Welcome to Fortress CHaD

[From the CV Spectator of May 28, 2009]

When your child is in the hospital, among the last things you want to worry about is whether some predator is going to sneak into your kid’s room and do something terrible.

The world is awash in deviants who are busy conspiring to steal your offspring – or worse. Overworked hospital staff are consumed with the task of delivering care; they cannot keep an eye on the comings and goings of strangers.

This flawed thinking explains the impending lockdown at CHaD – the Children’s Hospital at Dartmouth. Hospital officials are putting the finishing touches on plans to put the inpatient ward, located on the fifth floor of Dartmouth Hitchcock Medical Center (DHMC), under 24-hour lock and key.

Currently, family members and friends are free to wander onto the inpatient ward, which cultivates a friendly and pleasant air. There are clearly posted instructions to check in at the nurse’s station, a requirement that is generally honored in the breach.

Those days are numbered. Once the new security measures are in place, if you don’t have the proper identification prominently on display – hospital officials are deciding whether this will be a bracelet, a sticker or something else – you will be presumed a no-goodnik and treated like a trespasser.

Visitors are still welcome, but they will have to be buzzed onto the ward after stating their business.

Hospital officials breezily rattled off these plans a couple of weeks ago at the monthly meeting of the CHaD Family Advisory Board (FAB). They wanted to know if families preferred the bracelets or the stickers.

Good grief!

The FAB is a terrific thing. It operates under the aegis of CHaD’s Boyle Pediatrics Program, dedicated to the notion that caregivers have a lot to learn from the children and families they serve.

Unfortunately, the FAB is comprised almost exclusively of hospital insiders. Aside from the CHaD bureaucrats who serve ex officio, most of the family representatives are either themselves DHMC employees or close relatives of one. For example, the FAB’s chairman is the practice manager at DHMC’s radiology department.

As the result, the FAB tends to tell CHaD what it wants to hear. And what CHaD wants to hear in this instance is that making our community’s inpatient pediatric facility feel more like a prison and less like a home is the right medicine.

There is at least one FAB member – his byline appears at the top of this column – who is, perhaps, too inclined to treat CHaD initiatives with skepticism. Hence this question at the meeting:

Exactly how many incidents has CHaD experienced in which someone snuck onto the inpatient unit and did something bad?

Nobody could think of any.

Instead, they offered the perennial “all it takes is one” defense, noting that other hospitals have experienced incidents, which are inevitably followed immediately be security clampdowns that are hastily and poorly executed.

They also mentioned that nurses frequently observe people on the CHaD inpatient ward who don’t belong there. But, when pressed, they admitted that most of these folks are adult patients from other units. They wander onto the CHaD unit in search of some cheering up from what they hope will be the smiling face of a happy child.

Could DHMC find something else for these adult patients to do? Apparently not.
It has been my family’s misfortune – and also our good fortune, given the excellent care – to have a child who has a chronic illness that tends to require two-week hospitalizations every 18 months or so.

In the five such hospitalizations our daughter has experienced since 2002, we’ve never seen anyone try to get near her who had no legitimate reason to do so.

She had such a grand time there last fall – classmates and their families stopping by to say hi, tutoring visits from her teacher, jaunts to the various play areas throughout DHMC – that she actually wants to go back. I am worried she won’t recognize the place.

More worrisome is where this all leads. The security-at-all-costs mentality makes it inevitable that all of DHMC will become a locked fortress, along with our schools and every other public facility.

We’re not just locking others out – we’re locking ourselves in.

[Photo above: Rose and her classmate Brendan making mischief in the CHaD inpatient unit during Rose's stay there last fall.]