Why you should delay that visit to sick people in hospital, by Raji Bello

I often wax nostalgic in my writings, which I believe is a function of my age and how dramatically some things have changed in Nigeria over the years. When I was a medical student and a young doctor in the 1990s, visits by relatives and friends to hospital in-patients were still regulated in most Nigerian hospitals. There was a specific time window for it (usually 4 – 6 pm) and one of the public notices that you would see conspicously displayed in the ward areas were those of “Visiting Time” and “Lokutan Ziyara.” Compliance by relatives and friends was usually good.

Of course, the way that the hospitals were managed in those days had made that regulation possible. Patients were fed from the hospital kitchen, medical supplies were available on the wards to be used when needed, medications came from the hospital pharmacy, and hospital auxiliaries were available to run errands. It was therefore possible to care for the in-patient without the constant involvement of relatives.

As the years went by, the feeding of in-patients stopped, the staffing ratios deteriorated, and supplies and medications became strictly cash-and-carry. It became impossible to keep away the relatives, who remain a constant presence around the patient. It was probably at that point that most hospitals forgot about regulating visits to the wards. Another phenomenon that reared its head gradually was that “big” men and women became more influential and menacing in Nigeria such that no hospital staff had the courage to regulate when the members of that category of Nigerians could visit their sick relatives.

My personal experience is that excessive and unrelgulated visits by relatives and friends, as well as their constant presence around the patient, could significantly interfere with the process of care. Clinical staff are often put off or intimidated by the constant presence of a large number of relatives. Some of them could become meddlesome and critical–sometimes for legitimate reasons but often out of ignorance of the process of care that they have witnessed. The result is that the in-patient who is constantly surrounded by relatives gets less close observation from staff and even suffers delays in receiving scheduled care procedures. I’m often struck by the paradox of a patient’s care being impeded by the very people who think that they love them the most.

The advent of mobile telephony has not helped matters by placing these hospital visits on steroids. Instant communication means that staff could hardly get a quite one hour to stabilise a new patient before visitors begin to hang around the doors and windows of the ward, peeping through every available crack to see what is being done to the patient. And these instant visitors may not even be very close to the patient. They may just be freelance voyeurs hoping to witness dramatic situations so that they could share it with others.

It is normal now to see encampments of relatives on the hospital grounds whenever prominent individuals or heads of large families are on admission with a lot of chatter, eating and littering. You can’t even stop a few relatives from spending the night at the reception area, for example. There could be roughly three relatives sleeping in for each of the five patients that you have on admission inside the ward! And don’t ask me where these sleepers go for their plumbing breaks during the night. Just be more understanding the next time that you visit a hospital and is greeted by a certain “smell.” It’s not always the CMD’s fault!

I can only make an appeal since I can’t change how hospitals are managed to restore all the services and the accompanying sanity of the past. I know that the presence of a few close relatives is necessary these days. But the public can help to keep the numbers at manageable levels. When you get the call that someone you know has been admitted, do not rush to visit them unless you are among their available three or four closest people. Delay it by a few days while you pray for their recovery so that you wouldn’t contribute to the unnecessary crowding in the ward. When you eventually visit, just see the patient and leave. Do not hang around in one of the mini camps outside the ward and join in the eating, chatter and littering. You wouldn’t be helping the patient if you do that.