I had a positive post planned for this week, but it is 10:47 pm, and I am waiting to hear from my lung cancer patient, who is currently in the hospital on the Hospice floor.
So I am sharing another example of How The Health Care System is Built for The Healthcare System – NOT For the People Who Use It.
She has been in the hospital since May 22 and was to be discharged to home as a Hospice Patient today.
She has been waiting all day to go home all day. The equipment is at the house, and her family has prepared their home for her – all are anxious as it is a big step for each of them. I have been in contact with the patient, the family, the hospice unit, and the hospice team all day.
At 9:30 pm, I had not heard from her or her family, so I texted them to see if she was home. I thought they forgot to let me know she was at home and wanted to check as I was getting ready for bed.
The patient and her aunt both replied that she had not been picked up by the ambulance…she was still in the hospital.
I called the Hospice floor at the hospital to ask if they have an estimate on the time. Her nurse said she talked to the ambulance company, and they said 20 minutes – that was at 9:15 pm. I asked to speak to the nursing supervisor because I thought sending the patient home was too late. She is very weak and nervous as it is, and it is close to 11 pm.
The supervisor told me that this is not unusual for patients to be discharged this late – and even if she stayed overnight, the same scenario could occur tomorrow. The ambulance services are busy, and this is not unusual. She said it is the effect of COVID, and we have to put up with it. There is nothing to do. So we all wait.
I called the Hospice Unit at 11:30 pm and was told the patient had left a few minutes ago.
I am so disappointed in this system – I am at a loss and embarrassed at we treat people today.
I am saddened but not surprised to read this post. We have witnessed poor discharge planning and its execution throughout the country. It is appalling to think that hospital discharges requiring home services/equipment include a list of VNAs or durable medical equipment companies because they were not able to ‘pass the baton’ coordinate care.
The real kicker is when Medicare patients are discharged and bounce back in within 30 days, the hospital won’t get paid; thus, further perpetrating the problem.
I’m saddened by reading this story; it shows a lack of respect for the patient, her particular circumstance and her family. Why is it ok for any patient to be transported (non-emergently) at such an ungodly hour. It seems that everyone just shrugged their shoulders like it was no big deal. The saddest part is the same system that is supposed to support patients when they are their most vulnerable is the same system that conspires to systematically rob them of their dignity. How/when did we become so insensitive??
This situation occurs all too often. Transporting non-emergent patients are not a priority for the ambulance companies and many have not made provisions to have alternate transportation to move patients out of the hospital to either nursing homes or to their home. This results in late discharges that impact the patient who is trying to transition to another level of care. Communities need to be made aware for this dilemma and changes must be made to accommodate these situations.
Healthcare and community leaders need to collaborate to eliminate this situation. They need to do a better job of caring for their vulnerable community members.
As a changemaker, you know from our discussions, Anne, from my posts, and long term shares on our healthcare system or lack there of my thoughts and opinion.
Patients too often seem to be last on the list as the system takes over and tries to be efficient based on protocols, policies and procedures.
The lack of empathy and compassion is evident every single day. A complete overhaul is desperately needed in regard to insurance and all payor sources.
How sad and awful for a person choosing hospice care at home to be subjected to poor coordination of services needed to get her there.
At what point will everyone stop hiding behind COVID and blaming it for everything that’s gone so wrong? We’re 3 years into this pandemic now and it’s become a way of life. So, that’s certainly no excuse. I’m sure they’ve done it that way since before then anyway. Pfffttt. Poor lady. Sometimes our “sick care” system makes me so “sick”. I always stop to ask myself WHO was the person who ultimately make it okay for that to happen. Wouldn’t you love to know the chain of command and be able to ask them “What were YOU thinking?” And wouldn’t you just love for them to be the one it happens to one day. Maybe instead of the show “Undercover Boss” we ought to have an “Undercover Patient” TV Show instead. I’d love for them to live a life in the day of those they serve. Maybe then we’d get somewhere. Keep on fighting the good fight for her! Thank God she has you.
Anne, I just finished reading your post and all the above 5 comments. I can echo many of the words of wisdom posted here as I help clients with d/c out of the hospital.
In my experience the CHALLENGE of communicating with the d/c planner and the ambulance companies for sure can be continuously improved. A personal friend/client was sent home from a hospital in South Florida at 11:45 pm home by a “private transportation” company. She was under the influence of medication and not 100% capacity. Her family was not informed of this transport (live close and would have come back to the hospital to pick her up) and obviously very upset when she arrived.
Thanks, everyone for your comments.
The patient is home and doing well. The Hospice Nurse and Social Worker visited today.
The patient likes both and feels safe at home.
Best!
Anne Llewellyn
Unfortunately, this is a common occurrence. Patients are triaged, based on their level
of need.
I don’t know the solution except the hospital-owned their own ambulance company
In a nutshell the lack of consideration seems all too prevalent in our “system”. When you point it out everyone shrugs their shoulders. We must do better! What if this was your family member? Would it be ok?