Russian Hospitals Practical, While America’s Lavish

Cartoon by Riverh




Each summer at the dacha I spend  a week in Peno Hospital.  I am lucky to have  insurance  on my вид на жительсво, spoken~ vide na jeetelcva , my permanent resident passport, and  a great doctor...  my wife’s cousin.  She reviews my diagnoses and orders IVs for reducing edema and to tone  my heart.


I usually have a single room.  This trip I was in a room with four beds, but I was the only occupant.  I was there from 21 - 26 June, when I returned to Zaloza with arriving family.

I’ve been reading about the problems of schools and hospitals  in the US.  Seems that self-aggrandizing administrators have over-built, while ignoring what really counts... getting an education, and getting well.  Things aren’t always good in education and medicine here either, but in medicine you don’t find the unproductive frills that are found in much of America.

My observations are based on my experience in six St Petersburg hospitals and the one  in the  former agricultural community of Peno... and as a patient at New York Columbia, Cabrini downtown, and at Hunterdon Medical Center, Flemington NJ.  


In progress Moscow is usually a step ahead of St Petersburg, the other cities less advanced, and the vast  rural section of Russia can seem fifty years behind the times.  There may be exceptions as medicine is getting government attention and things seem to be changing.


So, if you are a pampered Westerner, prepare to be surprised at what Russians do without, and ask, “Is this item really necessary to help a patient get well?  Or, is it something that is a luxury, a frill, presented as a necessity?”


Guest Pack... Water glass, ice water pitcher, bed pan, soap, shower cap, slippers, toothbrush, toothpaste, tissues, hospital gown... all disposable .  In Russia you wear your own sports togs.  I wear pajamas.


Wheeled adjustable tray with compartment and mirror.  I’ve never seen one of these here.


Bed linen and pillows.  Sheets changed often,  pillows disposable.  Here you get a sheet on top of the mattress, and then a пододеяльник, spoken pododeyelnik...  a double sheet in which you push in a blanket, like the filling in a sandwich.  You make your own bed and are not expected to spend much time in it.  Clean sheets are available once a week on request, or as needed.


**  I am always impressed with the beautiful wool hospital blankets.  A great genuine souvenir from Russia would be one of these blankets, that rank in my mind with the American Indian blankets of my youth.


Private or shared toilet and shower.  Here most people walk down a hallway to a communal men’s or women’s toilet.  The men’s room often has smokers standing at an open window .  Don’t forget your own paper products.  You can request use of a shower but most people don’t.  Its condition can be shaky.


Television on the wall.  The hospital isn’t in the TV rental business.   There is a TV lounge on every floor.  TV on 8 to 10 PM.


Private or Room for Two.  Most Russians share a room with four or five .  Great for card games.  I’ve been in singles, doubles, and once had five other patients with me.


 Electric-powered hospital bed.  The hallmark of the Western hospital.  Most hospital beds in Russia are unmechanical  narrow beds.  In the hospital where my heart surgery took place, the bed had hand cranks, and a rope the patient used to pull himself  to a sitting position.  You won’t see a nurse buzzer attached to a cord, but occasionally there is a  working call light on the wall.


Large observations windows from the hallway, and the door kept open.  You are the easily seen goldfish.  Here, except in ICU, privacy wins over attentive care.  No hallway windows, the door has no window and is always kept shut.  But, strange to me, the staff usually enters without knocking.  

When I visited my surgical hospital the first time, I though it was next to empty.  Larissa explained that it was rest time and all patients were shut in their rooms, while at other times they walk the halls.
 
**  A Zaloza friend reports that he was at a hospital in Moscow that had American-style hallway windows... so at least in that hospital... times are changing!


Night time nursing.  After 10 PM everyone settles down... your nurse, too.  They go to sleep in a room or in the hallway.  No one checks you.  If you have pain, are cold, or whatever, you need to yell for the nurse to wake her up.  


Most Russians would never do something so out-of-place  as bellow for the nurse.  They are стесняется, spoken stesnighetca,  reserved and shy.  But one night last year I gave in to my American initiative and willingness to be loud...  “Ah-ooh!  Ah-ooh!  Nurse, I need a blanket!  And so do the other patients!... and caused quite a stir!


**  Responsive, not pro-active nursing, is typical of Russian thinking.  Prevention is low priority.  Few people plan well for future negative possibilities.



Patient-centered care.  Few doctors, and no nurses will encourage questions.  They will tell you what they think you need to know.
No one has ever given me a Patient Satisfaction Form to fill out. 

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Clergy visits.  They won’t ask your religion when you check-in and no clergy will call.  The church won’t know or care if you are sick.


Get Well Cards though the mail.  Not a custom in Russia.  People are more likely now to call your cell phone.


Flowers delivered to you room, or brought by visitors.  No flower delivery.  Visitors are more likely to bring food.  


**  But remember, if you do bring flowers to a Russian, it’s an odd number for the living, an even number for the dead. Never thoughtlessly order a dozen roses for those still alive and kicking!


Plastic food.  I remember American hospital food as wrapped in plastic, shipped from far away, microwaved, and sad to look at and taste.  Here the food is cooked locally, and it’s tasty and nutritious.
 
You  walk to the столовая,  spoken stolovaya, a dining room.  Or you may take your food back to the room to eat at a table with your roommates.  Often the food workers brought my food to the room... either because of my diagnosis or perhaps because I was a foreigner.  

No dietician will stop by to ask about your food needs.  You don’t get a daily  Check-off  Sheet to order what you want.


Heat and Air Conditioning available year round.    Russian District Heating is turned off around May 15 and back on by October 1, depending on the weather.  If it gets colder when it is off, you need to  add some clothes and get another blanket.  Year round heat control may be found in only the newest hospitals.



Memorial and Donation Plaques, charity appeals.  The hospitals here miss a great opportunity to get help to fix the rooms.  Russia has a weak tradition of charity, especially toward those you don’t know.


Hospital Community Board,  Hospital Auxiliary, involvement of young people such as Candy Stripers... .  People are just not so social here, and don’t show interest in Western ways to improve a hospital.  Administrators  are poor in asking for help and money... maybe something to do with pride.  


** Russian culture discourages community involvement, volunteering, showing initiative.  A popular saying states that инициатива наказуема... Initiative is punished!... which applies to doing something wrong when you don’t wait for instructions.  Therefore, much of charity for hospitals comes from overseas and from the expatriate community, where people are raised to look for ways to help people, even strangers.


NPO’s, non-profit organizations, were banned during Soviet times.  Only organizations sanctioned by the Party were allowed.  Private initiative is still viewed with suspicion.

We are happy to hear from you!


What items are worth keeping in American hospitals?

Which add to the expense of healthcare without really helping you get better? 

Do you have some facts or ideas you want to tell about?


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