Staying in but not admitted...

There was this 8 y/o girl who suffered from fever. No cough nor running nose was noted initially. She was seen by her family physician and ? common cold was impressed. Syrup acetaminophen was prescribed. Her fever had worsen and prn voltaren use was warranted to ease the fever. 4 days later non productive cough was noted and her fever was still stationary with no improvement. On Day 5, decrease air entry was noted over her rt lower chest and she was brought to ED where a chest xray was taken. The chest xray revealed right lower lobe lobar pneumonia and she was admitted. Parenteral augmentin and oral erythromycin was prescribed; fever had subsided on D2 and she was discharged well on D7. A simple history but a stress for me….Yun was the patient.

I had accompanied her in the hospital during and after my calls for the past 1 week. Yun had been admitted multiple times since her birth. Roseola, viral fever, bacterial tonsillitis, febrile convulsion…. And now pneumonia. I had no explanation – just a act of god, some people never get admitted but some suffered from wave and wave of disease. Yun was a healthy girl in general, but fever was a nightmare for all of us. Her fever was so difficult to control in the past. Acetaminophen(full dose of 15mg/kg) q6h and voltaren supp q6hrly. We really had a hard time with Yun as she got admitted on a yearly basis, most of the time was before her birthday. Well, she had overcome her major fear during the admission, she learnt to drink grinded pill with yogurt during this admission. A great leap for her as her body resisted of taking any medication except syrup…. Well, nice to see your child taking their step one at a time (or maybe a great leap)…

I had some thought during the stays in the hospital. The hospital had too much space to improve. The room was not cleaned properly before we enter. There was this blood stain over the curtain extended straight up to the wall and ceiling. I had to tell the head nurse before she sent the cleaner to take off the curtain and take a good clean over the wall. However the new curtain was never installed before the discharge. The fridge was not clean, ice perk over the cold storage making it not cold. The dust bin was not cleaned at a regular interval… I think something should be done – after all service is one the key factor to attract people. I considered the medical industries had no different than the hotel service. Comfort and hospitality(after all we are really a hospital…) is key to success….

As a attending physician in the hospital, I think it is a basic ethic to get admitted to the home hospital if care is available. Our fellow cardiologist had chosen to get admitted to our own hospital during his last admission – he could have stayed elsewhere nearer his house, he even had to share a room with another patient as no single room was available…