Madrid hospital staff shortages causing operations to be canceled

Raquel Moreno arrived on time for her operation at Madrid’s Gregorio Marañon hospital: 8.15am on March 18, just as she had been told. She went to the admissions desk, collected her paperwork, went to the room she had been assigned and was given a nightgown and some toiletries. She was ready to enter the operating theatre to undergo surgery to treat a paracolostomy hernia that, although “not a matter of life and death,” she says, was causing her intense pain and needed to be dealt with immediately. “It was then they told me the operation was being postponed, because there was no anesthetist available,” she says, holding up her release form, which stated that the hospital would contact her by telephone to arrange a new appointment “as soon as possible.”

Moreno says hospital staff told her the postponement was due to an operation having gone on longer than expected the day before and that, as a result, no anesthetist was available. What staff failed to explain was how, with a waiting list in Madrid of more than 71,000 patients, an operating theater could be closed for an entire morning.

A hospital spokesman confirmed that Moreno’s operation had been postponed, but would not say how many others had also been put back that day. He also confirmed that the operation was delayed because of the lack of an anesthetist after an operation had taken 16 hours to complete, until 2am, the previous day. For “safety reasons, it was decided to allow the team to rest and that scheduled operations were therefore postponed,” he said, adding that Moreno’s operation was “not serious” and that it would take place “soon.”

The postponement was due to an operation having gone on longer than expected the day before

The spokesman declined to divulge if it was common for operations of this kind to be suspended on a normal working day, or whether it had also been impossible to replace staff on other occasions.

Marciano Sánchez-Bayle, the spokesman for the Federation of Associations to Defend Public Health, says the case illustrates the problem of personnel shortages in Spanish hospitals. “When their staff are working at the limits, any situation to be expected, such as the absence of a professional, will create these kinds of problems. There used to be enough back-up staff before, and these gaps could be covered, or operations sent to other theaters. This is about poor organization and planning,” he says, adding: “The health service has lost around 53,000 people over the last two years.”

Speaking from her home on Wednesday, where she is still waiting to be given a date for her operation, Moreno said she hoped it would be in the same hospital, and not in a private clinic. Hospital staff told her that at least one other operation was postponed on the same morning as hers was, she says. Two years ago, Moreno underwent a colostomy procedure – which involves creating an opening in the abdominal wall to enable defecation – and that from time to time this causes a hernia, a common problem associated with this kind of treatment.

“It’s not the doctors or nurses’ fault that the operation was delayed,” says Moreno, who has undergone treatment on several occasions in the same hospital and has always been happy with the attention she has been given. “Those people have saved my life; this is a problem with the way the hospital is run,” she says.

There used to be enough back-up staff before, and these gaps could be covered”

Moreno has filed a formal complaint about the incident. “The complaint isn’t about the medical staff,” she says, “it’s to show that the hospital is being run without enough staff, and that this does not allow for any unforeseen circumstances, which in this case meant closing an operating theater. I was not given the choice of waiting until the afternoon, or staying the night so that I could be operated on the next morning. I suppose they already had too many other operations to carry out,” she says.

Meanwhile, in a case that raises questions about cooperation between regional health authorities, the governments of the Basque Country and Castilla y León say they are looking into the death on March 17 of a three-year-old girl who was ill with chickenpox. Three days earlier, her parents had called the Basque emergency services to request an ambulance. The family lives in Treviño, an enclave of Castilla y León in the Basque province of Álava. The girl’s parents say they were told they had to use their own regional government’s ambulance service.

The girl had been released from hospital in Vitoria on Sunday evening, but her condition worsened in the early hours of Monday. Instead of sending an ambulance, say the family, the Basque emergency services called a doctor in a neighboring village.

The Basque health service says it has listened to the emergency calls, and that it was the girl’s parents who called their local health center. While they were waiting for the doctor to arrive, the parents took their daughter to the hospital in Vitoria, where, three days later, she died.

The mayor of La Puebla de Arganzón, where the family lives, has criticized the apparent lack of cooperation between both health authorities.