days.  Koreans have crazy work ethic, so essentially the only way you really can get out of work for more than maybe a day...is if you are in the hospital.  There is no "I don't feel well today, I'm not coming in".  You get up, you go to the doctor, and then you go to work.  If you are really bad, you might get someone to cover your for the day while you get an IV and a little rest, but you are "hospitalized" in Korea for far less than in the states, and for far longer.  But before you criticize it, it's necessary if you too sick to work and need 3 days off for a bad case of something.  In looking up recovery times I've found that most were not cleared for returning to work until week 3 or 4 after having just ACL recon.  Ten days after surgery, I get out of the hospital and will return to work on day 11.  It's just the culture. So when I got here every bed was full, but because it's a holiday weekend those who weren't too terribly sick left for a few days and others discharged as it's a holiday.  The only people here are those who need to be. 

3.5 Open Door Policy.  Unless maybe the rule is different for really severe patients..there is no hospital policy on visitors coming in (no visitor times, check-ins, etc) or patients going out.  The girl in the bed next to me hasn't been here in 2 days but all of her belongings are.  The lady across from me at least once a day leaves for hours and hours at a time.  Outside you will see patients standing on the sidewalk smoking a cigarette pushing an IV pole wearing hospital attire.  The rule is there are no rules.  So if you aren't deathly sick and you want to go home for a bit, grab dinner with friends down the street, or need to run to the market on the corner for some snacks....knock yourself out.  No one will stop you from coming or going in my experience. There is a coffee shop next door to the hospital.  Feeling cooped up and sweating from a particularly hot day...yesterday I asked a friend to push me in my wheelchair next door in my hospital jammies with a taped down IV port for an iced coffee and 30 minutes of real air conditioning.  So as strange as it should have looked (and as it felt), it was probably the most normal and Korean thing I've done to date.



a little rolling screen that blocks half
room in the event of a real procedure
needing to take place.

4. Shared rooms.  Other than recovery rooms and similar situations, back home everyone pretty much has their own room/bathroom. Not here.  My floor has I think 2 private rooms that you pay significantly more to utilize (with reason) that resemble an "American hospital room".  Everyone else goes into a shared room of 6 or 7 males or females.  Each has a bed, a cot under their bed, a cabinet for personal items and a small mini fridge for drinks built into the cabinet.  Also shared are the community bathrooms and shower rooms.  There is one open shower room for all the women on my floor and a bathroom with 3 stalls and one sink for all the women on the floor.  The males have the same.  So roughly 60 patients share a his and hers shower room, and about 6 total bathroom stalls. 

5. Privacy.  There is none.  Save yourself the HIPPA

My notecard
 

 phone call, it just doesn't exist here.  I have 5 roommates and there are no curtains separating the beds, no special room for when the doctor does his rounds to discuss your illness or to do a check up or change my bandages.  On the front of each bed is a large notecard with your name, age, date you entered the hospital, and what you are being treated for in 3 or 4 words. So I can tell you who has a burn on their left foot, who has a fever, and who has liver disease.  Luckily....no one really cares. 




medicine come sealed with yourname and info. 
Nurses just deliver them like mail.

6. Nurses.  They do very little here.  If teaching isn't for you, learn the language and be a nurse here.  It has to be the easiest job you could ever imagine.  They pass out meds, the check temp and blood pressure (I've only seen them actually chart the results maybe once a day), put in IV's, and ask how you are maybe twice a day (although this never changed my medication regimen or treatment) .  There is no call button on every bed to beckon a nurse.  They do not personally assist you as that is not their job.  Ask them to, and they will likely get uncomfortable and look around wondering what to do as it's not a part of the job description.  Need help getting out of bed, or to a bathroom...don't ask the nurse.  Would you like something to drink, nope not her job.  Is your IV empty?

No decorative nursing scrubs

  Get moving to the front desk unless you want to wait until the next time they come in and then have to flush it as its been empty too long and blood is entering the line.  If you need the nurses desk, there is a number you can call or you simply get up and go to the front desk where they will switch out your IV there.  There was no saying I'm in pain and they add a shot to my IV that wasn't already scheduled. And none of my nurses speak English.  There is no fancy translation machine or here is a print out in English of the medication we just stabbed you with in the ass...you just roll with it and when the nurse does her rounds you either say "ahpaeyo" or "ok".  The head nurse will use google translate on my phone to be nice but the rest do their job and move on. 

