Capital Health policy regarding day surgery

Hospitals under the Capital Health District Authory – including the Halifax infirmary, Dartmouth General, and the Victoria General – have a policy saying “when you go into the hospital for day surgery, someone has to be there to drive you home following surgery, or surgery will be cancelled otherwise.”

This means one cannot take a personal vehicle, bus or taxi home alone after surgery.

Some people feel the policy is problematic, saying they might not have close friends or family who could accompany them or drive them – or that those people might otherwise be busy during the day.

Unless the surgery is an emergency, the surgeon is often unable to move surgery to an evening or weekend (when someone might be more available to drive).

According to medical experts, it is unsafe to go home alone after surgery because anaesthetics render the patient drowsy for up to 24 hours afterward.

The policy does not specify that this “someone” must be a family member. However, different sources claim the surgeon has told them this should be a family member who was present during surgery.

According to a nurse who works at the Dartmouth General Hospital, there is one surgeon there who refuses to do surgery unless either the patient's husband, wife, or other immediate family member is present.

Two questions arise from this situation:

What is someone who cannot make those arrangements to have someone drive them home following surgery supposed to do?

What type of home care/home support services are available for these people?

Doctors are hesitant to answer these questions because hospital policy states that the patient is “responsible for making those required arrangements (themselves).”

There are several homecare agencies around Halifax/Dartmouth, such as: Bayshore, Northwood, Comcare, and RJF Healthcare. But homecare workers are not permitted to drive patients home in their own vehicles after surgery. Homecare only provides service for 21 hours, and will only be covered for people under a certain income level or on income assistance.

I have two experiences where I had to deal with this myself.

In 2010, I had to go to hospital for a hernia repair. I had a month's notice as to the date of surgery. It was 11am on a weekday – my local family all being preoccupied with work, I had to arrange with my brother, who lives in Antingonish, to take me home.

In summer 2011, I needed surgery when I broke my hand on a public sidewalk. The surgeon wanted to operate on five minutes' notice – which made it impossible for me to arrange for my brother to be in town on the day of surgery. My local family were on vacation at the time, so I ended up having a family friend take me home.

In each case, my family has asked me to see if surgery could be done on evenings or weekends so they could help out.

It would be good for surgeons to be more flexible with when they can do surgery for this reason.

Three friends of mine have had similar experiences. They live by themselves and do not have local family.

One says she has a friend who might be able to pick her up, if only weekends and evenings were an option for surgery.

One friend had her surgery cancelled by hospital staff, because there was no one who could be present on the day of surgery to drive her home.

At the time of my hernia repair, my brother and other relatives wondered why the doctor was not making arrangements.

All four of us asked our doctors to phone our family members and friends to make arrangements. However, doctors are not able to help: “calling people to make those arrangements for us is breaching confidentiality,” they say, adding that this is against the law. The doctors further said: “If I do make those arrangements for you and the medical board finds, I could lose my medical licences over this.”

There are a lot of mixed feelings about this policy: some understand why this policy is in place. Others see the policy as problematic and possibly even discriminatory.