“I want to use the restroom,” I said in my best Korean. The nurse stopped in her tracks and tilted her head as she considered what I had said.
“Where are your friends?” she asked.
Confused, I cast a glance at the clock hanging above my bed. “Working,” I said in bewilderment.
The nurse sighed and hurried out of the room with one last glance in my direction. She returned after a moment with a wheelchair from the hallway and helped me navigate myself into it, taking special care of my wires and recently operated leg. I got the distinct impression that the nurse really didn’t want to help me into that restroom, despite the task being what I had thought was part of her job.
Later, I would learn that the responsibilities of nurses in South Korea are, in fact, vastly different from those in the USA.
In America, nurses do a variety of small jobs. They hook up monitors, make note of the patient’s fluid intake and output, check to see if the patient has been getting adequate rest, relay information given to them by the doctors, and ensure that the patient is following a prescribed diet if one exists. In many hospitals in South Korea, the story is quite different…
I was asleep, finally. It was probably around 9 or 10 A.M. I remember having already been woken up around 5:30 A.M. for my morning butt injections. I hated those. I was victim to the nurses’ needles at least three times per day. I switched sides on the nurses because each butt cheek would become so sore that sitting on it became uncomfortable. Later, someone would tell me that injections are cheaper than pills. Maybe that’s why I was getting so many? I didn’t know.
Anyway, it was around mid-morning, and I was finally asleep, when I suddenly heard the crinkling of cellophane. I opened my heavy eyes slowly, seeing only a wall of black fabric at first. It backed away from me, and surprised, I looked up and realized what I was seeing. A man in a suit was standing at my bedside and placing something beneath the pillow, where my face had just been a second before.
Why was a man sticking things under my head, and why was he waking me up when I was finally, finally asleep, I asked myself. By the time I opened my mouth, the man had moved on to give one of his bags to another patient. I propped myself up on my elbow and pulled the package out to look at it. It had several hard fruit candies inside with a religious leaflet. Ah. Advertising for a church, I realized.
I looked around the room. There were seven other patients and some of their family members. At the other end of the room, an older patient talked with a person I didn’t recognize. They had Bibles in their hands.
In the United States, I have the impression that the nurse is like a knight standing guard between you, the patient, and the outside world. If a visitor comes into the hospital and brings forty friends, the nurse and/or nurses will not let the stress of forty visitors (plus one) into the room where the patient is fighting a battle to regain or maintain newly-won good health. It wasn’t long ago that men weren’t allowed into birthing rooms. It wasn’t long ago that children weren’t allowed into hospitals. If it brings too much stress, or too many germs, the nurse forms a human barrier against it and keeps that riff-raff out of her kingdom.
And yet here I was, trying so hard to finally get some sleep, and a strange old man in a pinstriped suit was sticking candies under my pillow. He didn’t even ask if I was diabetic! On a few occasions, a woman would come with huge trash bags full of things like panties, slippers, socks, and pajamas, which she would drape across our beds and start hawking right there in our room. Other patients would come in from other rooms while dragging their IV carts behind them. Then, people would actually buy this woman’s underwear.
The American parts of me thought, “What the hell is going on here!?” How could people expect to get any sleep in these conditions, and did nobody care at all about the germs from outside? Seriously? The nurses weren’t monitoring the things that were happening in that room at all. By this point, I had contacted my friends and coworkers and told them that the nurses made it clear to me that I would need help from someone other than them.
It is thus impossible for me to write this without making some mention of the gratitude I owe to so many people from outside the hospital. There were people who helped me take a shower, despite how awkward it is to help your friend undress and get in and out of a wheelchair while naked. There were friends who helped me repeatedly get into a bathroom that really wasn’t meant for handicapped people. There were people who brought me home-made chili, fruit trays, chocolates, chips, candies, books to read, extra blankets, and pillows. One person even painted my nails. My boss came to make sure I used the restroom and got fresh water to drink at least every morning and every night. She held a cup and straw to my mouth and stayed with me for eight hours post-operation when I was told I wasn’t allowed to lift my head from my bed. I never knew how loved I was until I needed to be loved in this way. Thank you.
But the bottom line is, we had people barging into our rooms day and night, and the nurses were doing nothing. They didn’t help us get our lunches, they didn’t help us into the bathroom, they didn’t even help me get down to the basement when I started physical therapy and learning to walk again. I began to think about what that meant for the hospital environment. It meant that we patients had to rely on other people to fight for our right to sleep and regular bathroom visits.
Because of this initially uncomfortable situation, I realized that the hospital is a much more cheerful and welcoming place when you rely on the help of your loved ones than on a stranger to care for you.
