ONE VOTE CAST FOR WARDS

Ocean County Observer

September 9, 1982

The old saying “You make your bed and lie in it” should apply to the health planners, architects, trustees and licensing authorities who construct hospitals. Most of the time those in charge of hospitals don’t have to lie in the beds they make.

Currently Community Memorial Hospital and Point Pleasant Hospital are in the process of designing additions to their present hospitals. (Point will have its new facility in Brick).

Predictably they will all build the so-called semi-private room. The semi-private room came into being shortly after World War II when insurance plans promised that people wouldn’t have to go into a ward, but could ascend towards privacy. The insurance plans weren’t affluent enough to promise complete privacy, but a semi-private room was upward mobility in the hierarchy of patient status.

The only catch is that the semi[-private room is not semi-private. It is semi-public. It is bad enough with just two patients in the cubicle; but two patients plus four visitors (two for each patient) make a crowd.

The semi-private room eats ujp money, consumes nursing power, makes feeding difficult and fails to afford privacy. If there are any positive functions it offers they have yet to be enumerated.

One major expense of the semi-private accommodation is that caused by matching patients. For example if beds are vacated by two female patients in different rooms, one of the remaining females will be transferred to the other room so as to free a room for a waiting male patient. Every time a roommate is changed the cost is about $50. Thus a hospital making about 20 changes a day encumbers itself with costs of about $365,000 a year for an exercise that provides no positive benefit to society or the patient.

The national average of private rooms, and that recommended by government agency is about 20% of all hospital accommodations. Thus a hospital with 500 beds should have 100 in private rooms. Although capital costs for private construction exceed that for semi-private rooms by about one third, the upkeep is lower because empty rooms can be decommissioned, they do not have to be heated or cleaned till refilled.

As for space requirements, three private rooms could be build in space allotted for two semi-private rooms.

It woould be reasonable to assume that 20% of the new beds to be built in Ocean County will be private rooms, but that is not so.

Just for discussion, however, let’s suppose that that the private rooms were built. That would help with some important problems, particularly isolation of infected patients, and providing accommodations for dying patients, could then be joined by family during the final hours.

Let’s assume the impossible. That sensible construction of private rooms will evolve. What then to do with the rest of the space to be built?

In this time of fiscal squeeze, DRG, and nursing shortages, this column casts a vote for the old-fashioned ward, made more hospitable by modern design. One nursing data station and two nurses in the middle of the ward can provide better care for more patients than the same care cadre can provide for patients in semi-private rooms.

Interestingly, as crowded and unseemly as the holding areas at CMC seem to be, because of crowding, apprehensive patients appreciate the fact that they are under constant surveillance by real live nurses who are only a few feet away from each bed. The holding areas are really wards; the intensive care unit is really a ward. Whenever a hospital seeks increased nursing surveillance and care it creates a ward, now called a unit because the term ward evokes uncomfortable images.

The fact is that the semi-private room is not acceptable as the sole accommodation in the hospital. Hospitals should break with recent tradition to the extent that private rooms and wards (with real live nurses working right inside them) should comprise most of the new additions.

It is not too late to be adventuresome. Hopefully the trustees will look into this matter so that the dismal errors of the past are not repeated.