7.  Self Serve/Family Duties.  You or your family are expected to do all the things the nurses don't do.  Want help walking to the bathroom then your daughter, mother, brother, grandma, best friend does the job.  Thirsty?  Drinks don't come with the meal and there is a hot and cold water dispenser near the front desk...you or your family can get up and get it yourself or you can buy and keep it in your mini fridge as no one is bringing you ice chips, water, or anything else.  Bed pan I believe is also the expectation that family is emptying it.  They made a few exceptions for me the first day since I was unable to get up and I obviously don't have family here.  So they put a bedpan under my bed and after I used it, could just return it under the bed and they would then empty it on their next visit in.  This was the what I understood from charades and one or two words I understood.  I assure you that I refused to use it and leave it under the bed and had sweet friends who helped me get to the bathroom despite the bedpan. and then I held it until doctors rounds the next day after breakfast to get the okay to try and move on my own so the nurses would stop freaking out that I was trying to move around and that I was not using my bedpan.

7.5 That one was long.  Meal times just like at home, a tray is brought in and sat on the tray table.  However when you are done, you have to get up and walk it to the end of the hall where you put your empty tray in the rolling tray holder.  If you can't get up, you need someone to do it for you, or you learn how to balance a tray on a wheelchair while pushing the IV with one foot and using your hand to push your wheelchair to the tray location.  Chopsticks and spoon....you bring those from home and you wash them yourself after each meal.  So you'll be thirsty and confused if you don't bring your own silverware, cup, drinks, etc. 

8.  Air Con. Back home hospitals are known for being unnecessarily freezing year round.  Here...it's the opposite.  There are two windows in our room and 90% of the air comes from there..too bad its May!  There are times where while it's still hot and i'm sweating, there seem to at least be a little "new neutral air" so there may be some sense of fan usage at times but often I find it cooler outside than inside.  I get out of bed sometimes just to give my sheets and my back a chance to "dry".  It's lovely (especially since I'm not permitted to shower!!)

9.  Germs.  Have to be everywhere.  I've seen 3 patients wash their hands after the bathroom and I watch and listen.  They all brush their teeth 6 times a day but never see the same rules applying to their hands.  I have a blood drop on my bed sheet as we speak as the nurse drew blood and had to transfer it into the little vials as they do it the old school way. When getting an IV, there was a tiny splatter of blood on my tray table..I washed it off.  2 days ago a nurse left the end of a need or IV that she took out on my cabinet top.  I left it there and when I woke up later from a nap it was gone.  When my drainage tube came out, it was done on my bed...and there was seepage onto the pillow under my knee.  The doctor took of the pillowcase and called it a day.  They clean the ends of IV's disinfect stuff, but the rest seems to come out in the wash.  It's just not a concern.  While not germs I'd like to note that spitting is a Korean thing, everyone here has seen it and hated it.  But living with 60 Koreans and being across from the shower room...I hear it constantly, especially in the morning.  Its disgusting and flemmy and worst than the sound of my alarm. 



One of my many IV ice packs.  Waste not, want not!

10.  Technology.  Not sure what the right word is here...but things aren't exactly state of the art.  At home everyone I know used a polar cooler to circulate cold around the knee to eliminate swelling.  There were slings or special pillows for elevating the leg.  None of that happens here.  If they have it, I wouldn't know it!  Post op, a friend had to go ask for an additional pillow to put under my leg as I was laying in a bed with just me a blanket and a pillow.  We also had to ask for ice packs.  The ice packs....are frozen IV bags.  I only wish I could make that up.  So while I've been told that isn't the case everywhere...it is the case here.  I live in the richest district of my city and at least my floor, uses frozen Saline IV bags.  Korea gets a 10 across the board (even from Russia) and take the Gold for creativity..but they lose out a little on effectiveness and attentiveness when it comes to the nursing staff. 

So while I could go on and one and have an honorable mention list...Letterman would not approve of me breaking the rules of my Top 10 list (in no specific order).  So there you have it.  Apples and Oranges.

Both are fruit, both are "well-being", and while categorically the same, it's like comparing apples and oranges.  I prefer apples, but they aren't in season and far more expensive.  So I have assimilated to the orange, learned what makes it unique, and even come to appreciate it some ways.  But one thing is for sure, the orange will forever affect the way I see the apple.