In thinking about it, I realized that if I had to choose between my own mother helping me get my pants down for a shower or having some stranger do it, I’d rather it be my own mother. On top of your own family members caring for you, the fact that my bed had no privacy curtain coupled with the fact that I was stuck in a room with seven other people meant that those seven other people were in the same plight as I was. Though some of them could walk, they understood what it meant to be there in that moment and to be stuck in it. One of the walkers would get our lunch trays and put them on or next to our beds, and the woman who did this for me always slammed mine down and yelled “EAT YOUR RICE!!” in Korean. It was like I had my very own angry Korean grandmother, and even though I really, really did not want to eat my rice, the fact that she wanted me to eat it made me very happy—and it even made me try a little bit.
Perhaps even worse than not monitoring who was coming or going, the nurses didn’t seem to care whether we left—which we did. Every couple of days, one of the walkers would simply leave the hospital altogether (still wearing her gown and still pulling her IV behind her on a wheeled stand), and return with treats for us, having walked herself all the way to the supermarket and back. Why even stay in the hospital?
The surgery I had, while I don’t recommend just going in and doing it for fun, is actually an out-patient procedure in the United States. However, in Korea, I had to beg them every day to let me leave. Finally, twelve days after my operation, they let me go…but they didn’t know that I had actually left before. With the help of two friends, I decided to go outside and get some fresh air, and even go to a café just behind the hospital. We had a really good time taking pictures of me pretending to walk, but really just balancing on my good leg with the wheelchair out of view.
I thought very seriously about going home, but since I lived two floors up on slick granite floors and was completely unable to bend my leg, I decided to stay until they released me. So why do nurses not care if their patients come and go, why do they fill such minimalistic roles, and why do they not care who visits the patients?
I found an interesting blog written by a Canadian woman who talks about her child’s stay in a Korean hospital, and she recounts many of the same things I’ve mentioned, though it seems that her hospital was furnished with more equipment than mine. It’s important to remember that my story might stray from the norm.
Originally, my thought was that patients in Korea have long hospital stays because Koreans work hard and have stressful lives, so staying in a hospital grants them a reprieve from their responsibilities. I recall someone telling me that a hospital stay can be a bit like a vacation for people there, and I remember being a little horrified by the notion, because I would have much preferred to have been at work than confined to a bed. I did some digging around on the Internet and learned that there are incentives to having patients stay longer. Apparently, South Korea ranks #2 behind Japan in average length of hospital stays in the OECD.
In my reading, I also read that there are fewer nurses per patient in South Korea than there are in the US and in most other OECD nations. Perhaps this helps to explain why nurses seem to do so little for patients in Korea. Perhaps they’re stretched thin. I came across an article advocating better treatment and conditions for nurses in South Korea, and it said:
“Nursing in the two countries also differs in many respects, too. For example, in addition to the much higher patient load in South Korea, nurses there are expected to fulfill many of the duties support personnel here in the United States would normally handle. Sung Hee Kwon, an operating room RN at Korea University Hospital, was impressed that OR nurses here never leave their patients’ bedsides. Back home, she is expected to also manage all the OR equipment, supplies, cleaning, set up, ordering, and inventory.”
It appears that while I thought my Korean nurses simply didn’t care much for me or that culturally they weren’t expected to, what may have been happening is that they were simply too busy to devote to me and my fellow patients the kind of time and attention that I expected due to my American background. I am quite impressed by the number of tasks that nurses accomplish which have so little to do with direct patient care, like the management of inventory.
Another interesting excerpt from the article is this paragraph:
“We are still thinking about what number to propose in Korea,” said Yoo Ji Hyun, RN and secretary general of KMHU. “To start, we’re looking at a range from 1:5 to 1:10. But the hospital industry is attacking that, saying that 1:10 in Korea is about the same as 1:5 in the United States. That’s why we’ve come to compare actual nursing tasks to refute their argument.”
Why would the hospital industry attest that one nurse for ten patients in Korea is the same as one nurse for five patients in the US? I think it is making a reference to the apparent fact that much of the care patients receive in hospitals comes from patient family members and friends than from nurses. Given what I’ve learned about nurses’ responsibilities, I’m inclined to disagree with this ratio.
Korean nurses don’t do less; they do different things. Perhaps if Korean hospitals hired support staff to take care of some of their responsibilities, the nurses could devote more time to patients—but is it really better that way? When I think of my very own ajumma yelling at me to eat my rice, it honestly makes me think fondly of my time there somehow.
Perhaps they’re already doing things in the best way possible.
If you're reading this, I'm flattered! I'm an American expat with a strong interest in eating things without knowing what they are, learning tongue-twisters in new languages, and I feel most at home when I'm not at home. Currently residing in France, I often think of returning to South Korea, where I lived for just over two years.
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