Perspective
Tuesday, April 14, 2009
Discharging a patient back to nothing is bad hat. Very bad hat. But apparently, the regional hospital near SQuIRT loves to do just that.
There's a little bit of perspective lacking in all this.
They also have a knack of 'getting people back as outpatients'. This is all well and good when the patient's digs are just around the corner. But when they live 400km West, it's just plain dumb.
The team is trying to discharge the patient because either they reckon the patient'll be better off at home, or they want an empty ward. I really hope it's the former, not just because the treating doc felt that needling the new lump in her chest could wait until 'after Easter'.
There's a little bit of perspective lacking in all this.
The poor old duck is going to be transported, quite rightly, by StateHealth. It's going to cost a couple of thousand dollars in transport, wages and the rest. And at least the same to get her back in a few weeks time. Assuming, of course, that her situation doesn't deteriorate further.
But maybe dear Betty's got things planned with her family for Easter? Easter is, after all, an imporant time for many Qld families, and what'd be worse than hanging out in a hospital for a four-day weekend. For Betty, though, this is unlikely, because she's likely going back to the local 'medium-care facility' - the rural hospital.
So, yeah, I appreciate the idea that staying in hospital sucks. If I was strung up in a hospital over a holiday I'd go stir crazy. It's a genuinely nice idea to have the LOL in NAD further assessed as an outpatient.
But before you ship her out, please have a good, long think about whether that test can be done now, or tomorrow, or maybe after the weekend, just so she doesn't have a twelve hour-round commute. When you weigh up her options, she'll be much better off snuggling down on the ward for the weekend. Sure, she's taking up that bed, but Betty'll probably enjoy being in the same place for a few days.
Frail, dementing octogenerians don't hold up too well when it comes to being transported for more than half a waking day.
So, yeah, I appreciate the idea that staying in hospital sucks. If I was strung up in a hospital over a holiday I'd go stir crazy. It's a genuinely nice idea to have the LOL in NAD further assessed as an outpatient.
But before you ship her out, please have a good, long think about whether that test can be done now, or tomorrow, or maybe after the weekend, just so she doesn't have a twelve hour-round commute. When you weigh up her options, she'll be much better off snuggling down on the ward for the weekend. Sure, she's taking up that bed, but Betty'll probably enjoy being in the same place for a few days.
Frail, dementing octogenerians don't hold up too well when it comes to being transported for more than half a waking day.
Coming up to Easter she would be being discharged to have minimum staff at penalty rates.
The hospital saves on wages and I bet another department pays for the transport of half a day.
Shifting people out of hospital early hurts my mob. It is reflected in hospital separation stats for Indigenous Australians in remote and very remote areas of are 820 and 606 per 1000 people respectively.
I'd like someone to tell me that isn't due to readmissions.
There is always a hidden cost to getting people out early. Unfortunately sometimes the cost is the patients well being
Robbo
Isn't that part of rural medicine? Yes I do agree that a lump found in any patient is alarming and should be attended to
immediately regardless of budgets.
However, this is an unfortunate part of life. Perhaps the staff have learnt to accept this and are trying to work around the situation
the best way they know how. There is also the possibility of complacency on the part of the doctor in question, which could be said about a lot of doctors at times and you highlighted another
incident of this in an earlier blog if I recall about mentors.
We also tend to hold romanticised views of vocations before we actually live and breathe them
24/7 (without a safety net). You eventually realise this is it warts and all. I'm not saying the situation is right but as you grow and experience life you sometimes learn to make the best choices you can within the confindes you're presented with. I'm sure there is a lot of politics involved in hospital based medicine. It's something in time you'll learn to deal with and you'll have this and I'm sure many more experiences to draw on when you're presented with you're own situation in the future.
Oh and isn't today Passover? (Pesach). I have a recipe for an Orange Passover Cake with Syrup, but we'd probably need to substitute the nuts! Anyway wherever you are I hope you had time to do something special and mark the occasion.