It was a bad week, the ward had been packed and patients got to be retained in the ED waiting for admission. 4 patients waiting for admission and patients had filled out all the beds in our unit.It had been a norm for many hospitals around the island for the past few 1 year.
It all started from the nursing shortage issue. Hospital expansion and the demand of patient to nursing staff ratio had caused the problem to worsen. The Health and Welfare Ministry had tried their best to increase the wages, giving out subsidies but yet the problems did not resolve.
There are beds in the ward but yet unable to serve due to lack of staff. The fire incident at a regional hospital nearby had led to an investigation and later ended up with fraud during building certification. The involved wing of the hospital was torn apart. ED was packed and crowded since then.
My first patient of the shift was an elderly who presented with a right lower leg cellulitis. The patient’s wife had brought him for help and most of the history was provided by the wife.
The patient was admitted 1 month ago to the hospital mentioned above and he was discharged after 1 week of admission. During the history taking, the wife kept complaining about the poor care that they received. Doctor did not treat them properly and they were forced to be discharged even though the patient did not fully “recover”.
“You see, my husband was unable to walk when he was discharged, the doctor said we treat only the leg and don’t guarantee you are healed as whole. we had to comply…you see we do not know”
Most of the conversation ended up with “you see we do not know” phrase.
Well, the story was actually exaggerated; some were true and some were self proclaimed.
It was a red flag where you heard the patient complaining about their former medical team. I explained politely to the patient that they were properly treated because after discharge the patient had actually recovered after 1 week of discharge; he was able to walk since then. I would be extremely cautious talking to such patients and family. They did not want to bear any responsibilities about their health, they would say you do whatever it was necessary and when things went the other way, they would blame it on the medical team.
Treating patients is different from what I knew during my childhood. Medical decision making nowadays has to be made by both sides; doctor’s decisions always prevail has long passed. How the doctor manipulates the patient’s and family’s decision is an art that every doctor should learn. Frankly said, reassurance to the family is a very dangerous act; you pacified them, the next thing you know, you had just been served to present to an arbitrary unit.
I don't know, should not be an excuse....
